Comfort for the carers

YOU'VE got cancer. Three words that nobody ever wants to hear

YOU'VE got cancer. Three words that nobody ever wants to hear. Because of its nature and resistance to cure, cancer is still one of the most feared diseases.

In recent years, the medical profession has become increasingly sensitive to the psychological impact of a cancer diagnosis, not least because the ability to cope emotionally with the disease increases the prospect of a successful outcome to treatment. What is now becoming obvious is that it is not only cancer patients who need help through this difficult period, but their families too.

While nursing staff in oncology units are highly sensitive and supportive, there has been a recognition of the need for a trained nurse to provide a communication link between the medical professionals providing the physical treatment and the patients and their families. To that end the Irish Cancer Society two years ago set aside funds from Daffodil Day to provide a new type of hospital based cancer nurse the oncology nurse specialist.

Three such specialists are now working in major cancer treatment centres at St James's and St Vincent's in Dublin and at University College Hospital in Galway. A further three are to be appointed before the end of the year and it is hoped that eventually every oncology unit in the country will provide the service. The nurses do not provide physical nursing but emotional and practical support.

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When Joan Nolan's husband, Bob, discovered he had a rare form of non Hodgkinson's lymphoma in June of this year, she found the support offered by the oncology nurse specialist at St James's Hospital to be invaluable. "Bob was being treated for ulcerative colitis for four years" she said. "Our doctors did not suspect cancer and therefore neither did we.

"As recently as last March he would have been given an `all clear' in that direction so that when we were told he had lymphoma, it was unbelievably shocking to me." The shock and fear were intensified by the memory of her sister, who had died from cancer some years earlier.

The Nolans have three children one 16 year old and twin 14 year olds "too young to be supportive but old enough to understand all the implications," says Joan. "I cannot overstate how helpful Catherine Banks Higgins, the oncology nurse specialist, was to me. Tough as things obviously are for the cancer patient himself, he is in hospital, surrounded by nurses, doctors and other forms of support. The family is at home, alone. To know that Catherine was at the end of a telephone line made such a difference.

"At one stage Bob was not responding well to his anti sickness drugs and I had a long list of contacts to ring, the first person I thought of was Catherine. I knew she would be able to answer my questions. I knew I'd be able to get straight through to her, that if she was busy she would call me back as soon as possible. I knew, in short, that I could count on her."

CATHERINE Banks Higgins says she finds her work "immensely satisfying". "It affords me the opportunity to see the person in his or her entirety, to see the relationship between mind and body, to take a holistic approach, which is the approach that has always attracted me. I get to know the patients and their families very well. I can anticipate their needs and problems and I can easily see the fruits of my work.

"As well as answering questions and allaying fears, I'll do lots of practical work on the patient's behalf, things like chasing their results for them. I'm their link to the rest of the team and I work very much as part of that team.

"There is always a sense of loss for the family of a cancer patient. Not just around death, though of course that is the first thought, the fear of losing the loved one. But even when a patient stands a good chance of recovery there is the disruption of family life. Spouses and children lose out. A mother, for example, may be unable to play her usual mothering role. A sense of loss is inevitable."

Joan Nolan agrees, but emphasises how support can lessen those feelings. "Things have changed so much in the 14 years since my sister was diagnosed. Then we, her family, felt completely left in the dark. This time I've had a great sense of being comforted."