Tips for Cancer Patients Undergoing Chemo

Belleruth got this question from an oncologist after a guided imagery presentation to the Integrative Medicine Fellows at the University of Arizona in Tucson. It was about general psychological advice for cancer patients undergoing treatment.

Hi, Belleruth,

I just attended your talk - I was very moved and impressed. I am a medical oncologist. Do you have advice for my patients actively undergoing chemotherapy ?

Thank you very much for your insight and input.


Thanks, Walter.

Aside from the usual holistic treatment advice that they can get many places about various integrative interventions to add to standard treatment – encouraging them to try yoga, massage therapy, Reiki, simple relaxation, guided imagery and meditation, I also used to recommend that they look into supplements to help reduce treatment side effects and support immune functioning (not my wheelhouse, so for this I leaned heavily on the late, great cancer guide, Henry Dreher, as well as the Block Center for Integrative Medicine in Skokie IL, the Center for Mind Body Medicine in Washington DC, and naturally, The Arizona Center for Integrative Medicine.

But I did offer some tips on how to handle the myriad emotional and social challenges that come up for people diagnosed with cancer.

For instance, one thing I always liked to tell people before starting chemo, or very early on, was that they may start feeling depressed and hopeless about their situation, certain that the whole chemo exercise was pointless and their chances for survival zero, but that this bummed-out thinking could very well be the side effects of chemo and not the reality of the situation – simply a piece of cognitive distortion that's a by-product of chemo-induced depression and fatigue.

I'd usually wag a finger to grab their attention and tell them to remember my telling them this now, when their brains were free of chemo fog. It was useful to offer this early on, because if I waited 'til they were depressed, they'd be less likely to believe me. But if I jogged their memory with "Hey, remember when I told you about chemo-induced depressive thinking?" it usually had validity.

I also used to recommend they be clear with friends and family on what they need from them and what they don't need from them. (And if they can't speak for themselves, to have a trusted spokesperson do it for them – a friend, spouse or sibling.)

I'd also say: If visits and calls and cards feel good, let people know that. If those things feel like an assault on privacy and energy, tell them that. For those who insist on being "kind" in their way, don't over-explain the why's of your wishes – that will just invite more energy-sapping insistence, and you risk getting talked into something you don't want. Instead, try the phrase "It's out of the Question", and then stop talking. Few people press on after being told that.

Another tip I'd offer: it's good to ask for help from family and friends, but important to be smart about whom to ask for what, so you won't be disappointed. Some friends are great listeners. Others are better at making dinner or running errands. Give people the jobs they can do well, and everyone will be happy for it.

I'd also recommend asking capable and age-appropriate kids for help. Don't lean so heavily that you undo their lives, but don't overprotect them either - let them help in ways they can. It's good for them to have something they can do for you, and it can enrich and deepen your relationship with them as well.

And finally, in the "unwanted advice" category – a very important topic! - chemo patients should be prepared in advance with a firm, fast response to people with insufficient boundaries offering any of the following:

  • unwanted, overwhelming or just plain dumb advice
  • their own cancer horror story or anecdotal "teaching story"
  • a reproach or guilt-trip for your not accepting their "help"
  • inappropriate assumptions about how close you are and what you should share
  • creepy degrees of smarmy handwringing or condescending "sympathy"
  • anything that makes you uncomfortable (with or without justification!)

Some replies that work for most of these situations are "That is not helpful"; "I don't need to hear that right now" or "We need to change the subject". Even if you're not in the mood to be assertive, fake it. You'll be needing protection from well-meaning but clueless people.

The corollary, of course, is to treasure the people with the sense and sensitivity to treat you exactly right – enjoy them, appreciate them and thank them.

If appropriate for you and for them, ask friends and family for prayers. If you or they aren't into prayers, then ask to "keep me in your thoughts". It gives them an assignment they can do, and can be felt in the aggregate – all those sweet wishes coming your way from all over.

So that pretty much covers my drill on this. Hope some of this is useful to you.

All best,