Before Treatment: Coping With the Fear of Side Effects

Listen to the Cancer.Net Podcast: Coping With the Fear of Side Effects, adapted from this feature.

The possibility of cancer treatment causing side effects that may make you sick and debilitated is a real fear you may experience. Feeling apprehensive about starting treatment for cancer can be even more overwhelming and harder to handle than the cancer diagnosis itself. Although cancer treatment can be associated with certain side effects, major advances have been made over the last decade and the majority of cancer treatments given today are well-tolerated.

Understanding your fears

It is normal to fear the unexpected and to anticipate that treatment will be difficult. In some circumstances though, the fears you may have can be so overwhelming that you would rather delay cancer treatment. It is important that you recognize and accept these feelings and identify the reasons why you are feeling anxious and afraid. Facing your fears will help you control your level of anxiety, so you can make educated decisions about receiving optimal treatment and consequently, the optimal benefit from your treatment.

Ask yourself what you are afraid of, and communicate your concerns to your doctor or nurse.
Certain side effects associated with treatment may or may not happen to you.
Many side effects related to cancer treatment are temporary, and there are many medications available today to help diminish these effects. Come up with a plan ahead of time on how certain side effects will be managed and seek support from your health-care team.
Don't be afraid to ask questions no matter how "silly" you may think they sound. Any unanswered questions you have will only contribute to your fears of not knowing what to expect.
The fear of having pain during treatment can be the most frightening. You may experience pain from the cancer itself or from the procedures associated with treatment. Pain management is a priority in the health-care profession today and the goal is achieving pain control and preventing pain from occurring. It is important that you communicate these concerns to your doctor or nurse and realize that they are aware and in tune to the concept that pain is different for everyone. The options available today to manage pain can be very effective. Individualized pain management strategies can be developed by you and your doctor and tailored to meet your needs.

There may be other concerns that cause you emotional distress and may cause you to think about delaying treatment. These may include:

Fear of becoming dependent on others, especially if it involves child care
Fear of lifestyle changes
Financial concerns about requiring prolonged care if you experience side effects that are debilitating
Concerns about losing your job if the side effects cause prolonged illness

In order for your doctor or nurse to help you, they have to know what and how you are feeling. This means keeping the lines of communication open and making sure your needs are always addressed. Remember, there can be solutions, but you have to identify the problems first.

The following is a list of suggestions that may be helpful:

Be proactive, stay involved in your care, and give your input about initial treatment decisions. This will give you a sense of control and help you feel less anxious.
Try to stay positive and realize that treatment is meant to help you, not hurt you. Gather information on your cancer treatment and possible side effects, so you know the facts, not the fallacies.
Try some relaxation techniques, such as deep breathing, music therapy, and meditation, to try to alleviate some of your anxiety. When you are less anxious, you will be able to focus better and make more educated decisions.
Seek the support of your health-care team including your doctor, nurse, social worker, and realize that their goal is to help relieve symptoms and maintain good health and emotional well-being.
Ask to speak to others who have gone through the same treatments. Seek support groups that may be available in your local community where you can talk with others about how you are feeling. It may be beneficial to know you are not alone.
Stay focused on the present; don't get overwhelmed you with what could happen. This may help you overcome some of the fear and anxiety you are experiencing.
Ask a family member or friend to accompany you on your visit to the doctor to help support you when it is time to discuss treatment options. The less overwhelmed you feel, the more information you will be able to gather about your treatment.
Talk with your family and loved ones ahead of time about your concerns and expectations of treatment. The help and support of family and friends makes the journey through cancer treatment more tolerable. Use their help and try to delegate responsibilities with children and household chores. This may help lighten the burden you feel about not being able to keep up with your responsibilities if you should experience side effects from treatment. Read Cancer.Net Feature: Supporting a Friend Who Has Cancer, Talking With Someone Who Has Cancer, and Family Life for more information.
Talk with your employer ahead of time, so he or she knows what you will be going through. Perhaps there may be some adjustments that can be made to keep you working at a manageable pace after you begin treatment.
Weighing the risk of treatment against not getting treatment at all may be helpful in putting things into a better perspective.
Keep a journal, so you can get in touch with the issues that affect you on a personal level. Everyone experiences things in different ways, and your health-care team needs to know what your individual concerns are.

Additional resources

CancerCare: Controlling Cancer Pain: What You Need to Know to Get Relief

The Wellness Community is a nonprofit organization that provides online counseling, information to help cancer patients.

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