» Families Facing Cancer – Helping carers to cope with cancer

Stages of Grief and Tasks of Mourning

Anne Orchard — Thu, 29 Jul 2010 13:03:35 +0000

Stages of Grief

According to research conducted by psychiatrists J. Bowlby and C.M. Parkes, there are four stages of grief that people commonly experience. You may find that one or more of these phases describe where you are in your grief at any time. Your progression from one stage to another may not be smooth, and where you are can vary from day to day. The four stages are:

Numbness. This is where you may be in shock, feeling disbelief and cut off from reality.
Yearning, pining. Here you find you wish to bring back the person, long for them. You may feel much anger and disappointment at this stage.
Depression, disorganisation and despair. Now you find it difficult to function in your everyday life. You may struggle to concentrate or not be able to bear thinking about the future.
Recovery and reorganisation. At this stage more positive feelings begin to surface. You are ready to take the first steps of moving forward with your life, and adjusting to your new reality.

When you first reach the stage of recovery, it is likely to be fragile. You may start by catching fleeting glimpses of how life may be. It is tempting at this stage to slide back into guilt, thinking “How can I be thinking of the future when he or she is not here?” Guard against this temptation. Guilt serves no one, especially not your loved one, who has left already.
Describing these phases of grief makes them seem passive, as though you have no control over your route through them. There is a benefit to taking your time. No one can tell you how long it should take you to move from one stage to another. There are many things that affect your ability to adjust and move on through this unfamiliar landscape.

Tasks of Mourning

A more ‘active’ way of looking at grief comes from William Worden, who described a series of four tasks that are involved in mourning.

To accept the reality of the loss. This shows that you can make the choice to face this reality with courage, and resist the temptation to deny it.
To experience the pain of grief. This task is where you dive into the pain. When giving birth, a mother is encouraged to flow with the pain, rather than resisting it. If you give yourself the time and the space to do this with your grief, you will allow the emotions to flow rather than become stuck. Self-medicating with alcohol, or anything else that prevents you truly feeling your emotions, would be avoiding this task.
To adjust to the environment where the deceased is missing. The loss of someone close to you changes the scenery of your every day. In fact the build up to death may have changed your life beyond recognition, so that it revolved around caring for the person with cancer. When they die, this is a huge adjustment. Your task now is to create the new landscape of your life, metaphorically moving the furniture to at least partly fill the hole that they have left.
To emotionally relocate the deceased and move on. This task involves making a space for your loved one as a memory rather than a current relationship. Keeping them in your heart in this way allows you to look forward to a future without them and not feel bad about yourself for doing so.

You will find a way through these phases and tasks. The human spirit is resourceful and resilient. In the early stages it may feel as though your world has ended. And so in a sense it has. However, there is a new world for you to step into, when you are ready.

Invasive

Anne Orchard — Wed, 28 Jul 2010 10:06:51 +0000

Invasive cancer is cancer that has spread into (invaded) healthy surrounding tissue instead of staying confined to where it started. Invasive cancer may also be described using the type of cancer, for instance invasive carcinoma.

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Talking to Children About Cancer

Anne Orchard — Thu, 22 Jul 2010 12:21:02 +0000

When a family member receives a cancer diagnosis, one of the things you may fear most is discussing this devastating news with your children. If you’re wondering how to best approach the cancer subject with your kids, here are some hints that may make the conversation easier.

First, take into account the child’s age. Older children need more information than younger ones. Essentially, most professionals divide children into two age groups with regard to information about illness.

Children under the age of 8 – These children don’t need a lot of detailed information. They should be told that there is a part of the patient’s body that is not working the way that it should and that it will need medicine or an operation to get better. Children this age don’t really need much information beyond this about the disease, but they do need to know how the illness and its treatment will affect their lives. For example, if the cancer is in a parent, they may see big changes at home, and they should be prepared for these. However, if the cancer is in a relative who does not live with you, and for whom you will not be providing regular care, they may need very little further information.
Children over the age of 8 – These children can handle, and will expect, more detailed information. But, again, the age of the child must be taken into account. Older children may be scientifically interested in the disease, and may benefit from reading material and pictures aimed at their reading and maturity level. They can also foresee consequences better than younger children – but not as well as an adult. They may have many questions about the future. Encourage them to ask questions, and answer them as honestly as you can. But, don’t plant questions that they may not have had on their own.

