Cancer, Survivorship, and Self-Isolation for the Most Vulnerable
For those who have recently finished treatment for breast cancer, the coronavirus pandemic and self isolation may be cause for great concern
Hypnotherapist Beverley Longhurst explores the complicated nature of self-isolation as a cancer survivor
If you are struggling to cope with anxiety and fear related to the Covid-19 lockdown, find a therapist here
Just when you had completed your treatment and were looking forward to getting life into a new normal, you find yourself negotiating another new normal – with coronavirus. It is common to feel anxious about your increased risk of infection since there are particular concerns when you have recently finished treatment. Quarantine or self-isolation is the most robust measure we know of to keep safe and your specialist will be able to advise.
Keeping up to date can be minefield but there is important advice and guidance on the Government website here as well as clear guidance from MacMillan. MacMillan have a 24/7 support line for patients – 080 808 00 00. Also take a look at the frequently asked questions and nurse advisor number on Breast Cancer Now.
Cancer can feel isolating at any time. Now you have different barriers to contend with; physical, psychological and environmental. Everyone is adapting to this at the moment and none of us are alone in this. You are likely to feel a range of emotions as you adjust. There is a grieving process, which may be happening to us as individuals and as a society. We can see this in the way people have reacted so differently; some compliant, others defiant, some very active on social media and others struggling to find a routine. It’s normal to go through shock, denial, guilt, anger, bargaining and loneliness before feeling an upward turn as you start to feel acceptance and hope.
Find moments to be present and allow yourself to go through these stages. Don’t put extra pressure on yourself to learn a new language by the end of the week. This is a worldwide change, so be gentle on yourself. Check in with yourself and see how you're doing. Remember the HALT principle-never get to hungry, angry lonely or tired. Don’t forget your peer support too. Making contact with those who are on the same journey will help you navigate feelings.
If you haven't received your vulnerable person letter by now and you think you should have one, contact your GP. It’s also a good idea to check with your treatment centre whether on-site appointments are still in place, or need to be delayed or held remotely. One of the things we have on-side is the ability to use telemedicine, wherein you can connect with your specialist team online. Ask if you can do this by video to increase your sense of connection.
As always, if you have new and unexplained symptoms that last for more than two weeks contact your specialist team to discuss them. Your treatment centre will have preferred contacts for you to call if you are experiencing symptoms associated with coronavirus, eg. a high temperature and/or a persistent cough-have these to hand. It may be contraindicated to go to your treatment centre in person in the first instance.
The term immuno-compromised is broad and not limited to chemotherapy. It can also refer to factors such as age or lifestyle, which could encompass smoking, for example, along with conditions such as diabetes. Immune systems are usually most compromised during and just after treatments, although this varies. Every day after your treatment has finished in survival is another day of getting stronger. You may have taken better care of yourself during your cancer journey too. Many people eat more healthily, give up smoking, reduce alcohol and try to limit stress. This will have helped your body recover more efficiently and will help you now when your energy levels are normalising.
Diet and exercise are great steps to keep up and now is an ideal time to focus on how you might fine-tune your health and wellbeing even further. Get enough sleep, take moderate, varied exercise, keep hydrated, enjoy cooking whole foods and maintaining a balanced diet. Enjoy ideas from Nutritionist Jane Clarke for inspirational recipes and products. Utilise online shopping services well in advance. Keep a well-stocked pantry of frozen and fresh fruit and vegetables just in case you can’t get what you want fresh. Batch cooking can also be helpful if your finding cooking every day too much. The Mindful Chef has also been a great resource for some people with reported easy 1 hour delivery slots.
Home and social life
There are lots of ways you can keep distracted and busy at home. There is an array of free exercise classes online so try different ones to prevent boredom. Try some PE with Joe Wicks sessions - the kids ones are ideal if you’re starting back into fitness. "Rise and Shine" classes with former Ballerina of English National Ballet Natalia Kremen are gently invigorating and Yin yoga with Dee provide expert instruction with a soulful approach.
