Well-being after a cancer diagnosis: psychological support and resources

A cancer diagnosis turns everything upside down: the person affected, their family, daily life, and their plans [1]. Beyond medical treatments, the psychological well-being is an integral part of the journey. There are several resources available in Quebec—the mostly free — to provide support at every stage. This article provides an overview of normal reactions, free resources in Quebec, psychotherapy options, complementary approaches, and post-cancer support.

On this page

• How a Diagnosis Can Affect You
• When to Ask for Help
• Free Resources in Quebec
• Individual Psychotherapy
• Complementary Approaches
• Support for Family Members and Children
• Life After Cancer and Survival
• Palliative Care and End-of-Life Care
• Myths and Misconceptions
• Frequently asked questions
• Sources

How a Diagnosis Can Affect You

Receive a cancer diagnosis almost always triggers a a whirlwind of emotions. These reactions are normal and are part of the adaptation [2].

Common Reactions

• Shock, shock, disbelief
• Anxiety, fear of death or suffering
• Sadness, depressive symptoms
• Anger, a sense of injustice
• Fatigue, sleep disorders
• Difficulties with communicate with loved ones
• Guilt («What did I do to deserve this?»)
• A feeling of’isolation, the feeling that no one understands
• Concerns about the’body image (hair, scars, weight)
• Anxiety related to work, finance, and insurance
• Questions existential and spiritual

The Stages of the Journey

• Diagnosis and investigation: shock, agonizing wait
• Announcement and treatment plan : gradual integration
• Active Treatments (surgery, chemotherapy, radiation therapy): fatigue, side effects, mobilization
• End of treatments : paradoxically difficult, fear of a relapse
• Survivance : adapting to the «new normal»
• Recidivism or possible development: the return of intense emotions
• Palliative care and end-of-life care, if applicable

Key Takeaways

• All the emotional reactions after a cancer diagnosis are normal
• A distress that persists, interferes with functioning, or is accompanied by’dark thoughts warrants professional support
• Several free resources exist in Quebec: Quebec Cancer Foundation (FQC), Canadian Cancer Society (CCS), Cancer: I'm Listening, hospital staff
• Visit FQC (1-800-363-0063) offers free psychological services, a cancer information hotline, housing, and massage therapy sessions
• Visit PQPTM provides access to free psychotherapy, and several group insurance plans reimburse costs for private practice
• Visit complementary approaches (adapted physical activity, mindfulness, nutrition) support the journey
• L’post-cancer deserves special support (survival programs)
• Visit Neighbors and children also receive tailored support

When to Ask for Help

Signs That Indicate a Need for Professional Support

• Distress that lasts longer than a few weeks
• Distress that prevents to function on a daily basis
• Presence of’dark thoughts, despair, suicidal thoughts
• Anxiety intrusive, panic attacks
• Insomnia severe and not improving
• Disorders of the’appetite not related to treatment
• Social isolation marked
• Conflicts worsening family problems
• Feeling of loss of meaning deep
• Difficulties with make decisions on treatments
• Side Effects of Treatments psychologically unbearable

Who should I talk to first?

• L’treatment team in oncology (physician, primary nurse, social worker)
• Visit family doctor or the IPS
• Visit Quebec Cancer Foundation (FQC)
• Cancer: I'm Listening from the Canadian Cancer Society
• Visit CLSC in your area
• Info-Social 811, option 2 (24/7)
• In the event of an acute emergency: 1 866 APPELLE (1-866-277-3553) or 911

Free Resources in Quebec

Several organizations offer support free to people with cancer and their loved ones throughout Quebec [3].

