The diagnosis of cancer is initially a shock. Many of the patients ask themselves: "Am I to blame for the disease? Did I do something wrong?" gesund! asked Vivantes psychooncologist Barbara Knebel: "Is there a cancer personality? And how does one adjust to life with cancer?"

While more people die of cardiovascular disease in Germany, for many a cancer diagnosis represents hopelessness and incurability. Current statistics read differently: today, we are living much older on average than 20 years ago, cancer mortality has been declining for years, and the life expectancy of the patients is rising sharply. Before 1980, more than two-thirds of all cancer patients died. Although cancer is now considered a widespread disease, the chances of being cured are more than 50 percent. Many sufferers agonize over the question, "Why did I, of all people, get cancer?" They look for reasons, which they often also suspect in their personality. But numerous factors are involved in the development of cancer. In addition to hereditary predisposition, smoking, alcohol, an unbalanced diet, lack of exercise and certain pathogens of infectious diseases are considered the main risk factors.

Studies do not identify a "cancer type"

Why, despite a comparable risk, one person develops cancer and the other does not has not yet been scientifically proven. The influence of mental stress, character traits or the way people deal with psychological problems has not been proven in any of the many studies; there is no such thing as a typical "cancer personality". Nor is there a one-size-fits-all solution for dealing with cancer. As individual as the people affected are, as different is their way of dealing with it – there is no right or wrong way. But experience shows: It is possible to reduce the psychological burden on patients by adopting certain behaviors.

Ms. Knebel, do you often hear the question "Why did I get cancer?"

Yes, again and again. My answers to this are usually: cancer can affect any of us. No one deserves it, we are not asked.

How do you experience patients after they have received the diagnosis?

Very differently. Almost all of them experience their thought patterns, beliefs, values and emotions being called into question. For many, the diagnosis initially triggers an existential crisis, fear of death and helplessness. They do not know how to continue to deal with their lives. The situation is very stressful for patients who are at the beginning of their life planning. For them, all their wishes and dreams seem to vanish into thin air. However, parents whose children are still small or professionals who see their job endangered by the disease also have great fears. In addition: Not all of them have relatives with whom they can share their worries, and many stand alone.

How do you provide support in these cases?

All cancer patients have to and want to find a way of dealing with this situation – their very own way. They want to live. First of all, they have to find a way to live with cancer, which can then become a life without cancer. We accompany them on this path. The path is as different as the patients themselves. Coping with the disease can begin with finding out where concrete and current support is needed. This can be household help, aids, care services, tutoring for children or something completely different. In our psycho-oncological conversations, there is also time and space to learn more about the diagnosed disease. Technical terms from the discussions with the doctors can be questioned, for example, and treatment options can be reflected upon and broken down concretely to the question "What does this mean for me? This makes it easier to adjust to the so-called treatment stress and to develop strategies in good time for coping as well as possible with this time. Many patients have to find a new interplay between body and soul, allow themselves the time for therapy and accept and understand it as an exceptional situation.

What advice do you give to relatives and friends, and how can they help?

It is a relief for patients to be able to communicate and to feel understood in their feelings of powerlessness and fear. It also feels good to be cared for and comforted, both by the relatives and by the professional caregivers.

When do you feel your work has been successful?

Every person has resources, abilities and sources of strength, but sometimes they lie fallow. When I and my team succeed in discovering and mobilizing these together with the patients, then that is a very important step. If we also succeed in teaching and practicing relaxation and pain management techniques together, then that is also a success. If the person suffering from cancer feels: I am not only sick, but I remain me, I get to know myself anew in a new situation, which I want to face – as I have always managed to do in my life so far – then that is a huge gain!

 
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