Family Dynamics

You finally have a place of your own and you’re thrilled – despite the challenges. You are settled into your new apartment and set everything up just the way you like it and now, but now, faced with a cancer diagnosis, the challenges of living on your own are now so much greater and can be too much to take all at once. Many young women return home during their cancer treatment for support emotionally, physically and financially. Remember, a cancer diagnosis affects the whole family and leaning on your family for support can help you get through it.

Moving home can open up a new dynamic between family members, whether you just moved out or have been out of their home for years. Stress and frustration are often the result of family interactions and understanding of their family member battling a life threatening illness at a young age. Patients who are 18 and older and are legally capable to make their own decisions may create a sense of separation between the parent and child during the time of illness. That dynamic can be further complicated by issues of insurance if you are under 26 and still on your parent’s health plan. You may find that your parents want to be more involved in your treatment plan or sit with you during chemotherapy. This is your fight and they are there to help you. If you want to be alone, don’t feel guilty; it’s ok to ask for privacy or some personal space. Remember that your treatment is your priority and taking time for yourself may be necessary when the stress of family dynamics emerge. And be open to leaning on family and friends when you need a little help.

Parents

For patients who live at home with their families for the treatment process, many report that they fear their parents will become overprotective as a result of their diagnosis. An important reminder for cancer patients living with their parents during treatment is that asking for help does not mean that you have lost your independence. As a young woman, it may be difficult to remember that although your parents are frequently asking questions, checking in on you and giving unsolicited advice, they are in need of their own opportunity to cope. Just as you would handle difficult news, your parents will need to find their preferred way of coping. One way that you can assist them in this is to allow them to ask questions and offer advice (even if you don’t take it). There is a difference in asking for practical help and asking for someone to hear your thoughts. Be sure to specify before discussing your feelings in order for everyone involved in the conversation to feel comfortable.

Siblings

Your siblings often deal with different emotions in order to cope with difficult news or changes in their family dynamics. They may pick up on the tensions between your parents and the new fears circulating in your home. Many siblings may not understand you have cancer at such a young age which could bring up questions of their own mortality. They may fear for the future for both you and your family. Sadness and grief are common feelings that are caused by the “new normal” that your family has to adjust to. In some cases, there may even be a sense of jealousy in siblings due to the amount of attention that you require during treatment.

You may find that your sister or brother feels guilty because s/he is not the one going through cancer treatment or may feel guilty about past arguments or harsh feelings felt towards one another. To help your sibling move through these emotions; include him/her in your survivorship by designating tasks like taking you to your appointments or keeping you company during treatment. Allowing siblings (and parents) to play a significant role in the patients healing can be therapeutic for the entire family.

Children

Being a mother can be stressful enough without a cancer diagnosis. You may be feeling a loss of control due to your diagnosis or the side effects of treatment may impact the everyday tasks of being a mother. When your friends or family ask how they can help, take them up on an offer whether it is help cleaning or cooking, or just getting to your appointments. There are some great free apps you can download where friends can sign up to help out with tasks like MyLifeline.org or Caringbridge.com. Remember – It’s OK to ask for help.

Social life

You are now faced with a diagnosis many of your peers may not understand and your priorities have likely changed. Treatment can be emotionally draining – but you are not alone! There are numerous networks and resources for young women battling cancer who may also be asking many of the same questions and share many of the same feelings you have:

  • I feel alone, like I’m missing out.
  • I’ve lost my hair and I don’t feel beautiful anymore.
  • I’m dealing with menopause long before I’m supposed to.
  • How am I going to build my career when all my energy is focused on my treatment?
  • How am I going to date again?
  • Why does everyone treat me differently, I’m the same person!

You may find that your friends or coworkers treat you a little differently. Whether it’s out of concern or because of their own realization that cancer can happen at any age, now is good time to surround yourself with the people who can support you during the difficult times. You are strong and resilient.

