A doctor advises on how to open up to others about a cancer diagnosis

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Initiating a conversation around cancer can be a difficult task

Statistically, people diagnosed with cancer are more likely to suffer mental health problems when compared to other sectors of the population. With that in mind, how do you actually talk about cancer and the toll it takes on mental health? JOE spoke to an expert in the field, Dr. Mary Burgess. Dr. Burgess is lead consultant clinical psychologist with the Advanced Cancers Coalition (ACC). JOE: Why do so many people find it difficult to talk about cancer? Dr. Burgess: "Cancer is very common and yet we fear it. As humans, we are hardwired to avoid or fight the things we fear. So it's no surprise it is difficult to talk about cancer. "A common defence against our fear is to consider cancer as a disease that affects 'others not me'. This fear is what can make it difficult to talk about, either as the patient or another person." Why do so many men struggle to talk about the big C? "Men generally find it more difficult to talk about and express their emotions. This can be due to stereotypes that still persist and are reflected in many common phrases society uses e.g. 'men don't cry', 'man up', 'don't be soft'. "Cancer patients are more at risk of suicide, and this is particularly so within the first six months of diagnosis. Of those patients that commit suicide, men are twice as likely to commit suicide than female cancer patients." What role does having an open discussion about cancer have in coping with the condition? "Talking about our worries, or asking a person with cancer about their worries is the first and most important step for us to realise that these worries are normal and very common. "This realisation can make people feel more connected and less isolated and can normalise their concerns. This openness, acceptance and compassion are all vital in enabling people to clarify their worries, thoughts and feelings about their situation. Only when we have this can we begin to think about what may help. Awareness is the first step to making things better. Sometimes, just by talking or being asked about worries can be enough to reduce distress." How crucial can psychology be in overcoming cancer? "Approximately 20-25% of people after the first year of diagnosis will continue to experience distress. Psychological support can be very helpful in identifying strategies to cope." How can we talk about cancer if we're a patient's friend? "If you know someone who has been diagnosed:

1. Let them know it can be tough, this is normal and that you are there and available to listen
2. Be kind and show compassion to them
3. Ask what would help - a listening ear, practical help (e.g. drive to appointments, pick up some food, watch a match or a film, a hug even)
4. Assure them cancer doesn't define them and help them do something they like can remind them of who they are
5. Laughter and humour can be helpful, allowing you to connect and talk about emotions."

What tips would you give to someone who has been recently diagnosed? For the person affected by cancer:

1. Be kind to yourself - take time to listen to your worries and your body
2. It can help to write down your worries and be aware of how you are reacting. Notice the triggers, your emotion, your physical reaction, your thoughts and your behaviour
3. Make time to schedule in and plan enjoyable activities, notice what you feel grateful for each day and make time to relax
4. Focus on the here and now and what you can control. There will be uncertainty, and whilst that is normal, try to focus on what you want to do without getting derailed by your worries
5. Talk to friends, family and support agencies. Your hospital and clinical nurse specialist can help with your worries and can direct you to appropriate sources of help
6. There may be particular conversations you need and wish to have. Take time to know what you want to say, practice how to say it so it gets heard, take a breath, check it’s been understood
7. There may be different stresses you face, but if you keep thinking about your stresses you will feel overwhelmed. Stop, prioritise, focus on the most important and put the others aside.

Dr Mary Burgess is lead consultant clinical psychologist with Advanced Cancers Coalition (ACC), a group of 12 UK cancer patient groups with a shared interest in delivering improvements in care and treatments for people with advanced cancer. She co-authored this guide for talking about cancer, alongside the ACC. Stand Up To Cancer funds life-saving cancer research, to find out more about their work or how you can get involved click here.