Your coping toolbox

When you are first diagnosed, there is a lot of information to take in – and well-meaning family and friends may give you even more. This “information overload” can leave you overwhelmed and confused about what to do. You may need just the information that relates to your situation right now, or a way of dealing with the information that you already have.

Look for reliable information – Make sure your information comes from recognised cancer experts and is based on strong evidence. Cancer Council has booklets, online information and podcasts about different cancer types, treatments and issues.

Ask questions – If you are unsure or confused about anything, it can help to talk to your treatment team. Write down your questions beforehand and put them in order of how important they are right now. You can also call Cancer Council 13 11 20 to discuss your concerns with an experienced health professional.

Involve other people – Ask people you trust to help gather and make sense of new information. You could also ask your partner or a close family member or friend to come to your appointments with you. Let them know if you’d like them to take notes or join in the discussion.

Find out about suitable clinical trials – Your doctor or nurse may suggest you take part in a clinical trial. Doctors run clinical trials to test new or modified treatments to see if they are better than current methods. Over the years, trials have led to better outcomes for people with cancer. You can find trials at australiancancertrials.gov.au.

Get organised – Start a filing system for all your test results, information and records. You also have the option of using My Health Record, an online system provided by the Australian Government.

Keep a diary – You can use a paper diary or smartphone app to keep track of appointments and side effects. This will also be a useful record in the future (especially if you are seeing different health professionals).

Update your affairs – Many people with cancer review their insurance and superannuation policies and update their will and other legal documents. This doesn’t mean you have given up hope – everyone needs to do these things at some point and you might feel relieved once they are done. Cancer Council’s Legal and Financial Referral Services can connect you with qualified professionals – call 13 11 20 to find out more.

Find support – There are many ways to connect with other people in a similar situation. Cancer Council runs face-to-face and telephone support groups, or can put you in touch with someone who has had a similar cancer experience. You could also join our online discussion forum.

After a cancer diagnosis, you will probably need to make a number of decisions. These could include which treatments to have, how to involve or care for your family and friends, whether or when to return to work, and what to do about finances.

Know your options – Understanding the disease, the available treatments, possible side effects and any extra costs can help you weigh up the options and make well-informed decisions.

Take your time – Check with your specialist how soon treatment should begin. If it is safe to wait a short while, use that time to think about your decisions. Generally, people find it easier to make decisions (and have fewer regrets later) if they take time to gather information and think about the possible consequences.

Get expert advice – Ask your health professionals to clearly explain your treatment options, and the benefits and side effects of each. For non-medical concerns, you can ask to speak to the social worker at the hospital or treatment centre. The social worker can advise you and your carer about issues such as financial assistance, how to get extra help at home, and support for relationship or emotional difficulties. You can also call Cancer Council 13 11 20 for information and support.

Write it down – Organising your thoughts on paper can often be easier than trying to work everything out in your head. Start by identifying the purpose of the treatment (is it to cure the cancer, to control the cancer, or to keep you as comfortable as possible?), then list the pros and cons of each treatment option. You could rate how important each point is on a scale of 1–5, considering the short-term and long-term effects on you and others.

Talk it over – Discuss the options with those close to you, such as your partner, family members and close friends. You may feel worried about how your decisions will affect them, so hearing their opinions could put your mind at rest. Sometimes you might prefer to talk to someone neutral, such as a member of your treatment team or one of the experienced health professionals at Cancer Council 13 11 20.

Consider a second opinion – You may want to get a second opinion to confirm or clarify your specialist’s recommendations or just to check you have explored all the options. Specialists are used to people doing this. Your GP or specialist can refer you to another specialist and send your test results to them. You can get a second opinion even if you have started treatment or still want to be treated by your first specialist. You might decide you prefer the second specialist.

Expect to have doubts – Feeling unsure does not mean you have taken the wrong path. Reassure yourself that you made the best decisions you could with the information you had at the time. And remember that decisions are not always final – it may be possible to change your mind even after you have started down a particular treatment path.

Remember it’s your decision – Adults have the right to accept or refuse any treatment that they are offered. For example, some people with advanced cancer choose treatment that has significant side effects even if it gives only a small benefit for a short period of time. Others decide to focus their treatment on quality of life. You may want to discuss your decision with the treatment team, GP, family and friends.

Decision aids are online or printed resources that help you choose between treatment options. You answer questions that help you focus on what matters most to you. There are decision aids for a range of cancer-related issues, such as whether to have breast reconstruction or whether to have treatment for early prostate cancer. Ask your treatment team if there is a decision aid for your situation.

Download our booklet ‘Cancer Care and Your Rights’

Complementary therapies, such as relaxation, meditation, massage, art therapy and counselling, are widely used alongside conventional cancer treatments such as surgery, chemotherapy and radiation therapy. Many complementary therapies focus on a mind–body connection. They may offer physical, emotional and spiritual support, help reduce side effects from medical treatment, and improve quality of life.

Relaxation and meditation – These therapies can help reduce stress, anxiety and fatigue, and improve quality of life.

• Relaxation usually includes slow breathing and muscle-loosening exercises to physically and mentally calm the body.
• Meditation involves focusing on a single thing, such as breathing, to clear the mind and calm the emotions.
• Mindfulness meditation helps you to take things one day at a time. It allows you to focus more easily on the present moment, rather than worrying about the past or fearing the future.
• Body-based practices such as yoga, tai chi and qi gong combine a series of movements with breathing and meditation exercises to improve strength and flexibility while reducing stress and anxiety.
• Hands-on therapies such as massage and reiki are available in some cancer centres. In a massage session, the therapist helps release tension by applying pressure to your muscles. In a reiki session, the therapist gently places their hands on or slightly above your body – many people find this calming and relaxing.

