Cancer treatment varies depending on the nature and progression of the disease. It can focus on eliminating cancer tumours and cells, slowing down or stabilising the spread of the disease.
Not everyone will receive chemotherapy. Those who do, do not necessarily experience side effects. For some, however, the experience can be very difficult, adding further physical and emotional pressure. Sometimes, treatments are cut short by medical teams, because the body and immune system cannot cope.
Against this background, it is not unusual for those affected to consider pulling out of chemotherapy. Most who have not experienced cancer themselves or at close quarters may find this hard to understand. How can one consider taking such a risk, when the treatment is intended to be life saving?
While chemotherapy has clearly improved over the past decades, side effects remain common. Depending on the individual, the chemo drug, dosage and administration (eg oral or intravenous) difficulties can be temporary or permanent and include sickness, infertility, for women the onset of the menopause, loss of appetite and weight, insomnia, heightened anxiety, hair loss, infections, nerve damage (eg peripheral neuropathy in hands and feet), chemo brain (or cognitive impairment), memory loss, fatigue and more. Effects can vary between treatment cycles (eg every 2 or 3 weeks). The severity and unpredictability can be relentless and exhausting. Saying 'no' to treatment can sometimes appear the only choice left for a person, who feels that cancer has taken away all their control over their remaining life.
What to do? There is no single solution. Everyone undergoing treatment will have a slightly different experience and different coping threshold. However, there are some key emotional self-help strategies:
- Keep chemotherapy in perspective. It is intended to kill cancer cells. It is poisonous; your body and mind will be pushed to their limits. Read up on what to expect. Stress and responsibilities not related to cancer treatment must be avoided.
- Avoid making important financial or personal decisions. The chemo drug and emotional pressure can impair your sense of judgment. Lows can be very low and with heightened irritability (and sometimes loss of hope) snap decisions are not uncommon. If some decisions cannot be delayed, ensure you have a trusted friend to advise you and give a second opinion.
- If you work, consider stopping for the duration of your treatment and recuperation period. While some welcome the distraction and routine, this may come at a cost of unhealthy stress, undermining treatment and recovery. If you are struggling to claim welfare benefits while receiving treatment, then consider contacting MacMillan Cancer Care for help.
- Consider a holistic approach to extend care and treatment to all aspects of your being - physical and emotional. Speak with qualified practitioners (eg herbalist, nutritionist, physiotherapist, counsellor). Some hospitals and local cancer charities offer this support for free. Inform your medical team of what you decide to do.
- If you know you are going to lose your hair, consider cutting it yourself beforehand. This gives you a sense of proactive involvement and control. Investigate head covers that you like, are comfortable and warm.
- If you live by yourself, ask a trusted person to stay with you at least 24 hours after each chemo course (esp intravenous). You may feel sick and experience heightened anxiety.
- If you develop an aversion to treatments, try visualisation techniques. Imagine a clear and cleansing mountain spring, gently running through your body, washing away the cancer. Listen to nature music (eg running water) before, during and after the administration of the drug.
- Create a daily routine and try keeping to it: Get up, go to sleep and eat at set times. Have gentle, regular physical and mental stimulation, fresh air and rest. Avoid lying in bed during the day; rest on a day blanket instead. Take a walk (however long or short) 3 times a day. Do breathing exercises, meditate, listen to calming music, avoid arguments, noise, use essential oils.
- Avoid busy shopping areas, public transport and large groups of people. Your immune system will be vulnerable and your physical and mental energy low. Get help with your main shopping, cleaning, child care and other responsibilities.
- Acknowledge and celebrate every achievement and sense of improvement. You may find that some activities you have taken for granted become a struggle. You may also find that with time (eg after the first week of a 3 week chemo cycle) your fitness improves, only to drop again after the next chemo. This is normal, but shows that your body is recovering each time.
- Keep a journal: Record side-effects to help you see a pattern and link between the treatment and how you feel. It can be reassuring to realize that some side effects may happen mostly the first few days after each treatment cycle. Be creative and document your journey, including photos, memories, dreams etc.
- You are not alone. You can exchange experiences online via message boards or join groups run by local cancer charities.
It would be unhelpful to talk about self-help strategies without acknowledging that cancer is unpredictable and can be life-shortening. Not every treatment has the desired effect all of the time. Not feeling overwhelmed and defeated is hard. Things are even harder when the diagnosis is terminal.
This is a reality for us all. Accepting it is not easy, but an important step in channelling one's determination into taking charge of the life we have (however long or short), and have the best quality of life we can make happen.
MA (Couns.Psych.), Reg. MBACP (Accred)
Karin has personal experience of cancer treatment and specialises in counselling people affected by cancer (including family, friends and carers).