getting hit by a bus

10 things you shouldn’t say to someone with cancer

Okay, we get it. Sometimes, talking to your friend or relative with cancer feels awkward. What do you say? What if you say the wrong thing? How can you help?

Recently, a discussion in our private Facebook group took off – “What’s the silliest thing someone has ever said to you about cancer?” asked David, one of our members. More than 110 comments later, we felt like we had to share some of them with the world! Take a read and let us know what you think. If you’ve got cancer, we hope you’ve managed to avoid these comments (all of these are real, by the way – we haven’t made them up!).  If you’re supporting someone with cancer, we know you want to help. Stuck for words? Sometimes admitting, “I don’t know what to say” can be the best way forward.

1. “You don’t look like you have cancer”.

In the movies or on TV, the person with chemo usually spends their days losing their hair and looking increasingly ill. But these days, a lot of cancer drugs don’t make you lose

1454189966867

All of these people have, or have had cancer.

your hair, and many people don’t have chemotherapy anyway. Some people end up on “watch and wait” without treatment right away, while surgery and radiotherapy are frequently given for more localised cancers (or even advanced cancer if they can halt the spread). The key message here? A lot of people don’t “look” like they have cancer but just because you can’t see the side effects of the cancer or treatment doesn’t mean they aren’t there. A simple “How are you feeling?” can be a much better, and more sensitive way to start a conversation.

2. “So, how long have you got?” or “I’ll help you with your bucket list.”

We all know that cancer can cause death. But if, when, and how that might happen isn’t usually something that we want to talk about. When you’re asking your friend or relative about their illness, ask yourself whether your questions are more for your own information (read: nosiness) or to help them.Bucket List

Most people with cancer aren’t given a “timeline”, and even if they are, they might not want to share it. If your friend is openly creating a bucket list, great, but generally speaking it’s good to keep the death talk to a minimum. Journalist Helen Fawkes created a “List for Living” after she was diagnosed; this can be a much more positive way to think about treating someone with cancer to a nice experience than a “bucket list”.

3. “You don’t need chemo…..I know someone who cured their cancer with [insert questionable cure here]” or “Chemo doesn’t work – it’s just a plot by Big Pharma to make money” or “Have you tried turmeric?”

Wheat grass

This will not cure your cancer.

So, your friend is prepping to start chemo and this seems like a good time to tell them about an article you read about someone who shunned chemo and cured their Very Deadly Cancer with kale and wheatgrass, right? Wrong.

Chemo can be tough but it saves lives, and whether you agree with your friend’s treatment decisions doesn’t matter. Eating more fruits and vegetables, and getting more exercise is certainly good for us and there is some evidence that it can help reduce rates of relapse in certain cancer types. But if the person you’re supporting is undergoing chemotherapy, consider carefully whether it’s definitely the right time to bring up that raw food diet that your aunt’s sister’s best friend used to cure her dog’s leukaemia. It’s probably not.  Instead, why not make them a nice meal and take it over to their house? (Only include kale if you know they like it!).

4. “That’s a good kind of cancer” or “At least you’ve lost weight. There’s a silver lining in everything, right?”

When you’re diagnosed with a life-threatening disease it’s pretty hard to find any silver linings. Self-esteem can take a massive hit, so try to avoid making comments about someone’s appearance or weight or downplaying the seriousness of what they’re facing. Anyone diagnosed with cancer is likely to feel pretty shocked by the diagnosis. Sure, some cancer types are more curable than others, but as most oncologists will tell you, every case is different. Telling someone they’ve got a “good cancer” risks minimising their feelings. A better approach might be to say something like “I’m so sorry about your diagnosis. Do you want to talk?”

5. “Cancer is caused by past trauma and stress”

There is little good quality evidence that stress and cancer are linked and if your friend has cancer, they’re probably stressed because, you know, they’ve got cancer. Ask yourself what you can do to relieve their stress. Can you take them out for a film or a drink? Cook them dinner? Walk their dog? It doesn’t need to be a big thing – even small gestures can mean a lot. Take a look at our blog about how you can help.

6. “I’ve heard that’s a really bad way to die” or “I know someone who died of that.”

