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A patient with cancer has a right to moments of weakness, because the road ahead is not easy, but both he and his relatives should remember that cancer is often a chronic disease today, and in many cases it is 100% curable. Oncology wards, on the other hand, are not a sad death, but a place where patients have a chance to fight for themselves and accumulate strength. We talk with Adrianna Sobol, a psycho-oncologist, about the emotions accompanying patients and their families, and how they are affected by the awareness of a serious illness.
- Why did you choose psycho-oncology? This area seems particularly demanding and burdensome …
Adrianna Sobol:It's true, psycho-oncology is not the easiest thing to do, but oncology has always fascinated me. I believe that this is the field of the future, and as a psychologist I was able to combine my two passions. After all, cancer affects not only our body, but also our emotions.
However, this does not change the fact that cancer is not an easy topic. I do not wish anyone sickness, but I would also like to disenchant it with my work. Many difficult stories appear, and the diagnosis itself shocked the patient and his family. One could even say that a similar trauma occurs in a life-threatening situation. However, this does not change the fact that there is humor in oncology departments, there are spectacular metamorphoses, and friendships are made. Before I entered the hospital ward for the first time, I thought, "Okay, what I got into. Patients will probably be sad, emaciated, unhappy." This is not the case.
- So can it be said that cancer gives the patient something?
Yes. First of all, it takes a lot, but also gives a lot. This is evidenced by the story of Mrs. Małgosia, my patient. The first time she visited my office, I saw a woman who would be very difficult to reach. Every day she did hated work, and after that she devoted herself to household chores. There was an emotional coldness between her, her children and her husband. In all this, she completely forgot aboutherself, she did not have time to think about her needs, but also no one asked her if she needed anything, they did not take care of her. Well, maybe except for her 9-year-old daughter, who persuaded her to see a doctor after noticing that her mother's breast looks strange after leaving the bath.
Initially, it was difficult for me to break through the wall created by Mrs. Małgosia, but over time I noticed changes: first the patient expressed her anger, emotions that she had hidden for years. When I met her, she didn't look good. Some time later, in the corridor in the hospital, a woman smiled at me, at first I didn't know who it was. Only then did I meet Mrs. Małgosia, elegantly dressed, painted, in a beautiful blonde wig. For one of our last meetings, my patient came with her husband, they both did not hide their tears of emotion that they had been given a second chance. Today, Małgosia is he althy and is involved in activities related to the prevention of breast cancer.
Breast cancer is the most common malignant neoplasm in women. However, having this type of cancer does not mean the end of activity. Recently I was at a conference in Milan. One of the lectures was given by a patient with advanced breast cancer with bone metastases. If she hadn't said it, no one would have guessed that she was sick. You can live normally, function with cancer, not think about death, and even, which we cannot forget, heal 100%.
- The mere information about the disease must have a great influence on a person who was he althy until recently. What emotions do a person experience when he finds out that he or she is sick? Someone who has worked, raised children, worried about bills and believed that this mythical cancer is somewhere far away?
A person who hears such a diagnosis faces an abstract situation, enormous fear. There are people who are positive about treatment from the very beginning, but I don't believe that there is someone who is not afraid. The disease attacks us unexpectedly, no one is prepared for it, the patient is thrown into deep water without a lifebuoy and does not know which way to swim, where the shore is. The reactions are very different, a lot depends on our experience with cancer, because each of us has one: someone from the family, a neighbor, a friend was ill. If these stories are positive, we also have a better attitude. Unfortunately, this relationship also works the other way around. After hearing the diagnosis, we are accompanied by a lot of extreme emotions, we feel disbelief, shock, we try to bargain with fate, some people develop depression, but also at the end, after all these stages, the moment of acceptance. Although a better word than"acceptance" would be an adaptation, a habit, taking on the chest of what we are facing, treating treatment as a task to be performed. Sometimes, when I am in the ward, doctors or nurses call me to a specific room because someone is crying. And you have to cry out these emotions, it is also the stage of coping with the disease.
Let us allow ourselves to be weak, it really is an expression of the greatest strength. Reaching for help, calling difficult things a spade, and the ability to accept this help, be it from a doctor or family, or even a psychologist or psychiatrist, are very important in the treatment of cancer.
- Do the sick come to you willingly? Is there still a belief that if someone uses a psychologist's help, "there is something wrong with him"?
I would say that some patients come to see me. These are those who are open minded, know that psychology is nothing wrong, but on the contrary - they can help themselves. On the other hand, I am not a typical psychologist, I do not wait for the patient to approach me, I go out to him myself. I am on the ward every day telling patients that they have me at their disposal. I enter the room, establish a relationship, ask about what's outside, about the weather. And that's how it begins.
- How to tame a disease and is it even possible? How to "fit" it into the daily routine so that it does not dominate it?
It requires great vigilance both from the patient and the psychologist not to get lost in the disease. It often happens that with its appearance, the outside world disappears, there are no relatives, normality, there is focus on the tumor. Therefore, I always try to establish a minimum normality plan with the patient. We should remember that oncological treatment takes a long time, and in many cases cancer becomes a chronic disease. All the more so, it is not worth letting it dominate our everyday life.
I would also like to emphasize that I am opposed to defining cancer treatment as a fight against disease. These are words that scare you, as are the claims that someone who has died has lost the fight against the disease. Meanwhile, there is no loser, no loser-winner relationship, you cannot say that. I recommend that every person suffering from cancer learn about Krzysztof Krauze's anti-cancer decalogue, in which he emphasizes not to approach the disease as a fight, more as a challenge, try to tame the disease, "talk" with her.
