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How Can I Cope?
LEARNING ABOUT COPING :
Depression | Support Systems | Financial & Legal Matters | End of Life
Coping refers to how people or family members come to terms with an illness, make decisions, solve problems, and adapt to
life’s changes, while still feeling good about themselves. 1 Some factors that apply to how well you are able to cope are your emotions, whether you have a sense of control, whether
you have a positive outlook, and whether you have physical and emotional support.
It is common to have a full range of difficult and mixed emotions throughout an illness. Some emotions related to being diagnosed
with or having cancer are shock, disbelief, fear, anxiety, guilt, sadness, loneliness, depression, grief, and anger. These
feelings may come and go. It is important to remember that these are normal reactions. Your family members and friends may
have similar feelings, and similar ups and downs. 1,2
Working through these emotions is essential to successful coping. Because you may not be prepared for the unique stresses
imposed by cancer, you may need new ways of handling your emotions, thought processes, and behaviors. Talking with other people
about your feelings, writing in a journal, and finding quiet time can help you cope. 1
Feeling that you have some control over what happens to you will make things easier. A large part of dealing with cancer is
making decisions. Learning about pancreatic cancer will make you better equipped to make informed decisions, and will make
you understand that you do have choices.It also is important to focus on things that you can change, not on those you cannot
change. 1
It may be difficult to be hopeful and have a positive outlook when you are ill and worried. However, hoping for the best possible
outcome often provides the motivation to follow medical advice and take care of yourself physically, mentally, and emotionally.
Living in the present can help you focus on what is meaningful and enjoyable right now, rather than on what you do not have
or what you may lose. Feeling hopeless, powerless, or that you have nothing to live for can be signs of depression. 1
Sometimes no matter how hard you try, you may have negative feelings that do not go away. They may be symptoms and signs of
depression or anxiety. Being depressed is different from being sad. Depression takes over your whole life and causes emotional
paralysis. Your family members and friends should be alert for these symptoms ( Box 11-1 ).
Depression is common in patients with pancreatic cancer. Let your healthcare team know about your symptoms. Do not suffer
needlessly, because effective medications and other methods to treat depression are available. 2
| Box 11-1 |
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DO YOU HAVE DEPRESSION? 1,2
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Emotions
- Persistent sadness or a feeling of emptiness
- Loss of interest or pleasure in usual activities
- Feeling guilty, hopeless, or worthless
- Feeling overwhelmed
- Feeling angry or irritable
- Crying a lot
- Focusing only on worries and problems
- Inability to concentrate or to make decisions
- Thoughts of death or suicide
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Physical problems
- Difficulty sleeping or sleeping too much
- Feeling tired all the time
- Headaches
- Weight loss or weight gain
- Upset stomach
- Diarrhea
- Dry mouth
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Seeking the support, assistance, and companionship of others is a very important aspect of coping. Addressing legal and financial
matters, and planning may also help you cope. 1
DEVELOPING A SUPPORT SYSTEM
As a patient, you can reach out to family and friends for emotional support to help you cope with your cancer. Sometimes,
however, family members are too emotionally involved and may not want to – or be able to – hear what you have to say. It is
difficult to deal with a diagnosis of cancer in a loved one. Joining a support group may make a positive difference for you. 3 Finding new friends, especially others who have cancer, may help. They know how you feel. You can express feelings to other
patients with cancer that you may not be able to express to your family members. Other patients can validate your feelings.
Support groups, individual counseling, and group counseling are available. Support groups can meet in person, by phone, or
on the Internet. Not only does sharing with other people help you cope, but you can benefit from the experiences of all these
other people. They have a wealth of information about many aspects of cancer. They can give you ideas about how to cope. You
can trade advice. Some people like to join a group and just listen. 2,3 Conversely, you may have an opportunity to help others cope with their disease.
