Advanced cancer can be very scary and may very well be the hardest thing you and you family have ever faced. If you and your family have ongoing concerns that interfere with your lives, or if you just want to communicate and cope the best you can, you should talk with a licensed mental health professional. It can be very comforting to talk with an expert about your unique situation. Social workers, psychologists, and psychiatrists are all licensed mental health professionals who can be found through your oncologist or through the nearest large hospital in your area. Even one session with a licensed mental health professional can help you and your family to focus on what matters most in your lives at this time. Your cancer care team will work with you to find the right professional for you.
 

Dealing with worry and the unknown
 

Learning that you have advanced cancer may make you feel lost and afraid. This is normal. You may have questions such as:

• What is going to happen to me?
• Have I done everything I should have done?
• What are the other options?
• Am I going to die?
• How much control will I have over my life? over my death?
• Will my wishes be followed?
• How much pain and suffering will I have?
• What if I feel that I can't take much more treatment?
• How can I burden my family in this way?
• Will this be too much for my family to bear?
• What am I going to do about money?
• How long am I going to have to go through this?
• What happens when I die?

The list of fears may be overwhelming even to think about, much less go through. Worrying may make it hard for you to focus. You may even have tight muscles, trembling, and shakiness. Restlessness, shortness of breath, heart racing, sweating, dry mouth, and grouchiness are other signs of worry. But few people have all of these symptoms. And there are professionals who can help you manage these concerns. Along with your doctor and nurse, there are social workers, psychologists, psychiatrists, and pastoral counselors who are specially trained to help you talk about your concerns, control your fears, and make meaning of what you are going through. They can also support your family. Your doctor will know the local mental heath experts in your area.
 

Managing worry

• Sometimes just talking about feelings helps to relieve worry.
• Trying to relax with deep breathing and other techniques can be helpful. It works best if you practice and do it regularly.
• It’s important to let yourself feel sad and frustrated, without feeling guilty about it.
• Picking the right person to talk with can be important. For some, that person will be a minister or a good friend. For others, it will be a family member.
• Spiritual support is helpful for many people.
• If your worry is upsetting to you or your family and lasts for long periods of time, it is important that you request a referral to a mental health professional who is specially trained to work with cancer patients.

Along with these measures, a doctor may be able to suggest medicines to treat anxiety and depression. Short-term use of these drugs is rarely a problem. It can be just what you need to regroup and go forward.
 

Finding hope
 

Hope is a necessary part of everyday life. Hope gets many of us out of bed in the morning and keeps us going throughout the day.
 

Even if you have advanced cancer, you can still have hopes and dreams, even though some of these may have changed since you learned about the cancer. Now your hope may be to have a pain-free day. Another hope could be to do something special with a family member. Just sharing and talking openly can be a hope for people with cancer and their families. There may also be real hope for relief of symptoms and slowing down the growth of the cancer. And hope to make the most of whatever time you have left.
 

Managing pain and discomfort
 

Advanced illness can cause pain and other discomforts, like breathing problems or swelling. It can be hard to deal with these symptoms. Physical pain causes distress to the mind, too. Work with your health care team to manage your physical symptoms. Severe physical symptoms like pain can make it impossible to have any quality of life. But good medical treatment and some easy-to-learn coping skills can help you manage your physical symptoms best.
 

Use your pain medicines: Be sure you understand how and when to use the pain drugs your doctor gives you. You can get a lot more information on pain control and the different drugs that may be used in our booklet, Pain Control: A Guide for Those With Cancer and Their Loved Ones.
 

Get information: Knowing why you have a problem and what you can do about it can relieve stress. Don’t be afraid to ask why something is happening.
 

Take action: Doing something, sometimes anything, about a problem can help you feel more in control. For example, if the new drug you are taking for your stomach isn’t helping, ask to try something else.
 

Distract yourself: Getting your mind off the pain is always a good idea. When you are focused on your pain it usually hurts more. If you are watching an interesting movie while in pain and waiting for the pain medicine to work, you may even forget about it for a while. Visits from friends and family can serve the same purpose.
 

Take it one step at a time: It’s easy to get overwhelmed if you focus on all the discomforts at once. Tackling one problem at a time makes it seem more possible that all the problems can be helped.
 

Talk with others: Sometimes, it’s a relief just to talk about how discouraged and frustrated you feel about your symptoms. Many people are good listeners and can listen without passing judgment or giving advice.
 

Express yourself in other ways: For some, talking is not easy. Writing in a journal, painting, or meditating may be other ways for you to express your feelings.
 

Find your sense of humor: Humor is a tried and true coping skill for rough times. Even when life seems bleak, there is usually something that can lighten the mood and relieve stress.
 

Practice meditation: By focusing your mind on pleasant scenes you can direct your attention away from unpleasant feeling and thoughts. These mini-vacations may allow you to get a needed rest, both physically and emotionally.