How to deal with a cancer diagnosis? Psycho-oncological counseling can help

Mr. Decker, as a doctor you provide medical support to people diagnosed with cancer. What do those affected need?

Michael Decker: Of course, they need the right medical care and treatment for them. But they also need someone to talk to personally and openly. A cancer diagnosis is a very profound human experience. We don't want those affected to get the impression that they are being reduced to this medical diagnosis. We want to understand them in their entirety, as people who live in a social, professional and family context. That's why I always point out the possibility of psycho-oncological counseling right at the start of therapy. This can be very valuable for those affected.

What is psycho-oncological counseling about, Ms. Staub?

Ursula Staub: In the beginning, it is often a matter of understanding exactly what situation those affected are in. Time is usually limited during medical consultations. However, it is often important for patients to talk to a specialist in detail and personally about the disease, treatment and the overall impact on their lives. We have space for this in our psycho-oncological counseling. At the beginning, there are sometimes very specific questions such as: Did I understand correctly what the medical specialist told me? We then go into this in detail so that the person affected can really understand and grasp what is happening and what they will have to face.

Michael Decker: It is therefore naturally important that we work closely together. In our interdisciplinary teams, we exchange information intensively so that everyone has the same level of knowledge.

And what happens once these initial questions have been answered?

Ursula Staub: In the initial period after a diagnosis, many people are in a kind of state of shock and function first and foremost. They undergo their therapies and adjust to this new situation. Only then do they realize: I am more than just a functioning person. I am confronted with existential feelings and fears. I live in a social network. There are often questions like: How do I talk to my children about this? Or: How am I actually doing in life? What gives me pleasure, what is important to me? And how can I gain strength to get through this difficult phase of the illness?

Yes, how do you manage that? How can you find strength in such a situation?

Ursula Staub: That is individual. In counseling, we can find out what helps the person in question. Anyone who is confronted with a diagnosis such as cancer usually feels that their very existence is under threat. Even if the prospects are perhaps good. In this stressful situation, it is important to deal with yourself in a supportive way. Counseling sessions often also deal with the issue of performance. Who am I when I am affected by an illness and can no longer achieve so much, at work or as a family member? That's where we work on self-image. Psycho-oncological counseling should be a place where those affected feel seen and heard, where they can say anything and where there is room for all their feelings. Where they receive support and know that there is someone here to help them.

Michael Decker: We have to be aware of what is happening, especially with new diagnoses. From one day to the next, those affected have a daily routine full of appointments, clarifications, decisions and treatments. There is a lot of uncertainty and fear. You have to function while the rug is actually being pulled out from under your feet. We also want to talk about this and, above all, talk openly with those affected about their treatment goals.

What if the treatment goal is no longer "cure", but instead focuses on maintaining quality of life?

Michael Decker: This must also be clearly discussed and expressed. In such situations, the time left to live is often limited. Psycho-oncological counseling offers a space in which important questions can be addressed.

Ursula Staub: It's then about making the most of the time you have left. To ask yourself what you still have to do, but above all what you still want. What is particularly important to me for the time I have left? Whenever possible, I try to talk to those affected at an early stage about questions such as where they want to die. Should it be at home? Then the relatives must be involved in the decision.
M.D. Exactly. However, we always try to involve relatives at an early stage - even if the treatment goal is curative. Not only the person with cancer, but also their loved ones experience a challenging phase.

Does this mean that relatives and loved ones of patients can also take advantage of psycho-oncological counseling?

Michael Decker: Absolutely. We also make them aware of the offer right from the start if possible. You have to imagine: A person affected by cancer is often asked several times a day by those around them and the specialists treating them: How are you? Those closest to them, the people who accompany them and are ultimately also affected, are much less likely to be asked how they are feeling. The situation often arises that people who want to accompany and support their sick relatives and often feel helpless, that these people particularly benefit from psycho-oncological counseling.

How often do patients or relatives come for psycho-oncological counseling?

Ursula Staub: Those affected often come in for an initial discussion and we then look together at what the person actually needs. Sometimes this results in regular support, perhaps over a certain phase, perhaps over a longer period of time, perhaps it stays with this one conversation. Often it is simply good that we have already met once and the person concerned can come back to the offer at a later date. I find that people are grateful to know that they have me at their side as a contact person - regardless of whether they actually make use of the service or how intensive the support is.

When someone has survived cancer, the relief is probably great. But often the fear remains that the cancer could return. How can you deal with this?

Ursula Staub: This is a very important topic in most counseling sessions. A cancer diagnosis is such a drastic and existentially threatening experience that it is often impossible to simply let go of the fear. You have to find access to security and confidence again. You have to regain confidence in your own life, in your own body. That's why we always talk during cancer therapy in psycho-oncological counseling about what can help the person concerned later, when they have completed the therapy. We usually find individual approaches here. On request, we can also support those affected and their relatives beyond the cancer treatment.