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Coping after cancer – what does this mean and how can coping help you? Whether you’ve just been diagnosed with colorectal cancer or are managing side effects after treatment, you have been impacted greatly and life has likely changed. Coping strategies can help you regain a sense of control, and learn that there is always hope for an improved quality of life. This webinar will touch on how to successfully integrate coping so you and your support team can face the road going forward.
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Welcome to Fight Colorectal Cancer’s Webinar Session:
Coping After a Cancer Diagnosis – What does this mean and how?
Make Sure You Know the Latest News About CRC Research and Treatment visit fightcrc.org
Our webinar will begin shortly.
Today’s Webinar:1. Today’s Speaker: Dr. Kristin Kilbourn, Ph.D., M.P.H.
2. Archived Webinars: FightColorectalCancer.org/Webinars
3. AFTER THE WEBINAR: expect an email with links to the material. Also a survey on how we did, receive a Blue Star pin when completed
4. Ask a question in the panel on the RIGHT SIDE of your screen
5. Follow along via Twitter – use the hashtag #CRCWebinar
Introducing our much acclaimed: Patient Resource
Guide
Available online at: http://
fightcolorectalcancer.org/GuideInTheFight/
Fight CRC Funding Science
Established in 2006, our Lisa Fund has raised hundreds of thousands of dollars to directly support the innovative research in treating late-stage colorectal cancer.
100% of the funds donated go directly to Late-stage colorectal cancer research.
Learn more or donate:FightColorectalCancer.org/LisaFund
DisclaimerThe information and services provided by Fight Colorectal Cancer are for general informational purposes only. The information and services are not intended to be substitutes for professional medical advice, diagnoses, or treatment.
If you are ill, or suspect that you are ill, see a doctor immediately. In an emergency, call 911 or go to the nearest emergency room.
Fight Colorectal Cancer never recommends or endorses any specific physicians, products or treatments for any condition.
Speaker
Dr. Kristin Kilbourn, Ph.D., M.P.H.
Kristin is an assistant professor in the Department of Psychology at the University of Colorado Denver. She is a member of the University of Colorado Cancer Center and also holds an adjunct faculty position in the Division of Internal Medicine.
The Psychosocial Aspects of Cancer Survivorship
Kristin Kilbourn, Ph.D. MPHClinical Health Psychologist
Associate ProfessorDepartment of Psychology
University of Colorado Denver
OverviewThe psychosocial aspects of living as a colon
cancer survivor
Recognizing the signs and symptoms of distressDepressionAnxiety
Ways to improve or maintain good emotional well-being
Illness as a Major Life Stressor
Illness can lead to:Uncertainty about the futureMultiple losses
Independence & controlFunctional lossFinancial loss
Changes in one’s role within the family
Adjustment Across the Course of Illness
Diagnosis• Life Disruption• Decisions• Facing Mortality• Loss
Treatment• QoL• Social isolation• Stigma• Side-effects
Re-entry• Uncertainty• Hypervigilance• Distress• Adjustment• Economic stress
Screening• Fear• Anticipatory
anxiety
The Study of Cancer Survivors
“Not that you live, but how you live.” 13.7 million cancer survivors Increase over next 20 years
Increasing number of childhood cancer survivors Aging population and progress in cancer treatments
Unique Issues Following Treatment
Post-treatment represents a new phase of adjustment Loss of safety net of active medical treatment and
support Resume former roles in and outside the home Lingering physical and psychosocial symptoms
Stages of early survivorship Long term follow-up and on-going monitoring Uncertainty and fear of recurrence Redefining one’s sense of self
Often expectations of how an individual believes they will feel after treatment does not match how they feel
What about the family? Everyone is impacted by illness
RelationshipsFamily-rolesFinancial issuesFuture plans and dreams
Illness places high levels of stress on the “family” unit
How do you know if you are experiencing
significant levels of distress?
Symptoms of Depression Mood symptoms:
Sadness Anger/Irritability Hopelessness
Somatic Symptoms: Problems with sleep Change in appetite Low energy/fatigue
Cognitive symptoms: Problems with concentration and memory
Decreased interest in previously enjoyed activities Feelings of Worthlessness Feeling that life is not worth living/Suicidal thoughts
Symptoms of Anxiety
Excessive worry and anxiety Restlessness or feeling on edgeEasily fatiguedConcentration and memory problemsIrritabilityMuscle tensionSleep disturbancePanic attacks
(racing heart, difficulty breathing, sweaty, chest pain discomfort, feeling detached from self, trembling/shaking, feeling of choking, dizzy, nausea, fear of losing control, going crazy or dying)
How do you know when to seek help and support?