Remember that members of your healthcare team are also part of your support system. Contact them to discuss anything related
to your cancer and how you are dealing with it. They can aid you in finding what you need to help you cope. 3
ADDRESSING FINANCIAL AND LEGAL MATTERS
When dealing with a life-threatening illness you may need to put your financial matters in order. With the help of a trusted
individual, you can create an organized system for managing your financial resources. 4 Financial aid may be available from government programs, disability benefits, voluntary organizations, and living benefits
from life insurance policies. Having a financial plan may reduce some of the stress in your life and help you better cope.
You also may want to get your legal matters in order, because some of these are related to your healthcare needs. A number
of documents may be involved. A lawyer is not always needed, but you may need a notary public. 1
Two documents that are involved with your healthcare, called advance directives, are a living will and a durable power of attorney. 5 A living will lets people know what kind of medical care you want if you are ever unable to speak for yourself. A durable power of attorney for healthcare names a person to make medical decisions for you if you cannot. This person is chosen by you and is called a healthcare proxy. Note that each state has its own laws about advance directives. You may want to check with a social worker or lawyer about
the laws in your state. 2
Two documents that are not part of advance directives are a will and power of attorney. A will tells how a person wants his or her money and property distributed. Power of attorney appoints a person to make financial decisions when you cannot. 2
Because financial and legal matters can be very complex, you may need help. (See Services & Resources for more information on where to get this kind of help.)
ADDRESSING END-OF-LIFE CARE
Patients and their families may want to make decisions to make end-of-life care as dignified and as physically and emotionally
comfortable as possible. Patients may want to finish projects, have family and friends visit, speak with those closest to
them, and have a spiritual advisor visit.
Being cared for at home may make you feel more secure and more comfortable. You may want to be near your family members, friends,
and familiar surroundings. Healthcare providers can help you take advantage of the many services available to allow you to
be at home: access to medical equipment, visiting nurses, physical therapists, help with daily hygiene and care, meal preparation,
and delivery of medications. 6
Home healthcare professionals may allow patients to receive even complex medical care in their homes. Services range from
simple injections to complete care for seriously ill patients. Access is provided to a professional who can be contacted day
or night to make an assessment and relay that information to your doctor. Your overall care is supervised by your doctor,
who is provided with up-to-date information on your condition. 4
Hospice
Hospice is a concept of care that emphasizes palliative treatments rather than curative ones, quality of life rather than quantity,
and comfort measures. Hospice care may be provided in the home, at a hospice facility, or in a hospital. Patients who have
a limited life expectancy and who are no longer undergoing treatment for cancer may receive hospice care.
Both the patient and family members are included in the hospice care plan. Based on their needs and wishes, practical, emotional,
and spiritual support may be provided. The unique goals of the hospice team are to be sensitive and responsive to the special
requirements of each individual and each family. The patient is under professional medical care, with a focus on symptom relief.
Trained volunteers are available to support and offer respite to family members. 7
REFERENCES ! Click reference number to return to text.
1. Eyre HJ, Lange DP, Morris LB. Informed Decisions: The Complete Book of Cancer Diagnosis, Treatment, and Recovery. 2nd ed.
American Cancer Society–Health Content Products. Atlanta, GA; 2002.
2. National Cancer Institute. When someone you love is being treated for cancer. http://cancer.gov/cancertopics/When-Someone-You-Love-Is-Treated.
Accessed April 24, 2007.
3. Mayo Clinic. Pancreatic cancer. April 12, 2006. www.mayoclinic.com/health/pancreatic-cancer/DS00357/DSECTION=11. Accessed
April 17, 2007.
4. CancerConsultants.com. Oncology Resource Center. Support and resources. http://patient.cancerconsultants.com. Accessed April
17, 2007.
5. CancerConsultants.com. Oncology Resource Center. Advanced directives. http://patient.cancerconsultants.com. Accessed April
17, 2007.
6. National Cancer Institute. Home care for cancer patients. http://cancer.gov/cancertopics/factsheet/Suppor/home-care. Accessed
April 24, 2007.
7. Hospicenet.org. The hospice concept. www.hospicenet.org/html/conceptpr. html. Accessed April 25, 2007.
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