– In most cases, what an oncology patient needs is closeness. Our presence, sometimes in silence, is the greatest value we can give him. Let’s just listen to what our loved one says and follow him. We talk with Anna Morawska-Borowiec, president of the “Faces of depression” Foundation, about how to support a loved one with cancer.
Cancer is one of the most fearful diagnoses in the collective consciousness. Who do we share it with the most?
In most cases, cancer patients talk about the disease to their relatives: husband, wife, partner / partner. As for children, they will know the diagnosis later or not at all. It really depends on the family.
Does it happen that cancer patients hide their diagnosis from their relatives?
Yes, although there is a tendency to seek support from loved ones. Instead, we have patients in our free remote psychological support program for cancer patients who are working with our psycho-oncologists to just open up and tell their family. Sometimes they report to us thanks to the so-called “Second line of support”, that is friends who, knowing that they are sick, refer them to our program. The task of our specialists is to help in coping with the fear of the reaction of loved ones.
Cancer diagnosis is said to be like a “mental and physical tsunami” – how does the family handle the message “my loved one has cancer”?
It is always a very difficult confrontation. Primarily because, in the collective consciousness, cancer is still a life-threatening disease. And although we say: cancer is not a sentence, we feel fear, sometimes terror. So it is a diagnosis that causes the ground to be removed under the feet of both the sick person and their loved ones. Fortunately, there is an increasing number of cancers that can be successfully treated or maintained for many years in the chronic, controllable phase of the disease. So hope is and it is what allows us psychologists and psychiatrists to work with people suffering from cancer.
Sometimes it is oncological patients who do not want to talk about their disease, and sometimes their relatives do not want to hear about it. Is avoiding the topic of diagnosis and downplaying the severity of the situation our defensive response?
I would say that this is a certain stage of being ill, which was described by Elisabeth Kübler-Ross in her ground-breaking book On Death and Dying. According to her, the patient himself and his relatives may go through various stages of the disease: unawareness, uncertainty, denial, anger, bargaining with fate, depression and acceptance, understood as coming to terms with the disease.
The aforementioned phases sometimes run in a different order, they do not always occur together, and their duration is also different. So it is not a bad thing that the person or their loved ones do not want to talk about the disease, deny reality, or supersede information about cancer. They are a certain defense mechanism that allows us to overcome shock, maintain mental balance and gain strength to fight the disease.
What reactions should a loved one with cancer avoid? Messages like: “get a grip”, “do not overdo it”, “be strong”?
This is an individual matter, but in most cases the oncological patient does not want to hear: everything will be fine, be strong, nothing serious, many today get a similar diagnosis and live. Contrary to appearances, words that are an impulse of the heart and seem to be refreshing to us, annoy a person suffering from cancer. He knows well what his health condition looks like, what treatment he has a chance for and what his prognosis is. He’s already googled it all and read it. So he doesn’t need to lie to himself or minimize the fear he has to face himself.
The vast majority of cancer patients simply need closeness. Our presence, sometimes in silence, is the greatest value we can give them. Let us listen to what our loved one says and let us follow him. Perhaps he will want to talk about the disease, and perhaps the weather or the show.
When the life and health of a loved one is at risk, it is difficult to control your own emotions. Should we hide from crying or panic outbursts?
The difference between man and robot is that he has a whole range of emotions, and crying, as well as laughter, are for something in our lives. Tears help us not to “fall to our knees”, that is, not to break down. They are normal and needed. They become disturbing when sadness, despair, hopelessness, and other symptoms of depression last longer than two weeks. Undoubtedly, the relatives of cancer patients also need support. After all, cancer affects the whole family and is associated with great anxiety, both for the sick person and their relatives.
That is why our free remote psychological assistance program is addressed both to people who are ill or suffered from cancer, as well as their relatives, and even healthy people interested in oncological and psychological prophylaxis. Thanks to the support of Nationale-Nederlanden in the framework of the “Cancer? It’s not like that!” we received funding for 500 sessions. And anyone who needs help can contact us via the website: www.twarzedepresja.pl/pomocpsychologiczna.
The studies conducted so far show that cancer patients who work on strengthening their psyche respond better to treatment and recover faster. Do you think, at the moment of hearing the diagnosis: it is cancer, the patient should be looked after by a psycho-oncologist?
He should at least have a chance of getting such help. Of course, not all cancer patients will need it. I know patients who, due to a supportive family, their own mental structure, personality or temperament, are good at diagnosing cancer, but most people need psychological help and don’t have it. At the National Institute of Oncology in Warsaw, patients wait a year and two months for a consultation with a psycho-oncologist, which means that the records are currently being registered for September next year. On the other hand, families are not able to benefit from such assistance at all. And yet those you asked about: crying, broken, who are one step away from depression, need psychological support.
I think that the subject of mental health of people with cancer and their families is one of the most neglected in Poland. We have statistics showing that every third cancer patient also struggles with depression. Considering that one million Poles live with cancer, we are talking about hundreds of thousands of patients who face two life-threatening diseases at the same time. The scary thing is not only that most of them do not have a chance to seek professional help, but a significant part will not live up to the date of the first consultation. Especially that during the pandemic, as we are alarmed by oncologists, the number of people suffering from advanced-stage cancer has increased significantly.
From a medical point of view, this means that for most of them, doctors are unable to help. From the psychological point of view, it looks like that people after ineffective therapy, who underwent immediately during the last visit to the oncologist, receive a referral to a hospice with the information: I’m sorry, but we have nothing to offer you under the National Health Fund. These are people who until recently functioned well and were full of the hope that has now been taken away from them. They come home, sit in the armchair and fall into the black tunnel. Also with them in mind, the program was launched.