Coping with Cancer - It’s a Family Affair
by Michelle Riba, MD, MS, and Karen Hammelef, MS
Like any chronic medical condition, cancer is a family illness. Everyone is affected in some way. In fact, people with cancer frequently tell us that coping with a cancer diagnosis is worse for their families than it is for themselves. Since each family’s situation is unique, it is impossible to generalize. There are, however, some important points to convey to families when a loved one has cancer.
Review family priorities. What is still important? And what can be modified? Each family has to decide how to get through the immediate shock of diagnosis and then how to respond to a host of subsequent issues over the long term. For example, holiday traditions or vacation plans may need to be revised.
Don’t be afraid to ask for help. Who can help the family out? Assistance can come from within the family, outside friends, the community, and elsewhere. Family and friends may be able to help out by shifting work and play schedules, assisting with meals, and arranging for rides to and from activities. Teachers might be able to provide extra assistance to school-age children. Older siblings can provide support through phone calls or e-mails to younger siblings. Spouses or partners can ask for help from neighbors or friends with duties such as carpooling children or driving to and from radiation or chemotherapy appointments.
Sometimes a cancer diagnosis can bring a family closer together.
Look at finances and new ways for budgeting. Cancer is costly for families in terms of lost wages, co-pays for doctors’ appointments and medications, and additional expenses such as childcare and transportation costs. Families need to discuss these issues in order to allay worries and fears. Hospitals often allow people with cancer and their families to develop budgets for paying bills, and businesses often can offer financial assistance if they are aware of illness in the family.
Families sometimes lose their sense of regularity, such as eating dinner at the same time, when someone gets very sick. There are so many “losses” with cancer, but sometimes there are also some wins, times when the family can find great opportunities to be together. Figuring out a new normal is difficult, but sometimes open communication is good enough. Trying to laugh, being in the moment, and finding joy are all important goals throughout cancer care.
Many people try to tell you what they went through, or what their Aunt Tilly went through, even when the cancer or the situation is completely different from the one you and your family are experiencing. How should families deal with these folks who are well meaning but sometimes terrify you and your family? Making sure you and your family regroup each day or on a regular basis to share these kinds of “war stories” might be a good idea. We usually ask our patients about these kinds of issues when we see them for psychiatric care. These confrontations are so prevalent. Find someone in your life – a professional, friend, other relative – whom you can talk with about these issues.
Family members often feel depressed and anxious, themselves. It is important for family members to take care of themselves physically, emotionally, and mentally throughout the course of cancer care and into survivorship.
Job loss and stress are key issues for family members. For teenagers, the stress comes out in schoolwork and friendships. For younger children, it could be behavioral aspects, including sleeping troubles and regression. Each family member copes with stress differently. It is important to think about mental health issues for all family members and how to receive appropriate physical and mental care. Most oncology practices recognize this and are able to help make such referrals for people with cancer and their families.
There is no right way for families to survive the cancer experience. Whatever the past has been, one of the positive aspects of cancer is that it is a time for families to work together to help one another.
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Dr. Michelle Riba is professor and director of the PsychOncology Program and Karen Hammelef is director of patient support services, both at the University of Michigan Comprehensive Cancer Center in Ann Arbor, MI.
This article was published in Coping® with Cancer magazine, January/February 2009.