Finding a way of talking about cancer with family members can help sufferers to deal with the treatment
Apart from the horrors of chemotherapy, radiotherapy and the myriad of drugs which sufferers are forced to endure, there is another hardship of cancer which is not as well documented.
The emotional trauma caused by the disease is less highlighted but is a significant side-effect. Issues like confronting death or the breakdown of a relationship, the humiliation of hair loss or the demise of a career may need to be addressed.
For example, a new study published by charity Macmillan Cancer Support found that 57 per cent of cancer sufferers are forced to quit work or study, change their role or cut their hours. According to the poll of more than 1,000 people, seven out of 10 have seen their income fall, with their earnings cut in half on average. Yet 80 per cent did not receive any advice or warnings about the effects of cancer on their career.
A new book, Coping with the Psychological Effects of Cancer helps readers to navigate some of the confusing feelings and emotions associated with a diagnosis. Topics include money matters, family relationships, being a "patient" and changing unhelpful behaviour. Professor Robert Bor - a clinical counselling and health psychologist, who wrote the book with Dr Carina Eriksen and Ceilidh Stapelkamp - is only too aware of the sort of emotional response that cancer brings with it. "It throws up a number of different challenges. Who are they going to tell and how are they going to tell them? What impact will this have on the family?" he says. "There can be difficulties in disclosing to a family member because you don't want to upset them or affect their health and wellbeing. That is something people agonise over."
Bor explains that patients are not always willing to tell all and sundry about their condition because they do not want people to feel sorry for them, nor do they want to be smothered. Another common ordeal experienced is being abandoned by a partner or loved one.
But in the face of adversity, it is important to be strong. Bor claims that if you keep positive, it can help you deal with the medical side effects much better.
"We have found that people who have given thought to these kinds of issues take the treatment better," he says. "If you're coping better psychologically, sometimes the way in which you experience your illness can improve. We can't say that you will get better but you can cope better and often have fewer hospital visits, less uncertainty, better sleep, better relationships, improved compliance with your treatment and improved appetite."
One way to stay optimistic is the thought of not being alone with your illness. "This book talks about how other people have dealt with it," says Bor. He explains that the kind of information contained in the book has not been much written about elsewhere. "There are books on medical advances in cancer care but there is not enough that is usable and practical in terms of the psychological response which can be the most important part of the whole response and the one that we have control over," he says.
That is not to say the information is not out there. Nowadays patients are a lot more proactive - they find out about their illness by reading newspaper articles, talking to others and researching online.
Bor explains: "Self help is definitely the way in which medicine is going these days. Support can come from many different sources. It's done in a less prescriptive way than it used to be. Your doctor can work collaboratively with you in order to understand your health needs."
There are hundreds of independent cancer support groups and organisations across the UK where users can share their concerns and anxieties. Website healthtalkonline.org contains audio and video recordings of UK patients talking about their experiences, available for others to download. Meanwhile, Cancer Research's website, cancerchat.org.uk, has forums for fellow sufferers to meet and talk.
And it is not all depressing. Bor insists that there are positive feelings that are associated with cancer, even if they are few and far between.
"It's remarkable the number of people we talk to in the face of life threatening diseases who find something positive," he says.
"People report some changes that they have been able to embrace. It forces them to prioritise what's important. It can bring them closer to family members in a way they weren't previously."