Receiving a cancer diagnosis and learning how to live with the condition can impact substantially on a patient’s emotional well-being. The National Cancer Institute describes some of the most common emotions a person may expect to feel in the time following their diagnosis; these include denial, anger, fear and worry, stress and anxiety, depression, guilt and loneliness.
Accepting that it is normal to feel these emotions and understanding that your feelings might fluctuate on a weekly, daily or even hourly basis, is a key part of coming to terms with your diagnosis.
Nobody has the right to tell a person how they should be feeling. The complexities of our psycho-emotional well-being mean that it is very unlikely that two people will ever feel the same way about a situation. That being said, finding ways to deal with negative emotions is hugely important for maintenance of good health and overall survival. Studies have shown that cancer patients who exhibit symptoms of depression have a worse prognosis. Furthermore, those who took steps to actively improve their depressive symptoms, more than doubled their median survival times.
One major problem with negative emotions is that they can manifest themselves as physical symptoms. For example, those who experience profound anxiety may struggle to maintain a balanced diet and healthy weight. This is particularly problematic for those going through cancer treatment, who may already have a diminished appetite and reduced interest in food. Thus, at a time when good nutrition is essential, the physical and emotional symptoms of your condition can make eating well very challenging.
So, what about loneliness? What is it? How does it impact your prognosis as a cancer patient? And, what practical steps can you take to try and alleviate the emotional burden caused by feelings of isolation?
Loneliness – a distressing feeling whereby one has the perception that their social needs are not being met by the quantity, or quality, of social relationships.
Not all people who experience loneliness are actually socially adrift. People categorised as generally healthy, who form social interactions and spend much of their time surrounded by others, can still feel alone. Conversely, other people enjoy their own company and spend much of their time in isolation, but do not identify themselves as lonely. When it comes to cancer patients, the former of these two cases is particularly relevant; sometimes, despite the visitors and the family support, there is an underlying feeling of loneliness. A sense that nobody else really understands and that you are alone in tackling your concerns, fears and worries. In other cases, the perception of loneliness experienced by cancer patients is a reality; friends and family are anxious and visit less often, perhaps worried about passing on infections, perhaps caught up in their own lives. In addition, your reduced health might make it difficult for you to participate in the activities and hobbies that you enjoyed prior to your diagnosis.
As a chronic condition, loneliness can have long term effects on health, cognitive function and behaviour. Loneliness increases the risk of cardiovascular disease. It is also associated with cognitive decline and dementia. Cancer patients who are lonely are three times more likely to struggle to follow their treatment plan. In fact, a survey performed on behalf of Macmillan Cancer Care found that 5% of lonely patients refused treatment altogether. This in itself will have a huge effect on overall survival rates. Furthermore, lonely people are at increased risk of experiencing depressive episodes and, as described above, depression has its own causative consequences on cancer mortality rates.
Unfortunately, there is no quick fix solution to resolve loneliness. The fact that it is so intrinsically linked with a person’s perception makes managing it that much more challenging. In this article we attempt to offer practical suggestions, with a view to improving the overall quality of life and reducing some of the unpleasant side effects caused by cancer and its treatment. Hopefully, this will, in turn, lead to an improved state of mind and reduced feelings of isolation.
1. Join support groups
There is a well cited quote from the book ‘To Kill a Mockingbird’ by Harper Lee; it goes, “You never really understand a person until you consider things from his point of view… Until you climb inside of his skin and walk around in it.” Many people, throughout history, have identified strongly with these words. The book was initially written to explore the topic of racism in South America. However, its reach extends much further, encompassing anyone who is experiencing something that differentiates them from their family, their friends, their colleagues and their associates. Perhaps, for those who are surrounded by family and friends, but still feeling a sense of loneliness following a cancer diagnosis, these words are particularly meaningful.
If your feelings of loneliness stem from the belief that nobody else can climb into your skin and walk around in it and therefore, cannot really understand what you are going through, then it might be worth finding people who are in the same position. If they are going through a similar experience then they will be the people most likely to intrinsically understand and empathise. At a time where the use of social media has exploded, finding a support group to suit your requirements is straight-forward. Whether you want physical meets ups or virtual companionship you will find it. The people in these groups will have dealt with, or be dealing with, the same anxieties, stresses and fears as you. If they are further along the journey they will probably be an excellent source of practical advice. Having people who you can turn to at any time of the day or night, who are experiencing the same emotions as you, can really help to reduce those feelings of isolation and loneliness.
