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The Impact of Diagnosis

12375974A head and neck cancer diagnosis of someone you care about is extremely difficult to handle, and you’re likely to feel a range of intense emotions such as disbelief, shock, fear and sadness. This is normal, and it can last a few weeks or months before you begin to accept the diagnosis and adapt to your caregiving role.1 Depression (PDQ): Health professional version. National Cancer Institute – PDQ Cancer Information Summaries. http://www.ncbi.nlm.nih.gov/pubmedhealth/PMH0032529/. Note also that your emotional reactions to your family member’s diagnosis are likely to be very similar to the patient’s own reactions and be just as intense. In one study of head and neck cancer patients and their partners, about 35 percent of cancer patients experienced serious psychological distress while 33-39 percent of their partners did.2 Manne S and Badr H. Intimacy processes and psychological distress among couples coping with head and neck or lung cancers. Psycho-Oncology.2010 September;19(9):941-954. The diagnosis stage is often one of the most emotionally challenging parts of the cancer journey for both the caregiver and the cancer patient because it requires such dramatic psychological adjustments. Caregivers generally have their highest levels of distress and the greatest difficulty adjusting emotionally during the six months following diagnosis.3 Longacre ML, Ridge JA, Burtness BA, Galloway TJ, Fang CY. Psychological functioning of caregivers for head and neck cancer patients. Oral Oncol. 2012 Jan;48(1):18-25.

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Handling diagnosis

There are some steps you can take to help you and your family member process the diagnosis and begin to adjust emotionally to the changes that will come.

  • Be Open and Available to Talk About Anything with Your Loved One
    Invite your family member to talk about his or her fears and concerns. Don’t try to force him or her to talk, but make it clear that you are willing to listen and help to the best of your ability, and that he or she should not worry about upsetting you or burdening you. Open and honest communication is the best coping strategy for cancer patients and their caregivers. It helps both people to adapt more easily to cancer-related emotional challenges.
  • Avoid Protective Buffering
    Avoid “protective buffering,” which is when one or both people hide their concerns and negative feelings and avoid arguments in an attempt to not upset the other. Protective buffering tends to weaken rather than strengthen the relationship and raises both people’s levels of distress.2 Manne S and Badr H. Intimacy processes and psychological distress among couples coping with head and neck or lung cancers. Psycho-Oncology.2010 September;19(9):941-954.

As the primary caregiver, you may feel uncertain about the future and want to show strength in front of your loved one by hiding your emotions. While you’re being strong for your family, it’s important that you have an outlet or sounding board to lean on so you can let these powerful emotions out. Find someone you trust, whether this is a close friend, counselor, support group or someone from your place of worship.

  • Begin Learning About Your Loved One’s Cancer
    Many cancer patients feel too overwhelmed at first to deal with what seems like a flood of new information, unfamiliar terms and statistics related to their diagnosis. You may also feel overwhelmed, but you can help your loved one and begin to feel more in control by gathering information that will help you and the cancer patient understand what to expect and make better decisions about care and treatment in the future. This will also help you and the patient to prepare informed questions for the cancer care team. Being knowledgeable and knowing what to expect are excellent coping tools for you and your loved one.
  • Go to Appointments with the Cancer Patient
    Whenever possible, attend appointments with your loved one. Ask questions and take notes if necessary so that you both remember important information. Sometimes during treatment your family member might not be able to think as clearly as he or she usually does, and it will be up to you to make sure you both have the information you need. Plus, the emotional support of having one’s caregiver present at appointments can be invaluable to a cancer patient.
  • Find and Use Effective Coping Strategies
    It can be helpful to use relaxation exercises, prayer or spiritual support beginning early in the cancer journey. Begin or continue counseling or therapy for yourself or with your partner if needed. Continue hobbies or activities that make you happy. Start conversations with other family members and friends about how they might help once treatments begin. Prepare to delegate responsibilities to other family members or friends when you have more than you can deal with. Find tools to keep you organized and manage your time. Keep your own social network active as much as you are able, and don’t feel guilty when you need your own time to get out, be with others and not think about cancer for a little while.
I think once it started, I felt better because I felt like not only was he seeing doctors every day, but we were doing something. There was a light at the end of the tunnel. Bonnie S. (wife of a tonsil cancer survivor)

References

1 Depression (PDQ): Health professional version. National Cancer Institute – PDQ Cancer Information Summaries. http://www.ncbi.nlm.nih.gov/pubmedhealth/PMH0032529/.

2 Manne S and Badr H. Intimacy processes and psychological distress among couples coping with head and neck or lung cancers. Psycho-Oncology.2010 September;19(9):941-954.

3 Longacre ML, Ridge JA, Burtness BA, Galloway TJ, Fang CY. Psychological functioning of caregivers for head and neck cancer patients. Oral Oncol. 2012 Jan;48(1):18-25.