Relationships and Communication
Cancer doesn't affect just one person. Cancer affects those closest to you including partners, family members, and friends. The complex feelings and lifestyle changes that follow a cancer diagnosis can be almost as overwhelming for family members and friends as they are for the person with cancer.
Cancer changes the way you relate to your family and friends, and the way they relate to you.
Communication becomes especially important for people with cancer and those who care about them. Lack of communication can lead to isolation, frustration, and unmet needs. People with cancer who don't talk about their illness often feel they are facing cancer alone. Talking about and sharing feelings and needs together lets couples, families, and friends work with one another to solve problems and cope with difficult situations.
When feelings and wishes are left unsaid, you may be left with inaccurate, even hurtful assumptions, about why the people who care about you are acting in a specific way. Sharing your feelings, such as sadness and fear, also lets others know how much you care for and love them. Talking about feelings and problems with honesty, sincerity, and openness can greatly reduce the stress that cancer places on relationships. If you are having a hard time talking with people, consider asking for help by joining a support group or talking with a counselor or social worker. Those closest to you may also benefit from talking to someone.
Some people avoid telling their children they have cancer. However, children usually sense something is wrong even if they don't know what it is. When not told what is going on, children may imagine the worst. They may also find out from someone else, which can make them feel angry and confused.
Some parents think they are protecting their children by withholding bad news. In fact, your children may benefit by your open and honest approach. With planning, practice and support from your family or health professionals, most parents are able to talk to their kids about cancer.
Consider what you will say and how you will say it before the discussion. Talk to children in a language they understand - younger children need simple explanations and teenagers and young adults might ask for more details.
Communicating with children gives them the opportunity to ask questions and to express their feelings. Encourage your children to tell you what they know about cancer, and answer questions honestly. This gives you the chance to clear up any misunderstandings. Children may also need reassurance that your illness is not their fault.
Tell other people close to your children (grandparents, friends and school teachers) about your diagnosis and your plan for talking to the children, so that you all say similar things. Trusted friends can also talk to your children about cancer if you feel unable.
Source - Cancer Council
Cancer can affect your sexuality in both physical and emotional ways. The impact of these changes depends on many factors, such as treatment and side effects, whether or not you have a partner, your age, and your self-confidence and self esteem.
Cancer does not mean your sexuality will be destroyed. With support and clear communication, you will often still be able to enjoy a fulfilling sex life.
There are four main ways that cancer or its treatment can affect your sexuality. It can affect your:
- Physical ability to give and receive sexual pleasure
- Thoughts and feelings about your body (body image)
- Feelings, such as fear, sadness, anger and joy
- Roles and relationships
The links between these four areas are important. If there is a problem in one of them, it may have an impact on another.
When someone becomes ill, it can affect their ability to feel good about themselves sexually, or their physical ability to give and receive sexual pleasure. If this has happened to you or your partner, it might be helpful to understand that some changes will only be temporary. Even if the changes are long lasting, or permanent, you can find ways to adapt sexual techniques that are no longer possible or discover new ones. You can learn to feel good about yourself sexually despite the cancer and the possible side effects of the treatments.
Our sex lives are usually private and not openly discussed with strangers. Because of this you may feel that talking about sex will be embarrassing and difficult, both for you and the health professionals you talk to. This doesn't have to be the case.
Sex is an important part of most people's lives, which brings pleasure, closeness and helps us define who we are. So, even if you think it will be embarrassing or difficult, it's important to try and talk about any sexual problems the cancer or its treatment are causing. There are things that can help with most problems; but if you keep them to yourself, you may never find out about them!
It can often be difficult to bring up the subject of sexuality in an appointment with your doctor, but most doctors are used to dealing with this subject and should be able to answer your questions. Your GP or hospital doctor can discuss these issues with you. Many hospitals also have specialist nurses who can answer any questions that you have.
Health professionals may not think to ask you whether your cancer or its treatment, are affecting your sexuality. However, they would be happy to help or refer you for counselling or specialist treatment if they can't answer your questions.
It can sometimes be difficult to talk with your partner about sexual problems. You may feel embarrassed and not want to upset them. Your doctor or nurse can give you support and help with discussing these difficult issues.
If you don't want to talk to anyone face to face, there are confidential help lines with staff that can help you. Sometimes the anonymity of a helpline can help you to talk about issues that you may find difficult to discuss in person.
