How to cope with a cancer diagnosis – 04/02/2019

On February 4, World Cancer Day 2019, many affected people will remember the exact moment when they learned that they had a tumor. Coping with the diagnosis of cancer is not easy. For most people, this is the most traumatic and most important medical moment of their lives, and the news causes such emotional upheaval that doctors have verified that the patient do not even keep half of the information provided from that moment.

The feeling of threat, of blockage, and from there, the reactions oscillate between denial ("It can not be") and fear ("Am I going to die?"), Followed by an avalanche of doubts and concerns who dominate the mind. As a result, 14 people spend only one hour in Argentina, where the incidence of the disease is medium to high compared to the global level.

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The experts say that after this first phase of denial and blockade, the badimilation, the acceptance and the search for solutions and treatments allowing him to progress, when the patient asks questions about his case. These are the most common questions and how to deal with them.

That's serious? I will die?

"Cancer is linked to a very negative prognosis and Today, more than 60% of malignant tumors are curedand those who do not cure a good deal of people with long-term disease survive or even die for other reasons unrelated to cancer, "said Josep Tabernero, president of the European Society of Medical Oncology ( ESMO).

Tania Estapé, head of the psycho-oncology department of the Fefoc Fundació, also Spanish, reports that people equate cancer with a threat to their physical and mental integrity in their daily lives, and after this first generic fear of death, there are also more specific fears depending on the personal conditions of each, in which usually weighs a lot if you have young children.

"The person suddenly feels a very strong sense of vulnerability, of fragility of life, which creates uncertainty and, in many cases, creates difficulties when planning projects, advancement and, in some cases case, this fear does not disappear, disappears completely or after years of healing, "describes the psychologist.

Jaume Martínez, clinical psychologist integrated in the oncology department of the Vall d'Hebron Hospital in Barcelona, ​​explains that there are people who express their fear of dying but fear the pain or suffer as their loved ones suffer or get treated. .

I'm looking for another doctor? Do I ask for a second opinion?

"We recommend it for several reasons: because everyone has the right to receive another badessment and perhaps other treatment options and also because fear is not a good ally for the decision making, "said Estapé.

And he explains that seek a second opinion saves time so that the emotional tension of the first moment pbades and reduces the risk of adopting radical treatment decisions in a hurry or making legal changes, family or professional that we may regret later.

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Tabernero ensures that doctors themselves sometimes favor the consultation of another specialist so that the person becomes aware of his illness, especially when there are cases requiring urgent treatment and that the person hesitates or does not believe in the diagnosis. And I agree with Estapé to say that the speed with which the first treatment starts is not always the best solution, and sometimes more time to diagnose help later, more favorable evolution because "The most important strategy is to define the type of cancer and plan its treatment".

Does my recovery depend on the medical center that cares for me?

Tabernero, who is also director of the Institute of Oncology of Vall d 'Hebron in Barcelona, ​​believes that more than one hospital or another, the important thing is of: Consult with professionals with extensive experience of the tumor that person has, because each tumor is different in its behavior and in the most appropriate type of treatment.

"If you have a very common cancer, it's easy to find specialists who know the latest advances in any hospital, but if you have less common tumors such as sarcomas, brain tumors, or thyroid tumors. it is better to consult a critical patient specialist important enough to be up to date and focused on this disease, "he advises.

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And he points out that if you do not have any family members with the doctor, the best thing to do is ask for the help of the family doctor to find the best specialist for this specific disease, once you have an accurate diagnosis of the type of cancer it is.

Do you inform me on the Internet?

Many cancer patients feel that their oncologist does not provide enough information to clarify all their doubts and that is why they consult Dr. Google. But on the internet, there is so much information about this disease that it's easy to feel lost and unsafe, "and most of his discoveries have a negative impact on cancer perception and contribute to the rise of pseudotherapies, "says Vicente Guillem, president of the Foundation Excellence and Quality of Oncology.

Estapé says that it is impossible to prevent patients and their families from doing research on the Internet because they feel the need to do something, to look for solutions, so doctors should tell them on which websites to find truthful information, so as to avoid forcing them to trust recommendations without scientific rigor. However, seven out of ten cancer patients report that their oncologist has not provided reliable sources of information, according to data from the ECO Foundation.

