Coping after a Cancer Diagnosis Sept 2014 Webinar

Coping after cancer – what does this mean and how can coping help you? Whether you’ve just been diagnosed with colorectal cancer or are managing side effects after treatment, you have been impacted greatly and life has likely changed.

Coping strategies can help you regain a sense of control, and learn that there is always hope for an improved quality of life. This webinar will touch on how to successfully integrate coping so you and your support team can face the road going forward.

1. Welcome to Fight Colorectal Cancer’s Webinar Session: Coping After a Cancer Diagnosis – What does this mean and how? Make Sure You Know the Latest News About CRC Research and Treatment visit fightcrc.org Our webinar will begin shortly.

2. Today’s Webinar: 1. Today’s Speaker: Dr. Kristin Kilbourn , Ph.D., M.P.H. 2. Archived Webinars: FightColorectalCancer.org /Webinars 3. AFTER THE WEBINAR: expect an email with links to the material. Also a survey on how we did, receive a Blue Star pin when completed 4. Ask a question in the panel on the RIGHT SIDE of your screen 5. Follow along via Twitter – use the hashtag # CRCWebinar

3. Introducing our much acclaimed: Patient Resource Guide Available online at: http :// fightcolorectalcancer.org / GuideInTheFight /

4. Fight CRC Funding Science Established in 2006, our Lisa Fund has raised hundreds of thousands of dollars to directly support the innovative research in treating late-stage colorectal cancer. 100% of the funds donated go directly to Late -stage colorectal cancer research. Learn more or donate: FightColorectalCancer.org / LisaFund

5. Disclaimer The information and services provided by Fight Colorectal Cancer are for general informational purposes only. The information and services are not intended to be substitutes for professional medical advice, diagnoses, or treatment. If you are ill, or suspect that you are ill, see a doctor immediately. In an emergency, call 911 or go to the nearest emergency room. Fight Colorectal Cancer never recommends or endorses any specific physicians, products or treatments for any condition.

6. Speaker Dr. Kristin Kilbourn , Ph.D., M.P.H . Kristin is an assistant professor in the Department of Psychology at the University of Colorado Denver.  She is a member of the University of Colorado Cancer Center and also holds an adjunct faculty position in the Division of Internal Medicine.

7. The Psychosocial Aspects of Cancer Survivorship Kristin Kilbourn, Ph.D. MPH Clinical Health Psychologist Associate Professor Department of Psychology University of Colorado Denver

8. Overview The psychosocial aspects of living as a colon cancer survivor Recognizing the signs and symptoms of distress Depression A nxiety Ways to improve or maintain good emotional well-being

9. Illness as a Major Life Stressor Illness can lead to: Uncertainty about the future Multiple losses Independence & control Functional loss Financial loss Changes in one’s role within the family

10. Adjustment Across the Course of Illness Diagnosis Life Disruption Decisions Facing Mortality Loss Treatment QoL Social isolation Stigma Side-effects Re-entry Uncertainty Hypervigilance Distress Adjustment Economic stress Screening Fear Anticipatory anxiety

11. The Study of Cancer Survivors “Not that you live, but how you live.” 13.7 million cancer survivors Increase over next 20 years Increasing number of childhood cancer survivors Aging population and progress in cancer treatments

12. Unique Issues Following Treatment Post-treatment represents a new phase of adjustment Loss of safety net of active medical treatment and support Resume former roles in and outside the home Lingering physical and psychosocial symptoms Stages of early survivorship Long term follow-up and on-going monitoring Uncertainty and fear of recurrence Redefining one’s sense of self Often expectations of how an individual believes they will feel after treatment does not match how they feel

13. What about the family? Everyone is impacted by illness Relationships Family-roles Financial issues Future plans and dreams Illness places high levels of stress on the “family” unit

14. How do you know if you are experiencing significant levels of distress?

15. Symptoms of Depression Mood symptoms: Sadness Anger/Irritability Hopelessness Somatic Symptoms: Problems with sleep Change in appetite Low energy/fatigue Cognitive symptoms: Problems with concentration and memory Decreased interest in previously enjoyed activities Feelings of Worthlessness Feeling that life is not worth living/Suicidal thoughts

16. Symptoms of Anxiety Excessive worry and anxiety Restlessness or feeling on edge Easily fatigued Concentration and memory problems Irritability Muscle tension Sleep disturbance Panic attacks (racing heart, difficulty breathing, sweaty, chest pain discomfort, feeling detached from self, trembling/shaking, feeling of choking, dizzy, nausea, fear of losing control, going crazy or dying)

17. How do you know when to seek help and support? The symptoms are interfering with your daily life Your quality of life has decreased because of these symptoms Your family and friends have noticed that something has changed You are not experiencing joy in your life You have thoughts that life is not worth living and you would be better off dead