Counselling – Through discussions with a counsellor, social worker or psychologist, you can identify problems and explore ways of managing  unhelpful thoughts and feelings.

Counselling sessions allow you to express your emotions in a safe and supportive environment and learn new coping skills. They can provide an opportunity to talk about thoughts and feelings that you might not feel comfortable sharing with family and friends.

Art therapy – This technique uses visual art (e.g. drawing, painting, collage, sculpture, digital work) to express feelings. It can be done individually or in groups, and some hospitals run programs. You do not need artistic talent to join in or benefit – the focus is on the process of making the artwork, not the end result. An art therapist helps you explore the images you have created to encourage understanding of your emotions and concerns. Let your doctor know about any other therapies you are using or thinking about trying. Some may not be helpful and could cause problems if used with some medical treatments.

Complementary therapies are used alongside conventional medical treatments, while alternative therapies are used instead of conventional medical treatments. Alternative therapies are unlikely to be scientifically tested, may prevent successful treatment of the cancer and can be harmful. Cancer Council does not recommend the use of alternative therapies as a cancer treatment.

Download our booklet ‘Understanding Complementary Therapies’

People affected by cancer may find themselves going over and over the same distressing thoughts about the past, present or future. Ignoring such thoughts or trying to distract yourself may work at first, but they often return once you are no longer distracted – for example, during the middle of the night or early in the morning. The strategies listed below may be a helpful starting point if you are finding it hard to manage your thoughts. To learn more, you can explore resources such as apps and podcasts or seek support from a professional.

Identify where the thoughts come from – Ask yourself if your thoughts are the result of an underlying belief, such as “The world should be a fair and just place”, “If I can’t do everything I used to do, I am useless” or “I am a burden to my family and friends”. Or perhaps you tend to give personal meaning to everything that is happening, even to events that are beyond your control. For example, if you arrive at the treatment centre and can’t find a parking spot, you might think, “Nothing ever goes right for me. I don’t know why I’m bothering with the treatment, I know it won’t work.”
Consider your own advice – Think of someone you love and imagine what you would say to them if they felt the same way.

Check your thoughts – Ask yourself if you are jumping to conclusions or exaggerating the negatives. If so, is there something you can do to change the situation or improve it?

Write down your thoughts – This helps slow down your thinking and improves your ability to focus. It may also make it easier to work out if a thought is based on facts and if it is realistic or helpful. This can create an opportunity for you to challenge unhelpful ways of thinking.

Recognise the little positives – Some days it might be hard to find something positive. This is understandable, but if you feel like that every day, check whether you are ignoring any little achievements or happy events. Some people make a habit of writing down three good things that have happened to them each day. These don’t have to be major life events – they could just be an encouraging smile from a radiographer or a nice chat with a  receptionist on a tough day.

Practise letting your thoughts come and go – It is important to remember that thoughts are fleeting. We tend to notice some, but there are many we don’t notice. Try to let your thoughts come and go without getting caught up in them. You could imagine they are clouds in the sky or leaves floating down a stream. Cancer Council’s Finding Calm During Cancer podcast may help you practise this.

Be kind to yourself – Use encouraging thoughts to talk yourself through difficulties, rather than criticising yourself (e.g. you could congratulate
yourself for getting through a treatment session). This does not come naturally to most people, but counsellors and psychologists can teach you techniques to help you be kinder to yourself.

Seek professional help – Social workers, psychologists and other health professionals are trained to help people manage how they’re feeling. Check what support is available at your treatment centre or ask your GP for a referral.

It can be helpful to track how you’re feeling, and some people use free online self-help programs or smartphone apps to do this. You could visit moodgym.com.au, mindspot.org.au or thiswayup.org.au, or see the list of health and wellbeing apps at healthdirect.gov.au/health-and-wellbeing-apps.

Sleep can help your body cope with the physical and emotional demands of cancer treatment. You may find your sleep is affected by worry, pain,  nausea, menopause symptoms (e.g. hot flushes) and some medicines (e.g. steroids). If you are less physically active during treatment, your body may not be as tired and you could find it harder to sleep. Feeling sad or depressed can also make it difficult to sleep well at night.

Ways to improve sleep

• Try to go to bed at the same time every night and get up at the same time every day.
• Do some physical activity each day, but avoid vigorous exercise just before bed.
• Put screens away an hour before bedtime and do something relaxing – have a bath, read, or listen to music.
• Avoid coffee, tea, chocolate, cola and energy drinks after early afternoon.
• Avoid alcohol before bed. It may seem to help you relax and fall asleep, but it can keep you from getting quality sleep and feeling rested when you wake.
• Eat medium-sized meals in the evening. Your sleep can be disrupted if you go to bed hungry, but also if you have indigestion after eating a big meal.
• Limit naps to 10–30 minutes and take them before 3pm.
• Use relaxation practices before bed. Our Finding Calm During Cancer podcast has a sleep track.
• Keep your bedroom as dark, cool and quiet as possible.
• If you can’t sleep, get up and sit on the couch until you feel sleepy. Keep lights low and try doing something boring that you can easily put down when you are ready to sleep again.

Listen to our ‘Sleep and Cancer’ podcast episode for more tips