None of us ever expect to be diagnosed with lung cancer and when we are, it’s quite normal to feel very overwhelmed and fearful. We may even initially deny it and suggest that biopsy results and other tests must be wrong or those of another patient. Trust in yourself that you have the skills to deal with this overwhelming change. If you are experiencing a medical emergency, please contact your doctor or emergency health care personnel immediately.

While denial can be an effective short term coping mechanism that can protect us from being overwhelmed by a lung cancer diagnosis, when we first learn of it, it’s important to begin to deal with the reality of your diagnosis one step at a time. Ask your doctor / nurse to help you understand all the information – test results, treatment options, and unfamiliar words – you need to begin to move forward. Accurate information and open communications with your health care team are some of the most important coping tools you can have on your lung cancer journey. A professional counselor – a social worker, therapist, psychologist or other mental health professional – can provide support as you begin to organize your thoughts and put together a list of questions to ask your doctor. Religious or spiritual counselling may also offer comfort and support. 

We live in a world where it seems everything must have a cause. So given a diagnosis of lung cancer, it’s natural to be both angry and curious and want to know what caused your lung cancer, and whose responsibility it might be.

If you can set aside your anger and focus on how you might channel your emotional energy into becoming actively involved in your treatment planning and decision-making, this may be a more helpful thing to do right now. While your doctor will work with you to make those decisions, a professional counselor – a social worker, therapist, psychologist or other mental health professional – can support you to refocus your energy on getting the best treatment for your situation. Religious or spiritual counseling may also offer comfort and support. 

As you begin to deal with your lung cancer diagnosis, it’s natural to want to learn more about it. Many of us go to the Internet for that information.  Often, the information on survival rates can be especially depressing and evoke strong feelings of anxiety.  

Your doctor is the best source of information about your type of lung cancer and your overall prognosis.  But keep in mind that their information is an educated estimate of what they think may happen. At this point, no one really knows how well you may respond to treatment or what newly approved treatments or clinical trials may be available to you. As for those statistics, remember that a statistic never identifies any one person. Statistics represent the collective lung cancer experiences of thousands of individuals. As one lung cancer survivor said to a newly diagnosed colleague who began reciting the scary statistics, “Did it have your name next to it?” 

Many lung cancer survivors find that joining a lung cancer patient support group can help them gain valuable perspectives on survivorship through the experiences of the other group members. Support groups are often available as face-to-face meetings, as an online group or by telephone. Contact your national or local cancer organization for help to find a lung cancer support group near you.There are also cancer support organizations that can connect a new lung cancer patient with a more experienced patient who is willing to share their lung cancer experiences.  

Unfortunately, lung cancer is stigmatized by some people who think that individuals bring it upon themselves because the disease is associated with smoking tobacco. When asked “Did you smoke?” it’s natural to want to respond angrily to such insensitive behavior.  

Rather than responding directly to the question about smoking, ask them, “Why do you ask?” and then say, “I’m sure you realize that lung cancer has many causes besides smoking. These include exposure to second hand smoke; industrial chemicals; radon, a colorless, odorless gas which escapes from the ground into the air, and many other environmental factors. Did you know that ¾ of people diagnosed with lung cancer are not smokers at the point of diagnosis; and that almost 18% of people diagnosed with lung cancer never smoked and 60% had stopped smoking before diagnosis?”  Turning an inconsiderate question into a teachable moment can be a very powerful way to confront lung cancer stigma. 

You may also wish to consider joining a lung cancer patient support group. These groups share the principal theme, that “…it doesn’t matter whether you’ve never smoked, quit smoking years ago or stopped when you got your diagnosis…the only important thing now is living each day with lung cancer as well as you possibly can.” Contact your national or local cancer organisation for help in finding a lung cancer support group.

Hearing the word “inoperable” can certainly make you feel that your lung cancer situation is hopeless, but there are more treatment options today for people with advanced lung cancer. It’s important that you rely on your inner strength to hang in there and ask what other treatments can help you. 