18. Psychosocial Interventions Psychotherapy Interventions Cognitive-Behavioral Therapy Existential Therapy Supportive Therapy Mind-Body Interventions Relaxation interventions Yoga, meditation etc. Spiritual interventions Support Groups Peer led vs. professional led Psychotropic Medications Antidepressants Medication for anxiety

19. Strategies for maintaining good emotional and physical health 19

20. Stress management techniques Effective communication Adaptive coping strategies Use of your social support system Practicing healthy behaviors Identify your basic needs and developing and utilizing a self-care plan

21. Stress Management The chronic stress can lead to a number of problems in various domains: Emotional, Cognitive, Behavioral, Physical, Social Cognitive-behavioral techniques - identify distorted thoughts and change them to more accurate thoughts Relaxation exercises and pleasurable activities can help to decrease/manage stress Deep Breathing, Progressive Muscle Relaxation, Imagery, Yoga /Tai Chi Walking, Yoga/Tai Chi and other forms of Exercise Prayer/Meditation Different Hobbies / Artistic Endeavors

22. Communication Communication problems are very common in families dealing with serious medical issues It can include communication with your loved-one, other family, friends, co-workers, the medical team etc. Strategies and skills: Set aside time to talk Make an outline or list of what you want to ask/say Use assertive communication (“I” statements) Utilize good listening skills and reflect what you’ve heard Don’t jump to conclusions or make assumptions- just ask

23. Adaptive Coping There are multiple ways to cope with stressful situations Importance of matching the stressor type with the appropriate coping strategy Coping Skills Training

24. Matching the Situation and Stressor Situation Controllable Uncontrollable Coping Response Problem-Focused Problem solving Decision making Seeking information Goal setting Emotion-Focused Venting/talking to others Reframing the situation Journaling Exercise/relaxation Meditation/spiritual practices Pleasurable activities

25. Stressor Is: Coping Strategy: Controllable Problem-Focused Uncontrollable Emotion- Focused Active (adaptive) Information Seeking Goal Setting Decision Making Conflict Resolution Requesting help Focused activities Reappraisal of situation Reframing thoughts Exercise, Massage Meditation, relaxation Mindfulness exercises Expressing emotions: journaling, poetry, art, talking with others Accept Negative Emotions: (softening) Passive (maladaptive) Behavioral Avoidance Cognitive Avoidance: denial not thinking about it Smoke, Eat, Drink Alcohol Not Caring For Yourself: don ’ t take medication miss appointment non-adherence Stuffing Feelings

26. Coping Skills Those who handle stress have: Have a variety of coping techniques available to them (“more tools in the toolbox”) Can match the stressor to the coping response Awareness of your common coping style(s) is important Do you tend to be more analytical or more emotional in times of stress?

27. Social Support Do you know how to ask for support? Do you know who to ask for support? Match your support needs to the person(s) who can meet your needs: Emotional Support Informational support Tangible Support Consider ways to increase your social support network Support groups Professional therapy or counseling Try new hobbies or activities where you will meet others with similar interests (classes, clubs etc.) Quality is more important than quantity

28. Health Behaviors Poor health behaviors increase the risk for recurrence or the development/exacerbation of other health problems impact psychosocial well-being Weight/Body Mass Index Cancer treatment can lead to weight gain/changes in body composition Even modest wt. loss can lead to significant health benefits Physical activity – 1/3 of survivors have not participating in physical activity over the past 30 days. Step-counters and fit bits can be useful to increase activity Sleep – most Americans do not get enough sleep Alcohol General Recommendations- 2 drinks per day for men, 1 drink per day for women No level of alcohol considered safe for some survivors Smoking (15% survivors smoke )- includes tobacco and marijuana

29. Practicing Good Self-Care What does this mean? Putting your self-care first Maintaining good health behaviors (diet, exercise, sleep) Sticking to your medical regimen Engaging in pleasurable activities Finding balance in your life

30. Thriving Ask questions What can I do to maintain and/or improve my health and well-being Where can I find the support that I need Develop a plan that addresses physical, emotional , social and spiritual needs Seek out help when needed Now is the time to make positive changes in your life Adopt healthy behaviors Practice adaptive coping skills Reprioritize what is really important in your life

31. 31 “The bend in the road is not the end of the road unless you refuse to take the turn” -anonymous

32. Thank You [email protected]

33. Question & Answer Time . . . DONATE $10 NOW on your mobile. Text “FCRC” to 501501 (A $10 donation to Fight Colorectal Cancer will be deducted from your cell phone bill. Message rates apply.) BECOME AN ADVOCATE. Learn more at FightColorectalCancer.org /Advocacy How can YOU help? Join us.

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