Quebec Cancer Foundation (FQC)

• Psychological Services free
• Cancer Information Hotline : 1 800 363-0063
• Accommodations for people who need to travel for their treatments
• Sessions of massage therapy and other comfort treatments
• Support for close caregivers
• Several regional offices in Quebec
• Information and orientation
• Programs for young adults people with cancer
• Website: fqc.qc.ca

Canadian Cancer Society (CCS)

• Information and Support Service : 1 888 939-3333
• Cancer: I'm Listening : support by phone and text message
• Community online at ParlonsCancer.ca
• Program Cancer Connection: Peer Matching
• Information about the types of cancer, treatments, resources
• Support to loved ones
• Website: cancer.ca

Hospital Foundations and Hospital Programs

• Virage Foundation at the CHUM
• Foundation of the Hospitals and several other Quebec-based foundations
• Social worker from the hospital's oncology team
• Psychologist from the oncology team, when available
• Lead Nurse in oncology
• Programs survival
• Activities vary by center: groups, workshops, lectures

Specific Support Groups

• Breast cancer : Quebec Breast Cancer Foundation, local organizations
• Prostate cancer : Procurement, support organizations
• Colorectal cancer : specific associations
• Lung cancer, pancreatic cancer, brain canceretc.
• Leukemia & Lymphoma Canada
• Groups for young adults people with cancer
• Groups for parents affected children (Leucan, others)
• The FQC and the SCC guide to specialized resources

Table of Key Resources

Organization	Type of Support	Contact Information
Quebec Cancer Foundation	Psychology, Information, Lodging, Massage Therapy	1 800 363-0063
Canadian Cancer Society	Information, Support, Cancer: I'm Here to Listen	1 888 939-3333
Social Information	24/7 Psychosocial Support	811, press 2
Psychological distress	Hotline for Suicidal Thoughts	1 866 277-3553
Tel-jeunes (Cancer in a Parent)	Support for 12- to 25-year-olds	1 800 263-2266
Support for Family Caregivers	Information and Support for Family Members	1 855 852-7784

Individual Psychotherapy

Professionals Who Can Help

• Psychologists specializing in psycho-oncology
• Social workers the CLSCs and the oncology team
• Psychotherapists accredited (OPQ license)
• Marriage and Family Therapists
• Sexologists regarding issues of body image and sexuality
• Spiritual Advisors in oncology (spiritual care intervention)

Approaches Used

• Cognitive Behavioral Therapy (CBT) tailored to cancer
• Approaches humanist and existentialist
• Mindfulness-Based Cancer Recovery (MBCR)
• Dignity Therapy in palliative care
• Approaches narratives
• Support psychoeducational
• Therapy couples or family
• Groups structured therapeutic approaches

How to Access Psychotherapy

• Hospital Programs in oncology (team psychologist, when available)
• FQC : free psychological services
• Quebec Mental Health Program (PQPTM) through your family doctor or the IPS
• CLSC : social worker, sometimes psychologist
• Private practice, which is sometimes covered by group insurance
• Directory through the OPQ to find a specialized psychologist
• Tax Credit for applicable medical expenses

Mental Health Medication

• Visit antidepressants and anxiolytics may be helpful in certain situations
• Prescribed by the family doctor, the IPS, the psychiatrist, or the oncologist
• Interactions to be considered in conjunction with cancer treatments
• L’treatment team can be adjusted based on contraindications
• Often combined psychotherapy for the best results

Are you or a loved one going through cancer and looking for medical support or guidance? Omicron Clinic provides medical care during and after cancer treatment, assesses emotional distress, and refers patients to specialized resources at our locations in Quebec, with teleconsultations available. Make an appointment or opt for the teleconsultation.

Complementary Approaches

In addition to medical treatments and psychotherapy, several approaches support physical and psychological well-being during and after cancer.

Adapted Physical Activity

• Kinesiologist specializing in oncology
• Programs at the gym or at home
• Activity of’moderate intensity, tailored to the situation
• Benefits studies on fatigue, mood, quality of life, and possibly prognosis
• 150 minutes per week, as recommended whenever possible
• Reinforcement muscular twice a week
• Programs community-based in several regions
• Gentle Yoga, tai chi, nature walks

Mindfulness and Meditation

• Mindfulness-Based Stress Reduction (MBSR) and MBCR cancer-specific
• Programs for 8 weeks structured
• Effects on the’anxiety, quality of life, rumination
• Applications: Little Bamboo, Calm, Headspace, Mindshift
• Several hospitals offer groups Mindfulness in Oncology
• Regular practice for sustainable benefits

Appropriate Nutrition

• Registered Dietitian-Nutritionist (member of the OPDQ)
• Adaptation to side effects treatments
• Management nausea, malnutrition, loss of appetite
• Maintenance of a healthy weight adapted
• Hydration sufficient
• Limitation of the’alcohol and ultra-processed foods
• Power supply Mediterranean-style often recommended
• Caution with supplements and natural products (possible interactions)

