Cancer and the Family
The emotional, physical, and financial stresses of cancer on the patient and family can often seem overwhelming. Despite these stresses, many families discover inner strengths and courage they never knew they had. With a cancer diagnosis, a psychological crisis can be created which causes emotions ranging from anxiety, anger, fear and depression to despair and hopelessness. Then, during the first 100 days following the diagnosis, the patient attempts to address the meaning of the illness, the possible changes that will occur in life patterns, the lifealtering decisions that must be made, and also the possibility of dying may also be included. At this time, there may be many stressors related to the cancer diagnosis for you, the patient. Some of the symptoms that can be stressful can include losing weight, increased fatigue, and pain. How would these symptoms affect you and your family and the other systems that you interact with on a daily basis such as your job, parenting, or perhaps caring for elderly parents or adult children? Other questions may be, “what tests must be done to get a more accurate diagnosis?”, “what are the costs and can I afford them?”, “Will I have to miss work?”, “How many days will I lose just getting the diagnosis and will this affect whether or not my treatment works?”, and finally, “Will this affect my job opportunities and insurance coverage?” The treatment process may cause more stress because new decisions must be made and sometimes the choices confuse the issue. More questions ensue, “How will my choices affect my family and my lifestyle?” and “How long will my treatment last?” Once the treatment decision has been made, you will probably be wondering about the possibility of getting sick, losing your hair, gaining or losing weight, and most important, whether or not the treatment will work, or is there a risk that my cancer may come back? Various changes are beginning to take place and your role may change from being independent to being dependent. This is particularly devastating if you have always been a take- charge person and now everything is out of your control. You may no longer be able to parent, be a wife, husband or lover, be the bread winner, or be on all the committees you volunteer for.
Relationships also change and you must learn how to be the taker instead of the giver. Many don’t know how to take because they have always done the giving, so lessons may need to be learned on how to accomplish this task. Just remember, refusing to ask for help when you need it is refusing someone the chance to be helpful! Relationships with friends may change and you may experience the fear of abandonment because they haven’t called or come around to see you like they used to. You wonder if they still care or whether they ever cared. Now you must learn to make a place for cancer and put cancer in its place. Acknowledging and talking about your fear and uncertainty and the place it has in you and your family’s lives now that the diagnosis has been confirmed can reduce tension and create a closer connection. You can review how you handled a crisis in your life in the past and what resources you called on to help. Perhaps you helped someone else handle a crisis of their own and you learned some valuable lessons. What are your family’s best strengths and how do you take care to encourage the growth of these strengths? Can they be helpful to you now? Compartmentalize the cancer as much as you can. Some days are simply given up to doctor appointments, etc. Other days it is important to allow only so much time for cancer, and then you can take back the rest of your life. It may be changed, but it doesn’t have to be entirely dedicated to cancer. Don’t give cancer too much power! Make an appointment to have some fun!
What can a spouse do?
1. Listening is one of the most supportive ways to help a partner with a serious illness. It promotes safety and connection, both for your patient and yourself. However, when you are listening to the frustration or concern, don’t try to fix it! If the patient wants your advice or help, they will ask for it.
2. Stay emotionally responsive even when your patient turns inward and becomes quiet. Many patients “recharge” their batteries by becoming introspective at times to reprioritize or think about their legacy. This is not a cue to withdraw, but rather to be patient and supportive silently and steadily.
3. Offering physical closeness, while at the same time showing acceptance of the range of feelings, supports the ill spouse’s need for assurance that she/he is still loved and understood. Hold hands, sit next to each other, give frequent hugs and kisses, and try taking a bubble bath together!
4. Respect the need of the ill spouse to remain in control of her/his life as much as possible. Depending on the stage of the illness, much of what a patient called “normal” may be taken away. A partner can support the patient by understanding the great sense of security and accomplishment in retaining as much of what was normal as possible in a very abnormal experience. Give plenty of choices! You and your family’s ability to adapt is necessary when facing a serious illness. Illness and its challenges have been said to arrive like an unwanted, demanding, and unsettling guest that requires the entire household to shift and reorganize the ways in which it has been experiencing family routine and relationships with one another. The ability of a family to adapt to changing circumstances or life cycle tasks is balanced by a family’s need for enduring values, traditions, and predictable, consistent rules for behavior.
At different stages of the illness experience, you may begin to prioritize your life in a way that honors life with illness, gives clarity to what you really value about living, and encourages you to choose intentionally how you will engage each day you live. Often, patients will realize how much of life they have been accumulating that has not been particularly significant, and will decide to set new goals for themselves that better incorporate more of the meaningful aspects of life that have been neglected. Patients facing a life-threatening illness may at sometime begin to realize that the ultimate value of illness is that it teaches us the value of being alive.