Advanced Cancer : Confusion, Hope, Sadness and Depression

by National Cancer Institute

(Page 6 of 11)

Confusion

You may start noticing signs that you feel confused. This can occur in some people with advanced stage cancer. It can also be caused by some medicines. Confusion may begin suddenly or come and go during the day. Possible signs include:

• Sudden changes in feelings (such as feeling calm then suddenly becoming angry)

• Having trouble paying attention or concentrating (such as feeling easily distracted, having trouble answering questions, or finding it harder to do tasks that involve logic, such as math problems)

• Memory and awareness problems (such as forgetting where you are and what day it is or forgetting recent events)

If you notice these signs, talk to your health care team to try to find out the cause. Meanwhile, try one or more of the following to help relieve confusion:

• Go to a quiet, well-lit room with familiar objects.
• Reduce noise.
• Have family or loved ones nearby.
• Put a clock or calendar where it can be seen.
• Limit changes in caregivers.
• Ask your health care team about drugs that may help.

Coping With Your Feelings

You've probably felt a range of feelings during your cancer experience. You may have had these feelings at other times in your life, too, but they may be more intense now. There is no right or wrong way to feel. And there is no right or wrong way to react to your feelings. Do what is most comfortable and useful for you.

You may relate to all of the feelings below or just a few. You may feel them at different times, with some days being better than others. It may help to know that others have felt the same way that you do. You may also want to read "Ways You Can Cope".

Hope

"I feel it's important to me that I live each day to the fullest, and make peace with my relatives and friends and develop loving relationships with them." — Kate

You can feel a sense of hope, despite your cancer. But what you hope for changes with time. If you have been told that remission may not be possible, you can hope for other things. These may include comfort, peace, acceptance, even joy. Hoping may give you a sense of purpose. This, in itself, may help you feel better.

To build a sense of hope, set goals to look forward to each day. Plan something to get your mind off the cancer. Here are some tips from others with advanced stage cancer:

• Plan your days as you've always done.
• Don't stop doing the things you like to do just because you have cancer.
• Find small things in life to look forward to each day.

You can also set dates and events to look forward to. Don't limit yourself. Look for reasons to hope, while staying aware of what's at hand.

Inner Strength

"My biggest struggle is that I need help, but I don't want people to give me too much of it. I want to do what I can for myself. If I have to work at something, there's a reason to live." — Will

People with cancer find strength they didn't know they had. You may have felt overwhelmed when you first learned that your doctors couldn't control your cancer. And now you aren't coping as well as you did in the past. But your feelings of helplessness may change. You may find physical and emotional reserves you didn't know you had. Calling on your inner strength can help revive your spirit.

Some people find it helpful to focus on the present instead of the past or future. They start a new daily routine. They accept that it may have to be different from the old routine. Others like to plan ahead and set goals. With places to go and things to do, life stretches out before them. Others focus on the relationships they have with people close to them. Inner strength is different for each person. So draw on the things in your life that are meaningful to you. Look at other sections in this booklet for ways to tap into your inner strength.

Sadness and Depression

It's normal to feel sad. You may have no energy or not want to eat. It's okay to cry or express your sadness in another way. You don't have to be upbeat all the time or pretend to be cheerful in front of others.

Pretending to feel okay when you don't doesn't help you feel better. And it may even create barriers between you and your loved ones. So don't hold it in. Do what feels natural to you.

Depression can happen if sadness or despair seems to take over your life. Some of the signs below are normal during a time like this. Talk to your doctor if they last for more than 2 weeks. Some symptoms could be due to physical problems. It's important to tell someone on your health care team about them.

Signs of Depression

• Feeling helpless or hopeless, or that life has no meaning
• Having no interest in family, friends, hobbies, or things you used to enjoy
• Losing your appetite
• Feeling short-tempered and grouchy
• Not being able to get certain thoughts out of your mind
• Crying for long periods of time or many times each day
• Thinking about hurting or killing yourself
• Feeling "wired," having racing thoughts or panic attacks
• Having sleep problems, such as not being able to sleep, having nightmares, or sleeping too much.

Your doctor can treat depression with medicine. He or she also may suggest that you talk about your feelings. You can do this with a psychologist or counselor. Or you may want to join a support group.

About the Author

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