An Employee’s Guide to Navigating a Cancer Diagnosis
What to expect after you learn you have cancer
~Lisa Lefebvre, a two-time cancer “endure-er” and the Founder/CEO of Mend Together
Life will feel uncertain for a while. That’s okay. Cancer will affect your short-term plans and create apprehension about the future. Hang in there. There are things you can do to create a sense of stability, which I’ll cover below.
- Your needs will change over time. Expecting a roller coaster ride can make the ride feel more predictable.
- Be realistic, but focus on the positive. Do your best to avoid worst-case thinking. (I say this, but many of us do this anyway as a coping mechanism. By imagining the worst, whatever ends up happening usually isn’t as bad as our worst fears.) Oncologists know that hope is essential, and they will help you with this.
What to prioritize after a cancer diagnosis
- Get a second opinion. You want access to the most recent research on your diagnosis and treatment plan. Your oncologist will expect and welcome you to seek a second opinion. Reach out to top hospitals like MD Anderson, Memorial Sloan Kettering, or Dana Farber; they can meet with you virtually.
- Choose your Oncologist carefully. They will be following you for several years, so take time to find someone who feels like a fit. Don’t feel obligated to go with a physician you find insensitive. I sought advice from a prestigious hospital but decided to get the same treatment at another hospital where I felt more comfortable.
- Meet with HR. HR benefits teams work hard to put programs in place to support employees going through hardships; the same with your health insurance provider. Let both know about your diagnosis so they can help. Mend Together can advise you on free resources offered by cancer organizations, so you don’t have to do the research yourself.
How to tell people, “I have cancer”
While you may feel the urge to keep your health situation under wraps, doing so can cause stress that can inhibit healing. Given the overwhelming evidence that strong social support will significantly impact your health outcomes, consider being open to sharing your situation with others. There is no such thing as too many friends during this time. And people really do want to help.
Deciding who to tell …
There is no right or wrong approach. I shared my news with others because I felt that if roles were reversed, I would want to know that my friend needed support. I also knew I would need help at home and support at work. Sharing your news with colleagues can make navigating deadlines or schedule changes easier. Did you know acquaintances often feel the most helpless and eager to help?
It can also help to talk to strangers going through similar situations. Your hospital may have support groups that you can attend. Support Communities where you can ask questions, get tips, and seek support from others who “get it.” I didn’t talk to my friends and family about how much a nuclear injection can hurt, but I did commiserate with strangers about it.
Who not to tell …
Not everyone has the skills to be supportive. During this time, you may want to avoid people in your life who tend to be insensitive, have strong opinions on what you should do, or have difficulty accepting boundaries. I call these people “low dose” individuals— people you don’t want to spend too much time with, especially during a hardship.
And what to do when you don’t have a choice
Your work may require you to interact with clients or customers, and they may comment on your appearance. You may find it helpful to confide in them about your situation — or not. If not, try these phrases to redirect the conversation:
- I am dealing with a health issue, but I am okay. How can I help you?
- I appreciate your concern, but I am so busy today I don’t have time to get into specifics. I hope you understand.
- Cancer affects so many of us. I am sorry you have this experience, also. (Pivot to the task at hand.) Our next step on this project is to …
Deciding when to tell
You may want to share your diagnosis right away, so people can help you process your situation. Or, you may want to wait until you have a treatment plan defined, so you have a better sense of what is coming around the corner. Any approach works.
Deciding how to tell
Calls and texts may work for people you are close with, but after a while, saying “I have cancer” over and over can get tiring.
If you feel uncomfortable being the first to broach the topic, ask your manager or a coworker to take the lead. This can give colleagues time to orient. To help minimize the emotional burden on you, you may want to get your teammates together to share information and answer their questions instead of dealing with each person 1:1.
Lining up emotional support
Support is not one-dimensional and can come in many forms. Don’t forget how important it is to have social support during this time.
Accept that it’s hard to ask for help, and this is NORMAL
It’s hard to ask for help. Our discomfort with accepting help is part of our biological programming. It’s easy to offer help and do things for others, but asking for help can feel like a weakness.
Remember that we gain strength from those who love and care about us, and it’s okay to ask for help right now because your friends, family, and colleagues truly care.
Accepting help is giving help
One way to feel less needy is to know that helping your friends figure out what to say, do, and give is a way of giving back to them. They are going to struggle with what to do.
Consider a Helper
You don’t have to be the one to coordinate help from others. You can ask a friend or family member to take on this role for you.
Different sources of emotional support
Having others to talk to helps you process new information and make decisions. Here are some tips for building emotional stability:
- Contact your hospital or health care plan to find a mental health practitioner. Don’t discount talking to a social worker even though they may have fewer credentials. I have found they are often as (or more) emotionally skilled than psychiatrists or psychologists. If you can’t find a therapy resource through your hospital or plan, contact Cancer Care. Cancer Care provides free therapy sessions and can help match you with a therapist.
