As if a diagnosis of end stage renal disease (ESRD) is not enough, according to the United States Renal Data System (USRDS) one-third of people with ESRD get hit with a double whammy… a cancer diagnosis. ESRD patients are already dealing with a difficult disease, which impacts quality of life on many levels. A cancer diagnosis on top of ESRD can add even more burden to patients. Most people experience a wide range of emotions. If you have been diagnosed with cancer, some common responses you might feel are:
Loss of Control
Managing day to day activities with ESRD can be tough by itself, making a diagnosis of cancer seem even more tremendous. You may feel you could once predict your day, and now you are feeling uncertain about what each day will be like.
At first, you may not feel any emotions at all, or feel “in shock” when you hear of a cancer diagnosis. Sometimes people have trouble accepting the diagnosis is real at first. These responses are normal.
Anger is a normal response to trauma. A cancer diagnosis can often shake one’s belief in God or a Higher Power. Sometimes cancer patients get angry at doctors and nurses, or angry at their health insurance provider, or just angry with themselves. Most people wonder what would have happened if they had done something different, perhaps gone to the doctor sooner or maintained a healthy lifestyle. People will beat themselves up for not doing something different. Remember, cancer is caused by many things, and doctors haven’t discovered the cause of all types of cancer. If you are angry, it is important to talk to a healthcare professional or a trusted friend about your feelings.
Depression refers to feeling down or blue. People that are depressed often have trouble getting motivated to do things that bring enjoyment. Sometimes feeling depressed causes sleeping problems or may affect a person’s ability to think clearly. It is normal for a person to be upset and cry about a cancer diagnosis. Expressing feelings, good and bad, is a healthy way to cope. If you have thoughts of suicide you should immediately seek help from a doctor or social worker. Those professionals are there to help with these kinds of problems.
Finally, there comes a time when people begin to accept a diagnosis as a part of their life. Fortunately, it is in this stage that a person can begin to address how he or she copes and survive this new chapter in life.
There is no order to these feelings and responses. Oftentimes people go back and forth, in between stages. Each day will be different. Cancer patients have good days and bad days. It is important to take it one day at a time.
There is HOPE!
While you might not be able to change a diagnosis, you can change the way you deal with it. Here are some ideas to help you cope with a cancer diagnosis.
Knowledge is power!
Collect as much information about your diagnosis as possible. If you have concerns, write them down and take your questions with you to your doctor’s appointment. At first information might be hard to hear, but the more information you have, the easier it is to decide what route to take in treating your ESRD and cancer.
Keep open and honest communication with loved ones.
Talking about your feelings might be difficult, however, most people feel a sense of relief to tell someone about their ups and downs. Family and friends are not mind-readers! It is hard for them to know how to help you if you don’t tell them. That doesn’t mean you have to talk about your feelings all the time or with every person you meet; just share what you are comfortable with.
Seek out support.
Talk to a social worker about your fears and concerns. He or she may be able to find different ways to help you with some of the issues you are having. Explore your spiritual support system. Churches and synagogues are often helpful. Find out if there are support groups in your area. If you are uncomfortable talking to people, keep a journal of your thoughts and feelings. Writing things down may help you cope with feelings and eventually it makes talking about feelings easier.
Take good care of yourself.
Consult a dietitian about what you should and should not eat. Talk to your doctor about beginning an exercise program. Indulge yourself in things that bring you pleasure (healthy things!). Try bubble baths, gentle music, read your favorite magazines or go to the movies. Don’t feel badly about staying away from unnecessary stress. It is okay to tell people you are unable to do something because you just don’t feel up to it. You have to take care of you!
Most likely people will say, “call me if you need me.” Many times friends and family want to help, but just don’t know how, so you have to learn to be able to tell them. There is no doubt a cancer diagnosis is devastating for anyone battling a chronic diseases such as ESRD. Having multiple health problems can take a toll on your emotional health and create a wide range of feelings, from shock and anger, to depression and acceptance. Changing the way you cope with such traumatic experiences can help you enjoy your life more every day.
Cancer Prevalence in Patients with ESRD” Poster presented at 2005 United States Renal Data System Symposium at ASN http://www.usrds.org/2005/ pres/18U_asn_05_cancer_prevalence_in_pts_with_esrd.pdf
Liz Anderson, MSW, LCSW, is the former Social Services director for the Mid Atlantic Renal Coalition, ESRD Network 5. Her areas of expertise include dealing with patient and staff conflict and promoting patient-centered care.