In my last post, The Top Tips for Managing Stress and Cancer, Part One, I provided the first set of coping strategies to try in order to manage stress and cancer. Here are the remaining strategies that I recommend. Remember, these are broad coping strategies that do not take into account your unique situation. If you want more specific treatment for managing stress and cancer, contact me directly.
#5. Engage in Healthy Behaviors.
These problem-focused coping strategies are pretty straightforward.
1. Stop smoking now. It’s never too late. The latest research shows that even after starting cancer treatment, if you quit smoking, your outcomes are better than those that continue to smoke throughout treatment, regardless of cancer type.
2. Minimize alcohol.
3. Eat nutritiously. Eat a lot of fruits and vegetables. Avoid overly processed foods.
#4. Get Help with Finances.
These problem-focused coping strategies are also straightforward. Get help with your finances- it’s available! Speak with your oncology medical team and social worker to see what resources are available. In addition, The Cancer Finance Coalition (CFAC) is a group of national finance organizations that provide financial help to patients. Click here for more information. Cancer Care (1-800-813-4673) provides limited financial assistance for co-pays, transportation, home care, and child care. For additional financial resources, check out this link from the Fudge Cancer foundation created by Yael Cohen Braun and Julie Greenbaum.
#3. Activity Planning and Pacing.
Cancer and cancer treatment can result in many unwanted symptoms and side effects. Symptoms and side effects can include, but are not limited to, fatigue, mood changes, pain, insomnia and more. While it is important to speak with your oncologist about managing your symptoms and side effects, sometimes, symptoms can still interfere with functioning. It’s important to know that your mental health can suffer if your activity declines. Here is an active, problem-focused coping strategy you can use to work with your symptoms and side effects.
1. Make a list of activities that you want or need to complete. You can create a daily, weekly, monthly list of activities.
2. Then, take those activities and categorize them as high or low (symptom) activities. For example, let’s say you have a lot of fatigue the week after chemotherapy. Take your list and for each activity label them high or low fatigue (e.g., take a 30 minute walk-low fatigue; watch a movie- high fatigue).
3. Monitor your fatigue. You may notice your fatigue is worse at night compared to the mornings. Thus, you should schedule high fatigue activities later in the day/ night and low fatigue activities in the morning.
4. Fill in a blank daily, weekly, or monthly calendar with your list of activities based on the projected high and low symptom days/ hours/ etc. Readjust your schedule as needed.
5. Engage in the scheduled activities. You may feel less motivated at times to engage in your scheduled activities. Try your best. You may not feel motivated at first, but once you get into the activity, you may get the mood and energy benefits of participating in the activity. Note: You may have to adjust your schedule on a daily, weekly, or monthly basis depending on treatment cycle or other factors.
Exercise is natures anti-depressant. Cancer may change your regular exercise routine. Or, if you are not used to exercising regularly, it’s not too late to start exercising. This emotion-focused coping strategy is number two on the list because it is essential to taking care of yourself.
1. Go outside for a walk
2. Exercise as much as you can tolerate
3. Look for exercise and cancer programs in your community
4. Work with a personal trainer (even if just for one session to learn new, safe an effective techniques)
5. If you physically can’t exercise, VISUALIZE exercise (e.g., imagine yourself going for a run through the mountains). Even brief exercise is better than no exercise. Even if you can’t exercise, visualizing yourself exercising can have benefits. This strategy is suggested by Dr. Bernie Siegel. He is a renowned surgeon at Yale School of Medicine and author of Love, Medicine, and Miracles.
#1. Practice Relaxation and Restorative Exercises
The main challenge I hear from my patients is coping with uncertainty. There is a lot of uncertainty during the cancer journey. You often have to wait for results on scans and/or bloodwork, manage unexpected symptoms and side effects of treatment and disease, as well as understand that prognosis is often based on statistics from the population as a whole and may not be accurate regarding your unique situation. Thus, oftentimes, oncologists can only provide the facts based on the research. There is no crystal ball to tell you exactly what will happen to you in the future. This is true in life and this is also true in cancer. Thus, the best way to cope with uncertainty is to practice relaxation and distraction techniques. There is simply no point in going down the rabbit hole of ‘what-ifs.’ Stay out of the rabbit hole. Here are some emotion-focused strategies to help you stay out of the rabbit hole. In other words, ask yourself when you are worrying about uncertainty- is this in my control? If not, do the following:
1. Diaphragmatic Breathing: Sit up straight with your feet flat on the floor. Place one hand on your stomach and one hand on your chest. Imagine filling up a balloon in your stomach with air. Therefore, only your hand on your stomach should be moving up and down with your breath. Breathe in for 5 seconds, breathe out for 3 seconds. Repeat. Repeat. Repeat.
2. Brief Mindfulness Meditation: Pay attention to the sounds around you, noticing even distant sounds, like electrical appliances, or the traffic outside. You don’t have to like or dislike them, simply accept what sounds are there. Notice the sensations in your body, such as those in your feet or hands, or your breathe going in and out of your nose and belly. What is the most distant sound you can hear? Breathe.
3. Visualization: Dr. Bernie Siegel, Love, Medicine, and Miracles based on his work with 'exceptional' cancer and medical patients speaks to this exercise in his book. He recommends visualizing your cancer treatment as healing yourself. Some patients visualize the cancer treatment as a pac man eating away at the cancer cells. Others imagine the chemotherapy as a puppy licking the cancer cells away. Whatever works for you- just imagine the treatment as getting rid of the cancer cells and/or shrinking the tumor.
4. Free Relaxation Recordings: If you would like to practice more relaxation exercises, Dartmouth University offers free relaxation downloads on their website here. They are awesome and FREE. Just pop your headphones in, get comfortable, and go through the exercises. Remember, relaxation strategies are great to use when things are NOT in your control. The tips for managing stress and cancer are not just for patients, but they can also be helpful for caregivers. Remember, in order to take care of your loved one, you must take care of yourself first. You cannot serve from an empty vessel. Finally, these are broad coping strategies meant to help you manage mild to moderate levels of stress. However, if you are suffering from symptoms of depression, anxiety, seek more individualized help from a therapist. If you are having suicidal thoughts, reach out for help. You can call the National Suicide Prevention Hotline at 1-800-273-8255.
For patients seeking individualized help with managing symptoms and side effects of cancer, contact Dr. Nicole Amoyal Pensak for a free phone consultation 609-283-2056 or firstname.lastname@example.org.