counseling and resource center for cancer patients - serving the east end free of charge

Emotional Health & Cancer

A cancer diagnosis can be an overwhelming experience. Your feelings can change daily and may include denial, fear, sadness, depression, anxiety, guilt and stress. For some, feeling more vulnerable about treatment and what the future may hold, can understandably evoke strong emotions. Although these feelings may be a normal part of having cancer, educating yourself about your illness, identifying useful coping strategies, and finding support are just some of the ways you can manage your emotions and feel more in control.

A recent report from the Institute of Medicine proposes a new standard of cancer care that integrates social and psychological support as a “routine” part of medical care for cancer patients. The report recommends that all oncology providers assess patients for signs of “distress” from diagnosis through treatment, with appropriate referrals for psychosocial care. There is strong evidence that support and interventions help with treatment compliance and reduce levels of distress for the patient and family.

Organizations such as Fighting Chance, the South Fork Breast Health Coalition and Cancer Care to name a few, are in a unique position to work with your medical healthcare providers to assist with your concerns at every juncture of your cancer experience. It is important to let your oncologist and healthcare team know of your concerns. They are treating the “whole person” and can direct you to find psychosocial support, complementary medicine practioners, or pastoral counselors.

Self-Assessment of Distress
The American Cancer Society’s Distress booklet describes distress as “unpleasant feelings or emotions that may interfere with your ability to cope with cancer, it’s physical symptoms and it’s treatment”. The ACS questionnaire on the following page may help you sort out your concerns and issues to better determine if you might benefit from professional guidance,
complementary medicine techniques, or other services.

Do I Need Professional Support?
Self-Assessment Questionnaire for Patients
The following questionnaire may help you determine whether you might benefit from professional counseling. Every patient experiences some of these symptoms; there are no right or wrong answers.
During the past two weeks:
1. I have felt anxious or worried about cancer and the treatment I am receiving.
Not at all 1 2 3 4 5 All the time
2. I have felt depressed or discouraged.
Not at all 1 2 3 4 5 All the time
3. I have been irritable or unusually angry and I have not controlled it well.
Not at all 1 2 3 4 5 All the time
4. My sleeping habits have changed.
Not at all 1 2 3 4 5 All the time
5. I have experienced a change in my appetite.
Not at all 1 2 3 4 5 All the time
6. I have had difficulty concentrating at work or at home, or on routine things such
as reading the newspaper or watching television.
Not at all 1 2 3 4 5 All the time
7. Cancer and its treatment have interfered with my daily activities.
Not at all 1 2 3 4 5 All the time
8.Cancer and its treatment have interfered with my family or social life.
Not at all 1 2 3 4 5 All the time
9.Cancer and its treatment have interfered with my sex life.
Not at all 1 2 3 4 5 All the time
10. Pain and discomfort have caused me to limit my activities.
Not at all 1 2 3 4 5 All the time
11. Cancer has caused physical, emotional, or financial hardships for me.
Not at all 1 2 3 4 5 All the time
12. Cancer and its treatment have caused changes in my physical appearance and
this concerns me.
Not at all 1 2 3 4 5 All the time
13. I have had difficulty coping with the stress I have experienced.
Not at all 1 2 3 4 5 All the time
14. My quality of life during the past two weeks has been:
Excellent 1 2 3 4 5 Very poor
If you find that many of your answers are in column four or five, you may be experiencing significant distress and should consider discussing your feelings with a counselor.

Source: Developed by the Department of Psychosocial Resources, Tom Baker Cancer Centre, Calgary, Alberta, Canada. Derived in part from the Functional Living Index: Cancer and from the EORTC Core Quality of Life Questionnaire.
www.cancer.org

Counseling
Finding a safe place to talk about emotional issues can be beneficial and aid adjustment. Below you will find a listing of counselors in the area.

