Cancer : Stress, Pain, Self-Esteem, Sadness and Depression

by National Cancer Institute

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Stress

Your body may react to the stress and worry of having cancer. You may notice that:

• your heart beats faster
• you have headaches or muscle pains
• you don't feel like eating
• you feel sick to your stomach or have diarrhea
• you feel shaky, weak, or dizzy
• you have a tight feeling in your throat and chest
• you sleep too much or too little

Stress can also keep your body from fighting disease as well as it should.

You can learn to handle stress in many ways, like:

• exercising
• listening to music
• reading books, poems, or magazines
• getting involved in hobbies such as music or crafts
• relaxing or meditating, such as lying down and slowly breathing in and out
• talking about your feelings with family and close friends

If you are concerned about stress, talk to your doctor or nurse. He or she may be able to help you by referring you to a counselor or support group. You may also join a class that teaches people ways of dealing with stress. The key is to find ways to control stress and not to let it control you.

Pain

Even though almost everyone worries about pain, it may not be a problem for you. Some people do not have any pain. Others have pain only once in a while. Cancer pain can almost always be relieved. If you are in pain, your doctor can suggest ways to help you feel better. These include:

• prescription or over-the-counter medicines
• cold packs or heating pads
• relaxation, like getting a massage or listening to soothing music
• imagery, such as thinking about a place where you feel happy and calm
• distraction, like watching a movie, working on a hobby, or anything that helps take your mind off your pain

There is no reason for you to be bothered with pain. There are many ways to control pain. Your doctor wants and needs to hear about your pain. As soon as you have pain you should speak up. Dealing with your pain can also help you deal with the feelings discussed in this chapter.

Pain Scales and Pain Journals

Pain scales or pain journals are tools that you can use to describe how much pain you feel. These tools can also help your doctor, nurse, or pharmacist find ways to treat your pain.

You are the only person who can decide how much pain you feel. When it comes to pain, there is no right or wrong answer. On many pain scales, you are asked to rate your pain as a number from 0 to 10. For example, you would rate your pain as "0" if you feel no pain at all. You would rate your pain as "10" if it is the worst pain you have ever felt in your life. You can pick any number between 0 and 10 to describe your pain.

When you use a pain scale, be sure to include the range. For example, you might say, "Today my pain is a 7 on a scale from 0 to 10."

A pain journal or diary is another tool you can use to describe your pain. With a journal or diary, you not only use a pain scale but also write down what you think causes your pain and what helps you feel better.

When you describe your pain to your doctor, nurse, pharmacist, or family member, tell them:

• where you feel pain
• what it feels like (sharp, dull, throbbing, steady)
• how strong the pain feels
• how long it lasts
• what eases the pain and what makes it worse
• what medicines you are taking for the pain and how much they help

Control and Self-Esteem

When you first learn that you have cancer, you may feel as if your life is out of control. You may feel this way because:

• you wonder if you will live or die
• your daily routine is messed up by doctor visits and treatments
• people use medical words and terms that you don't understand
• you feel like you can't do things you enjoy
• you feel helpless
• the health professionals treating you are strangers

As one woman with cancer commented,

"Once I started to feel better, I found myself looking for new outlets for creativity. I had always promised myself that some day I would take a photography course. My satisfaction with my new hobby helped me feel better about other areas of my life as well."

Sadness and Depression

Many people with cancer feel sad or depressed. This is a normal response to any serious illness. When you're depressed, you may have very little energy, feel tired, or not want to eat.

Depression is sometimes a serious problem. If feelings of sadness and despair seem to take over your life, you may have clinical depression. The box below lists eight common signs of depression. Let your health provider know if you have one or more of these signs almost every day.

Early Signs of Depression

Check the signs that are problems for you:

• a feeling that you are helpless and hopeless, or that life has no meaning
• no interest in being with your family or friends
• no interest in the hobbies and activities you used to enjoy
• a loss of appetite, or no interest in food
• crying for long periods of time, or many times each day
• sleep problems, either sleeping too much or too little
• changes in your energy level
• thoughts of killing yourself. This includes making plans or taking action to kill yourself, as well as frequent thoughts about death and dying.

Depression can be treated. Your doctor may prescribe medication. He or she may also suggest that you talk about your feelings with a counselor or join a support group with others who have cancer.

Guilt

Many people with cancer feel guilty. For example, you may blame yourself for upsetting the people you love. You may worry that you are a burden to others, either emotionally or financially. Or you may envy other people's good health and be ashamed of this feeling. You might even blame yourself for lifestyle choices that could have led to your cancer. For example, that lying out in the sun caused your skin cancer or that smoking cigarettes led to your lung cancer.

These feelings are all normal for people with cancer. One woman with breast cancer said,

"When I feel guilty that I caused my cancer, I think of little children who have cancer. That makes me realize that cancer can just happen. It isn't my fault."

Your family and friends may also feel guilty because:

• they are healthy while you are ill
• they can't help you as much as they want
• they feel stressed and impatient

They may also want to be perfect and feel guilty when they cannot give you all the care and understanding you need.

Counseling and support groups can help with these feelings of guilt. Let your doctor or nurse know if you, or someone in your family, would like to talk with a counselor or go to a support group.

About the Author

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