It’s important to realize that, to a large degree, your children will react to a diagnosis based on your reaction. If you are obviously worried and upset, they will have more fear than if you are calm and reassuring. This in no way implies that you should lie to your children about the diagnosis. However, you should not plan to talk to your children when you are very upset.

A diagnosis of cancer in your family is not something you should try to hide from your children. They will know that something is going on – and if you hide it, they are likely to think that the situation is very serious. It’s far better to tell them what’s going on from the very beginning; though you may choose to give them pieces of the picture a little at a time.

Be certain to prepare your children for a visit to their loved one, if necessary. If they haven’t paid them a visit for a while, many physical changes may have occurred. For example, a child could be very frightened by a loved one’s sudden hair loss, if they are not prepared for it ahead of time. Remind your child that their loved one is still the same person, but that the medicine and the illness have made them look a little different. Once prepared for such a change, most children handle it quite well.

When the prognosis is of your loved one’s cancer is bleak, it is important to talk with your children about the future. Again, keep the information basic and geared toward their age level, but prepare them for their loved one’s death if it is inevitable and quickly approaching.

As with many parenting challenges, you’ll find that you learn as you go in regards to discussing cancer with your children. Once you’ve given them the basics, let them know that they can ask you questions whenever they have them and then let them take the lead. Some children will want more information than others. Listen to them carefully and follow your instincts. Children are very resilient, and with a little care in how the subject is approached, they will adjust to the new situation appropriately.

Further Resources

Living Sunny Side Up
Helping Children in Families with a Parent Diagnosed with Cancer

Uterus

Anne Orchard — Wed, 21 Jul 2010 09:50:45 +0000

The uterus is another name for the womb. It is the part of a woman’s body where fertilised eggs can lodge and grow in pregnancy to produce a baby. The uterus lining is shed each month in a woman’s period.

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How Do Others React to the Cancer?

Anne Orchard — Thu, 15 Jul 2010 09:46:19 +0000

As a supporter of a cancer patient, there will certainly be times that you will need to talk about your feelings, fears and frustrations with someone who is not as intimately involved in the journey. There will be things you need to say that you simply can’t say to your loved one with cancer. Talking with others about your own journey and experiences throughout the process is healthy and healing. However, you may find that the people you expected to be your best shoulder are reluctant, shying away from you when you need them most. On the other hand, people that you never expected to be available for you will step up to the plate unexpectedly. An excerpt from “Their Cancer: Your Journey” details this often disappointing phenomenon.

When facing a cancer diagnosis, one issue you (and the person who has cancer) will face is the attitudes of other people. There are many different ways that others will handle the news. Some may have difficulty talking about the cancer at all. They may go to great lengths to avoid the subject. You may even find that they seem to be avoiding
you, or the cancer host.
You may feel very hurt at what seems like indifference or lack of compassion. In fact this behaviour probably shows that they have some unresolved issues that make it hard for them to deal with illness. You may have no idea what has happened in their past for them to behave that way. It may not lessen the hurt you feel, but try not to blame them.
Other people may have a ‘poor you’ attitude. They will be pitying in the extreme for the ‘terrible situation’ in which you find yourself. This could feel good in one way. You are getting sympathy for your situation, and it’s nice to know that someone has noticed how awful it is! At least they don’t think the person with cancer is the only one who deserves sympathy. So accept their expression of sympathy the first time. Be especially glad if it is accompanied by genuine offers of practical help or emotional support. But if you find you are on the receiving end of endless streams of pity from some people, be wary. Whilst they may truly care for you, if they belittle your ability to cope with the situation this attitude could rub off on you. Both you and the person with the cancer need to be empowered to deal with the challenges ahead, not brought down to the victim mindset. It may be that you have to tell people, “Thanks for the sympathy, but I know we’ll get through this.” Possibly you could add, “What you can do to help is . . .”. If they continue to be negative, you may choose to limit the time you spend with them.
On the other hand, some people will be absolutely amazing. Firm friendships have appeared seemingly from nowhere in the face of adversity. When my first marriage broke down, my colleague,
Jenny, took me into her home while I looked for somewhere to live.
She talked to me as I made difficult decisions for the future and was the most staunch supporter I had at the time. She was a truly lovely person and a deep friendship came out of that experience. So be prepared to be surprised and delighted by how some people come through for you.
The truth of the matter is that other people’s reactions are just that – theirs! Whilst it is natural to feel happy or sad about how others behave, the fact is that their reaction is not about you. It relates to who they are, the experiences they have gone through and how they handle issues in their own lives. Don’t take it personally. Just make the most of those whose attitude helps you.