Fran Donovan, L.C.S.W.
P.O. Box 1574
East Hampton, NY 11937 .............................................................. 631-329-1314

Fighting Chance
Karrie Robinson, L.C.S.W.,
Bill Di Scipio, Ph.D.,
Laraine Gordon, L.C.S.W.
112 Hampton Street
Sag Harbor, NY 11963................................................................... 631-725-4646

Family Counseling Center
Accepts most insurance-sliding fee scale
Central Suffolk Hospital
1300 Roanoke Avenue
Riverhead, NY 11901 ................................................................................ 631-288-1954

Margaret Fox, L.C.S.W.
955 Albo Drive
Laurel, NY 11948 ....................................................................................... 631-298-8034

Susan Griffin, L.C.S.W.
P.O. Box 1551
Sag Harbor, NY 11963................................................................................ 631-725-2978

Hamptons Counseling Center
Jean Binnie, DAPA, M.S., M.A
143 Montauk Highway
Hampton Bays, NY 11946 .......................................................................... 631-723-0648
Sliding pay scale (Initial consultation is free)

Robert Kuisis, Ph.D .................................................................................... 631-907-0539

Karen Melnick, A.S.C.W., L.C.S.W., B.C.D., C.I.S.M.,
Family Therapy
East Hampton, NY 11937 ........................................................................... 631-324-0714

Mental Health Association
(Spanish speaking personnel)
Free referrals for therapists
199 North Wellwood Ave.
Lindenhurst, NY 11757 .............................................................................. 631-226-3900

Edyle O’Brien, L.C.S.W.
East Hampton, NY 11937 ........................................................................... 631-329-0520

Riverhead Mental Health Center
300 Center Drive
Riverhead, NY 11901 ................................................................................. 631-852-1440

Coping Tips
Today, the advances in cancer diagnosis, treatments and research have increased the chances for cure or long term remission. With this good news comes the reality of increased complexities and responsibilities that patients and caregivers face along the journey-from diagnosis, to treatment and beyond. It is our goal to provide you with the practical information, guidance and strategies to ease your adjustment and help you feel more empowered.

Fighting Chance provides telephone outreach, education, navigation and support, as well as individual, family and group counseling. Assistance with employment or insurance concerns is available as well. To utilize these services please call 631-725-4646.

Cancer and Depression
Cancer is a series of crisis from diagnosis, to treatment and beyond. It brings with it a great need to attend to our physical health while often experiencing overwhelming emotions that can leave us feeling as though our world has been turned upside down. Cancer takes away the illusion that we have control over our lives. Often the greater our need for control, the greater our sense of loss during cancer, leaving us more vulnerable to feelings of depression.

In general, patients with cancer are no more depressed than other patients. Yet, it is normal for periods of depression to occur at various stages of the cancer experience in response to diagnosis and treatments. For a great majority of cancer patients, a depressive reaction will subside within a week or two of its onset. Depression of this temporary form can be managed with education, active involvement in treatment, and support.

What is a depressive reaction?
A depressive reaction can include the following symptoms:
- Feeling sad, empty, hopeless, or worthless.
- Diminished interest or lessened pleasure in most activities.
- Fatigue or loss of energy, loss of appetite or overeating.
- Sleeping too much or sleeping too little.
- Thoughts of death or suicide.

When depression is more serious (where symptoms continue for more than two weeks), it is important to consult your healthcare team. Depression is manageable with medication and supportive counseling.

Strategies
·Remember that while your feelings of sadness and emptiness are unpleasant they are NORMAL. You may find that you experience them at different times during your cancer experience.
·Find ways to become an active participant in your treatment; make lists of questions for your medical team; become informed about your diagnosis and treatment options.
·Identify ways to manage your environment; make proactive choices about your diet and exercise, select the days and times (to the degree possible) you will receive your treatment, bring items (music, books, movies, people) to treatment that are soothing.
·Have compassion and patience with yourself. Give yourself permission to have your feelings.
·Engage in activities that bring you pleasure. Many people find that massage therapy, yoga, meditation, exercise, prayer, writing and art, are helpful distractions from “thinking cancer” constantly.
·If your feelings persist for longer than two weeks, consult your healthcare team to discuss whether medication and a referral for supportive counseling might be appropriate.

Here are some additional resources you may find helpful:
- National Cancer Institute - Cancer and Depression: http://www.cancer.gov/cancertopics/pdq/supportivecare/depression/patient
- National Institute of Mental Health: Cancer and Depression: http://www.nimh.nih.gov/publicat/depression.cfm
- Cancerbackup: http://www.cancerbackup.org.uk/Resourcessupport/Relationshipscommunication/Emotionaleffects
- American Cancer Society: http://www.cancer.org/docroot/MBC/content/MBC_4_1X_Cancer_and_Depression.asp?sitearea=MBC

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