When you first learn you have cancer, everything seems to change in an instant. You may feel like your life has been turned upside down. Once the shock wears off, the process of making changes begins. You may have to rearrange tasks and routines in your life as you start treatment. The symptoms and side effects may take a toll on both your body and your emotions. You may have to learn new ways of talking to your loved ones and to your health care team. And you probably have a lot of questions to ask about adjusting to all the new issues that cancer brings.

It can seem overwhelming at first, but knowing what to expect may help you feel more at ease.

There is a lot to learn about cancer and your treatment. There are many things to remember. And if you’re scared or confused, it can be even harder to take it all in. But, there are things you can do to make it easier to learn.

Express yourself clearly. Describe your problem or concern briefly. State the most important points first.

Ask your doctor or nurse to write down the name and stage of your cancer. There are many different types of cancer. "Stage" refers to the size of the cancer tumor and how far it has spread in your body. Knowing the name and stage of your cancer will help you find out more about your cancer and help your doctor decide which treatment choices you have.

Learn about your treatment choices. Ask your doctor to tell you about your treatment options. Ask how each treatment can help and which side effects you might have. Try to learn all you can about each choice. Let your doctor know if you need more time to think about these issues before you choose one.

Ask as many questions as you need to. Your doctor needs to know your questions and concerns. Write down your questions and bring them with you to your visit. Ask your most important questions first, in case the doctor runs out of time. If you have a lot of questions, you may want to plan extra time to talk.

Let your doctor know your concerns about costs. Your health care team wants to know if you're worried about finances for your cancer treatment so they can help you find ways to manage them.

Don't worry if your questions seem silly or don't make sense. All your questions are important and deserve an answer. It's okay to ask the same question more than once. It's also okay to ask your doctor to use simpler words and explain terms that are new to you. To make sure you understand, use your own words to repeat back what you heard the doctor say.

Take someone with you when you go to the doctor. Ask a family member or friend to go with you when you see your doctor. This person can help by listening, taking notes, and asking questions. If you can't find someone to go with you, ask your doctor if he or she will talk with a friend or family member over the phone.

Let your doctor know how you like to receive news. Tell your doctor how you like to hear updates and information about your cancer. For example, do you want it all at once or gradually as you go through treatment? Do you want all the details or just the main facts? It's also very important to let your health care team know which family members or friends they can share information with and when.

Take notes or ask to record your conversation. Many patients have trouble remembering what they talk about with their doctor. Take notes or ask if you can record the conversation.

Know that you have a right to privacy. Your medical information is protected under the Health Insurance Portability and Accountability Act (HIPAA). This law gives you the right to receive and review your medical records. It also gives you the right to choose who your information is shared with, including friends or family members. This may be face-to-face, over the phone, or in writing. Your health care provider should let you know about your privacy rights, but make sure to ask any questions you may have about this topic.

Cancer affects family and friends, not just the person with the disease. The people in your life may also feel worried, angry, or afraid. Family members may be very supportive, or they may start acting differently towards you. Some may feel guilty that they're not sick, or they may feel helpless, not knowing how to help you.

Adjusting to the new situation

When you find out you have cancer, daily routines may change for everyone. Schedules may be focused around treatment. Someone in your family may need to take time off from work to drive you to treatments. Or, perhaps you need help paying bills or cooking meals. You may need help with chores and errands. Other issues that often come up are:

Changing Roles

When someone has cancer, everyone in the family has to take on new roles and responsibilities. A child may have to do more chores, or a spouse may have to help shop or do carpool. It can be hard for some to adjust to these changes.

Money

Most people find it stressful to keep up with money matters. Cancer can reduce the amount of money your family has to spend or save. If you're not able to work, someone else in your family may need to get a job. You and your family may need to learn more about health insurance and find out what will be covered and what you need to pay for. These and other money issues can be hard to deal with.

Living Arrangements

People with cancer sometimes need to change where they live or whom they live with. You may need to move in with someone else to get the care you need. Or, you may need to travel far from home for treatment. This can be stressful because you may feel that you're losing your independence, even if it's just for a little while.

Daily Activities

You may need help with duties such as walking the dog, helping with meals, or coaching your children's teams. Asking others to do these things for you can be hard. But most people want to help and like to do so when you ask.

While some families find it easy to talk about these changes, it's also common for others to find the challenges hard to discuss. If your family is having trouble talking about these issues, ask for help from your health care team or request a family meeting. Your doctor or nurse can refer you to someone who can help families talk about cancer.

Help from Other Family and Friends

Once people learn of your cancer, some will ask you how they can help. Others will wonder what they can do for you, but aren't sure how to ask. You can help your friends cope with the news by letting them assist you in some way. For example, ask them to drive your carpool or go to the store. Make a list of things you think you might need help with, so they can pick something they're able to do for you.