This will be useful to youKrzysztof Krauze's anti-cancer decalogue
1.Get tested - although it is hard to believe, you are not immortal
2.Cancer is not a sentence
3.Don't look for the best doctor -look for a good
4.Get a second opinion
5.Don't be content with the diagnosis of a doctor who is not a cancer specialist. Go to the oncologist
6.Don't reject your loved ones
7.Seek support
8.Be ready to change a lot in your life
9.Ask, search, drill
10.Think positive!
Source: Krzysztof Krauze's Dekalog published in "Gazeta Wyborcza"
- One of the greatest fears of sick people is that treatment will be painful. What are the options for treating pain in a Polish patient? Does he require help from a doctor, or is he still convinced that suffering ennobles? What do you think about this approach?
The statistics are unambiguous - in about 90% of cases, patients can be treated without pain, but the Polish patient is still little aware of it. Fortunately, there are patient organizations fighting for the rights of patients, for the availability of innovative therapies and pain treatment. In my handbooks, I also try to emphasize that the patient has the right to a dignified, and therefore painless, treatment. Unfortunately, there is a conviction in our code that pain ennobles, that if I suffer, I will obtain some grace, I will be forgiven. Meanwhile, this is not the case, as Fr. Kaczkowski, who knew it best not only from his experience in working with patients, but also from his own.
- And what is the role of relatives in illness? What does a person with cancer expect of them and how to behave towards them? Should we talk about cancer or leave this difficult topic "hanging in the air"? How to show support?
The role of relatives is gigantic, because the whole family is ill with the patient. Moreover, sometimes families are worse off than the patient himself. He experiences the hardships of treatment, but at the same time he enters a certain system, remains active, something is happening: there is treatment, contact with patients, doctors, nurses, he has his day full.
The family stands aside for this and although they are trying to empathize with these emotions, to help them, they will never know exactly "what it is like". Often a wall is built between the patient and the family, built either by the former or by relatives when the family is hiding. How to support a sick person? There is no ready-made formula, but you must not sweep the disease under the carpet. The most important thing is to have the courage to take up difficult topics, even if they are at the cost of tears and anger. Let us try to cope with it and let a loved one be present. Let him be aware that there is someone nearby who will nibble you, catch youhand. Then no more words are needed.
Also, never forget that a person with cancer is still the same person as before. He has the same sense of humor, the same hobby, he will gladly go to the cinema or theater, he will hear what is going on in our work. So let's talk about it too, let's not be afraid of each other. If we are close to a sick person and we cannot cope with the situation, let them know about it. "I know that you are sick, and now I cannot give you what you expect. Maybe let's seek help together?" Let's not pretend, let's be authentic. I often work with my patients' families, in some cases only with them, because the patient is doing great, and this is worse with them.
Other patients play a significant role in this support during treatment. I often observe ladies making friendships in the wards. These relationships are very strong and they last outside the hospital walls. When one of the patients has a bad day, she calls the other, and she tells her that she has to give up this attitude because she's going to kick her ass. The "down" patient is aware that even if she is weak, someone will help her.
- Sometimes it happens that doctors first inform about bad prognosis and diagnosis not the patient himself, but his family. What to do then, how and whether to pass this information on to the patient?
First of all, the diagnosis is given to the patient, not his family. However, I am aware that sometimes doctors who are burdened and have a lot on their shoulders first inform their relatives or pass the information on to the sick person through the flight of a bird, and throw something on the run. The patient does not understand anything, he begins to worry. And remember that there are words that can kill. The communication of information about the diagnosis is very important. It can even be said that there will be palliative treatment in such a way that the patient does not break down.
- Is it really possible to stay in the palliative unit and not break down?
Of course it is. I have tons of patients who have been treated palliatively over the years. They are the ones who have a lot of distance to the disease, although they are very tired of it. If they are sick for the 6th or 7th year, they become reconciled with this state of affairs. Although their lives are definitely not idyllic, we often tell each other what's up with whom. For example, I know that a grandson was born to one patient two years ago, and now the granddaughter is on the way. Patients in the palliative department also want to be close to life.
Adrianna Sobol- psychologist, psycho-oncologist and psychotraumatologist. The owner of the Ineo Psychological Support Center, a member of the Board of the OnkoCafe Foundation - Together Better. He works as a psycho-oncologist at the hospitalMagodent Oncology Department in Warsaw. An expert of the Braster company, she conducts numerous trainings and lectures.
Worth knowingHow do women and men get sick?
You could say that the way of experiencing the disease depends on the gender. Women are distinguished by a much greater openness to talk about the disease, they also have greater social consent to showing weakness. This works to their advantage - it is not for nothing that it is said that if you throw something out of yourself, it will be easier. Women in the wards are also very supportive, they make long-lasting friendships.
It's different with men, they get sick more like big boys. Tough guys close themselves in their shell, scare themselves, and less often use the help of a psychologist. However, this is changing and more and more men are not afraid to talk about the emotions accompanying their illness, also thanks to the support of their wives and partners.
Ladies and gentlemen: don't hide, be honest about what you need, how to help you.
About the author
Anna SierantEditor in charge of the Psychology and Beauty sections, as well as the main page of Poradnikzdrowie.pl. As a journalist, she cooperated, among others. with "Wysokie Obcasy", the websites: dwutygodnik.com and entertheroom.com, the quarterly "G'RLS Room". She also co-founded the online magazine "PudOWY Róż". He runs a blog jakdzżyna.wordpress.com.
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