It is essential that you discuss your diagnosis with your doctor. You may also want to consider getting a second opinion. While the lung cancer tumor is considered “inoperable” that does not mean that it is “untreatable.” Learn about the various treatment options available to you, including clinical trials testing new treatments for lung cancer, and whether surgery may be an option later in your treatment plan. A national or local cancer center or cancer organization can direct you to trustworthy lung cancer resources for information and support and may be able to refer you to a doctor for a second opinion.

It’s not unusual to react angrily to a diagnosis of lung cancer, especially if you’ve spent some time seeing numerous doctors trying to find the cause of your symptoms.  

It’s not always easy to diagnose lung cancer. The symptoms that you presented with are also symptoms of other more common respiratory disorders. Often, doctors will treat for these illnesses first to rule them out. Try setting aside this anger and instead acknowledge the fact that you are now a person with lung cancer. You can be better served by focusing your emotional energy on the beginning of your lung cancer journey. This early work can include coping with additional diagnostic tests to properly stage your lung cancer, learning about your treatment options, perhaps getting a second opinion, and discussing the changes you’ll experience with family, friends and your employer. A number of lung cancer survivors have wisely counseled “Don’t get even…get better!” Working with a professional counselor to replace your anger with taking control over your lung cancer and its treatment can be extremely valuable. A professional counselor can be a social worker, therapist, psychologist or other mental health professional. Religious or spiritual counseling may also be helpful in this situation.

Sometimes, people diagnosed with lung cancer who have smoked believe that it’s their fault and buy into the guilt and shame associated with the lung cancer stigma. This may affect their decisions about treatment and even staying in treatment. If you feel this way, there are a number of resources that can help you work through these feelings.  

It can be helpful to change one’s thinking about lung cancer from being a punishment for an unhealthy practice to being a disease that randomly (by chance) affects smokers, never smokers and former-smokers alike. Smoking certainly increases one’s risk of being diagnosed with lung cancer, but not all smokers develop lung cancer and smoking is not the only cause of the disease. A professional counselor – a social worker, therapist, psychologist or other mental health professional – can help you work through feelings of guilt and shame, and more importantly, encourage you to get the treatment you need. Religious or spiritual counseling may also be helpful. You may also wish to consider joining a lung cancer patient support group, where members tend to help each other move away from focusing on past practices, such as smoking, and put an emphasis on living each day with lung cancer as well as you possibly can. Some cancer organizations offer support groups that meet face-to-face, online or by telephone. Contact your national or local cancer organization for help in finding a support group.

Newly diagnosed lung cancer patients are encouraged to consider getting a second opinion. Often this brings about a sense of concern on the patient’s part as to whether getting a second opinion will be considered by their present doctor as being “disloyal.” Keep in mind that you have every right to have a second opinion. 

Doctors are quite familiar with the second opinion concept. Your doctor may have provided a second opinion to other patients. You should feel free to discuss with your doctor getting a second opinion, and have he/she help you get copies of the necessary records required by the doctor providing the second opinion. Second opinions often result in agreement with the treatment plan originally proposed and may include some additional treatment alternatives. In rare circumstances, if your doctor is unreasonably negative about getting a second opinion, you may wish to consider whether he/she is truly interested in you receiving the best care possible for your lung cancer and explore the possibility of changing doctors. Your national cancer organization can help you find a doctor in your area who is experienced in treating lung cancer patients and providing second opinions.

It’s not unusual to be overwhelmed with all the details your doctor may be trying to convey during your consultation. The fear and anxiety that you’re dealing with can be very distracting and contribute to a sense of hopelessness. There are some very concrete steps you can take to overcome this. 

