1. Emotional Effects September 2012
of a Cancer
Diagnosis
Dee McKiernan (Cert, B.A., MSc )
Counselling Psychologist
St. Vincent’s Hospital

2. Scaling
Pick a number
between 0-10 that best
describes how much
distress you have been
experiencing in the past
week including today.
Adapted from the NCCN distress thermometer.

3. Overview
 Responses to a Cancer Diagnosis
 Stress and Cancer Related Stress
 Stress levels and illness trajectory
 What causes Stress ?
 What are the effects of Stress ?
 Coping, learning ways to manage stress

4. Responses to a Cancer Diagnosis
 With the diagnosis of a chronic, potentially life-threatening
disease, such as cancer, individuals usually find themselves
in a condition of ‘crisis’, facing physical, social and
psychological challenges
 A Cancer diagnosis is one of the most emotionally
distressing events for patients throughout medical care
(Carlson, Speca, Patel, & Goodey 2004)
 Distress is very common in patients, yet often undetected.

5. Stress - Pos v’s Neg...
 Not all stress is negative... It can have benefits
 Much of the stress we experience can be both helpful
and stimulating
 It can motivate us into productive actions – nothing like
a deadline to motivate!
 NB - stress is only harmful when it is excessive!!

6. WHAT IS STRESS
Taylor (2006) argues that stress is
“ a negative emotional experience accompanied by predictable
biochemical, physiological, cognitive and behavioural
changes that are directed either toward altering the
stressful event or accommodating its effects”

7. Cancer Related Stress - NCCN
The National Comprehensive Cancer network (2012)
defined distress as:
“a multi-factorial unpleasant emotional experience of a
psychological, social and/or spiritual nature that may
interfere with the ability to cope effectively with cancer,
its physical symptoms and its treatment”

8. Typical
Emotional
Responses
Anyone remember feeling like this....

10. Distress levels & Illness Trajectory
0
1
2
3
4
5
6
7
8
9
10
Diagnosis Treatment
Completion of treatment
End of Hospitalisation
Recovery
Fear of Recurrence
Survivorship
Further treatment
Illness
Column1
Column2
These challenges occur at different stages of the illness from diagnosis through
treatment, remission, recurrence or survivorship
(Carlson, Speca, Patel, & Goodey 2004)

12. BUT
It is important to note….
that high levels of distress
represent a
normal healthy adjustment reaction
to a cancer diagnosis...

13. Effects of stress
 Physical:
muscle tension, sweaty palms, chest palpitations, restlessness and
nausea, head-aches, neck or back pain, upset stomach, dry mouth
 Emotional:
excessive worry, concern, crying, weeping, feeling hopeless, panic attacks,
irritability, jitters, short temper
 Psychological:
distress, anxiety, depression, Generalised Anxiety Disorder

14. Effects of stress
 Behavioural:
Difficulty falling or staying asleep, Loss of appetite or overeating “comfort
foods”, increased smoking, alcohol consumption, nail biting, absenteeism at
work
 Cognitively:
difficulty concentrating, poor decision making, muddled thinking, memory
lapses, undue tiredness, ‘chemo brain’
 Prolonged Stress:
chronic backache, allergies, migraine headaches, high blood pressure, IBS,
depression

15. How do you cope
with stress....

16. I help myself by...*
When I am stressed I help myself by…..
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17. Identify resources
....helps alleviate stress
 What are my physical strengths?
 high energy levels, sporty, and agility
 What are my emotional strengths?
 High self-esteem and confidence, humour and creativity
 What support systems do I have?
 friends, family, ICS, helpline, peer support
 How is my present lifestyle helping me cope?
 Housekeeper, shopping on line, babysitter,

18. SUPPORT SYSTEMS
 Family – educate them, offer suggestions
 Friends – be honest about how your feeling, ask for their
support
 GP / Health Care Professionals / Therapists/ Community Groups
 Cancer support groups – meet other
patients,
 Online, Blogs, peer support groups

19. CBT

20. THOUGHTS
 Challenge your thoughts - Remember thoughts are not
facts!
 Exaggerating – magnifying your bad points
 Castastrophising – anticipating total disaster
 Overgeneralising – expecting everything to go wrong because of one
or two bad experiences
 Ignoring the positive – overlooking personal strengths
 Affirmations – I love and approve of myself, I can handle this,
I am safe, my health is improving day by day
 Interrupting those negative automatic thoughts and
replacing them with positive self accepting thoughts will
help alleviate stress

21. FEELINGS....
 Remember its ok to feel whatever you are feeling
 Talk it out.... Its good to talk....
 Refocus on what is happening around you, come
back to your breath
 Journaling - Write it down - 20 mins set an alarm
 Distract with a good movie, book, gallery, cooking,
time with friends/children...

22. BEHAVIOUR
 Meet friends, don't isolate
 Hobbies and Interests – give you time to unwind
 Call helpline – speak to other cancer survivors
 Diet – watch caffeine, sugar, alcohol intake
 Exercise – generate endorphins (hormones which reduce stress)
 bring the dog for a walk
 Gardening,
 cycle, walk, swim – know your limits
 Tai Chi, Massage (touch therapies), Reflexology, Yoga
 Learn to Scale – 1 – 10 – if low what do I need to do
 Gratitude list

23. RELAXATION
 Take time out for you.... Learn to put yourself first
 Reward and Pamper yourself
 Bubble baths, shopping, hairdresser, facial, get your nails
done, spa weekend
 Sacred Centre – plant, candle, poem, book
 Light a candle and just watch the flame
 Breathing 1 – 4 *
 Sleep patterns – naps, camomile tea, relaxation cd’s

24. Techniques to Relax...
Breathing - 1-4*
Diaphragmatic breathing*
PMR*

25.  Scale ???
 3 sentiments to finish with...
Take your pick...
To finish...

29. Dee McKiernan
Counselling Psychologist (Cert., B.A., MSc.)
Oscailt Integrative Health Centre
8 Pembroke Road
Dublin 4
http://www.oscailt.com
Ph: 01 660 3872 / 087 622 5011
Email: info@counsellingindublin.ie
Web: www.counsellingindublin.ie