Cancer: How to navigate the mental challenges of a diagnosis

An estimated 42,000 people in Ireland get cancer each year. This figure is made up of both invasive (cancers that can spread beyond the place they originated) and non-invasive tumours (cancers that do not spread).

The most recent research from the National Cancer Registry, Ireland (NCRI) shows that there are now more than 24,000 invasive cases of cancer diagnosed here each year. However, some 215,000 cancer patients or former cancer patients were alive in Ireland at the end of 2021. This means one in 23 people in Ireland are cancer survivors, a welcome 50 per cent increase in survivorship compared with a decade ago.

When you add in family members and close friends, that’s a lot of people dealing with the emotional burden of cancer. Not surprisingly in this age of information overload, quite a number of myths and misinformation surrounding the disease have emerged.

Which makes a new book, The Cancer Guide - How to Nurture Wellbeing Through and Beyond a Cancer Diagnosis (published on March 21st by Bedford Square Publishers), very welcome indeed. Written by Trinity College Dublin academic and consultant psychiatrist at St James’s hospital, Prof Anne-Marie O’Dwyer, it sets out to help patients and their loved ones navigate the mental challenges of a cancer diagnosis and its treatment. As well as explaining the human reactions to a cancer diagnosis, using real stories, it provides specific information for families and friends.

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“I also hope that, by providing a window into the experiences of our patients – the thoughts, feelings and emotions they experience, often too difficult to share with you – this book will help you better understand what is happening to them, guiding you to know how best to help”, says the author.

I was especially taken by a chapter on the most common cancer myths heard by O’Dwyer during almost four decades of clinical experience: “I must be ‘positive’ all the time if I am going to beat cancer”, “talking to my partner or my family about my feelings will only upset them” and “my energy levels have been damaged forever because of cancer” are just three examples of unhelpful cancer myths constructively dealt with in the book.

There are also many myths about cancer treatments. A lot of cancer patients pin their hopes on finishing their treatment and “going back to the way they were”.

In practice, that’s not a particularly helpful plan. Going backwards in time is rarely helpful in life.

“I am a failure for not bouncing back [after treatment]” is another commonly held but unhelpful belief. “That is why it is so important”, O’Dwyer says, “to know that ending treatment is just the start of rehabilitation . . . you have survived the active treatment phase – now you need support, kindness and help to rehabilitate yourself back to functioning again.”

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Then there is the pervasive myth that “everyone else is faring so much better than me”. The reality is that everyone recovers at a different pace. Because every cancer and every treatment is different, there is no basis for comparing yourself to anyone else.

Cancer-related fatigue, a major issue post-cancer, gets a chapter of its own. When the author and her colleagues first began a psycho-oncology service more than 20 years ago, fatigue after cancer was seen as inevitable. She explains the possible psychological, social and behavioural causes of post-cancer fatigue. As fatigue takes hold, a deconditioning response is almost inevitable as some patients confine their activities as part of a perceived need to rest more and more. There are a number of practical tips to help overcome deconditioning in the book.

Overall, real (but anonymised) patient stories help bring the chapters to life.

Their experiences of being heard and understood are powerful.

mhouston@irishtimes.com