It can be very helpful to have a family member or good friend attend visits to the doctor with you to be that “second set of ears.” They can listen, ask questions and take notes on what is being said. After the visit, it’s a good idea to sit down either in the waiting room, or in your car out in the parking lot to go over what the two of you heard. You may find it helpful to make a list of questions for the doctor and give it to him/her at the beginning of your visits. Some patients have shared that their doctors are agreeable to having them fax or email a copy of the questions to them a day ahead of a scheduled meeting. List the questions you think are the most important first. Focus on the medical and treatment information you would like to know. Professional counseling is an excellent way to get the support you may need to find answers to your emotional issues. A professional counselor can be a social worker, therapist, psychologist or other mental health professional. Some cancer support organizations offer counseling face-to-face, by email or by telephone.  

It’s natural to want to protect your children from bad news and possibly frightening subjects. This can make it difficult to decide how much to tell them about your diagnosis and what you are experiencing. While none of us are ever prepared for this kind of talk with our children, we can do it by following a number of simple guidelines.

Talking with your children about your cancer is very important. First, be sure that your conversation is suitable for their age and what they can understand. Reassure them that they had nothing to do with causing your cancer, and that they cannot catch your cancer. Provide accurate information about lung cancer. Explain the treatment you’ll receive and how it may impact everyday life. Listen carefully to your children’s questions and answer them as accurately as possible, taking care not to provide information that wasn’t sought. Encourage your children to express their feelings and reassure that they will be cared for. And most especially, reassure them that despite all that’s changing, your love for them has not changed. A professional counselor – social worker, therapist, psychologist or other mental health professional – can help you talk with your children about your cancer. Religious or spiritual counseling may also be helpful in this situation. Some cancer support organizations have printed and online information on talking with children about cancer.

Your lung cancer treatment may require you to change your work schedule / routine or even stop work temporarily during all or parts of your time in treatment. Learning about how your ability to work may be affected before you start treatment, and by looking into various regulations and laws that can protect your job during lung cancer treatment can help to reduce this anxiety.  

It’s best to discuss your concerns about continuing to work early on with your doctor, who can advise you on whether he/she believes you will be able continue working and at what level during your treatment. He/she will base their advice on your overall health, the stage of your lung cancer, what is known about the side effects of your treatment and the type of work you do in terms of duration, physical demands and stress levels. You should also contact your employer’s human resources person or department and discuss your upcoming treatment with them. Counselors at cancer support organizations can provide assistance with employment rights and other resources.

It’s common to feel anxiety over how you’ll pay for your treatment and how you and your family may be forced to make drastic changes in your lifestyle. When your sense of financial security is threatened, it’s also natural to feel fear. But when you confront the financial issues, it can reduce some of the anxiety and provide a sense of having some control over your emotions.

One of the best strategies for coping with the financial stress of lung cancer is to confront the financial issues. The very act of getting involved can allow you to feel that you are taking some control over issues that you feared were uncontrollable. Having a family member or a close friend assist you can be helpful, especially if they are willing to research potential resources to ease your financial burden. Here are some steps to consider:

• Speak with your doctor about the estimated costs of the recommended treatment options if they are not covered by your government’s health system or private insurance. 
• Understand your rights and appeal procedures.
• Contact your employer’s human resources person or department and ask about sick-leave allowances, disability benefits and / or compensation programs (if applicable) and how to apply for them.
• There are a number of cancer organizations or foundations that can provide limited or partial financial assistance for cancer patients who qualify.
• Develop a profile of your current financial situation. Ask a financial advisor, social worker or trusted friend for help with this task if needed.
• Contact creditors and discuss their policies on late, deferred or extended payments.

Lung cancer is an aggressive disease so treatment for it may be similarly aggressive. You may find the side effects to be so severe that you fear the cancer is progressing or getting worse. Your ability to openly communicate with your health care team about your concerns may help to minimize this fear. 

