Coping refers to the things that people can do to adjust to a stressful situation, such as a cancer diagnosis or cancer treatment. Research suggests that people can copy by either changing the way they think about a situation or by changing their behaviour in a situation. For example, changing a daily routine or work schedule to manage side effects from cancer treatment is a way of coping. Coping strategies can help a person deal with cancer in his or her daily life.
Thoughts, Emotions and Behaviours
People's thoughts, emotions and behaviours are related; that is, the way you appraise or think about a situation can affect your mood and your physical responses.
The Appraisal Process
Event or situation: Something is happening i.e. A stressful event.
Perception: The mind becomes aware of this event.
Appraisal, thoughts or self talk: After perceiving a stressful event you determine the impact that this event will have on you. That is to say, you think about what implications it will have for your personal wellbeing. Specific things you might consider include: what is happening, whether you care about it, whether it is good or bad for you, whether you can do anything about it, whether you can cope with it, and whether it will get better or worse.
Emotional and physical states: The way that you feel about an event is directly linked to how you appraise it. Emotions are the result of a set of appraisals, and emotions are accompanied by behavioural and physical reactions.
Feeling an emotion is an indicator that you are appraising something. When you feel the emotion, you can work backward to understand the event, how you appraised it, and how it made you feel.
If you have been diagnosed with head and neck cancer, it is common and normal to experience a range of emotions and physical reactions, including stress, shock, fear, sadness, anger and guilt. Indeed, many people say that, from the time of initial diagnosis through to treatment, and even post-treatment, they feel they are on an emotional roller coaster with the challenges they face.
A common physical reaction to a cancer diagnosis and treatment is stress. It is not only the cancer and the treatment that can cause stress, but also worries about how the things that you enjoy and care about the most might be affected (including your future, friends and family, job and finances). Chronic stress can interfere with your ability to cope effectively with cancer, its physical symptoms, and it treatment. It can also weaken your immune system on your psychological health.
Ways to Cope
The behaviours that you use to respond to your emotions and physical reactions (including stress are ways of coping. Below we aim to provide you with some strategies that you can use to cope if these reactions arise in response to different aspects of your diagnosis or treatment. Not all of them may seem right for you, and that's okay. Everyone has their own unique ways of coping with cancer. Think about what you need and work towards caring for yourself and your wellbeing. Some strategies may be more useful at particular times compared to others; some you may be more comfortable with and see as key to caring for yourself and coping well.
Express your thoughts and opinions about your treatment and be as actively involved in the decision making as possible.
For any questions that you may have about your diagnosis, treatment, side effects\\ and ways to best manage these you can speak with your nurse specialist. See our information on specialist nurses under each regional group.
Do things you enjoy
Do something that will make you feel good each day, such as reading a book, gardening, listening to music, going for a walk, or watching your favourite television show. For more ideas of activities that you might enjoy see this list. Click here to view.
Develop and maintain a support network
A support network refers to the people in your life that are there to help you whenever you may need them. This group may include close friends and family, doctors and nurses, and a counsellor or psychologist. These people can really help to life your spirits when you are feeling down. They can also be there for you when you need someone to listen to how you are feeling.
There are many ways to develop a support network. A good first step is to recognise the supports what are already present in you life, whether this may be friends, family members or health care professionals. Create a list of the people you know and the strengths and contacts they have to offer you. You may know someone who is really good at providing you with practical support (for example, someone who drives you to your medical appointments) ad someone else you is a great listener.
You can also create a list of the sort of people that you would like to meet and how you might go about doing this. Attend events or activities that will put you in touch with people who can provide you with information and support. You mitigation like to attend a support group such as the Head and Neck Cancer Survivors' Support Network in Auckland or one of those organised by the Cancer Society.
Attending a support group to hear how other have coped, and to share your own experience, can be beneficial and empowering. People how have gone through the same treatment as you can share their experiences and let you know about what to expect. They can also inspire you with how they cope and enjoy their lives.
You might like to try looking up online forums, where head and neck cancer people, and their families and carers connect to compare their stories, research treatment methods and more. It can be very helpful to talk with others and know that you are not alone. However, it is important to remember that other people's experiences may be different from your own.
Once you have developed contacts, stay in touch with these people on a regular basis.
Ask for help
Your family, friends, and co-workers are likely to want to provide you with help and support. Asking them for their assistance can help reduce the feelings of stress or worry, especially if you are specific about the things you will find most helpful. Have a think about the things that they can do, such as helping with shopping or picking up a child from school.
If you are worried about how your treatment will impact on your ability to work, arrange a time to have an honest and open discussion with our employer about your situation. They may be able to make some adjustments while you are undergoing treatment and recovering from its effects.
