A Cancer Diagnosis: What to Do Next?

Experts explain how to take control of your life after a cancer diagnosis.

From the WebMD Archives

"Cancer" may be the most frightening word in medicine. Life changes suddenly and profoundly after a cancer diagnosis. Initial shock gives way to a realization of the tremendous physical, emotional, and spiritual challenges that lie ahead.

Beyond the emotional turmoil that accompanies a cancer diagnosis, patients face a practical necessity: to develop a plan to live with and fight cancer.

A cancer diagnosis is likely to feel overwhelming. But resources are available to support you every step of the way. WebMD can help you get started on the journey.

After a Cancer Diagnosis: Time to Take Control

People often enter a "shock phase" after a cancer diagnosis, says Joy Fincannon, RN, MS, clinical nurse specialist in psychiatric nursing with the American Cancer Society. Such an initial reaction is perfectly normal.

“But then, you’ve got to take control of the situation,” says Dave Visel, author of Living With Cancer. Many things will be outside your control, but “strive to control the things you can.”

Here are important steps you can take to manage your life after a cancer diagnosis:

  • Find a partner. “No one should go through a fight against cancer alone,” says Visel. For many people this will be a spouse, family member or close friend. Pick someone you can talk to openly about serious issues.
  • Get organized. Start a notebook or binder to coordinate appointments, doctors’ phone numbers, and the information you collect along the way. Take it with you to each medical appointment, and keep notes on your test results and treatment options. Start a running list of questions to ask your doctor on your next visit.
  • Get informed. Take steps to learn more about your cancer diagnosis and treatment options -- but do so at a pace that is comfortable for you. “For some people, a lot of information is exactly what they need,” says Katherine DuHamel, PhD, health psychologist with Memorial Sloan-Kettering Cancer Center in New York. “Others might not want too much right away.”
  • Be sure to consult only unbiased, trustworthy sources when you do your research. Begin with the web sites for the American Cancer Society and the National Cancer Institute.
  • Consider a second opinion. Cancer treatment is complicated, and different doctors are likely to have different philosophies and approaches. A second opinion can also help you feel more confident in your treatment plan. Some insurance companies require a second opinion. The R. A. Bloch Cancer Foundation provides a list of second-opinion centers free of charge. For the closest center to you, call 800-433-0464.

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After a Cancer Diagnosis: Taking a 'Whole Life' Approach

A cancer diagnosis touches every area of your life, so your plans for managing after your cancer diagnosis should do so as well.

Take an active role in medical and treatment decisions. Given the complexity of cancer treatment, you may feel you should take a back seat to your doctors. But according to Michael Fisch, MD, gastrointestinal oncologist at M.D. Anderson Cancer Center in Houston, patients and families should “realize early in the process that they are crucial members of their own health care team.”

Treatment for cancer is highly complex and individualized. Your cancer treatment plan will depend on many factors, including the type of cancer you have, it’s location and stage of development, your current state of health, and your goals for treatment and quality of life. Seeking a cure regardless of the discomfort of treatment, or pursuing comfort above all else, are both reasonable treatment goals.

To make informed decisions, you will need to understand your cancer treatment options, which could include:

  • Surgery (a major or minor operation to remove cancer)
  • Chemotherapy (using anticancer medication that acts throughout the body)
  • Radiation therapy (using high-energy beams or implants to kill cancer cells)
  • Immunotherapy (using products of the immune system as medicine against the cancer)

You can find more detailed information on therapy on trusted web sites, and by talking with your doctors.

You may want to consider participating in a clinical trial. Clinical trials compare a cancer treatment known to be effective against one that shows promise to be equal or better. Clinical trials are ongoing for almost every form of cancer. The decision to enter a clinical trial is complicated but well worth considering. If you are interested in a clinical trial, talk the matter over with your doctor. The following nonprofit groups can provide more information on clinical trials: The Coalition of Cancer Cooperative Groups (CCCG); the National Cancer Institute Physician Data Query (PDQ); and the American Cancer Society Clinical Trial Matching Service.

