Engaging with your family and friends

Receiving a cancer diagnosis can be highly stressful. The trauma and intense feelings of shock, fear, hopelessness and helplessness that patients experience are also felt by loved ones, who may be unsure what to say or do to help.

Having a good support system plays a pivotal role in your cancer journey with the old adage that 'a problem shared is a problem halved' ringing true with every step you take together. So the best thing you can do as a patient, is to let them in by communicating openly with loved ones, right from the start.

Even if you usually find it easy to discuss the way you feel, talking about cancer can be an extremely difficult task. The word 'cancer' is coupled with such extreme emotions and the illness changes your world so completely that even the best of communicators often finds themselves at a loss for words. A cancer diagnosis can bring real trauma into the lives of those around patients.

Dr Vanessa Marais, a clinical psychologist who specialises in cancer, oncology, depression and anxiety, explains: "It often leaves your family and friends feeling completely overwhelmed, not knowing what to do or what to say. So the first thing you need to do for them - and for yourself - is to accept that 'being strong' does not happen by keeping your feelings to yourself. In fact, being strong is actually your ability to show and share your feelings and emotions with your special people, even if you're so numb you have no idea how you feel! Not only will this make you feel better and lighter but it will also give them the opportunity to understand (more or less) what you're going through and get an idea of how best to support and help you."

Dr Marais offers the following practical tips on how to engage with your family and friends:

To talk to your spouse, partner, family members who live with you, or those closest to you as soon as possible after your diagnosis. At the start, everyone feels pretty lost - including you, the patient. No one is sure about how to react or what to say or do, so openly communicating about where you as the patient are at, will help you all to gain a better understanding of the situation and offer a good starting point to work with
Don't negate or play down any negative feelings such as fear, anxiety or depression in order to protect everyone around you. Remember that having scary thoughts or doubts doesn't mean that you don't believe that you can be cured - it only means that you're experiencing normal, human emotions.
If you have young children, always try to explain the diagnosis, treatment and your emotions according to their ages. Not knowing the details is as stressful for children as it is for adults so it's always better for them to understand what is going on.

Talking about hair loss

One of the most distressing potential side effects of cancer treatment is the loss of hair for patients. Research has shown that even when expected, hair loss can change one's perception of who you are and negatively impact your self-esteem. "It often leads to shame which can impact on your social activities," says Dr Marais. "And, it does, unfortunately, label you by changing your identity from a healthy person into a 'cancer patient' with the accompanying loss of privacy since everyone can now see what you're going through. In addition, it can be a visible and constant reminder of your illness and in some cases, of your mortality. Engaging your family and friends in this sensitive and uncomfortable situation is a challenge," she adds, "But it can also be an enlightening experience."

Dr Marais offers the following guidelines when it comes to discussing your hair loss:

Involve your children in the cutting/shaving experience to enable them to see you transforming from having hair, to not having hair. Younger children tend to cope better when they are involved with the cutting of your hair as well as with buying a wig or head bands or hats. The sudden shock of seeing your parent - especially a mom - without hair, can add to their trauma.
Teenagers can easily feel ashamed of a parent with no hair, so be sure to get their input. Ask, for example, what they think you should wear - a hat or a head band or scarf - and whether they think you should cover your head when you're at home alone with only the family.
Rope in your friends to go shopping for 'head gear' before the start of your treatment or when you prepare yourself for the hair loss. It will make them feel more involved.
The best thing you can do for them- and for you- is to accept that 'being strong' does not happen by keeping your feelings to yourself
Don't negate or play down any negative feelings such as fear, anxiety or depression in order to protect everyone around you