Chemotherapy can bring major changes to a person's life. It can affect overall health, threaten a sense of well-being, disrupt day-to-day schedules, and put a strain on personal relationships. No wonder, then, that many people feel tearful, anxious, angry, or depressed at some point during their chemotherapy.

These emotions are perfectly normal and understandable, but they also can be disturbing. Fortunately, there are ways to cope with these emotional "side effects," just as there are ways to cope with the physical side effects of chemotherapy.

How Can I Get the Support I Need?

There are many sources of support you can draw on. Here are some of the most important:

• Doctors and nurses. If you have questions or worries about your cancer treatment, talk with members of your health care team.
  
  
• Counseling professionals. There are many kinds of counselors who can help you express, understand, and cope with the emotions cancer treatment can cause. Depending on your preferences and needs, you might want to talk with a psychiatrist, psychologist, social worker, sex therapist, or member of the clergy.
  
  
• Friends and family members. Talking with friends or family members can help you feel a lot better. Often, they can comfort and reassure you in ways that no one else can. You may find, though, that you'll need to help them help you. At a time when you might expect that others will rush to your aid, you may have to make the first move.
  
  Many people do not understand cancer, and may withdraw from you because they're afraid of your illness. Others may worry that they will upset you by saying "the wrong thing."
  
  You can help relieve these fears by being open in talking with others about your illness, your treatment, your needs, and your feelings. By talking openly, you can correct mistaken ideas about cancer. You can also let people know that there's no single "right" thing to say, so long as their caring comes through loud and clear. Once people know they can talk with you honestly, they may be more willing and able to open up and lend their support.
  
  The National Cancer Institute's booklet Taking Time offers useful advice to help cancer patients and their families and friends communicate with one another.
  
  
• Support groups. Support groups are made up of people who are going through the same kinds of experiences as you. Many people with cancer find they can share thoughts and feelings with group members that they don't feel comfortable sharing with anyone else. Support groups also can serve as an important source of practical information about living with cancer.
  
  Support can also be found in one-to-one programs that put you in touch with another person very similar to you in terms of age, sex, type of cancer, and so forth. In some programs, this person comes to visit you. In others, a "hotline" puts you in touch with someone you can talk with on the telephone.
  
  Sources for information about support programs include your hospital's social work department, the local office of your American Cancer Society, and the National Cancer Institute's Cancer Information Service. )

How Can I Make My Daily Life Easier?

Here are some tips to help yourself while you are getting chemotherapy:

• Try to keep your treatment goals in mind. This will help you keep a positive attitude on days when the going gets rough.
  
  
• Remember that eating well is very important. Your body needs food to rebuild tissues and regain strength.
  
  
• Learn as much as you want to know about your disease and its treatment. This can lessen your fear of the unknown and increase your feeling of control.
  
  
• Keep a journal or diary while you're in treatment. A record of your activities and thoughts can help you understand the feelings you have as you go through treatment, and highlight questions you need to ask your doctor or nurse. You also can use your journal to record the steps you take to cope with side effects and how well those steps work. That way, you'll know which methods worked best for you in case you have the same side effects again.
  
  
• Set realistic goals and don't be too hard on yourself. You may not have as much energy as usual, so try to get as much rest as you can, let the "small stuff" slide, and only do the things that are most important to you.
  
  
• Try new hobbies and learn new skills. Exercise if you can. Using your body can make you feel better about yourself, help you get rid of tension or anger, and build your appetite. Ask your doctor or nurse about a safe and practical exercise program.

How Can I Relieve Stress?

You can use a number of methods to cope with the stresses of cancer and its treatment. The techniques described here can help you relax. Try some of these methods to find the one (or ones) that work best for you. You may want to check with your doctor before using these techniques, especially if you have lung problems.

• Muscle tension and release. Lie down in a quiet room. Take a slow, deep breath. As you breathe in, tense a particular muscle or group of muscles. For example, you can squeeze your eyes shut, frown, clench your teeth, make a fist, or stiffen your arms or legs. Hold your breath and keep your muscles tense for a second or two. Then breathe out, release the tension, and let your body relax completely. Repeat the process with another muscle or muscle group.
  
  You also can try a variation of this method, called "progressive relaxation." Start with the toes of one foot and, working upward, progressively tense and relax all the muscles of one leg. Next, do the same with the other leg. Then tense and relax the rest of the muscle groups in your body, including those in your scalp. Remember to hold your breath while tensing your muscles and to breathe out when releasing the tension.
  
  
• Rhythmic breathing. Get into a comfortable position and relax all your muscles. If you keep your eyes open, focus on a distant object. If you close your eyes, imagine a peaceful scene or simply clear your mind and focus on your breathing.

Breathe in and out slowly and comfortably through your nose. If you like, you can keep the rhythm steady by saying to yourself, "In, one two; Out, one two." Feel yourself relax and go limp each time you breathe out.

You can do this technique for just a few seconds or for up to 10 minutes. End your rhythmic breathing by counting slowly and silently to three.

• Biofeedback. With training in biofeedback, you can control body functions such as heart rate, blood pressure, and muscle tension. A machine will sense when your body shows signs of tension and will let you know in some way such as making a sound or flashing a light. The machine will also give you feedback when you relax your body. Eventually, you will be able to control your relaxation responses without having to depend on feedback from the machine. Your doctor or nurse can refer you to some one trained in teaching biofeedback.
  
  
• Imagery. Imagery is a way of daydreaming that uses all your senses. It usually is done with your eyes closed. To begin, breathe slowly and feel yourself relax. Imagine a ball of healing energy -- perhaps a white light -- forming somewhere in your body. When you can "see" the ball of energy, imagine that as you breathe in you can blow the ball to any part of the body where you feel pain, tension, or discomfort such as nausea. When you breathe out, picture the air moving the ball away from your body, taking with it any painful or uncomfortable feelings. (Be sure to breathe naturally; don't blow.) Continue to picture the ball moving toward you and away from you each time you breathe in and out. You may see the ball getting bigger and bigger as it takes away more and more tension and discomfort.

To end the imagery, count slowly to three, breathe in deeply, open your eyes, and say to yourself, "I feel alert and relaxed."

If you choose to use imagery as a relaxation technique, please be sure to read the caution in the following section.

• Visualization. Visualization is a method that is similar to imagery. With visualization, you create an inner picture that represents your fight against cancer. Some people getting chemotherapy use images of rockets blasting away their cancer cells or of knights in armor battling their cancer cells. Others create an image of their white blood cells or their drugs attacking the cancer cells.

Visualization and imagery may help relieve stress and increase your sense of self-control. But it is very important to remember that they cannot take the place of the medical care your doctor prescribes to treat your cancer.

• Hypnosis. Hypnosis puts you in a trance-like state that can help reduce discomfort and anxiety. You can be hypnotized by a qualified person, or you can learn how to hypnotize yourself. If you are interested in learning more, ask your doctor or nurse to refer you to someone trained in the technique.
  
  
• Distraction. You use distraction any time an activity takes your mind off your worries or discomforts. Try watching TV, listening to the radio, reading, going to the movies, or working with your hands by doing needlework or puzzles, building models, or painting. You may be surprised how comfortably the time passes.

  
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