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The following article is written by Dr Melissa Weinberg from Deakin University’s School of Psychology. This is the first article in a two-part series examining the psychology of cancer.
Psycho-oncology is the area of psychology that involves working specifically with people with cancer and their families. Unfortunately, many of us will find ourselves in the unenviable position of experiencing a cancer diagnosis – to ourselves or a loved one – at some point in our lives. In this two-part series, we’ll take a look at the psychological reaction to cancer, from diagnosis through to recovery and beyond.
The psychological reaction to cancer is complex and multifaceted, and there are so many factors that influence how a person, or how their close family and friends might respond.
Some of these include the exact diagnosis in terms of the stage and type of cancer, their prognosis, the age of the person diagnosed, their previous experience with cancer or a family history, their treatment plan, and the trust they have in their medical team.
From my personal experience of working with people with cancer and their families, there are some commonalities to the psychological response.
For many, the moment they find out they have cancer sticks in their mind. And while medical incidents such as cancer do not qualify as ‘trauma’ according to the DSM-V, people at this point may have reason to fear for their life.
At initial diagnosis, there’s typically a lot of uncertainty. People are told they have cancer, but don’t always know the exact stage or treatment plan just yet.
My clients sometimes report experiencing flashbacks to the moment they were diagnosed. Unlike a specific traumatic incident, like a car accident, the flashback tends to be an auditory one, where the sound of the doctor saying the words ‘I’m sorry to tell you that you have cancer’ gets played over and over in their mind.
'My clients sometimes report experiencing flashbacks to the moment they were diagnosed.'
Dr Melissa Weinberg,
School of Psychology, Deakin University
Feeling in shock and out of control, the client is also faced with the difficult task of delivering the news to their friends and family. While some are well supported, others struggle to manage the emotional response from their loved ones.
They may feel guilty for causing their family and friends distress. They may feel that they need to put on a ‘strong’ and positive front to protect their loved ones, thereby denying their true emotions. They may feel burdened or overwhelmed when people respond to their news by sharing stories of others they’ve known who have been through a cancer experience.
Sometimes they report that they end up needing to comfort the people who they expect to be supporting them.
Once treatment begins (sometimes within days of the diagnosis), the client typically speaks of relinquishing control to their medical team. They will follow instructions, attend appointments, and basically do what they’re told.
Treatment will vary depending on a person’s diagnosis, but may include surgery, chemotherapy, radiotherapy, immunotherapy or hormone therapy.
The treatment they receive will typically affect their energy levels, their cognitive function, their mood, their appetite, and their ability to perform their ordinary day-to-day activities.
At this point, barely having had a chance to process the diagnosis itself, the patient is subjected to ongoing physical and psychological stress.
There’s also a loss associated with the change in their identity as a parent, sibling, child, employee, to assuming the role of a patient in need of care. With this typically comes a loss of independence and of the trust they had in their own body to serve them well. Sometimes, clients will grieve the loss of the future they had imagined for themselves, or the loss of the naivety they had about their own health.
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