Tabernero think that the complementary information can help the patient to know his illness and to take it better, to be more positive with the treatment, although he admits that there are still 10% of people who do not want to know more, that information overwhelms them. It is advisable to ask your doctor which pages are the most appropriate, but immediately suggest those of the European Society (ESMO) and the American (ASCO), the NCI (American Cancer Institute, with information in Spanish) and the National Comprehensive Cancer Network (NCCN), which brings together 28 cancer centers in the United States and provides clinical guidelines for professionals and patients.

Can I live a normal life? Do I stop working?

Being diagnosed with cancer, in addition to posing an emotional earthquake, places the person in an exceptional health situation. impacts on their family and their work environment. On the medical side, Tabernero states that "it is important to have the necessary time and encouragement to focus on the disease, which should be the priority, but we must also try." do not break with everyday life because you are going to go ahead and take care of our goals and objectives in life helps to be happy and to have a fighting spirit. "And he notes that the toxicity of cancer treatments has decreased and that most are compatible with a" pretty "normal life.

Psychologists say that whether or not to change a routine, to continue or not to work, depends on each person, their situation, the type of work to be done, and the course of the illness and the type of treatment.

"There are people who want to continue working because it helps them to normalize the situation, others use it as a defense or refusal, to show that they are doing well, They control the disease and the treatment according to the work and the company it will be easier for them to continue or not"Said Martinez.

Estapé thinks that it is desirable that the patient lead a more or less normal life, because it is the best way to feel, but each person must choose, because there is a person who causes cancer who thinks on his life, to see that his work is not positive, and decides to change course.

Should I explain it? Children?

A common concern is how to approach the disease with people from the environment for fear of worrying them. In fact, according to data from the Spanish Association Against Cancer (AECC), the level of discomfort and emotional distress expressed by relatives of people with cancer is higher than that expressed by the patients themselves (7). , 5 against 6.9). .

The specialists explain that there is not a single recipebecause there are introverted and extroverted people, everyone has to decide what, when and how they talk about their illness, although it has been shown that people who feel well supported by society and by their families adapt better.

What should be taken into account, say the psycho-oncologists, is that if the patient does not tell him, he will have to take the disease alone, which is not easy and leads to isolation. But be aware that if you say so, you will not be able to avoid some comments you do not like. They also stress that, in the case of young children, It is always better to receive information from the people concerned. and do not inquire about third-party comments. And they advise talking to teachers about behavioral changes at school.

It's my fault? Is it inherited?

In some cases, especially in cases of lung cancer and when the person smokes, the patient a feeling of guilt badails, or he sees that the family blames him. "As we believe that we control everything, when something escapes, the simplest is to blame us", justifies Estapé. And he adds that anxieties are also created at the family level in cases where cancer has a genetic component.

Innkeeper states that all tumors are of genetic origin, but only between 5% and 8% they have a hereditary component. "And when that is the case, we establish a special diagnosis to determine if there is a modified gene and to see how to diagnose this risk early for others," rebadures the oncologist.

Am I looking for psychological help?

This is an option to consider when it is needed. Tabernero explains that "the logic is that the initial fear and anguish evolve towards a phase of acceptance and then towards a voluntarism phase against the disease". But sometimes it does not happen "and then good psychological help is fundamental," which makes it much easier.

On the part of the Spanish Association Against Cancer, after the diagnosis, and especially during the treatment phase, reactions of anger, anger, anxiety, sadness and in 30% of cases, or members of their family develop trouble requiring specialized treatment.

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"Cancer is a health problem, but its diagnosis sometimes reveals other aspects of the life of this person, imbalance the pillars that had been established," says psychologist Jaume Martinez, although he says that everyone does not need to consult a specialist. .

Tania Estapé, however, thinks that going to a psychological counseling workshop from the first moment help the person know what to expect, to have tools to talk with your partner or your children, what you will need to manage and how you can do it. However, it is stated that consulting a psychologist and interacting with other affected people will benefit more or less from one person to the other.

Source: The Vanguardia