Thursday 19 April 2018

10 things that can help you cope better when a loved one is diagnosed with cancer

We're frequently lost for words when a friend or family member gets a cancer diagnosis. Dr Paul D'Alton offers expert advice on how you can best support them

Dr Paul D’Alton, head of the Department of Psycho-oncology in St Vincent’s Hospital, Dublin. Photo: Mark Condren
Dr Paul D’Alton, head of the Department of Psycho-oncology in St Vincent’s Hospital, Dublin. Photo: Mark Condren
In the face of cancer, never underestimate the value of good old-fashioned kindness

'I just don't know what to say' are often the first words people say when a friend, family member or colleague is diagnosed with cancer. It is an entirely understandable response. When someone in our lives is diagnosed with cancer we experience shock symptoms such as disbelief or feeling detached - like we're watching events rather than being there for them. We can't sleep, perhaps we even lose our appetite, we can feel angry and scared. Cancer is shocking because cancer is a life-threatening illness.

When we're scared we tend to do and say things that are sometimes not the most helpful. This can get in the way of helping our friend or family member diagnosed with cancer and also get in the way of helping ourselves. It's completely understandable - when we're scared our brains kick into a primitive gear, they become more blunt and bypass the more subtle things that are actually required in a crisis like cancer. Here are 10 things that will help us cope better when someone we love is diagnosed with cancer:

1 Don't be afraid to say 'I don't know what to say'

Saying this rather than avoiding the person is so much better. Many patients have said to me over the years what matters most was that people didn't avoid them. Sometimes the most helpful thing to actually say is 'I don't know what to say but please know I love you'. In the face of cancer never underestimate the value good, old-fashioned kindness.

Dr Paul D’Alton, head of the Department of Psycho-oncology in St Vincent’s Hospital, Dublin. Photo: Mark Condren
Dr Paul D’Alton, head of the Department of Psycho-oncology in St Vincent’s Hospital, Dublin. Photo: Mark Condren

2 Don't tell someone diagnosed with cancer to be positive and to look on the bright side.

Being 'positive' doesn't always help and can actually result in people not talking about their feelings. We can push people into a positivity bubble where everyone is on their best 'positivity behaviour' and what tends to happen is we get isolated and lonely.

3 Don't be vague

Saying things like "I'm here for you - let me know if I can do anything" to someone diagnosed with cancer is not helpful. For most people with cancer this kind of offer is actually another burden. Be really specific and offer to do certain things like "I can collect you from the hospital on Wednesdays and bring you grocery shopping on Saturday mornings". Or decide that you can cook and deliver a pot of stew every Thursday and just do it.

4 Don't take it personally - we tend to hurt the people we love

With a diagnosis of cancer comes a whole range of emotions. Anger and irritability are common emotions and it tends to be family and close friends who get the brunt of these. Be your biggest self and know that this will pass and it's not about you anyway.

5 Don't interpret no response as a bad response

Not hearing back from people doesn't mean your support is not appreciated. One patient said to me recently that getting a simple heart or smiley emoji from a friend when having chemotherapy made all the difference.

6 Don't expect emotions to flow in a logical sequence

We sometimes expect emotions to flow in neat stages beginning with shock, moving on to denial, anger and finally to acceptance. This is not how emotions work. When facing a diagnosis of cancer, people may feel all these emotion in the same hour. Think of emotions as more like the Irish weather - all seasons in one day.

7 Don't try to fix things

Giving advice is not a good idea unless you are asked for it and even then be careful. Try instead just to understand what it might be like to be in their shoes by simply listening and allowing them to express what they're feeling, even if it doesn't always appear to make sense or seem logical.

8 Don't expect it all to come to an end once treatment is finished

It is often after treatment and all the visits to hospital that the emotional fallout can happen. This is often a time when patients feel more afraid.

9 Don't forget to take care of yourself - look after the basics like sleep, food and exercise

The stress of a loved one's illness will naturally disrupt our usual routines at a time when it is more important than ever to maintain the basics of eating well, exercising and sleep. It's also a time when people can drink more - ensure there are at least four consecutive nights alcohol-free every week.

10 Don't be afraid to reach out

The Irish Cancer Society helpline is an excellent source of support, not just for people diagnoses with cancer. Many of the people who ring the helpline are friends and families of someone diagnosed. The helpline is staffed by experienced cancer nurses and they have excellent web-based recourses too (freephone 1800 200 700).

So, remember that with a cancer diagnosis we get scared. We miss the opportunity to help our loved ones with cancer, and also ourselves. Above all else what matters most is kindness - and that happens naturally and doesn't require words.

• Dr Paul D'Alton is the head and clinical lead of the Department of Psycho-oncology at St Vincent's University Hospital in Dublin

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