More aboutCancer and its Psychological Effects on the Family

tCulture plays a role in the way we live our lives.  It influences our ways of viewing, interpreting, and re-acting to our lives’ events and then relating and communicating with others.  One of life events is the realization that our health is at risk. In the case of this article, it is being diagnosed with cancer.   
Reviewing my last article, I mentioned that:
Being diagnosed with cancer is a frightening event and comes as a shock. With improved treatment strategies, prevention techniques, and early detection tests, a diagnosis of cancer is not as grim as it once was. In fact, cancer has become more of a chronic illness than a fatal disease.
With this change comes a focus on the quality of life concerns.  The patients, the families, and the community can play a key role in improving the quality of life for individuals and families.
Cancer patients and their family members may experience some of the following effects: depression, anxiety, anger or irritability, frustration with circumstances, fear of recurrence, anticipatory grief, and role changes within the family. (Payam-e-Ashena, September 2010)
Scientific studies confirm that each one of us has an important role to play in our well-being.  Our take on being diagnosed with cancer and our psychological approach to the treatment is shaped and affected by our individual characteristics and by our cultural environment.  
 Patients and close family members may experience a combination of the following emotions and thoughts.  Some are shared experiences among many different cultures, and some may be more in Persian culture.   
Feeling guilty:  “I got this because I am weak”; “I am unable to take care of my family”; “Now I am a burden to my family”, etc.
Fear of rejection: “I am afraid of how people will react to me being diagnosed with cancer and how I will, should,could respond to  them.”  
Feeling of mistrust of people: “I am not sure how people can be helpful.”   
Projecting their fear onto other people.   “It is fearful, so other people are afraid of hearing and/or talking about it.”
Lack of skills how to communicate their needs /emotions to people around them: “I am not sure what I may need and how to verbalize my needs.” The list can go on.  

When I was presenting the psychological effect of cancer last month, I became more aware of the issue of secrecy.  I heard that the view and attitude of keeping the news of cancer to a few close family members; sometimes even hiding it from their own young children,  is a more common practice among the Persian community.  First, I was shocked.  I could not see any good reason.  After thinking and asking people about it, I realized that people have several reasons, though dysfunctional ones, for not be open about their cancer.

What is the reason that some families, more than others, prefer to keep it to themselves? As an Iranian, you may have a list of explanations of what it might be.  I would like to hear from you. What do you think the reasons are for hiding it?  We need to shed a light on this and start a collective effort to make our lives more productive even in the face of cancer.  Please write me your views.  Your contribution is valuable.   
This decision of being secretive about the diagnosis of cancer has self -imposed limitations on the patient and the family members’ ability to ask for help.  So the patient and the caretaker will find themselves left with limited physically and emotional support.  

Setting limits and boundaries:
The demand of treatment, particularly in the first phase (diagnostic, frequent doctors appointments, medical treatment, hospital visits etc.) is so high that it calls for a thoughtful, organized, and dedicated approach.  Asking for help is critical.  At this point a family therapist plays a huge role through the initial crisis and following stages of stabilization, resolution, and integration. The family does need to reach out for help in any way possible from people who are whole heartedly ready to help.   At the same time the patient and care takers need to be able to set limits with people around.   That means that they do not have time to answer all well wishes phone calls.  

When my sister was diagnosed with cancer, they told every one in the family, relatives, and their circle of friends.  The help poured in with: giving rides to children for their multiple activities so there were no interruptions in their routines; babysitting; shopping, and cooking so my brother-in-law could just focus on my sister and her needs.  Obviously, everybody was very concerned and wanted to know how she was doing and if they could help.  In the first few months even a full-time secretary could not answer all the phone calls.  So, my brother-in-law being the only adult family member (all relatives were far away) set an outgoing phone message that briefly informed the callers of the latest developments.  He was also occasionally sending one short e-mail to thank people for their well wishes and informing them of her condition.   

We need to recognize and respect the precious time families have at the time of crisis and through the treatment of cancer.  With today’s advances in treatment, patients will experience the stages of stabilization, resolution, and integration.  They will learn to live a productive life with cancer. There is a life after cancer, even a better one because of it.

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