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Notes from a talk given to the London branch
of the Oesophageal Patients’ Association on
12 April 2008 by
Dr Claire Hallas, Consultant Health
Psychologist, Harefield Hospital |
Those who have been diagnosed with oesophageal
cancer have a number of common problems, some of
which are relevant to other illnesses.
·
Adapting to your diagnosis – sometimes the whole
process of becoming used to the idea of having
cancer can take people more than a couple of
years before they really come to terms with, and
become used to, the new situation.
·
Coping with uncertainty and the future
·
Living with symptoms such as unreliable
digestion
·
Improving quality of life is a worthwhile thing
to do, and can help your prognosis.
Getting
together with other patients can help those who
have had serious operations such as
oesophagectomy or gastrectomy. It can help to
talk to others who have had an unusual operation
as they can immediately relate to common
experiences. Family members and friends can be
a great support, but patient support groups can
be the source of advice and information, and a
forum for exchanging information about medical
conditions. But many patients will have been
to different hospitals and had varying
treatments from different surgeons and other
doctors for perfectly logical reasons.
We are all different. We react to things in an
individual way, and in some respects we
ourselves are the best expert about our own
bodies.
There can be positive feelings arising after a
diagnosis of cancer, such as:
·
Rediscovering love for family & friends
·
A chance to review your life and putting things
into perspective
·
A’new start’
·
Motivation to change old lifestyle/ habits
But inevitably there are also
negative feelings which may affect us all, such
as:
·
Fear (eg of pain, embarrassment, lack of
dignity, recurrence)
·
anger - ‘why me?’
·
worries/anxiety (what will we do about money,
jobs?)
·
low mood/depression
·
frustrations
·
loss of confidence
Common feelings experienced by patients are:
·
Having both ‘good’ & ‘bad’ days/ weeks at a time
·
Worrying about symptoms & the future
·
Not wanting to be ‘sick’, or letting the
diagnosis define you as a person – ‘Who am I
now?. Where am I going?’
·
Worrying about your family & others (eg patients
feeling the need to support those you care
about, and how they will cope.) Patients and
carers can both tend to ‘shield’ each other from
their worries – but in the end it is usually
best to deal with things asa team and give each
other mutual strength.
Coping with everyday life and symptoms can
involve:
Range of symptoms and side-effects of surgery
that can persist:
·
Fatigue
·
Pain
·
Dysphagia (swallow problems)
·
Regurgitation/reflux
·
Weight loss
How our thoughts affect us, and how we cope
with worries and symptoms can be improved with
self-help strategies:
·
Look at your weekly activities: develop a
structure or routine that is realistic -
planning reduces worries
·
If
we take two steps forward and one backwards, we
are still further forward overall!
·
Change the focus of your thoughts – and increase
self-control: eg ‘what I can do’
·
Talk with supportive friends and family about
any worries, and ask for support, especially if
we feel at times that we ‘can’t see the wood for
the trees’.
Common traps we can fall into:
·
Comparing ourselves to others
·
Setting up very high expectations of ourselves –
can be led by perfectionism. Do not ever think
of the word ‘should’ – as in ‘I should be able
to do this by now’.
·
Not being kind to ourselves or compassionate
during difficulties
·
What would you say to a friend/family member? –
heed this advice!
What can help?
Ask for professional help
·
Via medical team @ your hospital – gain more
information
·
Via Health Psychology @ local hospital
·
Via GP: request psychology referral
There are also counsellors who can be seen,
usually privately,
Final thoughts…
·
Try not to pressure yourself to cope with
everything – eg I “should be”!
·
Try not to generalise yourself with the
experience of others
·
Take control with positive, pro-active and
planned coping strategies
Some useful contacts:
-
The Oxford Cognitive Therapy Centre, Warneford
Hospital,Oxford, England
OX3 7JX Telephone 01865 223986
www.octc.co.uk for self-help books and
relaxation CDs
-
The British Association for Behavioural and
Cognitive Psychotherapies have a website to
help people gain access to private registered
therapists.
www.babcp.co.uk
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