Also, be skeptical of statistics. Statistics can help, or they can “mess with your head,” says Fincannon. Even if the odds are favorable, “people are often haunted by the numbers,” she adds. Consider your own preferences and ask your oncologist to communicate appropriately. “Some patients may like to know lots of ... statistical detail,” says Fisch. If not, “ask your doctor to use the words ‘most’ or ‘some’” in place of percentage numbers, suggests Fincannon.

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Communicating With Friends and Family Members

Support from family and friends after a cancer diagnosis can be literally lifesaving. At the same time, experts warn, dealing with all the well-wishers can wear you out. The key: getting the support you need while reserving time and energy for treatment and recovery. A few guidelines can help:

  • Don’t hide your cancer diagnosis. “Protecting” children or others from the bad news usually makes the situation worse.
  • When people ask if they can help, give them specific tasks. Driving you to an appointment, or helping with child care are examples.
  • Start a web site or designate a contact person to share information among family and friends.
  • Expect awkward conversations -- even inadvertently hurtful comments or behavior -- from well-meaning friends.

Financial Self-Care

A cancer diagnosis requires a financial action plan as well as a medical one. Budgeting for health care costs and ensuring your family’s security require advance planning. Regardless of income, everyone should consider the potential financial impact of a cancer diagnosis.

In our health care system, insurance makes a big difference in cancer care. If you have insurance, read your plan carefully and talk to your provider about your cancer diagnosis.

If you don’t have insurance, try to enroll in an insurance plan. While not always easy, joining a large company is the best way to get insurance quickly.

If you cannot acquire any insurance, your state may be able to enter you into a “risk pool” for the uninsured, which provides health care payments.

Dealing with financial issues can significantly add to the stress of a cancer diagnosis. This can be a good area to delegate to someone else, like a trusted family member or friend, or a certified financial planner sensitive to cancer issues. Type “financial” into the American Cancer Society’s web site search engine (www.cancer.org) for additional helpful information.

Taking Care of You

Taking care of yourself after a cancer diagnosis may be the most important task of all -- and the most overlooked.

Work obligations and other roles -- such as parent, spouse, or caregiver -- will compete for your time and energy. Rule No. 1: your treatment comes first, says Visel. DuHamel reminds people of the airplane advisory: “Put your own oxygen mask on before helping others.”

After a cancer diagnosis, you owe it to yourself to be your own No. 1 caregiver. Your personal care plan should include the following:

  • Try to keep life “as normal as possible,” says Fincannon. “You’re more than a cancer patient -- you’re who you were before” your cancer diagnosis, she says.
  • Exercise as much as you can. Short walks, even simple stretching, will help.
  • Staying positive is important. However, expressing your feelings -- even ones that seem negative -- is even more important.
  • Learn to rely on others. As Fincannon puts it, “you have cancer -- milk it!” Share responsibilities for child care or elder care with others.
  • Consider speaking with a mental health professional, particularly if you are depressed or anxious. Therapy can help relieve the stress of a cancer diagnosis, and give you a safe place to express your fears and hopes for the future.
WebMD Feature Reviewed by Paul O'Neill, MD on February 13, 2007

Sources

SOURCES: American Cancer Society web site: "Should I Get a Second Opinion," "Clinical Trials: What You Need to Know," How Can I Tell My Family?" " Advanced Illness: Financial Guidance for Cancer Survivors and Their Families," Anxiety and Fear." Visel, D. Living With Cancer, Rutgers University Press, 2006. Joy Fincannon, RN, MS, clinical nurse specialist in psychiatric nursing, American Cancer Society. Dave Visel, author, Living With Cancer. Katherine DuHamel, PhD, health psychologist, Memorial Sloan-Kettering Cancer Center, New York City. Michael Fisch, MD, gastrointestinal oncologist, M.D. Anderson Cancer Center, Houston.

© 2007 WebMD, Inc. All rights reserved.

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