For any side effects you may experience as a result of cancer treatment consult with your doctor or nurse about ways to manage them. A discussion with your health care team can be extremely helpful in easing your fears that the significant discomfort you’re experiencing is treatment related rather than the lung cancer getting worse. Some lung cancer patients have shared that they used imagery as a coping strategy to deal with their discomfort. For example, one woman described how she saw her chemotherapy as a troop of “white knights” riding throughout her body and spearing the “evil lung cancer trolls” on their lances. She was able to visualize her discomfort as the result of these ongoing clashes and found it much easier to tolerate. A professional counsellor – a social worker, therapist, psychologist or other mental health professional – can also work with you to develop coping strategies. Some cancer support organisations offer tips for managing side effects of treatment and counselling as well.

Most treatments for lung cancer can be expected to cause some level of fatigue as a physical side effect. The resulting limitations on energy and ability to do things can be quite frustrating.

For any side effects you may experience as a result of cancer treatment consult with your doctor or nurse about ways to manage them. Try to see yourself as a “patient in treatment,” which is a very different place than where you were before you started treatment. The expectations you had of yourself then, really don’t work in this new environment. Creating a new set of expectations for yourself can often lessen your frustration and make it easier to just “go with the flow” of having treatment. 

It’s not uncommon for chemotherapy to temporarily upset your stomach and make the meals and foods you used to love no longer appealing. Sitting down for three meals each day can be a turn off. However, family members often view food as a gift of life and love and may interpret your lack of interest in eating as a rejection of their love and life-giving gifts. Strengthening communication with your family around this issue can help to reduce your frustration.

For any side effects you may experience as a result of cancer treatment consult with your doctor or nurse about ways to manage them. There are many resources in print and online, with helpful information on nutrition for cancer patients during treatment. Share this information with family members to help them understand how you feel. Eating techniques such as “grazing” and eating “small portions” can be helpful. Create new “special times” with family without meals. 

It’s normal for you to have a great deal of hope that the chemotherapy you are on is going to work and make a difference for you. When your doctor tells you that the treatment is no longer effective and that you will be starting a new treatment, it’s easy to be overcome by fear and hopelessness. You may wish to try some new coping strategies that can help to overcome these feelings. 

Patients often fear asking the questions, “What next, and how about after that?” because they fear the answer. Your doctor is familiar with your diagnosis and history of responses to earlier treatments. He/she can provide information about why the new treatment is most appropriate and about other possible approaches should the new treatment fail at some point.

Many patients find that the coping strategy of “staying in the moment,” can be very helpful in this situation. It allows them to focus their emotional energy on today’s known facts rather than thoughts about the unknown future.

Professional counseling can be an excellent way to get assistance with learning how to “stay in the moment.” A professional counselor can be a social worker, therapist, psychologist or other mental health professional.  Religious or spiritual counseling may also offer help, and some cancer support organizations offer counseling as well through face-to-face meetings, by email and by telephone.

If you can move away from the feelings of fear, anxiety and loss of control you may have had when you were first diagnosed with lung cancer, it can be very helpful to feel hopeful about your lung cancer situation as you move into the treatment phase of your lung cancer journey.

Feeling hopeful at this point in your lung cancer journey can be a real plus for both tolerating the discomforts of your treatment and enjoying some quality of life. You may feel that you have regained some control over what is happening to you by working with your doctor to learn about your lung cancer and choose an appropriate treatment option. Reflect on how you are able to manage something you considered unmanageable just a short time ago. You can support your feelings of hopefulness by using a “staying in the moment” coping strategy and/or using visualization and guided imagery techniques to see treatment in entirely new ways. Sometimes, affirmations such as “I’m in charge here…” or thinking of yourself as a “healthy person with lung cancer” can also contribute to hopeful feelings. A professional counselor can help you learn and practice some of these hopeful strategies. A professional counselor can be a social worker, therapist, psychologist or other mental health professional. Religious or spiritual counseling may also offer be helpful in this situation.

The socialization that can occur between you, your health care team and other patients in a treatment setting can create a powerful sense of support throughout the treatment experience. After completing treatment, the loss of this support can make you feel isolated and abandoned. You can find new resources to replace this sense of loss and isolation.