Consider taking a short online course or enjoy the theatre from your armchair. The National Theatre is streaming a free play every Thursday night, you could even take a trip to the MET in New York. Discover what is enjoyable and mood-boosting for you.
Being able to reach out to others online is one of the saving graces of our present situation. Keep up with friends and family whenever possible. Board game apps offer fun ways to connect or if you fancy online dating, why not try Filter Off where you can have your first dinner date virtually? NetflixParty gives you the chance to watch films with others outside your household and Disney Plus gives kids an array of delights. I personally can't resist an afternoon cup of tea and laughter with Harriet Thorpe and Wonderbirds.
If you are reliant on broadband and mobile networks take a look at Ofcom’s updates. They have published helpful guidance titled ‘Seven tips to stay connected’. Too much technology, however, or frequently tuning into the news can be stressful and counterproductive. Limit yourself to updates a couple of times a day, then change the channel or turn off.
Some families cope better with structure, others in a more relaxed atmosphere. Do what’s best for your family and don’t feel pressure to conform to anyone else. If you have young children, direct, honest answers are always the best way to communicate. Children don’t cope well with secrets and mystery. In language that you know they understand, let them know why you’re staying in or washing your hands, again. Reassure them that it is to keep healthy and that it has a time limit.
It’s officially spring, so you could be really sensible and de-clutter your cupboards, sort clothes or organise paperwork. If you have tasks piling up, make a list and try tackling them one by one. Mix things up by spending some of your time on mundane jobs before turning to more pleasurable activities and break it down into chunks. Your energy levels may be variable and it’s important you keep yourself feeling as good as you can so celebrate the wins.
If you're working from home try to create a dedicated work space that you can leave at the end of the day. A standing area might be better for you or remember to get up and stretch and walk around regularly. Keep in touch with work colleagues through video to meet face to face and keep to your working hours, taking your days off seriously.
Find your zen
Whilst a peer support groups and forums can valuable, keep it limited, especially if you start to feel anxious or as if you’re getting lost in cyberspace.Your home will become even more important now so create your home, or an area of it as a retreat. Dedicate a day or part of your day to a home retreat to create some peace and stillness. Indulge in a facemask or use those bath salts you’ve been saving. Or do something more spiritual, with a timetable of yoga, meditation or listening to your favourite inspirational teachings.
Survivorship is often a time in which patients have told me that they reassess their priorities. Allow yourself to connect with yours. Either way, schedule it, set an intention and enjoy the solitude. This is your time.
Help your immune system
There is a relatively new theory called Psychoneuroimmunology (PNI). This encompasses how our thoughts and behaviours may influence our hormones and immune system function. Studies show that in depressed patients, the immune system is under more strain. It’s a feedback loop. So, what’s great, is it works in reverse too. It suggests that we may have the ability to regulate our immune system with more positive thoughts and feelings. Keeping stress levels low and regularly engaging in pleasurable relaxation has a soothing effect on the mind and nervous system which communicate with the rest of our body. This is perhaps why, anecdotally, many of us in oncology notice those with a positive attitude often experience less side severe effects from some treatments, or appear to cope better with them.
Self-hypnosis is a great way to do this. It can be learnt through working with a clinical hypnotherapist who will go through your concerns in detail and guide you through therapeutic hypnosis practice over a few sessions. They will also be able to teach you how to practice self-hypnosis in the best way to suit you as an individual. Everyone is different and it’s good to have a few different techniques to draw upon.
Meditation apps like Calm can be helpful too. Set aside time and allow yourself to really relax. Doing it regularly, say for 10-15 minutes twice a day, can really help manage stress. Rest and allow yourself time to top up your energy levels. They may be erratic post-treatment. If you can, take a nap before you absolutely need. Emotional processing can be just as energetic as physical activity sometimes, so listen to your body.
Finally, remind yourself and each other that this is a season. It will come to an end and life will change again. A lot of how you spend the time until then is largely up to you. If you feel yourself wanting to work through an issue during self-isolation and would like to use the time to see how hypnotherapy can help, do get in touch.
Beverley Longhurst is a verified welldoing.org hypnotherapist working online