As you can see, we all will have many different attitudes to cope with during the cancer journey. You’ll quickly learn who you can count on when you need a shoulder, a hug, or some sound advice. Lean on those people and be appreciative for the support that they have to offer. But, don’t be too hard on those who are unable to support you during this time. You don’t know the road they’ve traveled. And, you never know when your journey might inspire them to explore their own fears and come to terms with whatever prevents them from reaching out.

Adjuvant Chemotherapy

Anne Orchard — Wed, 14 Jul 2010 10:49:51 +0000

The term adjuvant chemotherapy refers to chemotherapy given when all visible signs of the cancer have been removed through surgery. For instance, in breast cancer surgery may completely remove a tumour from the breast, but chemotherapy be given afterwards to reduce the likelihood of the cancer recurring or spreading to other areas of the body.

Adjuvant Radiotherapy

Anne Orchard — Wed, 14 Jul 2010 08:10:51 +0000

The term adjuvant radiotherapy refers to radiotherapy given when all visible signs of the cancer have been removed through surgery. For instance, in breast cancer surgery may completely remove a tumour from the breast, but radiotherapy be given afterwards to reduce the likelihood of the cancer recurring. Adjuvant radiotherapy is common where a breast tumour has been removed using a lumpectomy rather than a mastectomy, and this may be given after or even during the surgery.

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With Cancer or Not, Death is a Natural Part of Life

Anne Orchard — Thu, 08 Jul 2010 10:18:56 +0000

Everyone recognizes that death is a natural part of life, but most people do not dwell upon it When cancer is diagnosed, however, everyone involved begins to think of death, if only fleetingly. Terminal cancer of course makes these thoughts more than fleeting. Dealing with this overriding concern of imminent death is discussed in my book Their Cancer – Your Journey:
Is it timely to think about death if your loved one has only just been diagnosed. Surely it’s far too negative to mention death at this point? It’s unlikely (unless you have received a very late diagnosis) that the medical team has raised the prospect of death. However there is a big ‘But’ to consider. Many advances have been made in the field of cancer treatment; but it is still something that people die from. In fact, as our ability to treat other conditions improves, it becomes ever more common that cancer is what will finally take us out of this world.
This means that whenever the word cancer is mentioned, the thought of the chance of death comes swiftly after. You will probably be trying to suppress it. You have almost certainly heard of the benefits of positive thinking, and want to apply it. The trouble is that the little voice in your head that says “What if they die?” is not easy to silence. The more you push it down, and refuse to listen to it, the stronger it is likely to become. I’m not telling you it’s a good idea to dwell on the likelihood of your loved one’s death. I’m just saying you need to acknowledge that thought.
The truth is that death is certain for all of us. It’s a natural part of life. You can think of it as being like the passing of the seasons. Our birth and death are as woven into the fabric of nature as the growth and falling of leaves on the trees each year. Cancer is by no means an inevitable death sentence, but we all have to go eventually. Who can say how long we are supposed to be here?
If your loved one’s cancer does lead to death (either now or in many years’ time), there is no point in resisting this. Yes, you will do everything in your power to support them and their health, but if that proves to be to no avail, so be it.
Children have a very practical attitude to death. They feel the grief and sadness as deeply as we do, they just don’t let it linger. They understand instinctively that life goes on. Once their grief has been expressed and noticed by others, they are likely to switch rapidly to getting on with the business of their lives, such as playing with their friends. They have a natural approach.
Society’s attitude has a great influence on our perception of death. Only a hundred years ago, most families would have experienced death first hand. Children died in infancy, mothers died in childbirth. In my husband’s family, his great grandfather was given the same name as another baby who died only a year before. This would be unthinkable now, but I think it shows how naturally death was treated then – because it was more common.
These days we have removed death from the family and into hospitals. The result is that it has become surrounded by an air of mystery. It also seems that death is almost always regarded with horror – instead of as a natural stage which we would all welcome at some point in our lives.
So do not fear death. Or if you are feeling fear, notice what is at the root of the fear. Are you afraid of being lonely, or of a lack of support? Would you desperately miss spending time with a person who brings joy into your life? Be honest with yourself, face up to your fears, and you will do much to still that little voice. This will then allow you to give more concentration to what you can do now to help.
As Deepak Chopra said in The Book of Secrets “Only by facing death can you develop a real passion for being alive.”
Most people have learned to accept the inevitability of death at an uncertain time in the distant future. The possibility of someone dying from cancer in the near future, however, is not so easily accepted. It’s comforting to be optimistic and hope for the best outcome, but it is also a positive step to recognize and accept the possibility, and to prepare for it.

