The Many Ways of Coping With Cancer
This year, more than 1 million Americans will learn they have cancer. Regardless of the type of cancer, most are likely to use several different methods of coping with the illness, according to a new UCLA study.
These methods include:
* Seeking social support, such as talking to someone about feelings.
* Using “distancing” measures, such as making light of the disease.
* Focusing on the positive, such as rediscovering what is important in life.
* Wishful thinking, such as hoping for a miracle.
* Trying behavioral escapes, such as overeating.
These were the coping patterns used by 603 cancer patients, ranging from ages 21 to 88, interviewed by Christine Dunkel-Schetter, a UCLA associate professor of psychology, and her research team. (Three-quarters of the sample was female; breast cancer was the most common cancer, followed by cancer of the reproductive system, gastrointestinal tract and other sites.)
Most of the cancer patients used “distancing” to cope, which involves such measures as treating the illness as a challenge or not letting the diagnosis get the better of them. Patients tend to use different patterns for different situations, Dunkel-Schetter found.
“When trying to decide whether to continue chemotherapy, for instance, a patient might seek support and talk to her doctor,” she says. But when in pain, patients might try a distancing technique, such as distracting themselves.
There seem to be age-related differences as well. “Younger patients are more likely to seek support and to focus on the positive,” she says.
The more religious a person, the greater the tendency to focus on the positive, the UCLA study also found. Catholics tended to be best at looking at the bright side, followed by Protestants. Less likely to focus on the positive were Jews and those with no religious preference.
The UCLA study, part of a growing body of research, “provides further evidence that social support is useful for cancer patients, and there is value for most cancer patients in seeking out support,” says Dunkel-Schetter, whose study was published recently in the journal Health Psychology. In agreement is psychologist Mitch Golant of the Wellness Community, a Santa Monica-based network providing psychological and other help for cancer patients. Seeking support, he says, helps patients deal with feelings of “unwanted aloneness” and loss of control that can follow a diagnosis.
If patients seek psychological help, timing might be important to the outcome, according to a study published recently in the journal Cancer.
Of the 205 patients studied, those who received psychological help four months after they learned the diagnosis seemed to benefit more than those who received help immediately after. Researchers speculate that patients might be consumed with working through life-and-death issues immediately following the diagnosis and might not be ready.
“Family and friends are available and valued right after the diagnosis,” says David Nowlis, University of California at San Francisco School of Medicine researcher, co-author of the study. “Some of those relationships are not as enduring four or five months later”--so the four-month mark might be a good starting point.
From her clinical work, Dunkel-Schetter has gleaned another finding of interest to the loved ones of cancer patients: “Cancer patients say they would like to be asked what they want,” she says. “Family members, wanting to be helpful, try to guess what patients need. But patients’ needs may change over time. There are times cancer patients want to be left alone; other times, they want something done for them.”
Calling for Facts and Help
* American Cancer Society: (800) ACS-2345. Callers will be referred to a local office.
* Cancer Information Service: (800) 4-CANCER. Cancer information specialists can answer questions and send free brochures on topics, including specific cancers, recurrences and nutrition guidelines.
* Vital Options: (818) 508-5657. Information, resource and support organization for people with cancer (ages 17-45), their family and friends.
* Wellness Community: (310) 453-2200. Network of programs designed for people with cancer and their families. Headquartered in Santa Monica, there are 10 locations in California and in three other states. Promotes patient involvement in healing; offers informal drop-in discussion groups, participant groups facilitated by therapists, groups for family members, training in relaxation and visualization, social events and other activities.
