[Narrator]

Section 4—"Emotional Aspects of Cancer."

Alexa, Marguerita, Lyria, and Elena are all survivors who have been meeting together in a support group for over a year. Some of them began to meet in the hospital clinic when they were receiving radiation treatment, and they have continued to meet. Rose has recently completed her treatment and just joined the group.

[Rose]

You know, I was expecting to feel really relieved—happy—when I finished my cancer treatment. All during those long months of feeling sick, I just kept thinking about how good I would feel when I was all done with it. But, when that day actually came, I was surprised… I didn't feel excited at all. Just the opposite. Now, I feel kind of let down and sad.

[Alexa]

Rose, I know what you mean. I felt that way, too, for a long time… like, will the cancer come back if I'm not taking any medicine?

[Lyria]

For me, it was good to know that everybody at the clinic was watching out for me during my treatment. I felt so alone when I stopped going. I felt very confused by these mixed feelings. I have to thank everybody in this group for helping me through it. People who haven't been through it just don't get it sometimes.

[Marguerita]

That's so true! You know what really bothers me? Some people at work are always complaining about all these little things, like traffic or the weather. And, I am thinking about cancer and all the people fighting it. Sometimes I just want to just stand up and scream, "Don't you know how lucky you are? What are you complaining about!"

[Elena]

At my job, all these young people have so much energy and are so slim. Here I am...I don't have energy to do much of anything. I can't seem to take off all the weight I put on with the medicines. I started meeting with my social worker for some counseling, and that has been a big help.

[Narrator]

What these group members are describing are actually very common emotional reactions of cancer survivors. Cancer has an impact on our lives in many ways: physically, emotionally, and socially. Some of the effects of the diagnosis or treatment are short term, others may continue for a long time.

The emotional distress that cancer causes can take many forms: anxiety… anger… depression… frustration … are all quite common. In fact, researchers have found that about one-third of the people with a cancer diagnosis experience anxiety or depression serious enough to require professional help. Cancer specialists use a short questionnaire, called a "distress thermometer," to help them measure the emotional impact of cancer on survivors. You can find a copy of this questionnaire in the Resource Booklet that comes with the Cancer Survival Toolbox and is available on the Toolbox website. If you are experiencing emotional distress from your cancer, it is very important to know that help is available, and to go get the help you need. Cancer is difficult to deal with—it's normal to need some help during your most stressful times.

[Joan]

As an oncology nurse, the emotion I usually talk about first with survivors is anxiety. Anxiety is a common reaction to the diagnosis of cancer. The most basic form of anxiety is the feeling of fear. Fear can be important for self-preservation, because it alerts us to danger and allows us to get ready to respond. Anxiety can focus your energy, so that your body, mind, and spirit can react effectively to get you through the challenges you face. Many survivors find that they cope quite well. They can respond as needed during diagnosis and treatment, and when they need to make decisions. Sometimes, however, for many different reasons, anxiety reactions can make it hard to relax and enjoy your health after your treatment ends. Mental health researchers still have not identified all of the factors that cause anxiety reactions, but some biological factors, such as changes in hormones, may be involved.

The symptoms of fear and anxiety include a rapid heartbeat, shortness of breath, sweaty palms, agitation, or a sense of panic. Some of these effects may also be caused by certain kinds of medical treatments. For example, some medicines that are prescribed for respiratory or other conditions can cause feelings of agitation or restlessness that are similar to anxiety. It is also important to be aware that people who stop taking certain medications and other substances, like nicotine, can develop these symptoms, too. Talk with your doctor if you experience these symptoms.

Your doctor can assess your physical symptoms and can help you decide on the best way to manage them. Medical factors do not account for all anxiety symptoms that occur during or following cancer treatment. Therefore, your doctor may refer you to other members of the healthcare team who can talk with you about nonmedical causes of anxiety and ways you can reduce or manage uncomfortable feelings. Some cancer support groups also address these issues.

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