There are also people who can help you if you are having any financial difficulties while going through your treatment. You multi-disciplinary team includes a social worker who is familiar with the costs of a head and neck cancer diagnosis. This person will be able to provide advice on managing cancer-related financial matters and direct you to sources of financial support. See our article on benefits and entitlements.http://headnecknetwork.ning.com/coping-with-cancer/if-you-are-unable-to-work-benefits-and-entitlements
Take it easy
Allowing yourself to take a break when you need a rest has not only been found to relieve stress and anxiety - it can also improve your mood. Take each day at your own pace. Set small goals that you would like to achieve, ever if they might be things like taking yourself for a short walk around the block, or calling up a friend for a quick chat. Give yourself a pat on the back when you do achieve your goals. Keep in mind that it takes time to feel better and that this is something that will happen gradually.
Taking it easy also means being aware of you limits. Allow yourself to say "no" to things that are not essential. Ask yourself, does it have to be done right now? Does it have to be done by me? If the answer is no, feel free to leave the task to someone else or save it for a time when you have more energy.
When you do have things that you need to get done, it can help to prioritise. Make a list of the things that you need to do and write these things according to how important they are. The focus on completing the items on the top of your list so that the most important and urgent task is taken care of. This easy you can reduce any worry that they may be causing you.
Focus on the present
Regretting things in the past and fearing the futures is common when you are facing a cancer diagnosis and treatment. However, by taking each day as it comes and not things ahead too much, you are less likely to feel sad and worried.
Express your feelings
Sometimes you may feel that you need to release some tension or emotions quickly. There are a number of things you might like to try to vent emotions, such as having a good cry, putting on some loud music and screaming and punching a pillow.
Distraction can be a great way to manage stress. Find an activity that can hold your attention and take your mind off your worries or discomfort. This could include watching TV or movies, listening to music, reading a book, taking a walk, or visiting friends. Sometimes creative pursuits can be a great distraction technique, including things like drawing or painting, writing poetry or stories, singing or making music, and dancing. Creative pursuits can also serve as a good way to express your feelings and emotions.
Use relaxation techniques
Researchers have found that relaxation techniques are a useful ways to manage side effects of cancer treatment. This is because these techniques help calm your mind and offer creative ways to reduce the stress caused by your treatment. There are many different types of relaxation techniques, such as deep breathing, visualisation, progressive muscle relaxation, mediation and mindfulness.
Relaxed or deep breathing: This is a technique that involves changing the rate, depths and pattern of our breathing, in order to reduce feelings of panic, stress or anxiety.
Mental imagery or visualisation: Imagery can also be sued to aid relaxation. Imagery exercises involve visualising and focusing on a particular image in order to provide the mine with a positive, relaxing focus. Many kinds of images can be involved, including visual "pictures", smells, tastes, sounds, tactile sensations, such as touch or temperature, and kinesthetic images such as the feeling of movement (e.g.dancing, swimming, or floating).
Progressive muscle relaxation (PMR):
PMR training involves learning to tense and then relax various groups of muscles throughout the body. While doing this, you pay attention to the feelings of tension and relaxation, helping you to differentiate between these two states.
Meditation involves being in an alert but relaxed state of concentration, without feelings of expectations or judgements. The goal is to focus your attention on one 'thing' at a time. Many people find that a convenient and relaxing focal point is the rising and falling of their own breath.
This refers to a relaxed mental state that can be achieved by focusing on your awareness on the present moment, while calmly acknowledge in and accepting one's feelings, thoughts and bodily sensations.
you can find more information on these techniques, as well as instructions on how to do them in a CD available from the Cancer Societyhttps://auckland-northland.cancernz.org.nz/en/how-we-can-help-2/want-local-support/relaxation-and-mindfulness-cd/
Having a massage is a great way to relax; massages can relieve tension and help you feel more comfortable. Massages may need to be modified slightly while you are undergoing treatment, such as by restricting massage to certain areas of the body or having the massage therapist use very gentle stroking motions. You might like to use the services offered by an Oncology Massage Therapist. A member of you multi-disciplinary team can provide you with the details of a registered massage therapist who has experience in working with people with cancer.
Try gentle exercise
Exercise is a great way to improve your mood because it can increase your body's level of endorphins (chemicals in our bodies that play a part in helping us feel good). A lot of people also find that doing physical activity a few times a week (such as walking, swimming or cycling) can help them to feel more energetic and less stressed. As long as you feel up to it, and your multi disciplinary team thinks it is okay, you can continue to exercise during and after your cancer treatment. Yoga, and tai chi are two gentle but effective forms of exercise that can help relieve stress. Yoga is a technique that focused the mind on breathing and posture to promote relaxation and reduce fatigue. Tai chi is a slow and rhythmic movement. Both yoga and tai chi can be modified for people at various stages of health.
A healthy, well-balanced diet can make it easier to manage your mood and feelings of stress. However, this is not always easy if you have head and neck cancer because it can make chewing and swallowing difficult. Your dietician (a member of your multidisciplinary team) is there to help you maintain a healthy diet. They can point out nutritious and tasty foods that require little to no chewing.
