Looking to the future with hope!

As life expectancy increases, more and more people are likely to suffer from cancer. There are, however, millions of people who have been diagnosed with cancer and cured the disease. Screening blood tests and exams are used to detect cancer in the early stages. Several methods used to treat different types of cancer, have improved over the years, resulting in the successful treatment of cancer. In average 60% of people diagnosed with cancer each year will live at least five or more years. Quite often, life expectancy is the same for cancer patients and healthy individuals. The American Institute of Cancer Research strongly recommends patient awareness and active participation as successful key factors in the treatment of cancer. In the following paragraphs we will present comprehensive answers to some of your questions and describe the emotions, almost all cancer patients experience when they find out that there is a strong possibility to have cancer.

What is cancer?

‘‘What can I do to fight cancer?’’ Although the term “cancer” refers to more than 100 different diseases that affect different parts of the body, these diseases have one thing in common, which is the uncontrolled growth and spread of abnormal cells that can invade and destroy healthy tissues and organs of the body. Most of them get their name from the body tissue they first attack, such as breast, colon or skin. Normally, cells divide to produce new cells only when the body needs them. If cells continue to divide while the body doesn’t need new cells, a mass of additional tissue, called a tumor, is created. Tumors can be benign, i.e. non-cancerous masses, or malignant-cancer. Cancer cells may enter the circulatory or lymphatic system, resulting in the spread or metastasis of cancer to other areas of the body. Scientists don’t know why some people develop cancer while others don’t. However, the risk of cancer increases with age. Cancer is rarely caused by a single causative agent. Probably is the result of the complex interaction between environmental carcinogens and genetic factors. The process starts with thousands of genes found in every cell of the human body. Each of these cells is made of DNA which carries information about the production of proteins. Proteins regulate all the procedures of the body and successfully metabolize toxins contributing to the fight with infections. Genes are activated and deactivated through signals sent by the human body or by the environment. For example, unhealthy diet, smoking, overexposure to sun, high levels of chemicals, can harm DNA and cause gene mutation. Most of the times the regulatory genes of the cells can identify when DNA is damaged and fix the problem, so it won’t be copied to new cells. When due to an inherited or environmental mutation, the reparatory mechanism malfunctions, the damaged cells continue to grow and multiply το new cells, leading to cancer. In general cancer is caused due to malfunctioning genes, nevertheless most people who are affected by cancer did not inherit mutant or damaged genes. 5% to 10% of all cancers are caused by some inherited “gene cancer”. Even if there is a family history of a certain type of cancer this doesn’t mean that cancer is unavoidable. An unhealthy diet combined with bad habits can interact with genes and increase the chance of cancer. Researchers are making progress in understanding cancer and what causes it, so they are able to improve diagnostic methods and treat cancer successfully. Many people who have been cured, now live a normal and active life. Your recovery begins when you fully understand your diagnosis and what this means to you and your family.

Understanding the problem/diagnosis

It is very important to understand the diagnosis you are about to hear from your doctor. The strong emotions you may be feeling by the time of the announcement are natural reactions even though it’s about a probable cancer diagnosis. It is important to examine the facts objectively because this will help you make all the right choices in the next few days. If you feel nervous, if you believe that you won’t remember what your doctor told you it would be wise to be accompanied by a relative or a friend and ask from your doctor to give all the necessary information in written or keep notes. Do not be afraid to ask questions. Make sure that you have fully understand what you and your Doctor have discussed. If medical terms sound confusing, please ask from your doctor to answer all your questions in a simple manner. It would be very useful to be fully informed and be active. Please inform your doctor that you are willing to be a part of everything related to your health and treatment of cancer. Please try to build a good and strong relationship with your Doctor and Medical Team. A good Doctor must be well informed but also supportive, understanding and willing to explain your choices, procedures and treatments that will follow. We sincerely hope that the following questions will help you feel strong again and be responsible for your health and medical care.

Questions addressed to the doctor or other healthcare professional regarding the diagnosis:

• From which type of cancer do I suffer exactly?
• At what stage is the cancer and what exactly does it mean?
• How does this affect my options?
• Which other healthcare professionals should I contact? How can they help me?
• How was my diagnosis determined?
• What tests were done and what did the results show?
• Do I need any further testing?
• What is the most probable prognosis? (You should ask your doctor to give you an honest answer, neither minimizing nor maximizing the chances. How likely are you to survive; how likely are you to have a good quality of life.)
• Which are following steps? (an oncologist should be consulted in order to find out what tests you should take and what is the appropriate treatment if the doctor who is treating you is not qualified cancer expert.)

