Madrid, 22 April 2024. Cancer is still one of the main causes of morbidity and mortality worldwide and this will continue to be the case over the coming years. In fact, according to the Spanish Network of Cancer Registries (REDECAN), figures suggest that the number of cancers diagnosed in Spain for 2024 will reach 286,664, representing a slight increase compared with 20231. Changes in self-image are one of the problems deriving from the disease itself and potential treatments, often causing emotional responses such as a sense of loss, reduced self-esteem and depression. This type of experience as faced by people with cancer is commonly known as grief and can be perceived as a threat.
"This feeling of loss can result in the patient entering a state of helplessness in the face of the fear, uncertainty, frustration and sadness that it generates. In the case of oncology patients, we are talking about a range of effects deriving from the different treatments. From hair loss to facial disfiguration, even certain challenges such as amputations or ostomies, which can impact not just the self-image but the functioning of the body”, began María Isabel González, psycho-oncologist at MD Anderson Cancer Center Madrid.
We need to consider this when analysing the intensity and duration of the emotional response and, as such, the psychological impact. "There are losses that are temporary and reversible, such as alopecia after chemotherapy, while others are irreversible, so we have to adapt, not temporarily, but indefinitely to this new situation," continues the psycho-oncologist, who insists that "it is essential to first evaluate the patient's needs" and then "transform the threat into a challenge."
In this regard, González points out that therapy "is always made to measure" because every patient is unique and his or her needs are not static and will change over the course of time. "Patient needs are not the same throughout the process, which passes from initial diagnosis to final treatments and continues into the survival stage. As they go through these stages, their circumstances change. As such, it is essential to tailor support and assistance accordingly”, she says.
According to the psycho-oncologist, preventive work can sometimes simply involve providing information, helping to manage emotions and offering tools to assist adaptation to the new situation. These measures may be sufficient for some patients, while for others the discomfort may be greater, more intense and prolonged over time, affecting different areas of their work, personal and family lives, thereby requiring a more specific therapeutic approach.
Information as the main tool to reduce the fear of uncertainty and adapt to your new situation
This new reality represents a challenge for patients, who will now have to begin the adaptation process. For this reason, she continues, it is essential that the patient knows about the coping mechanisms and resources available to help them manage their emotions. “One of the most vital tools in reducing the fear of uncertainty and enabling a greater sense of control is information. What now? What is going to happen to me? What will I have to face? What can help me? Knowing the answers to these questions will inevitably empower the patient," underlines the specialist.
Establishing realistic goals and expectations is another mechanism that can help patients cope with grief, alongside self-care strategies such as ensuring proper nutrition, exercise and rest.
The close circle of friends and family must learn to accompany the patient without invalidating their emotional reactions
Cancer is a disease that not only affects the patient, but also the entire family or close circle. As such, the psycho-oncologist at MD Anderson Madrid recommends that family members should try to assist in the psychological sphere, to accept and understand the problems that the patient may be going through, as well as to learn to accompany them on their journey and not to discount or invalidate their emotions.
"We need to avoid overprotection, messages of sorrow or pity. Otherwise, we are sending out a negative feeling that says ‘you are unable or incapable’. We must learn to make ourselves available for what they may need and offer help, but without getting ahead of ourselves before the patient asks for it. We have to allow them their own independent space”, he says.
This degree of independence is essential, as it translates to self-confidence and self-esteem. "Many times, going through a physical transformation causes a change in the way we relate to our social and even intimate environment. There may be frequent feelings of shame or vulnerability that can lead to social isolation. When consulting with patients we always place value on the family and social support network, but in the end, it is the patient who will tell their close circle of their needs”, concludes the specialist.