Almost all cancer survivors will face psychological and emotional issues that can show up many years after treatment. The good news is that you don’t have to suffer alone. Therapy, support groups, social media and community resources are available to help you cope with these issues. The first step in coping with psychosocial changes is realizing that you have an issue and having the courage to reach out for help.
Here are some of the most common psychosocial issues that cancer survivors may deal with:
Fear of recurrence: Many survivors worry that their cancer will come back at some point. Milestone events in their cancer journey can often trigger these feelings. Knowing your own body can help distinguish between normal physical changes and more serious symptoms that need to be reported to your doctor.
Grief is a natural result of loss. Loss can include your health, sex drive, fertility and physical independence. Support groups and counseling can help you work through these issues.
Depression: It is estimated that 70% of cancer survivors experience depression at some point. Know the symptoms of depression and seek treatment as soon as possible. MD Anderson’s Psychiatric Oncology Center provides counseling and medication for anxiety and depression. Call 713-563-6666 to request a referral.
Body image: Cancer survivors who have experienced amputations, disfigurement or a major change in physical function can suffer from a lack of self-esteem. A negative body image can affect your desire for intimacy and social interaction. Honesty and open communication with loved ones can minimize negative feelings.
Spirituality: Many survivors find that life takes on new meaning after cancer and will renew their commitment to spiritual practices or organized religion. Research suggests that spirituality improves quality of life through a strong social support network, adaptive coping, lessened depression and better physiological function.
Survivor guilt: Some people wonder why they survived cancer when others don't. If you suffer from a prolonged sense of guilt, seek help from a psychotherapist, clergy member or support group.
Relationships: You may find that friends, coworkers and family members treat you differently after a cancer diagnosis. They may avoid you or won’t discuss your cancer It can help to seek new relationships with other cancer survivors who know what you’ve been through.
The workplace: Cancer survivors often feel that they can no longer relate to co-workers who haven’t experienced cancer. You may be reluctant to talk about your cancer treatment to employers or coworkers for fear of being treated differently. See if your employer has a support group or other resources for cancer survivors.
BY Lauren Adams
Anxiety is a normal reaction to a perceived threat or stressful situation. It can range from mild nervousness to a full-blown panic attack. In some cases, it may be helpful; in others, it may not.
The nervousness you feel before a work presentation, for instance, might spur you to prepare for it a little better, giving you more confidence when the time comes to actually deliver it. But the fear you feel before cancer treatment or a medical scan doesn’t really help anyone.
Here are some tips to help you better understand why you’re feeling anxiety, and what you can do to relieve it.
What does anxiety feel like?
Anxiety can cause a wide range of feelings. You could experience a general sense of worry about the future, a sensation of tension in your head and shoulders, or an urge to avoid certain people or situations.
Other physical symptoms of anxiety may include:
- Rapid heartbeat
- Quick, shallow breathing
- Chest pain
- Fear of dying
- Tingling sensation or numbness
- Upset stomach/urge to empty your bladder or bowels
All of these physical effects are nature’s way of preparing you for “fight or flight” — in other words, a fight for your life or a quick sprint away from danger to save it. So, there’s nothing wrong with you for feeling this way, and you’re not crazy or broken.
Why do I react like this to stressful situations?
Think back to prehistoric times, when people lived in caves instead of cities. What would’ve been the most significant threat to personal safety?
Back then, it was likely fierce predators like lions, tigers, bears, and so forth, which were all around humans in the natural world. And if you encountered one of those face-to-face, it would make perfect sense to feel anxiety, right?
So, anxiety evolved as a way of helping to keep us out of danger. It gave us an evolutionary advantage by alerting us to when situations were not safe.
Common ways to cope with anxiety
Escaping dangerous predators is a far cry from the types of stressors most people face today. But the feelings we experience now can be just as intense, especially when you’re dealing with a cancer diagnosis or cancer treatment.
The brain and body are always trying to keep us safe by learning what sort of things around us are related to threats. For example, the sound of a predator’s growl or footsteps nearby is a signal that we are unsafe. But when you go through something scary like cancer, your brain starts associating certain sensory memories with being unsafe, whether it’s true or not. That’s why some patients tell me that just the smell of hand sanitizer or the act of putting on a mask can trigger a panic attack.
Fortunately, there are lots of tools available to help. Here are three of the most common:
- Psychotherapy: Talk therapy with a licensed therapist can help identify the sources of your anxiety and find ways to reduce them.
- Medications: Whether they’re taken daily or on an as-needed basis, anti-anxiety drugs work best when used in tandem with psychotherapy. They can only be prescribed by a licensed physician, such as a psychiatrist or your primary care doctor.
- Lifestyle choices: These could be coping mechanisms you use to reduce anxiety in the moment, or conscious choices you make to reduce the overall number of stressors in your life.
Physical activity can help reduce anxiety
Sometimes, just a little aerobic activity can help dispel anxiety, by burning off some of that nervous energy. Jumping jacks, wall jumps and brisk walking are all things you can do almost anywhere to increase your heart rate.
Box breathing can be done anywhere
If you’re not in a place where physical activity is possible, consider a simple breathing exercise instead.
In “box breathing,” also known as “square breathing,” you take four seconds each to perform four different steps, then repeat the sequence at least three times:
- Breathe in through your nose.
- Hold it.
- Breathe out through your mouth.
- Hold it.
It sounds deceptively simple. But it really works, and it’s something you can do almost anywhere — even when you’re having your blood drawn or getting an MRI done.
Use 5-sense grounding to help you refocus
In this exercise, you take several minutes to check in with yourself physically and identify:
- 5 things you can see
- 4 things you can feel
- 3 things you can hear
- 2 things you can smell
- 1 thing you can taste
Refocusing your attention on the physical world really brings you back into the moment. This method is especially helpful when you’re in the throes of an anxiety attack or feeling disconnected from your body.
This exercise is a little different from the previous one because it involves actions rather than perceptions, even if they’re only in your imagination.
- Sight: Picture a loved one or a beautiful bouquet of flowers in your head.
- Touch: Feel the softness of a fuzzy blanket or the warmth of a bubble bath.
- Sound: Listen to rain falling, a cozy fire crackling, or calming music.
- Smell: Rub a favorite scented lotion on your skin, or burn some candles.
- Taste: Savor a few pieces of sour candy or dark chocolate.
- Movement: Take a leisurely walk or do some gentle stretches.
While these may sound really simple, there’s a lot of research behind them that shows they’re proven ways to make you feel better.
Keep in mind, though, that the “taste” exercise is not a license to eat mindlessly. It’s about being intentional in savoring small quantities of something with a really strong flavor. So, think about the people in those TV commercials who act like they’ve never tasted chocolate before, and try to get that level of enjoyment.
Make a plan to manage anxiety
As our emotional intensity increases, our ability to think clearly decreases. So, take time to experiment with these methods when you’re feeling calm. Then, practice! Make the ones that work best for you as convenient as possible. That may mean storing a hard copy of the steps in your purse or bookmarking a video on YouTube.
The key is to make a plan before you need it. That way, you won’t have to worry about figuring out what to do when you’re stressed in the moment. Because you’ll already know. And you can just look at the plan you made earlier and carry it out.
When to seek help
Anxiety can be uncomfortable, but it’s actually a sign that our bodies and brains are working the way they’re supposed to. Ultimately, anxiety is designed to keep us safe.
But if you find yourself avoiding normal activities, turning to substances like drugs or alcohol for relief, or becoming unusually irritable with your loved ones due to anxiety, it’s probably time to seek help.
Request an appointment at MD Anderson online or by calling 1-877-632-6789.