2. Take care of your body
This article primarily explores the effect of cancer on a patient’s emotional well-being, however, it would be remiss not to at least mention how much physical strain the body may have to experience. The very properties that make cancer fighting chemotherapeutics so effective, such as their ability to target those cells that are dividing rapidly, also makes the associated side effects quite potent. Tumour cells divide rapidly, but so too do the cells lining the gut, the cells that form the outer layer of skin and the hair cells. This is why some of the most common side effects of chemotherapy are gastrointestinal problems, dry skin and hair loss.
To improve your overall state of mind, it is imperative to look after your body. Use products designed specifically for cancer patients, as you can be reassured that each ingredient will have been carefully selected for maximum benefit. For a detailed review on how to modify your beauty regime during and after chemotherapy click here. Looking after your body might seem like a small, almost inconsequential, step, but regaining control over that part of your life, can make approaching the other challenges you are facing less intimidating. This might well include making new friends at a support group, or guiding the friends that you already have in how to best support you over the coming weeks and months.
3. Plan activities with friends and families
Spending time with loved ones is one of the best ways of relieving loneliness. Even if you do not feel up to leaving the house, invite people round. Commit to meeting up on a regular basis and use the time to plan future activities you can do together. Have plans in your diary so you have things to look forward to.
Sometimes you might need to take the initiative in terms of making arrangements and this can be difficult at the best of times. Taking a proactive approach to your own social life when you are already feeling vulnerable and overwhelmed might not be something you feel capable of. If this is the case, start with small steps. Message your closest friends and tell them you could do with the company. Sometimes people want to help, they are just unsure how to and you will have to take the lead.
If there is something you are particularly worried about, make sure you have people by your side to support you at that time; whether that is undressing for the first time after surgery, or shopping for hats, scarves or wigs.
4. Find new hobbies/adapt existing hobbies
Sometimes you might find that physically you are unable to partake in the activities that you previously enjoyed and as a result you miss out on the social side of having a hobby. This is particularly difficult to come to terms with as it can serve as a stark reminder of your condition. If you are missing the social side of having a hobby, find a new one that still enables you to meet people and share a common interest. It is important to maintain a life outside of your cancer diagnosis and treatment. Take the time to think about whether there is anything you have always wanted to do, like learning a language, or taking up knitting, and invest your time in doing this.
Alternatively, see if you can use your original hobby in a different way. If you were a keen sportswoman before, look into coaching others. It can be particularly rewarding to help people of determination. If you were a member of a team, take on an administrative role so that you can still be involved. It will be a change, but it might turn out to be something that you get a lot of satisfaction from.
5. Speak to your health care practitioner
The most important thing is not to let any underlying feelings of loneliness turn into something bigger. As highlighted by the Macmillan study above, feelings of extreme isolation can impact not only your mental well-being, but also your willingness to undergo treatment. If things start spiralling speak to a medical professional.
Cognitive Behavioural Therapy (CBT) is becoming more widely used as a tool to manage loneliness. Patients are taught how to identify the negative thoughts that they have about others and specifically about social interactions, with a view to better understanding when their perception of a social situation is skewed and how it may be leading to irrational beliefs and self-defeating thoughts. This is certainly not an approach that everyone will benefit from, but is an option for those feeling intense feelings of loneliness.
Remember, when learning how to live with cancer, it is just as important to look after your emotional well-being as it is to manage your physical health. If you are experiencing bouts of loneliness try to find a way to overcome it; hard as it may be to tackle the issue at the time, the long-term effects will make it worth it and give you a good basis as you continue your treatment.
- Cacioppo , S, et al. “Loneliness: Clinical Import and Interventions.” Perspectives on Psychological Science, vol. 10, no. 2, Mar. 2015, pp. 239–249., doi:10.1177/1745691615570616.
- “Feelings and Cancer.” National Cancer Institute, www.cancer.gov/about-cancer/coping/feelings. Updated: August 20, 2018.
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