As with point 2 above, avoiding death talk is generally the way to go. Talking about how bad/painful/awful death might be is a big no no. And telling your friend or relative with cancer that you know someone who died of the exact same thing is also to be avoided. Know someone who has lived 20 years after a diagnosis? Feel free to mention them! Those are the stories we like.

7. “Managing someone with cancer will look good on my CV” or “What about me?”

If someone you know has cancer, it’s time to think about all the great ways that you can support them. A cancer diagnosis is about the person who has cancer and those immediately surrounding them (partners, parents, children). This can feel odd if you’re used to getting support from your friend or relative but think of it as a good opportunity to repay all the love and support that you’ve received in the past. Unsure who to turn to for support? Take a look at this handy “ring theory” guide and remember: support in, dump out!

Ring Theory

8. “If you need anything, just let me know.”

We know it might sound odd, but often, we don’t know what we need, and even if we do, it can feel scary to ask. Rather than making your offer general, try to make it a bit more specific. Ask if you can make dinner on a Tuesday, drive your friend to their next appointment, or do their grocery shopping next week. By making it specific, you’re taking away the burden of coming up with something – and that is helpful.

9.“Everyone dies” or “Any one of us could get hit by a bus tomorrow”.

Bus

“I might get hit by a bus tomorrow”.

You’re right – everyone does die. But the difference with cancer, especially cancer at a young age, is that death goes from being a vague hypothetical, to something that is giving you a cold hard slap in the face. That bus everyone’s talking about? Your friend has already been hit by it. They’re just waiting to see whether they’ll survive, and they’re likely really scared. It’s great to ask someone if they want to talk but sometimes distraction can be the greatest gift. Seen a funny cat video online? Now may be the time to send it over (assuming you’ve already checked on how they’re feeling).

10. “So, you’re all better now, right?”

One of the things that few people talk about is the long-term effects of cancer. The media shows us people who have survived cancer and go on to run a marathon or write a best seller. What you don’t get to see is that those same people are often also left scarred, depressed and tired after months or years of intensive treatment. For many people with cancer, the end of treatment is a tough time. They’re no longer seeing their doctors and nurses as regularly and, on the surface, life appears to be returning to normal. They may be in remission or be looking forward to a long treatment break but they’re unlikely to be “all better now” or for a long time to come.

We know it can be tough to keep up the same level of support once treatment has finished but keep in mind that your friend or relative may be feeling especially lonely. Make sure to keep checking in and, if you can, make sure they still get the odd treat. Be ready to chat if they want to talk about how they’re feeling and remember that you don’t have to solve all their problems. Just being a good listener can be all that’s needed.


If you’re in your 20s, 30s or 40s, why not join us online? We’ve got a private Facebook group here, or you can follow us on Twitter or Instagram

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young adult cancer conference

Getting connected

In 2016, Shine decided to go large and hold our first annual conference. With close to 100 people in attendance, it was a great day and for 2017 we decided to go bigger and better! Shine Connect was held on 20th May in London and was designed as a way for young adults from across the country to come together and connect for a day. With expert speakers and much more, it’s now one of our favourite events, and this year 120 people joined us. Take a read of Jen’s blog about the day – and get set to join us next year!


Connect 1I’m not sure there are many – in fact any – other cancer conferences that combine singing and cute dogs with dating advice and frank discussions about sex and relationships. And that’s what makes Shine Connect unique!

Shine supports a diverse group of young adults in their 20s, 30s and 40s with the unfortunate commonality of having had a diagnosis of cancer. Our needs differ vastly from the older cancer demographic and Shine Connect, Shine’s annual conference, works to address those needs. It is a conference both for young adults with cancer and for healthcare professionals looking to better support young adults with cancer.

Following an introduction from Shine Directors, Ceinwen and Emma, the day kicked off with a panel discussion – think Oprah, but without the tears. Three young adults living with a cancer diagnosis, Robin, Chris and Jess, spoke eloquently about a range of subjects and took questions from the audience. Topics included dealing with uncertainty and anxiety; managing your own feelings and needs alongside the needs of your partner, parents and wider family and friends; dating after cancer; and returning to your career or readjusting career plans. Far from being depressing, their discussion was a lively, funny, raw and honest. Pretty much every person I spoke to could identify with something that was discussed on the panel and many people felt it was one of the best sessions of the day. (NB: You can view the Facebook Live video of the panel here). 