- Be open to antidepressants. I declined antidepressants the first time I had cancer because I thought it was natural to be sad, and I knew I was emotionally “tough .” But my sadness turned into long-term depression, and it was rough. When I was diagnosed a second time, I started antidepressants right away. I wanted to minimize the emotional pain I was feeling on top of the physical pain. Antidepressants can be hard to prescribe, so be patient and expect to experiment with a few before finding one that works best for you.
- Streamline communications with friends and family. Keeping everyone updated can be a full-time job. Fielding individual calls, texts, and emails can be exhausting, and not all of us feel comfortable posting our medical updates on social media. I found it uplifting to get words of support during my recoveries.
How to answer, “How can I help?”
It’s hard to know how to answer, “How can I help?” We don’t always know what kind of help is needed, or we are too shy to be specific. But we need help.
Over 50% of the U.S. population lives alone, and many of us live away from our friends and family. Giving loved ones options on where they could contribute — in person or virtually — lets people choose where to pitch in, whether it’s providing encouraging words, dropping off meals, sending a gift, or making a donation.
Getting help without the awkward ask
A Volunteer Calendar can serve as one central spot to organize all help: meals, childcare, prayer calls, paperwork, or visits. It eliminates the awkwardness of directly asking for help while making it easy for friends and family to see where assistance is needed, and they can pick what matches their abilities, time, and skills.
When people don’t step up
Expect to be surprised about who helps out and who doesn’t. One common experience is that friends you thought you could count on disappear, but acquaintances step up out of the blue. Try not to judge. Realize that some people have more emotional skills than others when coping with your diagnosis. You may find that you drop some old friends during your journey and make new ones along the way. It’s something most cancer patients experience.
How to cope during treatments
You will need more than extra rest to speed healing after surgery or during radiation and chemo. Here’s what I found to be helpful:
- Get a minimum of 8 hours of sleep. The only thing more important to your health than staying connected with others is rest.
- Try to walk 5 minutes a day for every hour you are awake. Movement helps move toxins out of your system, brings oxygenated blood and nutrients into your cells to speed repair, and minimizes strength loss.
- Try to include berries, beans, and dark greens in your diet — like smoothies, bean soups, and salads. It’s hard, but try. Your body needs these micronutrients to heal. Remember to ask people to choose healthy foods if they offer to bring a meal.
- Use the programs at your hospital. Try to attend yoga, movement therapy, or art therapy. Hospitals offer them because they are proven to improve outcomes. It’s good to try these out.
- Seek out specialists beyond your clinical team. Oncology massage, nutritional counseling, and physical therapists specializing in myofascial release and craniosacral therapy can help facilitate healing.
- Work with a functional medicine physician. Functional medicine focuses on identifying the root causes of disease and understanding how well our systems work. My functional physician tracks 800+ biomarkers through blood, urine, and saliva tests — while my primary care tracks 40. Visit the Institute for Functional Medicine to learn more.
What to expect after treatments end
There are many reactions people have to the end of treatments:
- You may feel immense relief after treatments end, and you are no longer constantly at doctor’s appointments.
- Some of us feel abandoned as doctor appointments wind down and friends and family go back to their busy lives.
- Others feel anxious that they are no longer actively “protected” by chemo or radiation. That’s normal, too.
- For yet others, an outcome can be post-traumatic growth. Cancer made me more compassionate. It’s the reason I started Mend Together.
- Whatever your emotional reaction, don’t feel bad if it takes time to physically recover from treatments and surgeries. Physicians notoriously underestimate recovery time. Your body will be going through a lot. It’s going to need time to repair, and that’s okay.
- Treat yourself as much as you can within your budget. Take an “end of treatment” celebration trip. Go to a sporting event that you have always wanted to attend. Simple things like an Epsom salt bath or a warm beverage can be a form of self-care.
What if treatment will not end?
Getting a Stage IV diagnosis may mean that you are in treatment for the rest of your life. This is a tough situation to face. You will need support from others – and you deserve that support.
Everyone copes in different ways after tough news, and all reactions are okay. My Uncle went into denial. My Aunt immediately put her affairs in order. My friend David put cancer out of his mind and focused on enjoying each day. I don’t know many people who can do this, but I hope it inspires.
Gather the people you love around you and leave nothing positive unsaid. Know that whoever you are, you have made a difference in the world, and your life has mattered. If you are facing end-of-life decisions, Livestrong has some helpful resources and guidance.
We all hold each other up
I hope the above has been helpful. Going forward, consider three things:
- Don’t rush important decisions. It can feel like you need to act immediately when diagnosed with cancer, but it’s better to take the time to research, think, and decide what is best for you. Read up on your diagnosis and treatment options, speak with specialists, and get good advice from people you trust. Answers will become clear in time.
- Use programs designed to assist you. You don’t have to reinvent the wheel. Your HR team, health provider, and hospital have researched what will help the most on your cancer journey. Take advantage of our recommendations and suggestions.
- Be open to accepting help. You don’t have to deal with this alone. Having support has been proven to support better health outcomes and fewer hospitalizations. Share your story with as many people as you are comfortable with, and help them help you by accepting support.
The best way to get through difficult times is together. Your manager and colleagues have your back. Your friends and family are there to support you.