Dating, Intimacy and Sexual Health

You’re young, you’re supposed to be in your sexual prime, and you have ovarian cancer. At a time when you’re defining your sexual identity, this diagnosis can be devastating. Questions of fertility, body image and basic logistics, like how to tell a date you have cancer, can all seem overwhelming. You may feel that your fight with cancer is personal and not the business of the man or woman you are on a date with. Or, you may feel it’s dishonest to withhold that information about yourself with your partner. It is up to you how and when you share this information.

Take some time alone to think about where you are emotionally with your diagnosis. There are specially trained social workers who work with oncology patients to understand questions like these and can provide tactics for dealing with these conversations. Many oncology clinics employ therapists who specialize in sexual health concerns; talk to your doctor to see if s/he can recommend someone. For more information on support organizations, see the Resources section.

The physical side effects from treatment can compound many of those emotional side effects. Recovery from surgery can take several weeks and you may feel fatigued or lethargic and notice some changes in your libido. The change in hormones due to early onset menopause can also impact sexual pleasure and desire. Loss of estrogen can lead to the narrowing of blood vessels and secretions in the vagina causing vaginal dryness and can make sex uncomfortable or painful. Additionally, estrogen depletion and scarring from radiation may also cause a shortening of the vagina.

But the good news: there are also solutions! Over the counter lubricants can help with vaginal dryness due to menopause. Regular intercourse, or vaginal dilators if you are not ready for intercourse, can help to stretch your vaginal walls. Talk to your doctor about the benefits and risks of recently approved medications designed to help combat female sexual dysfunction. Open communication with your partner is critical to reestablishing a sense of intimacy when you’re ready.

Career and School

Whether you’re in school, just starting out in a new job or well on your way in your dream career, the emotional stress of a cancer diagnosis and the side effects of your treatment are going to make juggling your responsibilities more difficult.

Are you in school?

So you’ve determined your treatment plan with your health care team, but how does that fit with your other responsibilities like coursework and exams? Treatment can take a physical and mental toll on you – you may find a decreased ability to concentrate during treatment, feelings of sadness or fatigue and pain or nausea during treatment cycles and will likely impact your performance in school. Schedule a time to meet with an advisor or trusted instructor to talk about your overall goals in school and your goals during treatment. Work with him/her to devise a plan where you can meet these goals and still make your cancer treatment a priority. Keep in mind this may mean taking some time off or reducing your course load.

Are You Currently Working?

Adjusting to life with cancer while maintaining the steadiness of a job can be demanding.
Some common career related fears:

  • Underperformance due to fatigue/inability to concentrate
  • Losing your job because of your cancer
  • Inability to pursue other opportunities because of fear of losing health insurance
  • Fear of not finding a job after your treatment

All of these fears are legitimate and common. Remember – it is your choice when and how to discuss your diagnosis with your boss or Human Resources Department. This can be a nerve racking decision – Who do I tell? When will I tell them? How will this impact my job performance? First things first, it is against the law to fire someone because of a cancer diagnosis. In fact, your employer may be obligated to make certain accommodations under the Americans with Disability Act should you need them. Cancer and Careers is nonprofit that focuses on helping cancer survivors understand their rights in the workplace and gives them tools to help navigate the tricky waters of cancer and work.

Paying your bills

As a young adult handling new financial obstacles and information, whether your parents are handling the bills or you are taking on this task alone, being organized is a key factor to staying on top of payments. Creating a filing system that can be taken with you to each appointment will keep all bills and forms neat and organized. Talk to a nurse navigator or case manager in your hospital about working out a way to ease the stress of handling bills to help better understand them.

Cancer treatment costs can vary depending on your insurance plan, diagnosis and type of treatment. There are services out there to help if the costs start to get expensive. Check out the Resources section of this guide for local and national organizations. Your doctor’s office can also be a great resource. Often they will be willing to work with you on payment. Many doctors will tell you they would prefer patients be open with them about their financial situations and often they are able to prescribe comparable drugs that are more affordable if possible, thus lessening the stress on you. Your doctor’s billing office can create a payment plan for you or offer reduced rates base on your salary. Remember your priority is your health. Do not let bills stress you out, they’ll still be there when you’re finished with your treatment.