Madrid, 5 March 2024. The number of cancers diagnosed in Spain in 2024 will reach 286,664 cases, an increase of 2.6% compared to 2023, according to the Spanish Society of Medical Oncology (SEOM)(1). This diagnosis not only has a significant emotional impact on patients but also on those around them. Fear, uncertainty, anger and sadness are emotions that are part of the process and vary in intensity throughout the course of the illness.
Often, those close to the cancer patient do not know how to act or how to talk to their loved one during the process. That is why it is important to find out about the various situations that may arise and how to deal with them from a specialist such as Fátima Castaño, a psycho-oncologist at MD Anderson Cancer Center Madrid.
Castaño recommends avoiding catch phrases and motivational phrases such as "don't worry", "everything will be fine" or "I'm with you", as well as the warlike language that, she points out, is still often used in the media. "We have to move away from the language of fight and battle, of loser and winner, which puts patients in a psychologically negative position. We still hear phrases that patients and their families can hardly identify with and that do not reflect their reality," she stresses.
In this sense, the specialist also insists on avoiding what is known as the tyranny of positivism. "Excessive demands on positivity can influence and generate discomfort in patients because they may think that sadness or fear, normal for the circumstances, are related to their illness or a possible worsening; that their positivity is related to medical improvement," she explains.
However, she says that a positive attitude helps to face the process with greater resources, to improve quality of life and to prevent mood disorders. However, she continues, this tyranny of positivity is one of the elements that often brings patients to the clinic: "In many cases they explain that they feel they are not doing well enough because they are transmitting sadness to their relatives, which generates an added pressure, they feel guilty and do not allow themselves to transmit negative emotions, which makes it difficult for them to ask for help and can lead to further isolation."
Castaño maintains that feeling negative emotions is "unavoidable" and that it is also necessary, "externalising" them helps to drain them and find support to cope with them. "In fact, this is natural and healthy. In my opinion, negative emotions are wrongly called negative; they are emotions that are not pleasant but are part of the psychological adaptation process that favours acceptance and coping with a life crisis situation such as cancer. We must allow patients to feel and express themselves," she adds, emphasising that this step helps us to get closer to them, to seek resources and to feel more connected.
Listening, questioning, presence and information-seeking as main strategies
Regardless of the case, the psycho-oncologist stresses the importance of starting any interaction with the patient by actively listening and asking questions to understand and get to know their needs. "Each person is unique. We have to adjust our communication style to their own circumstances, conditions and personality. This strategy will help them feel that their relatives are close and present," she explains.
In the case of patients who withdraw into themselves, the psycho-oncologist says it is important to respect their space and idiosyncrasies. "We must find other ways to communicate – not only verbal but also non-verbal communication is valid. Keeping them informed about possible resources, help and needs in the illness process will be of great help in offering the best support."
The MD Anderson Madrid psycho-oncologist offers a series of tools to facilitate communication in these cases:
- Listen and do not take for granted.
- The open question to facilitate expression: How do you feel, what do you need, what would help you at this moment?
- Identify circumstances that favour communication and prepare for these communicative moments.
- Put yourself in your loved one's shoes and understand that not everyone benefits from expressing how they feel at every moment.
- Keeping a conversation going in a complicated context.
- Working as a team.
Communicating with a child with relatives with cancer
When communicating with a child whose family members have been diagnosed with cancer, the specialist says that it is "crucial to explain what is happening, as well as to give them information adapted to their capacity for understanding to help them understand the changes that may arise in the family environment". In this way, she points out, they will be able to understand the situation and feel part of the process: "For this reason, it is not advisable to hide the information because it can generate a feeling of guilt, incomprehension and a perception of isolation and loneliness."