The symptoms are interfering with your daily life
Your quality of life has decreased because of these symptoms
Your family and friends have noticed that something has changed
You are not experiencing joy in your life
You have thoughts that life is not worth living and you would be better off dead
Psychosocial Interventions
Psychotherapy Interventions Cognitive-Behavioral Therapy Existential Therapy Supportive Therapy
Mind-Body Interventions Relaxation interventions Yoga, meditation etc. Spiritual interventions
Support Groups Peer led vs. professional led
Psychotropic Medications Antidepressants Medication for anxiety
Strategies for maintaining good emotional and
physical health
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Stress management techniques
Effective communication
Adaptive coping strategies
Use of your social support system
Practicing healthy behaviors
Identify your basic needs and developing and utilizing a self-care plan
Stress ManagementThe chronic stress can lead to a number of
problems in various domains:Emotional, Cognitive, Behavioral, Physical, Social
Cognitive-behavioral techniques -identify distorted thoughts and change them to more accurate thoughts
Relaxation exercises and pleasurable activities can help to decrease/manage stressDeep Breathing, Progressive Muscle Relaxation,
Imagery, Yoga /Tai ChiWalking, Yoga/Tai Chi and other forms of ExercisePrayer/MeditationDifferent Hobbies / Artistic Endeavors
Communication
Communication problems are very common in families dealing with serious medical issues
It can include communication with your loved-one, other family, friends, co-workers, the medical team etc.
Strategies and skills: Set aside time to talk Make an outline or list of what you want to ask/say Use assertive communication (“I” statements) Utilize good listening skills and reflect what you’ve
heard Don’t jump to conclusions or make assumptions- just
ask
Adaptive CopingThere are multiple ways to cope with
stressful situations
Importance of matching the stressor type with the appropriate coping strategy
Coping Skills Training
Matching the Situation and Stressor
Situation
Controllable
Uncontrollable
Coping Response
Problem-Focused•Problem solving•Decision making•Seeking information•Goal setting
Emotion-Focused•Venting/talking to others•Reframing the situation•Journaling•Exercise/relaxation•Meditation/spiritual practices•Pleasurable activities
Stressor Is:
Coping Strategy:
Controllable
Problem-Focused
Uncontrollable
Emotion-Focused
Active(adaptive)
Information SeekingGoal SettingDecision MakingConflict ResolutionRequesting helpFocused activities
Reappraisal of situationReframing thoughtsExercise, MassageMeditation, relaxationMindfulness exercisesExpressing emotions: journaling, poetry, art, talking with othersAccept Negative Emotions: (softening)
Passive(maladaptive)
Behavioral AvoidanceCognitive Avoidance: denial not thinking about it
Smoke, Eat, Drink AlcoholNot Caring For Yourself: don’t take medication miss appointment non-adherenceStuffing Feelings
Coping SkillsThose who handle stress have:
Have a variety of coping techniques available to them (“more tools in the toolbox”)
Can match the stressor to the coping response
Awareness of your common coping style(s) is importantDo you tend to be more analytical or more
emotional in times of stress?
Social Support Do you know how to ask for support? Do you know who to ask for support? Match your support needs to the person(s) who can
meet your needs: Emotional Support Informational support Tangible Support
Consider ways to increase your social support network Support groups Professional therapy or counseling Try new hobbies or activities where you will meet others with similar interests (classes, clubs
etc.) Quality is more important than quantity
Health BehaviorsPoor health behaviors
increase the risk for recurrence or the development/exacerbation of other health problems
impact psychosocial well-being
Weight/Body Mass Index
Cancer treatment can lead to weight gain/changes in body composition
Even modest wt. loss can lead to significant health benefits
Physical activity –
1/3 of survivors have not participating in physical activity over the past 30 days.
Step-counters and fit bits can be useful to increase activity
Sleep – most Americans do not get enough sleep
Alcohol
General Recommendations- 2 drinks per day for men, 1 drink per day for women
No level of alcohol considered safe for some survivors
Smoking (15% survivors smoke)- includes tobacco and marijuana
Practicing Good Self-CareWhat does this mean?
Putting your self-care first
Maintaining good health behaviors (diet, exercise, sleep)
Sticking to your medical regimen
Engaging in pleasurable activities
Finding balance in your life
Thriving• Ask questions
• What can I do to maintain and/or improve my health and well-being
• Where can I find the support that I need• Develop a plan that addresses physical,
emotional, social and spiritual needs• Seek out help when needed• Now is the time to make positive changes in
your life• Adopt healthy behaviors• Practice adaptive coping skills• Reprioritize what is really important in your life
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“The bend in the road is not the end of the road unless you refuse to take the turn”
-anonymous
Thank You
Question & Answer Time . . .
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