Do What You Can

You probably can, and want to keep doing things on your own. It's important to let people know that you can still do some things for yourself. As much as you're able, keep up with your normal routine by making decisions, managing your home, running errands, and taking part in things you enjoy.

Ask for Help

It's okay to ask for help if you need to. Asking for help is not a sign of weakness. Most likely your loved ones want to help you. You can also find volunteers to help you through churches or community groups. Professional helpers can be hired to assist you with physical care and other needs. You could also ask your doctor about respite care, which is when someone comes to your home and takes care of you while your family member goes out for a while.

Show Gratitude for Your Caregivers

Cancer and its treatment are hard on everyone, especially the people who take care of you. Sometimes loved ones become run down and get sick from the stress. Because of this, they need to have balance in their life—time to take care of personal tasks and errands, rest, be with friends, or enjoy hobbies. Your caregivers will also need time to sort through their feelings about cancer. Let them know that you want them to have a break, and that it's okay for other people to take care of you for a while.

Your spouse or partner may feel just as scared by your cancer as you do. You both may feel anxious, helpless, or afraid. You may even find it hard to be taken care of by someone you love.

Some relationships get stronger during cancer treatment. Others are weakened. Nearly all couples feel more stress than usual when cancer occurs. They often feel stress about:

• Knowing how to best support each other and how to communicate
• Dealing with new feelings that come up
• Making decisions
• Juggling lots of roles (such as childcare, housekeeping, work, and caregiving)
• Changing their social life
• Changing their daily routine
• Not feeling connected sexually

It helps to know that people express their emotions in different ways. Some like to talk things out or focus on other people. Others like to focus inward by doing things, such as washing the dishes or fixing things around the house. These differences can cause tension because each person may expect the other to act the way they would in their place. To reduce stress, it may help to remind yourself that everyone reacts differently. But if you don't feel like your communication needs are being met, you may want to seek help from a counselor or social worker.

Ways to Improve Communication

Some couples find it easier to talk about serious issues than other couples. Only you and your partner know how you feel about this. The sections below may help you think about ways to communicate that work for both of you.

Share the Decisions

Including your spouse or partner in treatment decisions is important. Together you can meet with your doctor and learn about common symptoms, your treatment choices, and their side effects. This will help you plan for the upcoming weeks and months.

Help Each Other

Everyone needs to feel needed and loved. You may have always been the "strong one" in your family, but now is the time to let your loved one help you. This can be as simple as letting the other person fluff your pillow, bring you a cool drink, or read to you. And in turn, make sure you help your partner. You can simply express gratitude and let them know you understand it's a tough time for them too.

Be Open about Stress

Some things that cause stress for you and your partner can't be solved right now. And yet sometimes talking about these things can be helpful. Look at the issues that bother you such as dealing with the unknown or feeling a strain between you. You may want to say up front, "I know we can't solve this today. But I'd like to just talk about how it's going and how we're feeling." Getting things out into the open may help you both.

Be a Team

You and your partner may need to be a team now more than ever. It may help to think things through together. Talk about what decisions you should make together and which ones you should make alone. You may want to decide what tasks to share and if other people in your life could help with them.

Make Dates

Many couples find that it helps to plan special occasions. Some days may end up being better than others, depending on how your partner feels. So you may need to be okay with last-minute changes.

Your dates don't have to be fancy. It's about spending time together. That can mean renting a movie, going out to eat or for an event, or looking through old photos. It can be whatever you both like to do. You can also plan these dates to include other people, if you miss being around others.

Even though your children will be upset when they learn about your cancer, don't pretend that everything is okay. Even very young children can sense when something is wrong. They will see that you don't feel well, are away from home more often, or can't spend as much time with them as you used to. Children as young as 18 months old begin to notice what's going on around them. It's important to be honest. Telling the truth is better than letting them imagine the worst. Give your kids time to ask questions and express their feelings.

What Children of All Ages Need to Know

About Cancer

• Nothing your child did, thought, or said caused you to get cancer.
• Just because you have cancer doesn't mean you'll die from it. In fact, many people live with cancer for a long time.
• Your child can't make you well. But there are ways he or she can make you feel better.
• Scientists are finding many new ways to treat cancer.

About Living with Cancer in the Family

• Your child is not alone. Other children have parents who have cancer.
• It's okay to be upset, angry, or scared.
• Your child can't do anything to change the fact that you have cancer.
• Family members may act differently because they're worried about you.
• You will make sure that your children are taken care of, no matter what happens to you.

