by TIM SMITH
Cancer is not just a disease that attacks the body – it can have a crippling effect on the mind too.
The shock at discovering you’ve got cancer, fear over the damage it may cause and the mental trauma associated with invasive and painful treatment add up to a potentially devastating emotional impact on any patient.
And that’s before you even consider the constant reminders from well-meaning friends and family, for whom your health suddenly becomes the main topic of conversation.
There’s so much for the human brain to process – but thankfully medical services are increasingly providing support to help people cope.
Dr Sharon Alikhani, the medical director at PALS Cancer Care in Bermuda, has seen many people grapple with the mental side of cancer.
“Irrespective of how old you are, when you are diagnosed with cancer, the first thing most people think about is dying and they are very, very frightened,” Dr Alikhani said.
“In the doctor’s office, when you are first given the news, people tend to be in shock, thereafter follows disbelief, then fear. It doesn’t matter if you are an independent young adult or if you are 80 or 90. I have seen 90-year-olds who are genuinely and understandably scared when they get this diagnosis.”
Patients can also be burdened by the potential impact on their loved ones, particularly if their role as breadwinner is jeopardised.
The emotional stress doesn’t end there.
Dr Alikhani said: “Once they have got over ‘Oh I’m really really scared about dying’, the next thing is ‘What will my treatment involve and how will I feel?’
“Treatment may involve surgery. This may alter body image and can impact one psychologically.”
Even when you’re cured, life is never “the same” again. There is a new normal.
Dr Alikhani said: “At this time one should be jumping up for joy. But guess what? You no longer go to oncology or see a doctor or nurse as often as you used to. You’re like a tadpole let out into the pond and just have to get on with it. This can be overwhelming for some.
“I don’t know many survivors who at the back of their mind don’t have that occasional thought – what if it comes back?”
Many people choose to embrace life as much as they can – particularly during this post-lockdown world where we all cherish our freedom more.
“Our motto at PALS is living with cancer,” Dr Alikhani said. “We have to learn how to live with our diagnosis and our new norm.”
The first step is to seize control of your life by figuring out what you can do to help yourself.
“People generally do what their doctors suggest: surgery, radiation or chemotherapy. That’s all well and good and no doubt necessary, but these aren’t things they are doing for themselves,” Dr Alikhani said.
“We are empowered by looking after our physical being, our psychological wellbeing and our nutritional health.”
Eating fruits and vegetables and cutting out processed food is one small step you can take.
“People can get nervous if I say exercise,” Dr Alikhani said.
“But you can simply keep moving. You can walk or take the stairs instead of the lift. If you love the water, go for a swim. Yoga. Breathing.
“Anything which keeps you moving helps with cancer. It helps not only with treatment but also with mental wellbeing and survivorship.”
“It’s so, so, so important. Cancer treatment take a lot of energy out of us. Sleep is where restoration happens.
“Many people find night-time sleep is disrupted with cancer. If we can improve sleep without the use of drugs, it’s massively empowering. It helps people feel they are not helpless.”
“Pick your tribe and surround yourself with those who add good things to your life. People fulfil different roles in our lives and it is important to keep all of them involved somehow. It is important to remember that person is still the same person they were before cancer.
“Oftentimes, friends feel they have to talk about the diagnosis and this makes them nervous and perhaps stay away. It’s OK to say we don’t need to talk about it.”
HELP FROM PALS
PALS empowers its patients through a six-week oncology programme which involves yoga, nutrition sessions, a psychological therapy group, reflexology and the medical team.
The psychology group, run by Dr Jade Templer, a senior clinical and liberation psychologist at Solstice, encourages patients to embrace and find meaning in their experiences.
Dr Templer said people react to their situations in different ways.
“There’s a massive range,” she said. “It’s very individualised and people can be very different.
“Some people can feel numb, others can feel angry. Sometimes we see people feeling depressed, anxious or traumatised because of what’s happened. Sometimes just the chemotherapy can be quite traumatic. The pain people can go through can be quite disturbing.”
Members are encouraged to develop “psychological flexibility” by drawing on acceptance and commitment therapy.
“The idea is to notice what goes on in our mind and body. Not packing it away; not battling with it. Opening it up to all experiences.”
This includes finding ways to get distance from our thoughts, becoming more values-led and present-moment focused.
Some changes can be positive.
“People might want to live in the moment more,” she explained. “It doesn’t mean we are accepting it’s a good thing. But we don’t need that second battle with our body. We want to try not to beat ourselves up when we are down.”
Narrative therapy helps patients realise their life is “multi-storied” and that they are more than just a cancer patient.
Music therapy, expressive arts therapy and yoga all help create “beautiful moments” at the group sessions.
“They can be surprised at how strong they realise they are,” she said. “It can feel really humbling to be a part of.”
For more information on services from PALS or Solstice, visit pals.bm or solstice.bm