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Having cancer is hard. It impacts the person with cancer and their loved ones. Having cancer affects the physical, social, emotional and spiritual parts of life. This is the psychosocial effect of cancer.

Psychosocial problems may include:

• Trouble coping with having cancer
• Feeling apart from family and friends
• Changes in how a family gets along and works together
• Problems with making decisions
• Concern about not being able to do what you enjoy
• Problems working or going back to work
• Worries about money
• Stress about making choices about care
• Problems talking about how you are feeling
• Changes in how you feel about your body and sexual self
• Grief
• Fear of the cancer coming back
• Fear of death and dying
• Concerns about being able to provide good care for a person with cancer

Some people have more specific mood changes, such as anxiety, depression and distress.

If you need help, there are teams of experts available who understand how cancer affects a person and their loved ones.

It is normal to need some extra help when you’re dealing with cancer. In fact, studies show that people with cancer who have social and resource support report better quality of life. But many people who could benefit from support services don't use them because they don’t know about them or don’t know how to find them. 

Psychosocial support can include counseling, education, spiritual support, group support, and other services. These services may be provided by psychiatrists, psychologists, social workers, psychiatric clinical nurse specialists or nurse practitioners, licensed counselors, or pastoral counselors. They can help you deal with your issues and refer you to other types of support as needed. 

Think about the kinds of problems you have, how much your emotions bother you, and how you have coped in the past. This will help you decide which services can best help you.

You should also talk to your cancer care team about any psychosocial problems you are having, so they can help you find the right support.

Support groups

Support groups bring together people with similar situations. In these groups, people can share their concerns and learn how others have coped. Support groups can help people deal with their feelings and side effects of treatment. They may also help members make decisions by sharing what they have learned. Support groups might also help a person figure out how to deal family concerns or day to day issues like work and money concerns.

 There are support groups for all sorts of people with cancer. For instance, groups may be for:

• People with a certain kind of cancer
• People with any type of cancer
• People getting a certain treatment
• People at a certain point in their cancer (such as ending treatment or dealing with cancer that has come back)
• Women or men only
• People in certain age groups

There are also support groups for families, children, and caregivers of people with cancer. These groups often discuss common concerns. These may include changes in relationships, fears about the person with cancer, and how to best support the person with cancer. Support group for children and teens are grouped by age. There is often a support group for parents as well.

Some groups are led by professionals, such as oncology social workers, psychologists, or oncology nurses. Other groups are led by cancer survivors. Some groups are more structured, such as those that provide education. Others are open to whatever the group members want to discuss.

There are also options for when and how support groups meet. Some support groups meet in person while others meet online. Some include the same people in each meeting while others allow people to come and go as they need.

Privacy is key for support groups. It is vital that everyone feels safe talking about their concerns and feelings. Members need to know that what they say will not be shared outside the group.

Choosing a support group 

If you decide to join a support group, talk to the contact person about:

• Who the group is meant for
• Where and when they meet
• Whether meetings are in person or online
• How many people attend
• Who leads the meetings
• Whether the group is meant to provide education or support
• Whether you would need to talk or could just listen

 You might want to try a couple of groups to see which feels right for you. Your comfort level is a helpful gauge of how good a fit the group is for you.

Individual (one-on-one) counseling

One-on-one counseling might be a good option if your feelings are keeping you from doing your normal activities. In counseling, you can talk with a trained professional about your worries and concerns. Having cancer or having a loved one with cancer is a different experience for each person. Individual counseling gives you a chance to focus on your own feelings and concerns.

One-on-one counseling can help you:

• Focus on what you are most bothered by
• Learn ways to cope with your cancer and changes in your life
• Deal with symptoms from your cancer and treatment
• Figure out how to handle changes, such as end of treatment or if your cancer comes back
• Figure out how best to deal with family issues
• Deal with strong feelings
• Talk about your concerns about intimacy and sexuality

A counselor may also suggest couples or family counseling. This helps a couple or family figure out what problems they are having. Learning why you or your family members act in certain ways are key to dealing with it. A counselor will work with your family to improve how they express their feelings and help resolve conflicts. This can help the family come up with ideas about how they can better work together.

Some people may also join group counseling. People who have the same kinds of concerns meet to share what they have been going through and support each other. Groups are led by a counselor and have more structure than a support group.

Counseling, either one-on-one or group, may also be helpful for children or caregivers of a person with cancer.

Choosing a cancer counselor

When looking for a counselor, think about the kind of help you need. There are many options, such as psychiatrists, psychologists, oncology social workers, psychiatric nurses, licensed counselors, and pastoral counselors. Each has different training and focus. If you are not sure which one to choose, ask your cancer care team what they suggest.

Most of the time, you will want a counselor who has experience working with people with cancer. Counselors who focus on cancer usually know more about how people react to having cancer. A counselor’s experience with cancer, whether personal or professional, helps you see that your feelings are normal. They can also help you make sense of what’s going on with you.

Once you know what type of counselor you would like, ask your cancer care team about your options. If they don’t offer these services where you get treated, ask about counselors in your area. You might also ask for ideas from others with cancer where you get treated or through online or in-person support groups. It can also be helpful to check with your insurance company. They likely have a list of counselors covered under your plan.

Once you have found a few counselors who might be a good match for you, see what you can find out about them. Many will do a short phone call to discuss what you are looking for and whether they think they can help you. (There may be a cost for this call, but not always.) This can help you get a better feel for their style and your comfort with them.

Once you begin meeting with a counselor, make sure the relationship is working well for you. Think about whether you:

• Feel safe sharing your concerns with this person.
• Trust that they are able to help you.
• Feel that the counselor listens to you and knows who you are as a person.

 Your feelings may be hard to describe, but trust your instincts. If you just don’t feel at ease after a few sessions, you may want to try someone else.

Paying for counseling services

Most health insurance plans pay for some counseling, But coverage may be limited. Mental health coverage is supposed to be part of most insurance, but sometimes the amount may not meet your needs. Some policies only pay for a limited number of sessions.

An insurance plan may also limit your choices about whom you can see. Your insurance might only have contracts with certain counselors. Also, check on your co-pay and how much your insurance will pay for visits.

If you cannot afford counseling, see if there are free counseling services in the hospital or clinic where you get treated. Your oncology team should know of services in your area that may adjust fees based on your income. There might also be services offered at low or no cost.