About What They Can Do

• They can help you by doing nice things like washing dishes, cleaning their room, or even drawing you a picture.
• They should still go to school and take part in sports and other fun activities.
• They can talk to other adults for support, such as teachers, family members, and religious or spiritual leaders.

How Kids May Act When You Have Cancer

Children can react to cancer in many different ways. For example, they may:

• Be confused, scared, lonely, or overwhelmed
• Feel guilty and think that something they did or said caused your cancer
• Feel angry when they are asked to be quiet or to do more chores around the house
• Miss the amount of attention they're used to getting
• Regress and behave as they did when they were much younger
• Get into trouble at school or at home
• Be clingy and afraid to leave the house

Teens

If you have a teenager, know that they're at a time in their lives when they're trying to break away and be independent from their parents. Try to get them to talk about their feelings and ask questions. Tell them as much as they want to know about your cancer. Ask them for their opinions and, if possible, let them help you make decisions.

Teens may want to talk with other people in their lives. Friends can be a great source of support for them, especially those who also have a serious illness in their family. Other family members, teachers, coaches, and spiritual leaders can also help. Encourage your teenage children to talk about their fears and feelings with people they trust.

Adult Children

If you have adult children, your relationship with them may change now that you have cancer. You may:

• Ask them to help with making health care decisions, paying bills, or taking care of the house
• Ask them to explain medical information
• Need them to go to the doctor with you or pick up medicines
• Rely on them for emotional support
• Feel awkward when they help with your physical care

For some parents, it may be hard to ask for comfort and care from their grown children. But it's important to talk about cancer with your family members, even if they get upset or worry about you. Try to include them when talking about your treatment. Let them know the choices you would like them to make about your care, in case you're too sick to make the choices yourself. Recognize that it may be hard for your children to have this talk and that, like you, they're trying to adjust to your illness.

Cancer support groups are meetings for people with cancer and anyone touched by the disease. They can have many benefits. Even though a lot of people receive support from friends and family, the number one reason they join a support group is to be with others who have similar cancer experiences. Some research shows that joining a support group improves both quality of life and survival.

Support groups can:

• Help you feel better, more hopeful, and not so alone
• Give you a chance to talk about your feelings and work through them
• Help you deal with practical problems, such as problems at work or school
• Help you cope with side effects of treatment

Types of Support Groups

Some groups focus on all kinds of cancer. Others talk about just one kind, such as a group for women with breast cancer or one for men with prostate cancer. Some can be open to everyone or just for people of a certain age, sex, culture, or religion. For instance, some groups are just for teens or young children.

Support groups can also be helpful for children or family members. These groups focus on family concerns such as role changes, relationship changes, financial worries, and how to support the person with cancer. Some groups include both cancer survivors and family members.

Online support groups are "meetings" that take place online. People meet through chat rooms, listservs, webinars, social media (such as Twitter or Facebook), or moderated discussion groups. People often like online support groups because they can take part in them any time of the day or night. They're also good for people who can't travel to meetings, or live in rural areas. Some are sponsored by cancer organizations, while others aren't monitored. Therefore, always check with your doctor about any cancer information you receive to make sure it's correct.

Telephone support groups are when everyone dials in to a phone line that is linked together, like a conference call. They can share and talk to others with similar experiences from all over the country. There is usually little or no charge.

Where to Find a Support Group

Many hospitals, cancer centers, community groups, and schools offer cancer support groups. Here are some ways to find groups near you:

• Call your local hospital and ask about its cancer support programs.
• Ask your social worker to suggest groups.
• Talk to other patients who have tried support groups.
• Do an online search for groups. Or go to the NCI database Organizations that Offer Cancer Support Services for suggestions.

Is a Support Group Right for Me?

Before joining a support group, you may want to ask yourself if you're comfortable talking about personal issues. You can also think about what you hope to gain by joining one. A support group may not be right for everyone. Some people don't like to hear about others' problems. And some find that their need for a support group changes over time.

If you have a choice of support groups, visit a few and see what they are like. See which ones make sense for you. Although many groups are free, some charge a small fee. Find out if your health insurance pays for support groups.

If you're thinking about joining a support group, here are some questions you may want to ask the group's contact person:

• How large is the group?
• Who attends (survivors, family members, types of cancer, age range)?
• How long are the meetings?
• How often does the group meet?
• How long has the group been together?
• Who leads the meetings - a professional or a survivor?
• What is the format of the meetings?
• Is the main purpose to share feelings, or do people also offer tips to solve common problems?
• If I go, can I just sit and listen?

Support groups vary greatly, and if you have one bad experience, it doesn't mean these groups aren't a good option for you. You may also want to find another cancer survivor with whom you can discuss your cancer experience. Many organizations can pair you with someone who had your type of cancer and is close to your age and background.