Stage

Anne Orchard — Wed, 07 Jul 2010 10:29:55 +0000

Cancer stage is a measure of how large and invasive the tumour is, and whether it has spread to other parts of the body (this is different from the cancer grade). The exact cancer staging system varies depending on the type of cancer and where in the body it is found, so you should ask for a detailed explanation. However, the cancer stages will generally follow this pattern:

Stage 1 – the tumour is small and well contained in the area of the body where it started.
Stage 2 – the tumour is larger than Stage 1, but still contained with possibly some cancer cells present in lymph nodes in the surrounding area.
Stage 3 – the tumour is larger, may have spread in the local area of the body and cancer cells are present in nearby lymph nodes.
Stage 4 – the cancer has spread to other parts of the body. These additional tumours are known as metastases.

Cancer stage is sometimes written in roman numerals, so Stage 4 may be written as “IV”.

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Dealing with Anger

Anne Orchard — Thu, 01 Jul 2010 09:38:50 +0000

Anger can erupt for many reasons. News of a debilitating illness like cancer can certainly bring about rage, particularly when the disease strikes someone who is in the prime of life. As a loved one and supporter of someone with cancer, we can feel anger on behalf of that person, but we just as often feel anger of our own. We feel robbed of time together, and we may even feel angry about the amount of time and effort we’ll be putting into the care and support of our loved one. Some of our anger may surprise us, and may overwhelm us, as well.

Dealing with anger effectively is a skill that many people never master. But, it is critical that you learn to deal with and let go of your anger so that you can focus on the cancer journey productively.

Anger is one of the most damaging of all emotions. We hear and read a lot about road rage, but anger can occur in many other situations. Feeling fury can be terrifying. You are convinced that the anger will consume you, and there will be nothing else left. When you are tired, stressed and worried, anger often arises more easily.
A long wait to pay at the shop can send you spiraling into a fury far beyond what is reasonable. I’m sure you’ve seen someone yelling at an assistant over some seemingly insignificant problem. Their anger is probably not much to do with the current issue; it’s more likely related to what kind of day they’ve had, or what kind of person they are.
Feeling anger is one level of problem, but the more important issue is what we do with it. Those shop assistants do not deserve the fury that’s being aimed at them, but they are on the receiving end of it. If you vent your anger at someone, you can’t take back the things you said – and that is dangerous. When you are angry, you can damage your relationships with those around you.
All these things mean that we are scared of feeling anger. We’re not good at dealing with it, as we have not been taught how to. Instead we tend to suppress those angry feelings, because this seems safer than allowing ourselves to feel that way. In fact what you are doing by suppressing anger is choosing to hang on to it. You may have heard the expression “What you resist, persists”, and so it is with those feelings of fury.
Of course I’m not recommending that you let it out and shout at people in shops, but there are many safer ways of expressing feelings – or even just dropping them. You can learn many ways in the book Their Cancer – Your Journey, or try one of the Calming Techniques listed in this article.
As you can see, feelings of anger must be dealt with. Suppression is unhealthy, but unleashing can be dangerous, particularly if your anger is directed at an undeserving bystander. It’s critical to work through your emotions in a healthy way, so that you can put anger to rest and focus positively on the future.

» Families Facing Cancer – Helping carers to cope with cancer

Stages of Grief and Tasks of Mourning

Stages of Grief

Tasks of Mourning

Recommended Reading

Invasive

Talking to Children About Cancer

Recommended Reading

Further Resources

Uterus

How Do Others React to the Cancer?

Recommended Reading

Adjuvant Chemotherapy

Recommended Reading

Adjuvant Radiotherapy

With Cancer or Not, Death is a Natural Part of Life

Recommended Reading

Stage

Dealing with Anger

Recommended Reading