What is psychosocial distress?
Facing a serious illness such as cancer can be very stressful for both you and your family. There may be feelings of confusion, a sense of loss or feeling overwhelmed. To help you and your loved ones manage cancer-related distress it may help to understand:
- what distress is
- what kinds of supports are available
- where to get support
People living with cancer and their families can experience a wide range of feelings including:
- fear
- anxiety
- sadness
- anger
- numbness (no feelings)
It is important to remember that these feelings are all normal and that you are not alone in working through them.
What causes distress?
Distress can be more noticeable at different times in the cancer experience. For example, you may have greater distress any time you have a change in treatment, or if you fear your cancer may return as you move from active treatment, such as chemotherapy, to another phase of care. The effects of cancer can be life-changing and can affect your emotions and mood.
It is important to remember that there is no right or wrong way to feel or react. Everyone is different and people’s emotions can change over time.
These changing feelings and emotions are part of the process for many people as they deal with their cancer and it can take time to regain confidence and get used to these changes.
What can I do?
After a cancer diagnosis, it is helpful to take things as they come and focus on adapting to change. Cancer can be life changing. Remember that it will take time to adjust or to find a new “normal” that’s right for you.
During this process of change, there may be times when you need the help of your family and friends or professionals to cope with the difficult emotions you may be having. This is normal. Besides seeking support, there are also things you can do yourself to help you feel better.
If you are feeling afraid, anxious, angry or stressed, here are some things you can try.
Communicate.
- Stress and tension can often be released by talking to someone.
- Some people avoid talking about their fears and worries while others feel more comfortable speaking to family and friends. There is no “normal” amount of communication.
- The simple act of talking may help you to better understand your own feelings. If you live alone or don’t have a social network, talk to your family doctor or hospital staff about being connected to the supportive care department in your cancer centre, such as Psychosocial Oncology. Or you can try a support group offered by Gilda’s Club or Wellspring.
- You may find that instead of talking to someone, it helps to keep a journal or a diary where you can freely express your feelings and emotions.
Keep active.
- Keeping active is a good way to reduce stress and enjoy life more.
- By getting your muscles moving, you can help yourself focus on things other than cancer.
- Exercise can also reduce:
- pain after treatment
- insomnia
- fatigue
This can further help reduce stress in many people. - Exercise does not always mean going for a jog or lifting weights. Walking, taking the stairs or doing light housework are also good ways of exercising and can help manage your worries or anxieties.
- Ask your doctor about the Cancer Rehabilitation and Survivorship Program at Princess Margaret and the exercise programs they offer.
Use meditation and relaxation.
- Yoga, meditation and relaxation are some techniques that may help you lower stress by quieting your mind. Focused breathing, hypnosis, or imagery may also help.
- Princess Margaret Cancer Centre offers private, individually guided relaxation sessions that are available to all patients, free of charge. For more information, call Occupational Therapy at 416 946 4501 extension 5580.
Be creative.
- Take up an old hobby or try a new activity that might give you a way to release your emotions.
- Art, music, or dance can give you the chance to express yourself in a different way.
Get help from a professional
Talk to your doctor about getting help from a professional counselor to help manage your distress.
If you are:
- having trouble concentrating
- being nervous or restless
- feeling or looking tense
- worried about “losing control”
- feeling uneasy and that something bad is going to happen
- having headaches
- being cranky or angry with others
- feeling tired or fatigue
- trouble sleeping or restless sleep
Getting help is not a sign of weakness.
Facing a serious illness such as cancer is very distressing. At Princess Margaret, help is available for patients and family members having difficulty coping with their illness or treatment.
Staff in the Psychosocial Oncology Clinic specialize in providing practical and psychological care for cancer-related distress. This multidisciplinary program is focused on the social and psychological parts of cancer.
The program includes staff in the areas of social work, psychiatry, expressive arts and psychology. Clinicians provide outpatient and inpatient services to patients with cancer and their families to meet their practical, emotional and psychological needs.
Please see the Psychosocial Oncology Clinic at Princess Margaret Cancer Centre brochure for a more information about programs and services or speak with your doctor for a referral.
Remember, it is normal to have some bad days and healthy to accept your emotions as they come.
Some people believe that they got cancer because of something they did or did not do. Blaming yourself can cause extra stress and anxiety, and is not helpful. Do not blame yourself. Remember, cancer can happen to anyone.
If you have fear of cancer coming back, here are some things you can try.
Keep a record of your appointments.
- Go to all your medical follow-up appointments. Follow-up care means seeing a doctor for regular checkups. At these visits, your doctor will look for side effects from treatment and check if your cancer has come back.
- Knowing what to expect after cancer treatment can help you and your family make plans, lifestyle changes, and important decisions.
Be informed.
- Learn about your cancer. Some people want to know about the risk of cancer for their family. Others want to know what symptoms of recurrence to look out for.
- Talk to your doctor and ask any questions you may have about your cancer experience. Having more knowledge may give you with a greater sense of control over your life.
Share your feelings.
- People have found that when they share strong feelings like fear, anger or sadness, they are more able to let go of them. Some people talk to friends or family, other cancer survivors, or a counselor.
Access resources.
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Wellspring offers programs that can help you connect with other people with cancer or friends and families.
How do I prepare for my appointment with my doctor?
If your feelings are too overwhelming or you cannot enjoy your everyday life anymore, you can talk to your doctor.
Before you see your doctor, take time to think about how distress is affecting your life.
Ask yourself these 5 questions and write some notes:
- Keep a diary every day for at least 1 week before your appointment with your doctor. Write down any differences in your mood and how you are sleeping.
- How does this distress affect you emotionally (feeling sad, blue, anxious)?
- How does your distress affect you physically (fatigue, difficulty functioning at work, doing daily activities)?
- How does your distress affect how much you enjoy your life (doing social activities)?
- In the past week, what have been the major triggers of your distress (examples: family, chores, emotions, fears, etc.)
- Have things gotten so bad that you’ve thought about hurting yourself or ending your life? If you have any suicidal intent, speak to your doctor right away or reach out to Crisis Services Canada.
For Crisis Services Canada, call 1 833 456 4566. Suicide Prevention Services are available 24/7/365 and can connect you to responders immediately. Online chat and text options are also available. For more information, see
Crisis Services Canada.
Take these notes with you when you go to see your doctor. Talk to your doctor about your answers. Let your doctor know how you feel. Only your doctor can help with some causes of your distress.
What can I expect after seeing my doctor?
Your doctor will talk to you about different options that may help including a referral to Psychosocial Oncology.
Where can I find more information?