Many patients feel lost or abandoned when their treatment ends. Joining a post treatment survivor’s support group can be very helpful in overcoming that sense of loneliness and isolation. Many cancer treatment centers now offer these groups and some cancer advocacy and support organizations also offer survivor support groups that meet in person, online, or by telephone. Other patients, out of treatment, find that contributing their time and effort to increase lung cancer awareness and research is a special way to overcome the post treatment isolation. Working with other ex-patient volunteers provides a sense of bonding with others and accomplishing something worthwhile in the effort to get out the word about lung cancer. Both national and local lung cancer advocacy and fund raising organizations welcome volunteers to help with awareness and outreach activities. 

It’s not unusual for you to have a sense that as long as you are in treatment you’re “protected” and have a shield that will keep your lung cancer away. No longer receiving treatment can make you feel isolated and vulnerable.  

It can be very helpful to discuss these feelings with your doctor who can assist you with understanding why it was medically appropriate to end your treatment. In most instances, the focus of your treatment was to stabilize your cancer or to put the cancer in remission, rather than acting as a shield to prevent the cancer from returning. A professional counselor – a social worker, therapist, psychologist or other mental health professional – can help you finds ways to deal with this new chapter of your lung cancer experience. Religious or spiritual counseling may also offer comfort in this situation. Some cancer support organizations offer counseling through face-to-face meetings, by email, or by telephone.

If you normally live alone, you probably consider yourself fortunate when people close to you take on the role of caregiver, providing excellent care and support, oftentimes in their own home. Sometimes, your caregivers may become so engaged in their caring role that they find it difficult to give it up when your health improves and you can be independent again. Professional counseling can help your caregivers and you achieve a more emotionally comforting situation.

It’s important to acknowledge that good caregivers have invested substantial physical and emotional energy, and possibly made personal sacrifices, in taking on a role that they probably never expected to fill. Being a good caregiver can provide them with enhanced of self worth and a feeling of truly being needed. Your improvement to a point where you no longer require that intense level of care can be difficult for your caregiver to accept. They may react by dismissing the doctor’s recommendations and urging you to slow down and stay under their care.  

You may find it helpful to arrange a consultation with the caregiver and your doctor to review your improved health status and need for less care. Find a quiet time to talk with your caregiver and reflect on the wonderful care they provided. You may find it useful to identify new, less intense tasks, which your caregiver may take over. The tasks should be designed to assist you in your new, more independent environment and allow your caregiver to change their caregiving contributions. Arrange for a few family counseling sessions, which could provide both you and your caregiver with a safe forum to discuss your new relationship and expectations. Religious or spiritual counseling may also be helpful in this situation.  

It’s not unusual for you and your family members to view the end of treatment from very different perspectives. You may find it difficult to share your family’s joy and optimism and your fear that your lung cancer will come back. This difference can make you feel frustrated and emotionally isolated from them.

Joining a cancer survivor’s support group can be especially helpful in coping with this situation. You will find that you are not alone in having these feelings, nor is your family much different from the families of other patients. Often, group members are also able to share that it wasn’t until their treatment ended that they confronted the reality of how serious and threatening their diagnosis was, and how they are dealing with a post traumatic reaction to it all. Individual professional counseling may also be helpful, but a group setting should usually be attempted first, whenever it’s available. Religious or spiritual counseling may also offer comfort in this situation, and some cancer support organizations offer either group or individual counseling.

Post treatment follow-up scans can create tremendous anxiety for you as a lung cancer patient. While you know that the scans have to be taken regularly and you’re familiar with all the good reasons for doing them, the fear of what the scan may find can be extremely distressful. Getting professional counseling around the time of the scan and learning some new coping strategies can be very helpful in overcoming this fear.