Comfort Care and Home Care

• Massage Therapy tailored (offered free of charge by the FQC in certain situations)
• Reflexology, cosmetic treatments for oncology patients
• Nursing care at home for comfort and the management of side effects
• Service UVO Home Care and other in-home services in Quebec
• Acupuncture in certain cases (effects on nausea, pain, and fatigue)
• Coordination with the’treatment team to verify the absence of interactions

Support for Family Members and Children

For Family Caregivers

• Support for caregivers : 1-855-852-7784, lappui.org
• Support groups for spouses, adult children, friends
• Respite and home care
• Support psychological specifically for caregivers
• Tax Credits for family caregivers in Quebec
• Maintain one's own health : sleep, diet, physical activity, social connections
• Request’help early, before it runs out
• PAE at work, if available

For Spouses

• Visit cancer also disrupts the couple's relationship: roles, intimacy, plans
• Couples Therapy in psycho-oncology, if possible
• Sexologists specializing in issues related to sexuality and intimacy
• Importance of communicate openly
• Make time for login and enjoyment
• Recognize that the spouse is also going through a difficult time

For Children When a Parent Is Ill

• To speak Cancer in Children, Age-Appropriate
• Use a language simple, true, without unnecessary scary details
• Maintain the routine as much as possible
• Enable the’expression emotions
• Ask the teachers to support the child at school
• Resources: Tel-jeunes 1 800 263-2266, Kids Help Phone 1 800 668-6868
• Programs programs specifically for children of parents with the condition (offered at certain centers)
• Children's Books on the topic of parental cancer
• Support psychological for the child if the distress is severe

For children with (pediatric cancer)

• Leucan : a Quebec-based organization for children with cancer and their families
• Sainte-Justine University Hospital, Quebec University Hospital, other pediatric centers
• Programs specifically for children and adolescents
• Educational Support and educational
• Support for siblings and to parents
• Tracking long-term care for pediatric cancer survivors

Life After Cancer and Survival

Visit end of treatment can be, paradoxically, difficult: fear of a relapse, lingering fatigue, returning to work, a sense of identity in flux. Several survival programs accompany this pivotal period.

The Challenges of Life After Cancer

• Fear of a relapse, chronic anxiety
• Residual fatigue which can last for months or years
• Undesirable effects late side effects of treatment (chemobrain, neuropathy, chronic pain)
• Changes to the’body image (scars, temporary hair loss, others)
• Changes to the sex life
• Back to work : adaptation, communication, and sometimes a career change
• Identity thrown off balance: «Who am I after cancer?»
• Sense of Being misunderstood by family members once treatment is complete
• Concerns on insurance and finance
• Post-Traumatic Growth possible: reevaluated values, a new perspective on life

The Role of the Family Physician

• Continuity medical care beyond oncology
• Monitoring according to the recommendations specific to the type of cancer
• Management of long-term effects treatments
• Prevention and screening for other diseases
• Support psychological and referral to resources
• Communication with the oncology team
• Support for the back to work
• Renewal of the prescriptions

Survival Programs

• Available in several hospitals québécois
• Accompaniment structured over several months
• Map personalized survival guide
• Support psychological, nutritional, physical
• Information about the long-term effects
• Strategies for the fear of a relapse
• Support Groups specific for survival

Palliative Care and End-of-Life Care

Visit palliative care are intended to improve quality of life at all stages of cancer, not just at the end of life. They can be combined with active treatments.

What Palliative Care Offers

• Management of the Pain and other symptoms
• Support psychological and spiritual
• Help for decisions end-of-life care (advance medical directives, power of attorney)
• Support for Neighbors
• Healthcare in institution, at home or in a hospice
• Approach multidisciplinary : doctors, nurses, social workers, spiritual counselors, volunteers
• Medical Assistance in Dying (MAD) accessible according to Quebec's criteria

End-of-Life Resources

• Hospices all over Quebec
• Teams home-based palliative care (CLSCs, others)
• Albatross, Greater Montreal Home Hospice Care Organization, other organizations
• Spiritual Support Through the’intervention in spiritual care (interfaith, non-denominational)
• Support for mourning For loved ones after a death
• Information about the’AMM and advance medical directives

Myths and Misconceptions

«We have to stay positive no matter what.»

