Author Archives: Ellyn Kerr, M.Sc., science/technology communications consultant

Dealing with Breast Cancer Stresses: Supporting the Supporters

 

Mammogram photoWith one in eight women developing invasive breast cancer in her lifetime, most of us know at least one person who has been diagnosed. Each October, Breast Cancer Awareness month in North America highlights the excruciating experience of this disease and its courses of treatment.

In a previous RealWorldHealthCare.org article, I described the emotionally and physically burdensome aspects of cancer, for the patient. But what can easily be overlooked are the enormous challenges for caregivers, who may be at increased risk of depression, anxiety, and sleep and cardiac disorders, as well as higher blood pressure and reduced immune function.

Unless the caregiver is either a survivor or mental health professional, supporting another through bona fide trauma may exceed one’s emotional capacities. The patient’s psychological responses, let alone physical challenges, might often feel like “too much.” Caregivers’ ongoing recommitment to their own health—including sufficient sleep, regular exercise, healthy diet, and stress-management approaches—may attenuate the enormous strain of caring for someone with breast (or other) cancer. The family caring for me during my treatment were not always so diligent when in taking care of themselves, and even through my own required focus on my own healing, I was keenly aware of the resultant wear on them.

The justifiable focus on the patient may steer caregivers to ignore seeking psycho-emotional support of their own; but doing so puts them at risk for clinical levels of distress. Counseling or peer groups can play a key role in alleviating emotional burdens unique to those in supportive roles. (Local chapters of Gilda’s Club, and its now umbrella Cancer Support Community, offer caregiver options globally.)

I didn’t join a support group until years after my initial diagnosis. Retrospectively, I would have done so from the very start of my own “cancer journey”, in part to gain support for myself, but also to lighten the challenges on my support team. Caregivers would do well to encourage patients/survivors to join dedicated support communities also, to expand the patient’s helping network.

Since patient supporters genuinely want their efforts to be effective, it may be useful to be aware of needs identified by breast cancer patients. From an informal, small survey of survivors, I identified some common themes caregivers may not always think of:

  • Financial assistance. Out-of-pocket costs alone may exceed $700 monthly for cancer patients—even for those with insurance. A fundraising campaign through Facebook or other social media site can help alleviate an enormous burden that significantly compounds breast cancer-related stress.
  • Physical company and gently supportive dialogue. Cancer organizations offer guidance about how to communicate with a survivor/patient, including things not to say.
  • Assistance with appointments and tasks, including filing and organizing of medical records and insurance forms. Lotsa Helping Hands or Google calendars can help volunteers coordinate assistive tasks across the patient’s care giving network.

Several cancer organizations outline additional tips about how to truly be there for a breast cancer patient. While it may seem obvious, the often-overlooked well-being of caregivers is also of paramount importance— both to sustain themselves during prolonged periods of giving aid, as well as promote the healing of all affected by the challenges of breast, or any other, cancer.

Are you in need of assistance with cancer treatment costs? Several copay foundations make funds available to offset copay expenses for cancer patients.

Have you ever been a direct caregiver for a cancer patient? Were you aware that not only cancer patients, but also their caregivers are at increased risk for clinically relevant levels of distress? Tell your story or share your thoughts in the comments section below.

 

Coping with Cancer: Managing Anxiety with Body-based Methods

The frightening gravity of cancer is difficult to convey. Every treatment option has undesirable, potentially distressing side effects. Medical costs can easily surpass financial resources, compounding stress and limiting patients’ treatment options. Realistic anxiety about death becomes a prevalent companion.

The emotional-freedom technique (EFT)

The emotional-freedom technique (EFT)

We know stress weakens the immune system, interferes with digestion, disrupts healthy cortisol (and therefore insulin) metabolism, and restricts blood flow. For cancer patients, whose bodies must fully harness every physiological mechanism available to heal and to prevent metastases, the severity of cancer stressors can open the door to adjunct psychological “disorders”, including post-traumatic stress, complex trauma, anxiety, and depression—weakening patients’ spirits when they most need emotional and physical strength.

Complementary care providers have long understood stress and trauma to be somatic (“body-based”). According to Dr. Bessel Van der Kolk, trauma “has nothing whatsoever to do with cognition [but rather] your body being reset to interpret the world as a dangerous place.”

To rehabilitate from trauma/high-stress states, interventions that target the body would thus seem to make sense. However, published studies conflict as to the effectiveness of somatic methods. One review of “energy psychology”, for instance, is highly critical of emotional-freedom technique (EFT), which has a person finger-tap on various acupressure points while verbalizing a progression of “de-stressing” statements. The review (not an experimental study) noted the lack of evidence for the existence of acupressure meridians, which renders them “unfalsifiable” and therefore makes EFT impossible to validate scientifically.

Despite a graduate education in biology and my love of the scientific method, as a survivor myself, I now understand that there are highly subjective emotional states in the cancer experience that need support. I’d argue that any relief is welcomed by cancer patients, whether evidence-based or not, regardless of potential placebo effect.

In the case of EFT, one study has shown it to be more effective than talk therapy in reducing cortisol, stress, depression, and anxiety (though the study was of nonclinical subjects).

In healing through cancer, I faced distress I wouldn’t wish on a worst foe. I needed a reliable, discreet way to immediately and tangibly reduce anxiety. (Cancer fears do not respect work schedules or whether one is in public.)

I’ll never know whether EFT measurably lowered my cortisol levels. But the method (also called “tapping”) seemed to palpably relieve anxiety each time I used it. I credit EFT with having had a cumulative effect in my healing the psychological component of cancer, however subjective and anecdotal that statement may be. (I also turned to other somatic modalities, including core energetics, acupuncture, and reflexology, which I believe also helped.)

The industry-wide costs of treating cancer in the U.S. may reach $174 billion by 2020. I heartily welcome evidence-based studies to corroborate which interventions effectively heal the body, mind, and emotional state after cancer. All treatments demonstrated to be effectual, whether allopathic or complementary, might then be made more readily available (i.e., covered by insurance), while those that are less effective could be optional to patients. This could help an inflated health care system as well as patients’ individual recoveries.

I appreciate that esteemed medical practitioners, like Dr. Sheldon Feldman, Chief of Breast Surgery at Columbia University Medical Center, have initiated clinical assessment of complementary therapies like reiki for breast cancer care. I am pleased that published studies confirm that integrative care approaches (including somatic methods like yoga therapy) improve patient experience and reduce in-patient costs for hospitals.

But anecdotal observations also carry weight for me. The headmaster of an orphanage for teen genocide survivors in Rwanda claims that EFT was responsible for a 90% reduction in trauma outbreaks since 2008. Given my experience, such observations are important and should encourage further consideration of complementary and somatic therapies as integral components of allopathic medical regimens. Cancer is simultaneously a biological and psychological experience, and the most effective approaches to healing must ultimately address both aspects.

Cancer survivors know the value of shared information about healing. If you are a survivor (or caregiver), have you explored body-based techniques in managing stress, depression, or trauma? Were they effective? Please share your experience below.

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