A diagnosis of cancer, its treatment and the aftermath can be emotionally demanding, no matter who you are. It is common for people and those around them to experience difficult feelings, such as a sense of loss, worry and to struggle with the changes to your lives. People often draw on resilience and support from friends, family and health professionals to deal with this difficult time.
Unfortunately, sometimes these feelings can become overwhelming and difficult to deal with and affect quality of life, well-being and relationships.
How therapy can help with cancer
Cancer triggers a change in circumstances and relationships and with the help of those around you, many people adjust to the changes. However, you may struggle to meet the demands placed on you because of these changes. I will work with you to look at how you can make sense of what is happening and how to talk to others. It will involve problem-solving and also conversations about you and how your resilience could help with difficulties you are faced with at present.
Depression is not unusual for people who have cancer. Sometimes there can be medical causes for this so it is important you discuss your low mood with your treating team. Psychological treatment for depression is effective, though some sadness may persist in spite of psychological treatment. Treatment would look at self-care and your routine to help with energy, appetite and apathy. We would work on managing your expectations and motivation to allow you to make changes that might improve your mood. It might also involve compassion towards your own difficulties at this time and protecting your sense of self. Depression can also affect carers and psychological treatment might be useful.
Chemotherapy and Radiotherapy
Some of the consequences of chemotherapy and radiotherapy can be very distressing. You might experience bodily changes such as infertility, early menopause and hair loss (see body image). You may also have other temporary or permanent changes. This can include changes to your energy levels (fatigue), your memory, reduced physical sensations and pain. These additional problems can be burdensome. I will help you look at how you respond and cope with the feelings you experience as a result, for example frustration, so these are not burdening you further.
Body image changes
Cancer treatment can change your appearance, sometimes permanently. For example, you may lose your hair or part of your body, you may be left with scarring, have a colostomy bag, or your speech might be affected and you can experience weight changes. Such changes to your appearance can mean you may feel less confident, more anxious, angry or sad or feel less attractive. For some people, these changes also mean they prefer to keep away from others, do less or it can also affect intimacy.
Sometimes surgery or practical things can help. Psychological therapy helps you reflect on these changes and sometimes grieve for the permanency of these. It also looks at how you can build your confidence, handle questions or comments about your appearance and care for your body. It supports you to look at changes that might be helpful to make to help build your confidence and reduce the interference of these body image concerns on interactions.
Short episodes of anxiety are entirely normal and expected in the context of cancer. However, if worry is unrelenting and also interferes with your day-to-day life or stops you from doing what you may wish to do (including cancer treatments or investigations), then getting help is important. Anxiety can manifest itself differently. Some experience panic attacks, others have a mind that can never switch off, others might have physical symptoms or feel very unsure about everything. Some might check their bodies frequently or fail to be reassured by information from their treating team. For some it shows itself as wanting to know nothing and avoiding most things that could make them feel anxious.
Psychological treatment helps you to understand your worry, why it has come about, what keeps it going and how to manage its physical symptoms. It might teach you skills that can help you when you are feeling anxious or help you make changes that mean you feel less anxious.
Intimacy and relationships
This may be an area of concern to you whether you are in a relationship or not. If you are single you may have concerns about whether, when and what to say about the cancer. Some people also feel that the changes to their sexual functioning because of cancer or their confidence in their body might stop them from being interested in relationships. Psychological therapy can support you in these areas.
For people in a relationship, the cancer has happened to both of you and you might each experience different emotions and have different needs. It is not uncommon for each person in the relationship to wish to protect the other from further upset. Emotional protection can sometimes have unintended consequence for example making you feel like you are unsure what is going on with the other person or making you feel less close to each other.
Psychological treatment might look at changes each person can make to help the relationship be more like you both want it to be. It can also involve specific focus on intimacy and feelings, particularly as these affect arousal, and can be drive by changes in appearance.
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Private Patients, Royal Free Hospital
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