Having cancer as a young adult is a lonely business, and more than once someone at the conference mentioned the frequency with which we hear ‘oh, you’re very young for cancer!’ at clinic appointments. Having the opportunity to listen to and talk with others who are also ‘too young for cancer’ is like being hugged many understanding, warm arms. For me, this first session really set the tone for the rest of the day.

Connect 4

Shine participants, Plus Ones and healthcare professionals came together

After the panel discussion, the conference attendees split into different sessions: building resilience, fertility after cancer, managing fatigue, and supporting children through an adult’s cancer. There was also a separate session for attendees who were the family/friends of a young adult with cancer, and a session about the needs of young adults with cancer for health care professionals. Over lunch (a super scrummy, healthy spread, followed by fruit or something a little more chocolaty if you preferred!) there was plenty of time to mingle and chat with others, and to swap tips gained from the various sessions. There was also a chance to talk to some of the other organisations that had stalls in the conference “market place”. These included Ellie’s Friends, a charity providing treats like days out and theatre tickets to young adults with cancer; the Lymphoma Association; Insurance With, a specialist travel insurance company for those with pre-existing medical conditions; and Maggie’s Centres. Look Good, Feel Better were there giving makeovers, while a couple of fabulous massage therapists set up downstairs and managed to give out 50 (!) free massages over the course of the day. Last, but definitely not least, Shine had invited Pets as Therapy to the conference, giving everyone who attended the chance to meet some very cute therapy dogs!

 

Connect 2

One of the therapy dogs gets some love from a Connect participant!

The afternoon session saw some of the morning sessions repeated but there were also new sessions on sex, singing, and creativity in health. More than one person told me how difficult it had been to choose! Along with the majority of afternoon attendees, I went to the interactive sex session (that’s interactive as in talking about sex, in case you were wondering!) Led by the amazingly frank and funny Karen Hobbs and Dr Isabel White, a leading specialist in sexual problems related to cancer treatment, a range of issues were discussed, from physical limitations due to treatment, to chemically induced menopause. It was refreshing to focus on an area that is generally neglected by the medical profession.

Sex after cancer

Dr. Isabel White and Karen Hobbs hosted a great (and funny!) sex after cancer session

The day was rounded off with a fascinating keynote speech from Professor Mark Petticrew, a global expert in public health at the London School of Hygiene and Tropical Medicine, who has carried out extensive research into psychological factors and whether they influence cancer and heart disease. During my own experience of cancer and recovery, the questions of how a ‘stressful’ life might have contributed to my diagnosis, and whether emotional stress might hinder recovery, were often brought up. Professor Petticrew’s research showed, however, that there is very little convincing evidence that stress causes cancer and that many of the studies on stress and cancer are seriously flawed. It was an interesting note to end on given that so many of us worry that we have done something to cause our cancer. There’s no need to get stressed out about this too!

Mark P

Prof Mark Petticrew from the London School of Hygiene and Tropical Medicine

If you go to Shine’s website you’re able to listen to some fabulous podcasts of ‘Not Your Grandma’s Cancer Show’. Shine Connect could have been called ‘Not Your Grandma’s Cancer Conference’. It’s certainly unique in the cancer world. If you weren’t able to attend this year I strongly recommend you keep an eye out for Shine Connect 2018; who knows what fun will be added next year!

 

It definitely takes a village to make these events happen and we’d like to send massive thanks to TTA, the amazing events management company who helped us pull Shine Connect off for the second year in a row! Huge thanks also to Don’t Forget the Kids, Emily Hodge of Coaching Emily, Toby Peach and Tenovus Cancer Care for delivering some fabulous sessions at the conference! We’d also like to send a huge shout out to Look Good, Feel Better for running some great make-over sessions, and Keith and Rozalia from the Complementary Therapy Department at the Royal Free Hospital for giving free massages to our participants all day!

Meet Jonathan!

There aren’t many jobs where having had cancer works in your favour, but here at Shine it strangely does. Today, our first ever Programme & Administrative Assistant, Jonathan, starts working with us and we couldn’t be more excited! We were delighted when we met Jon and found that he had both the skills and enthusiasm we wanted – and also that his own experience of cancer meant that he totally gets what our work means.

