A diagnosis of cancer will sometimes result in families really pulling
together and offering support to one another. But sometimes family
members may pull away because they don't want to upset you with their
own worries. If this happens, everybody worries alone, which only
makes the task of coping more difficult. Sometimes strained
relationships have existed in a family for some time, then suddenly
the family is faced with a crisis that may seem overwhelming.
Sometimes people with cancer don't have family members they can depend
on. In that situation, a cancer counselor can offer the support that
family members may be unable to provide.
In some families, going to a counselor for any reason is looked upon
as a sign of weakness. Some people have misconceptions about
counseling. They may worry that openly discussing problems will make
things worse or that they will be "exposed" or their personalities
will be changed in some way. The idea that something about the way we
think or behave will have to change is a scary thought for many of us.
A counselor doesn't begin with the idea of magically changing
people -- that's not possible. A counselor will help you identify the
problems that are troubling you and will work with you to find ways to
deal with them.
Sometimes people with cancer would like to try counseling but their
families do not, or vice versa. In that case, whoever wants help
should have it, although the ideal situation is to approach problems
as a family. In a hospital setting, counseling is frequently
short-term to help you figure out how to approach certain
cancer-related problems. People new to the experience and their
families might find counseling helpful at the time of diagnosis, when
everything is so confusing. Learning new ways to solve problems during
this time may be all you need to handle the entire cancer experience.
Or you may find counseling useful at a later stage if you need more
treatment or if new family problems occur. Sometimes it's difficult to
"see the forest for the trees," and talking with someone outside of
your family or circle of friends can help relieve your worries and
allow you to make important decisions.
Counseling services for you or your family are often free where you
are receiving treatment. The counselor will want to discuss your
concerns in a general way with other health-care professionals who are
treating you so that they understand you as a whole person, not just a
medical problem. You must give your permission since counseling is
HOW COUNSELING SERVICES CAN HELP
Offer help with communication problems. For example, you may not
know what to tell people about your illness, or how to explain cancer
to your children.
Offer help with managing the normal feelings of anxiety, sadness,
anger, worry, or depression that can be associated with diagnosis and
Offer help for you and family members in dealing with feelings and
changes in family life to accommodate a chronic illness.
Teach you specific techniques, such as behavioral counseling,
which may relieve the physical (nausea) or emotional (anxiety) side
effects of treatment.
HOW DO YOU FIND THESE SERVICES?
If you want to know if counseling services might help, talk to
your doctor, nurse, or social worker. The first or second session with
a counselor will help you decide if counseling will be beneficial for
you or your family members.
Hospitals are often staffed with counselors who provide free
services. They may be social workers, oncology clinical nursing
specialists, psychologists, or psychiatrists who have been trained for
counseling and who know about emotional problems that people with
cancer often experience. If your hospital does not have such people,
community agencies are available, often for fees adjusted to your
Cancer counselors are trained to help people solve problems.
Counselors should have at least a bachelor's degree in a subject like
social work or psychology. Many will have a master's or doctoral
degree as well. A counselor's experience in helping people solve
cancer-related problems is as important as his or her education. Don't
be afraid to ask about this.
If you decide to see a private counselor (outside the hospital
system), you may want to interview more than one before making a
choice. Be sure to select someone with whom you will feel comfortable
discussing your problems.
Your local American Cancer Society may provide you with a list of
qualified cancer counselors.
Not all people with cancer want or need counseling. Many people
choose counseling only during a period of crisis, when life may seem
overwhelming, when decisions need to be made about treatment, or
during changes in family life. But keep in mind that your emotional
response to cancer is as important as your physical reaction to
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