Suggestions to Help Cancer Patients Reduce COVID-19 Stress

COVID-19, the infectious disease caused by the novel coronavirus, has confronted the world with new uncertainties. These unknowns have naturally caused panic.

Fear is a very human emotion... We are all more or less uneasy because of the outbreak. People with serious illnesses such as cancer may be more anxious during this period, but managing this prolonged situation is still within our power. We need to analyze and understand the situation well and learn to live with it.

In this article, you will find questions posed to psychologist Shelley Johns about managing COVID-19 stress, along with her answers.

At Times Like These, How Can People Tell Whether They Are Experiencing Stress or Anxiety (Worry)?

Stress usually manifests itself in four areas of our lives: our emotions, bodies, behaviors and thoughts.

Common emotions amid everything happening now include fear, worry, sadness, confusion, frustration and anger. Some people may be feeling lonely because of social distancing. In this situation, we can observe our emotions, acknowledge them to ourselves and then choose how to turn them to our advantage. For example, fear of COVID-19 may persuade us to stay home to protect ourselves from the virus. Loneliness may prompt us to call a friend or have more video chats with family members who live far away.

We may notice the effects of stress on our bodies through muscle tension, headaches or greater tiredness than usual. While watching the news, we may feel our heart rate increase or discomfort in our chest. We may experience some shortness of breath or restlessness.

Some behavioral signs can include sleep disturbances, irritability, changes in appetite, nail-biting and pacing. Our stressful thoughts may include the idea that "the world will never be the same again," but we should instead think, "although this is a very challenging time, I can still persevere and live accordingly."

How Do Stress and Anxiety Affect the Health of Someone Who Has Survived Cancer or Has Recently Been Diagnosed?

Some of the most resilient and strong-willed people in the world are cancer patients. From the moment of diagnosis, they become adept at adapting to unwanted realities and uncertainty. People with cancer have looked death in the eye and still know how to move forward.

One of my greatest concerns right now is cancer patients whose immune systems are already compromised. The prolonged stress we are all experiencing can negatively affect the immune system, which is already weakened in people with cancer. I think it is important for immunocompromised people, such as cancer patients, to maximize their physical and emotional health during the COVID-19 threat by maintaining an active life. The basic strategies for physical health are clear: follow social distancing, wash hands frequently and properly, keep surfaces clean, and contact an oncologist or primary care physician if fever or cough occurs. For emotional health, I recommend various research-supported stress-management skills.

What Types of Skills Do You Recommend?

One thing we can all do through this experience is decide what kind of person we want to be. In other words, during the COVID-19 crisis, which deeply held values would you like to embody?

For example, would you like to be compassionate and generous toward others? Would you like to deepen your faith or reconnect with friends you have not spoken to recently? Would you like to be known for your sense of humor under stress? Allowing our values to guide our actions in uncertain times can make them a compass that helps us find our way.

Another suggestion is to find a practice that helps you feel grounded and release energy. This might be deep breathing, prayer or mindfulness meditation. Mindfulness means being fully "awake" in the present rather than caught up in thoughts about the future or past. Physical activity is also a healthy way to relieve stress, and this can be as simple as maintaining social distance, trying a few yoga movements or taking a brisk walk. Doing something to help others is important too. Everyone knows someone who lives alone, so staying in close contact with that person by phone can give this experience meaning for both sides. I also recommend writing down things we are grateful for. Making a list of three specific things you are grateful for each day can be a pleasant way to remember that life is more than cancer and COVID-19.

Would You Recommend That Patients Stick to a Routine to Help Manage Stress and Worry?

Absolutely! Having a healthy routine and schedule for our day is one way to maintain some control over our lives. For example, going to bed and getting up at the same time each day and limiting naps can help maintain energy and normality. Eating healthy, regular meals and limiting alcohol consumption are important too. Scheduling physical activity every day, to the extent possible for each person, is another excellent way to build resilience during COVID-19 stress. Meditation, prayer and other self-care strategies, such as listening to mood-lifting music, can also be part of the daily schedule.

• Related topic: Art-based cancer therapies

What Would You Suggest People Do to Take Their Minds Off Current Events?

Choosing activities based on our values is the best distraction I can think of. For example, you can text family members, organize family photos or learn something new online. Rather than feeling stuck at home, one of my patients decided to use this opportunity to learn to speak Spanish through an online course. Having activities planned each day can help us maintain a sense of normality during this highly unusual time.

• Related topic: What is photography therapy? How can it help during cancer?

Is There Anything You Would Recommend to Help People Avoid Unnecessary Stress and Worry?

What I do not find helpful right now is too much exposure to news and social media. We all need to stay informed, but excessive media consumption can increase distress rather than reduce it. Personally, I limit my exposure to the news to one hour a day, because research shows that people felt more anxious with greater exposure to social media and news during past public health crises. Consider replacing some of the time you would spend watching the news with a funny film or a favorite comedian.

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