[2020-11-03] Cancer's impact on the family
I spent part of the day reading about the impact of cancer on the family of patients diagnosed with the disease. This interest stemmed from a recent conversation with my sister, who noted the general lack of information on and understanding of the effect of a cancer diagnosis on the patient's loved ones.
This has been my experience as well. When I look for resources on cancer, I find that most address the needs of the patient. Few address the needs of the cancer patient's extended family. Among those that do, many recognize that cancer affects not just the person afflicted but everyone around them. That wasn't surprising. What did strike me was the finding that family members can experience even more distress than the ill individual. In their article Cancer: a family at risk, Katarzyna Woźniak and Dariusz Iżycki note:
The diagnosis of cancer is a family experience that changes the lives of all its members, bringing an immense amount of stress and many challenging situations. The daily routine, common activities and distribution of duties all have to change. Family members follow the phases of the disease, very often suffering comparable or greater distress than the patient.
Woźniak and Iżycki identify the range of emotions family members may experience as the disease progresses:
Cancer is a family experience, and often family members have as many problems coping with it as does the diagnosed patient. The family goes through different stages of adjusting to the disease. The emotional reactions may include anger, resentment, guilt and adjustment pain, and may or may not lead to the acceptance of the disease. The cancer's diagnosis, as well as the subsequent phases of the disease and its treatment, may be a source of intense stress both for the patient and for the family. Patients and their relatives need to face the challenge of a life defined with uncertainty; treatment routines, the threat of recurrence or the failure of the treatment.
Even when the impact of cancer on loved ones is acknowledged, the focus tends to be on the patient's immediate family, for example, the spouse or partner and children of an adult with cancer, and often on providing advice on how to support the patient. Very little is written about adult siblings, parents and friends. This lack of information leaves people in the latter category with limited support to deal with their emotions, which can include worry, anger and fear, but also guilt that they're not sick and a sense of helplessness as they grapple with how to help the sick person.
And it's not just a lack of information resources that loved ones face. Sometimes it's a lack of support. Woźniak and Iżycki state:
Sadly, within the medical establishments, not enough attention is given to the family's condition. No matter what the phase of the cancer, it always makes a tremendous impact on family functioning, destroying the everyday rhythm, and present and future plans.
I suspect the situation in Canada, and in the Ottawa region in particular, is better than in other countries. When The Ottawa Hospital contacted me with a proposal for psycho-social support, they did offer some supports for family members. As well, the Ottawa Regional Cancer Foundation offers cancer coaching to the entire family.
Beyond the recognition in the healthcare community of the impact of a cancer diagnosis on the extended family, we would be well served for the broader community to understand the potential impacts of cancer on loved ones—both the immediate family and the extended family. One way to acknowledge this impact would be to simply ask loved ones how they're doing. They might benefit from talking about their feelings as they too experience a gamut of emotions from fear to hope.