Many patients find that the coping strategy of “staying in the moment,” can be very helpful in the period between their scans. They find that staying focused on today’s known facts rather than thinking about what may or may not appear on the next scan, frees them from anxiety. Professional counseling can be an excellent way to get assistance with learning how to “stay in the moment.” Some patients also find it helpful to have one or two sessions with a professional counselor just before their scan to support coping with their anxiety. A professional counselor can be a social worker, therapist, psychologist or other mental health professional. Religious or spiritual counseling may also offer comfort in this situation, and some cancer support organizations offer counseling through face-to-face meetings, or by email or telephone.

News of your lung cancer returning can be a terribly disappointing experience and can destroy all the hopes you had for being disease free for a longer period. You may also feel hopeless about seeking further treatment. It’s important that you seek assistance when you have these feelings.  

Before making any decisions about further treatment, arrange for a consultation with your doctor to discuss your treatment options and possible outcomes and benefits. Be sure to have all your questions answered before making your treatment decision. Work through this process with a professional counselor who can assist you in asking appropriate questions of your doctor and in helping understand your own personal and medical needs and goals. A professional counselor can be a social worker, therapist, psychologist or other mental health professional. Religious or spiritual counseling may also offer comfort in this situation, and some cancer support organizations offer counseling through face-to-face meetings, or by email or telephone.

At some point, you may feel that you no longer wish to continue treatment. In addition, you may want to have some control over the stress and physical discomfort, and prefer to enjoy some quality of life rather than continue to endure treatment which offers little or no quality of life. Such feelings are not uncommon and there are things you can do about them.   

Deciding to discontinue active cancer treatment should always be a fully informed decision made in collaboration with your doctor. He/she can provide information on what you can expect if you choose to end treatment. The discussion should address if that choice will ease the pain and discomfort you are currently dealing with, how much longer you might live without active treatment, and what palliative and hospice care you may need and how to access it. 

Sometimes, family members may join this discussion and attempt to influence you to continue treatment and not “give up.” Remember that it’s your decision to make. A professional counselor can help to ensure that your decisions and wishes are considered fairly by all and respected. A professional counselor can be a social worker, therapist, psychologist or other mental health professional. Religious or spiritual counseling may also offer comfort in this situation. If a decision is made to end active cancer treatment, it can be helpful to arrange for hospice care where available and appropriate ahead of time.   

You may feel strongly about staying in treatment as long as possible even when your doctor advises you that he/she believes there is little point in continuing further treatment. You can act on your desire to continue fighting by getting a second opinion.

It can be useful to seek second opinions on other treatment options. Doctors at major cancer centers are often the best resource for this information, and they may indeed have appropriate treatment options for a late stage lung cancer patient to try. You will need to provide this doctor with a complete set of records and reports documenting your treatment history. As with all treatment discussions, you should be fully informed on the side effects and the anticipated goals of any treatment being recommended.   

You may come to a point in your lung cancer journey where you understand and are at peace with the idea that you have a life-limiting illness. However, the idea of coping with possible pain and physical distress can result in real fears and a sense of being powerless to avoid it. There are definitely resources that can help you.

If you are anxious about dealing with pain and physical distress speak with your doctor about referrals to a palliative care specialist or hospice as early as possible. Palliative care is specialized medical care for people with serious illnesses at any age and any stage of their disease. It is focused on providing relief from the symptoms, pain, and stress of a serious illness, such as late stage lung cancer. The goal is to improve quality of life for both you and your family. This care is provided by a team of doctors, nurses, and other specialists who work together with your doctor to provide an extra layer of support. If your doctor believes that your health situation has progressed to a point known as “life limiting,” he/she may suggest a referral to hospice care instead of palliative care.  Hospice care provides supportive care to people in the final phase of their illness. It focuses on providing comfort and quality of life through the use of aggressive pain management so that you can be free of pain. Hospice care may be provided to you either at home or in a hospital-like facility. It is administered by a specialized team, which includes a doctor, nurse, social worker and clergy person, who are focused on providing you with physical, emotional and spiritual comfort.