How counselling can help

Counselling can help you sort out many different types of problems that you may face when you have cancer. For example, it can help with

• Coping with your reactions to cancer
• Family and relationship issues
• Exploring personal issues
• Dealing with practical issues

People have many reactions to cancer. You may feel fear, have strong reactions to changes to your body, or be anxious about treatment. Some people feel very angry, or find it difficult to cope with a feeling of loss of control. You may feel very stressed about having to cope with side effects of treatment, such as fatigue, pain or sickness.

Cancer can also affect your family relationships. It may affect how to talk to your children, intimacy with your partner or lead to role changes within the family, if you are no longer able to fulfill the role you used to - even temporarily.

Cancer can stir up many deeply personal issues such as consideration of your spirituality, sexuality and relationships. It may also affect your usual work and pleasure activities or your goals and ambitions.

Cancer may also cause financial strain. There may be conversations you need to have about financial support, mortgages and pensions or making a will. All these can cause family tensions or extra stress for you. There may be practical problems that others think are less important - but look anything but that from where you are sitting - such as transport problems or difficulty talking to your doctors.

It can help to talk through any of these feelings through with someone outside your friends and family. It helps to talk to someone outside your daily life because your friends and family may be too close to the issues to see them clearly and objectively. A counsellor may help you to find different ways of coping that hadn't occurred to you before.

There is no evidence to suggest that having counselling will help treat or cure your cancer. Nor is there any convincing evidence that it will help prolong your life. But there is a lot of evidence that counselling can help you cope better with the many difficulties you face, during and after your cancer diagnosis and treatment. It can help reduce the stress you face and improve your quality of life.

We know from research that counselling can help some people overcome the depression and anxiety that cancer can cause. There’s also evidence that certain methods of counselling can help people deal with phobias about having cancer treatments - such as having injections or being confined to a small space during an MRI scan.

Although some doctors and nurses may provide their patients with emotional and psychological support, many don’t feel comfortable doing this, or they may feel they are not properly trained. Or they just don’t have the time. Their main focus is on treating and curing your cancer. Of course, if you have cancer, this is very important. But many people are also worried about how they can cope with their illness and how it will disrupt their everyday life. Because of this, some cancer units now have a counsellor or psychotherapist as part of their team.

A study published in the September 2004 issue of the Journal of Clinical Oncology found that regular counselling sessions helped women with stage 2 or 3 breast cancer feel more relaxed. There were 227 women on the trial. This was a randomised trial.  The women were put into 2 groups: either to have a simple psychological assessment, with no counselling sessions, or to have small group counselling sessions once a week for 4 months.

By carrying out regular blood tests, the researchers also found that the women in the counselling group had a boost in the activity of their immune system. The numbers of particular white blood cells called T cells increased. T cells are part of the immune system. Your immune system helps to protect your body against infection. It can play an important role in people with cancer because

• Cancer can weaken the immune system
• Cancer treatment can weaken the immune system
• The immune system may help to fight cancer

Although the results of this study are very interesting, the researchers admit that we need much larger studies to find out for sure whether counselling does increase immune system activity in people with cancer.