Cancer has a way of turning life upside down, no matter how prepared you think you are. Tammy was excitedly planning the final details for a girls’ trip for her 50th birthday, but within only a few days, she found herself meeting with an oncologist instead. “I had always kept up with my health, my mammogram, but suddenly everything changed” – her main focus veered towards understanding, treating, and surviving breast cancer.
The sudden impact of a cancer diagnosis like Tammy experienced is often noted by individuals who face an abrupt shift in their lives following a cancer diagnosis. According to recent research, nearly half of cancer patients experience significant levels of psychological distress with symptoms particularly including overwhelm, anxiety and/or depression (1,2). It makes sense too, because how do you prepare for something you never saw coming?
Project “Yes”
In this uncertainty, Tammy needed a plan – she quickly defaulted to treating her cancer as a ‘project’ she needed to manage daily, one that became her full-time job. Part of her approach was to gain a complete understanding of the project scope and options, which meant seeking and saying “yes” to every available avenue of learning and support.
Within the first month, Tammy’s doctor told her about Inspire Health (Kelowna) and their health resources in nutrition, exercise programs, clinical counselling, etc. While Tammy says her decision to say “yes” initially gave her a sense of control over her treatment, it also later resulted in her first experience with counselling.
Control and Clarity with Understanding
Research shows that cognitive-behavioural therapy and psycho-oncology counselling can reduce patient anxiety and depression, encourage a more positive outlook, and support emotional resilience (3,4). Additionally, patients participating in clinical counselling sessions were more likely to adhere to their treatment regimens and understand complex medical instructions (5,6). In Tammy’s case, saying “yes” to the full spectrum of support options, including counselling, supported her resilience and reinforced her commitment to developing and understanding her treatment plan, a critical component of improved outcomes (7,8).
While Tammy’s experience with counselling was initially focused on developing her treatment plan ‘project’, she found that over time, the skills she learned also improved communication and care within her healthcare team. “Before I started counselling, I hesitated on the number of questions to ask my doctors or to suggest alternative treatment options,” she explains. As she worked with her counsellors, Tammy more clearly identified and expressed her concerns; as a result, her doctors began to better understand and meet her needs.
Aligned with Tammy’s experience, improvement in patient-doctor communication is a well-documented benefit of patient counselling. A 2019 study found that patients participating in psychological counselling were more likely to engage in open, effective dialogue with their healthcare providers, leading to treatment plans that were better tailored to their needs (9,10). Tammy’s ability to communicate confidently with her medical team meant she had the information she needed to make more informed decisions about her care: “Counselling gave me the tools to ask the right questions and make sure I understood every step.” This further boosted Tammy’s trust in and commitment to her evolving ‘project’ plan.
The Power of Reframing Everything
While clinical counselling helped Tammy understand, shape and stick to her treatment plan, she says the most transformative result was how counselling helped her reframe her perspective on cancer: “At first, everything felt so scary. But counselling helped me change that. I learned to focus on what I could control—nutrition, exercise, my attitude.”
Tammy’s experience is supported in recent research – 2020 study emphasized that psycho-oncology counselling improves patients’ health-related quality of life, particularly by addressing the emotional and social dimensions of their experience (11,12). Research also confirms that early interventions like counselling can reduce the long-term emotional impact of cancer, offering patients a way to reclaim their sense of control and improve their well-being throughout treatment and survivorship (13,14).
Counselling offers patients the opportunity and tools to reorient the cancer experience within their lives. For Tammy, this shift in mindset towards her cancer was crucial: “Counselling didn’t just help me get through treatment – it helped me see my future in a different way, slowing down, and appreciating every moment.”
Tammy’s Takeaways
When asked about what she wished she knew at the start of her ‘project’, Tammy says that as she learned more, she developed the understanding and confidence to take responsibility for her outcome. She became used to asking many questions, and seeking second or even third opinions. Being able to know and consider all her options helped her find clarity when making difficult decisions: “There are no dumb questions – ask as many times as you need; that’s courageous – be proud of it, you’re taking care of your health, and you are not bothering anyone.”
About her experience with clinical counselling, Tammy says, “I realized how important counselling is when going through health issues. It supported my need to reframe everything and focus on the positives.” As a breast cancer survivor and this ‘project’ closed, Tammy carries this understanding into her next projects and her relationships – this experience, although difficult, changed her: “We tend to be the hardest on ourselves out of anyone – when you can be kinder and gentler on yourself, you’ll be kinder and gentler to everyone else.”
References
- Carlson LE, Waller A, Groff SL, et al. Online screening for distress, the 6th vital sign, in newly diagnosed oncology outpatients: randomized controlled trial of computerized vs personalized triage. Br J Cancer. 2020;122(5):668–74.
- Linden W, Vodermaier A, Mackenzie R, Greig D. Anxiety and depression after cancer diagnosis: prevalence rates by cancer type, gender, and age. J Affect Disord. 2020;240:30–7.
- Andersen BL, DeRubeis RJ, Berman BS, et al. Screening, assessment, and care of anxiety and depressive symptoms in adults with cancer: an American Society of Clinical Oncology guideline adaptation. J Clin Oncol. 2021;39(23):2378–91.
- Sharpe M, Walker J, Holm Hansen C, et al. Integrated collaborative care for comorbid major depression in patients with cancer (SMaRT Oncology-2): a multicentre randomized controlled effectiveness trial. Lancet. 2021;393(10188):2407–16.
- Greer JA, Jacobs JM, El-Jawahri A, et al. Role of patient education and communication in cancer pain management: patient-reported outcomes from a comprehensive cancer pain program. J Pain Symptom Manage. 2020;59(2):301–11.
- Ruddy KJ, Mayer E, Partridge AH. Patient adherence and persistence with oral anticancer treatment. CA Cancer J Clin. 2020;69(1):40–56.
- Kissane DW, Grabsch B, Clarke DM, et al. Supportive-expressive group therapy for women with metastatic breast cancer: survival and psychosocial outcome from a randomized clinical trial. Psychooncology. 2019;16(4):277–86.
- Hack TF, Degner LF, Parker PA. The communication goals and needs of cancer patients: a review. Psychooncology. 2020;24(2):129–39.
- Tattersall MH, Dear RF, Jansen J. Integrated cancer care: supporting patients in decision making. Cancer. 2021;127(2):198–204.
- Street RL Jr, Makoul G, Arora NK, Epstein RM. How does communication heal? Pathways linking clinician-patient communication to health outcomes. Patient Educ Couns. 2020;74(3):295–301.
- Spiegel D, Giese-Davis J. Depression and cancer: mechanisms and disease progression. Biol Psychiatry. 2020;54(3):269–82.
- Watson M, Dunn J, Holland JC. Psychosocial care for people with cancer: a systematic review. Lancet Oncol. 2020;15(11):1135–45.
- Fisch MJ, Lee JW, Weiss M, et al. Prospective examination of pain, symptoms, and quality of life among patients receiving chemotherapy for advanced cancer. Qual Life Res. 2021;22(1):232–43.
- Adler NE, Page AE. Cancer Care for the Whole Patient: Meeting Psychosocial Health Needs. Washington, D.C.: National Academies Press; 2020.