Avoid overuse of alcohol
There is nothing wrong with having a glass of wine or a beer every now and then. But sometimes when we are feeling low or anxious, we can be tempted to overuse alcohol or other substances to dull our negative emotions. While this might help in the short term, it can lead to feeling even worse in the long run.
Improve your sleep
Sometimes our emotions can interfere with our ability to sleep well, leading us to feel even more sad or stressed, not to mention, tired. Sleeping well can go a long way towards helping you to cope with the challenges you are facing. Fortunately, there are a number of things you can try to improve your sleep, such as going to bed and getting up at the same time each day, spending time relaxing before bed (having a bath, reading, or listening to music), sleeping in a comfortable, calm and quiet place, and avoiding too much caffeine throughout the day.
Keep a journal
Writing down your thoughts and feelings can help relax your mind and enable you to make sense of what is happening. It can also be a great release to put your thoughts on paper instead of keeping them all inside.
Set aside time for worry
Designating yourself a daily worry time can actually help you to decrease the amount of time you spend worrying. Set a specific time each day that you will allow yourself to worry as much as you want for a certain amount of time. Afterwards, postpone all future worrying, until your next designated worry time.
At the end of each day, put your day to rest. Before you go to bed, spend some time reflecting on the events of the day. Focus and acknowledge what you have achieved and consider your plans for tomorrow. Try to think about the things that are going well, and what you are grateful for. Research has found that gratitude can help to reduce feelings of worry and stress.
Remember the goal of treatment
Keep in mind that the long-term goal of treatment is to help you, not hurt you. Know that while people with head and neck cancer usually experience decreases in quality of life and well being during treatment, these do improve for the majority of people shortly after treatment. The graph below demonstrates how quality of life typically changes from the time of diagnosis up to three years later for people with different stages of head and neck cancer.
Self-Soothe - Helpful Strategies
Some other things that may help you to manage your mood, emotions, or feelings of stress are called self-soothe techniques. These techniques involve doing things to soothe four senses - vision, hearing, smell, and touch - to feel better, calmer, or more relaxed. Try some of the techniques listed below as a way of being comforting, nurturing, and kind to yourself.
Buy flowers; light a candle and watch the flame; go to a museum; look at nature around you; watch the stars; look at beautiful pictures in a book; be mindful of each sight that passes in front of you, not lingering on any.
Listen to music you enjoy; pay attention to sounds of nature (waves, birds, rainfall, leaves rustling); sing your favourite songs; hum a soothing tune; learn to play an instrument; be mindful of any sounds that come your way, letting them go in one ear and out the other.
Use your favourite perfume, aftershave or lotions; light a scented candle, make tea or coffee; smell the roses; walk in the bush; or by the sea; and mindfully breathe in the fresh smells of nature.
Take a bath; put clean sheets on the bed; pat your dog or cat; soak your feet; have a massage; sit in your favourite chair or sofa at home; hug someone; experience whatever you are touching; notice touch that is soothing.
Expressive writing is a technique in which you write down your thoughts and feelings about a difficult, stressful life experience. Research has found that this can help people to cope with such events, and improve both mental and physical health. Initially, it was thought that expressive writing worked by allowing people to express their emotions. However, there is now evidence to suggest that it is more complex than this; thinking about a stressful experience - making sense of it, putting it in perspective, and understanding how it is connected to other important life events - seems an essential element to the way that expressive writing improves health.
Expressive writing may help a person to: find meaning in a stressful event, better manage emotions, find it easier to talk about the stressful event with others, and find it easier to reach out to others for support.
Given that expressive writing has proven effective at reducing stress and improving health (and is an easy and low cost technique), you may like to give it a try as a way of coping with any challenging feelings and emotions that you have been experiencing.
Instructions for Expressive Writing
For the next 4 days, write your very deepest thoughts and feelings about the most traumatic experience of your entire life or an important emotional issue that has affected you and your life (this may or may not be related to your cancer). In your writing, really let go and explore your deepest emotions and thoughts. You might tie your topic to your relationships with others, including parents, lovers, friends or relatives; to your past, your present or your future; or to who you have been, who you would like to be or who you are now. You may write about the some general issues or experiences on all days of writing or about different topics each day. The only rule is that once you begin writing, you continue until the time is up.
• Write over 4 days for 20 minutes per day.
• Find a quiet place where you won't be interrupted.
• Write nonstop and freely (that is, whatever comes to mind) during the time you've set aside.
• Don't concern yourself with grammar, punctuation or writing style.
• While writing, try to explore your innermost
thoughts and feelings without holding back.
• Keep the writing confidential, so you're less likely to inhibit yourself.
(Adopted from Linehan, 1993)
You can also use this exercise to understand how your stressful experience is related to other significant aspects of your life - childhood memories, important relationships, how you have developed as a person, or your hopes and dreams for the future.
If you find that you are feeling sad all of the time
and, that none of these techniques seem to help,
please contact your multi-disciplinary team. It is
important that you do this so that they can provide
you with any help that you need and direct you
to further sources of support.