False. The order to « positive thinking »might be" guilt-inducing and harmful. All emotions are legitimate, including fear, sadness, and anger. What really helps is to recognize, to express and to seek support. Studies do not confirm that «positive thinking» influences the course of the disease.

«Asking for psychological help is a sign of weakness.»

False. Request’help is a sign of force and clarity. Cancer is one of the most difficult life events. Support professional improves quality of life, treatment adherence, and overall well-being. Many people regret not having sought treatment sooner.

«Support groups aren't for me»

Maybe it's worth a try. Visit self-help groups aren't for everyone, but many people find them to be a invaluable support : feeling of being included, practical advice, and examples of people who have gone through the same experience. You can try attending a meeting no obligation before making a decision. Several formats options: in person, online, by phone, by text message.

«Mental health medications are dangerous when you have cancer.»

Not necessarily. Visit antidepressants and anxiolytics can be useful and compatible with cancer treatments. A few interactions must be taken into account, but the treating team (physician, oncologist, pharmacist) may adjust them. The unaddressed distress also has an impact on quality of life and adherence to treatment.

«Life after cancer is inevitably a return to normal life.»

Not exactly. Many people experience a « new normal »rather than a return to the old life. The residual fatigue, the fear of a relapse, and changes in one's body and sense of self require weather and sometimes specialized support. The programs for survival are available specifically for this period.

Frequently asked questions

When should you seek psychological support?

À at any time along the way, whenever you feel the need. No need to wait for a « genuine distress ». Support early helps people navigate these stages more effectively. Diagnosis, the start of treatment, the end of treatment, and the survival period are key moments. Also, in the event of recidivism or progress.

Does the RAMQ cover psychotherapy for cancer patients?

Visit psychotherapy in a hospital setting (oncology team) is free of charge. The departments of the FQC and other organizations are also free. The PQPTM provides access to psychotherapy through the public health care system. In practice private, the costs are covered by the patient or group insurance.

What should I do if I don't have access to an oncology psychologist at my hospital?

Several options are available: free psychological services from the FQC, supported by Cancer: I'm Listening (SCC), a social worker on the oncology team or at the CLSC, asks the family doctor to refer the patient to the PQPTM, psychologist in private practice (partially covered by insurance). The teleconsultation expands access.

How do you explain cancer to a child?

Adapt the language age: simple, true, without any unnecessary scary details. Use the the word «cancer» rather than euphemisms. Explain that it's not It's not the child's fault, that it isn't not contagious. Reassure them of their parents' love. Maintain the routine as much as possible. Encourage the questions. Ask a speaker (social worker, psychologist) or consult specialized resources from the FQC or the SCC.

How can you support a loved one with cancer?

Listen without judging, without trying to solve everything. Ask the person what they need (sometimes just your presence). Maintain a normal relationship as much as possible. Offer concrete actions (meals, transportation, child care). Respect times when a person prefers to be alone. Taking care of oneself too. The’Support (1-855-852-7784) provides support to family members.

Returning to Work After Cancer: How to Approach It?

Discuss gradually with the employer, ideally with a gradual return. Ask for advice from the family doctor or the oncology team. Possibility of’facilities (schedule, tasks, remote work). Program for’Employee Assistance Program (EAP) if available. Take into account the residual fatigue. There are several specific programs designed to help people return to work after cancer. Patience and adaptation are the norm.

Sources

1. Quebec Cancer Directorate — MSSS. Quebec Cancer Program.
2. Canadian Cancer Society (CCS). Cancer Information and Psychological Support.
3. Quebec Cancer Foundation (FQC). Services and the Cancer Information Hotline: 1-800-363-0063.
4. INESSS — National Institute for Excellence in Health and Social Services. Guides on Oncology and Survival.
5. Canadian Association for Psycho-Oncology (CAPO). Standards of Care in Psycho-Oncology.
6. Leucan — Association for Children with Cancer in Quebec. Support for families.
7. Support for Family Caregivers. Resources for Caregivers.

Medical consultation | Clinique Omicron