Sexuality is an important part of many people's lives and it can be very reassuring to discuss any problems that you have.
Sources - Cancer Council NSW and Macmillan Cancer Support UK
You may still be adjusting to the news that someone you know has cancer, and that you will be their carer. You may be wondering what carers do. You may be worried about the impact being a carer will have on your life and how caring might affect your relationship with the person with cancer.
You may also be questioning how you will manage the emotional and physical needs of the person you are caring for during the stages of cancer. Perhaps you have been providing care for some time and need some reassurance.
This information aims to support you in your role as a carer. You may relate to several of the emotions and feelings described here, and you might learn practical tips on how to balance the demands of caring, family, work and your own needs.
Your role as carer is valuable. Many carers have said they are better people for the experience of caring.
Becoming a carer is not always a natural progression or straightforward. You may feel forced into being a carer, and pressured into taking on a caring role. You may have conflicting demands such as a young family or a busy job, or not be very close to the person you care for.
Becoming a carer is probably a big change for you, and it may take some time to adjust to your new role and responsibilities. It is quite natural to have strong emotions; feeling confused and stressed is common. You may think the only way to cope is to put aside your own feelings and needs. This may work in the short term, but it will be hard to maintain, and your health may be affected. As a carer you have an important role, and you must be healthy and well to perform at your best. A carer needs to care for themselves too.
How will I feel?
A carer often experiences a range of feelings about their role and responsiblities. It's common to feel as if you are on an emotional rollercoaster. It may help to know that your feelings are normal, and they are similar to those experienced by the person with cancer.
- anger and frustration
Ways to cope
Some carers use a diary to record their role as they find it helps:
- give them some perspective, for example, reading what you wrote yesterday may help you see that today is a better day
- release some of their own worries or frustrations and see them in a different light
- acknowledge their feelings
Don't expect to be perfect, sometimes you may feel like you could have handled the situation better or done something differently. It's okay to make mistakes and each new day gives you a chance to try again. You may expect too much from yourself, and you may need to learn not to be so hard on yourself. No one is perfect; you're doing the best you can.
Caring for someone with advanced cancer
The person you are caring for may have been told that they have advanced cancer - cancer that won't go away and is unlikely to be cured. You may both be trying to come to terms with this and experiencing a range of strong emotions such as fear and sadness.
Caring for someone with advanced cancer can be frightening. You may find that you try not to think about this very much and focus on the everyday practical matters.
As the illness progresses, their needs may change and a different type of care may be required. You may have to reassess the type of care you can offer and who else can help.
It may be necessary for the person with cancer to be admitted to hospital or another type of care facility. Some carers feel guilty doing this but handing over the everyday care to somebody else will allow you to spend more time just being together. If you like, you can still help staff look after them.
The place of death may be more important to some people than others. This is an important issue to discuss with the person you're caring for. Some people may prefer to be in a hospital or hospice. Some people prefer to die at home in familiar surroundings and in the company of their family. One of you may have strong views, making the decision easier. If the person with cancer is not clear what they'd like, it may be good to discuss it now to avoid any regrets or feelings of guilt later.
The aim of palliative care is to enhance the quality of life of people with cancer and help them maintain their independence for as long as possible. It also supports carers in their role.
Palliative care is tailored to an individual's case and involves the coordination of services to meet their medical, emotional, spiritual and social needs.
A GP or community health nurse can coordinate palliative care but if the needs of the person with cancer change, they will be referred to a specialist palliative care team.
Many carers experience anticipatory grief. This is the grief you feel when you are expecting a loss such as death. Anticipatory grief feels similar to grief after a loss, for example, depression, extreme concern for the person, preparing for the death and beginning to think about what life is going to be like without the person.
Anticipatory grief can give family and friends time to slowly get used to the death, to say what they want to say or tell the person what they have meant in your life.
This type of grief may not always occur, and it can be different to the grief a carer experiences when the person dies. The grief experienced before a death does not make the grief after the death last a shorter amount of time.
Death and grief
If the person you have been caring for dies, you may feel a range of emotions, including:
- numbness and shock, even if you thought you had prepared for this moment
- relief that you are free of your caring responsibilities and can now make plans for your own future
- anger towards the doctors or the hospital, God or the deceased person for dying
- guilt that you are thinking of yourself at this time.
All these emotions are normal. Feeling relief or guilt is not a sign that you didn't care. These emotions may come and go and change in intensity over time.
Source: NSW Cancer Council