The emotional effect of cancer diagnosis

Your personal reactions: Strong emotions, both positive and negative, are part of a cancer patient’s life. For many people, the most intense emotional confusion comes immediately after the diagnosis. Emotions change rapidly in the first days and weeks. You may feel denial, anger, fear, anxiety, loneliness and depression. Family members and friends may also experience similar feelings or may try to hide their grief and anxiety by trying to “distance” themselves emotionally. All these emotions are natural reactions and you don’t have to worry about them. Most of feelings are temporary. Cancer experts suggest to directly address and cope with these emotions, although methods and time schedules may vary according to individual needs.

• REFUSAL: Initially, denial can help lessen the psychological burden of diagnosis and give you time to process the information. Denial can be a problem if stops you from going ahead and do your treatment. Most cancer patients can process these emotions before starting the treatment.
• ANGER: Once you accept the fact of diagnosis, anger can replace the feeling of denial. You might ask yourself, “Why did this happen to me?”. Feeling angry with the disease or angry because people you know are healthy could be a way of hiding other emotions, such as fear or impotence. Accepting these feelings can help you accept the diagnosis as well.
• FEAR: The diagnosis of cancer scares a lot of people. It can be the fear of pain or death, or fear of the physical consequences, the cost of treatment and the burden on your family. Ignorance of what comes next can cause more fear than the following events themselves. That’s why it’s important to be active about your diagnosis and treatment. This will make you feel more involved in controlling the situation and the fear will decrease. Read Cancer Resource for useful information.
• ANXIETY/STRESS: Stress that follows the diagnosis can cause a variety of physical symptoms, such as faster heart rate, headaches, shaking, loss of appetite and sleep. Stress can also affect your immune system and how well your body fights the disease. Some techniques to reduce stress and anxiety are exercise, relaxing music, talking openly about your feelings. It is very important to continue doing what pleases you. Visiting a psychologist or a support group can also help.
• LONELINESS: Cancer patients may feel isolated when they choose to be left alone because of their problem/condition or when their friends are distancing themselves because of the diagnosis. If you’re feeling alone or no one understands what you’re going through, try to get in touch with other cancer patients or a support group for people with problems like yours.
• DEPRESSION: You may feel melancholy about the diagnosis of cancer. If symptoms become more severe, such as strong feelings of sadness and despair and loss of interest in life, or you feel unable to continue doing the activities that were part of your daily life, you should tell your doctor to get appropriate help or treatment.
• HOPE: Once the initial shock of cancer diagnosis passes, most people can look to the future with hope. Since each case of cancer is unique, it is not possible to accurately predict the result of treatment. However, the knowledge that there are now improved treatment methods and that many cancer survivors have a full and productive life can help you and your family feel more optimistic about the future.

Often, people with cancer believe that participating in support groups can help them overcome some of the emotions described above. If you are interested in joining a support group, please contact the hospital or the Centre where you are being treated for further information.

Family issues/problems management

“I am very concerned about the way my family will handle the cancer diagnosis.” Adapting to new roles and responsibilities can cause changes in the way family members behave and act. Children may need special attention and guidance, as many of their daily habits are likely to be change for some time. They need to be informed that they are not responsible – they did not say or do anything that caused the cancer – and that their help and support means a lot to you and the whole family. Sharing your feelings and needs with your spouse or partner is also very important. If family members are unable to help you or have difficulty adapting to the idea of cancer, consult your doctor or the hospital’s social service. You can also contact local organizations and support services that can help you deal with the emotional impacts of the disease.

Psychological support

“My friends and family members have helped me a lot.” Cancer support groups can be also a wonderful source of strength, hope and practical ideas for your daily life. Joining a support group can help you plan your week by getting psychological support from people who sympathize with you. Some patients find that the help of the social worker at a local hospital or in a local healthcare unit is invaluable. For others the support could come from a doctor’s staff member, a relative who has experienced a similar experience or a neighbor who can help when you feel tired.