Jonathan grew up in Bournville, Birmingham (with the scent of Cadbury chocolate in the air!) going to drama classes, singing, playing the piano and building a huge Lego collection. He studied acting at university and is now based in Poole. Jonathan will be helping to ensure that everyone has a great time at Shine’s national events and that as many people as possible know about Shine’s work via social media. We asked Jon to write his personal experience of cancer so that we could all get to know him.  Read on to learn more!


What were you diagnosed with, and when?

jonathan-smith

Shine’s new Programme & Administrative Assistant, Jonathan

I was diagnosed with a malignant brain tumour (pineal germinoma) in 2007 which had spread to my spine.

How did you find out that you had cancer?

Unquenchable thirst and un-ending trips to the ”porcelain throne” were my first strange symptoms in 2004. I was told constantly by my GP that I was a “healthy young man”. It was 2006, when my weight had dropped to below 7 stone and I’d begun to see double, that my GP finally referred me to eye hospital.

After identifying (and filming) a rare eye condition, the eye department sent me for a MRI scan which revealed a ”small benign lesion” pressing on my pituitary gland and optic nerve. A pituitary condition (diabetes insipidus) which was causing my water problems was also belatedly diagnosed.

On 27th March 2007, I woke up barely able to walk or speak, and emergency brain surgery finally revealed I had a malignant tumour.

What did you think and feel when you were diagnosed?

I had no idea what a “lesion” was or that it could mean “tumour” or “cancer”. I continued working for a year not thinking anything of it and just coping with the daily symptoms.

Everything changed following surgery as I understood that the tumour was life-threatening and what the treatment entailed. I always felt fortunate knowing that it was likely to be curable and I didn’t feel scared as I was determined to do everything to get through. But I was naive about what that would involve.

How did the people around you react?

People at work really supported me throughout the strange symptoms while I continued to work and once I began treatment. They took me out and visited when I was able and kept me sane.

My parents and family were there for me 100%. I moved in with my folks and there were times when they had to do everything for me. I reacted badly to medication and radiotherapy and changed so much with the hormonal effects and tiredness, but they were always positive that I’d return to my old self.  I know it was really difficult for them and my sister to see my anxiety and panic attacks but not once did I see them get upset or short-tempered with me. Legends!

What treatment did you have?

The brain surgery (an endoscopic third ventriculostomy) relieved the pressure on my brain. I was then put on high calorie drinks to increase my weight and strength in prep for six weeks of radiotherapy.  I was also on dexamethasone which caused my longest stay in hospital as I reacted badly to being weaned off the drug following treatment.

For a couple of years afterwards I still had regular tests to determine what hormones had been affected and I had six monthly MRI scans until 2012 to ensure the tumour was completely gone. Physiotherapy helped my walking and counselling helped me cope with the hormonal and emotional impacts of the illness.

How did you feel through treatment?

I felt in limbo after the surgery in March 2007 as I waited for radiotherapy to begin in July. I was determined to increase my weight but felt very apprehensive about the effects of the rays. Unexpectedly those three months also gave me time to sit back, to think, to appreciate the everyday things in life that you don’t notice when rushing about in work (I enjoyed the changing seasons). I felt really close to my parents as they cared for me day to day and I found comfort in creativity, drawing, writing and art.

Anxiety, tiredness, restless legs and other nervous system effects of medication and hormone deficiencies had the biggest impact. I became withdrawn, found talking very difficult, couldn’t tolerate loud noises, music, follow conversations or cope with any confrontations. During the withdrawal of dexamethasone I began to think my brain had gone AWOL as I had panic attacks and couldn’t cope with stimulus at all.

What happened after treatment finished?

It was tough getting my life back on track and returning to work, handling my new anxiety, energy and physical conditions and getting accustomed to being partially sighted. I developed techniques to manage the effects and to help me get used to my new day-to-day reality.

The support of friends and family was uplifting but my condition made it very difficult for me to socialise, and I felt pressure to return to “normal”. I felt a need to push myself, taking a new promotion within weeks of returning to work, which I wasn’t ready to cope with.

Starting a part-time Masters degree gave me something else to focus on and work towards other than just getting better. I was incredibly thankful that the medical profession were able to cure my tumour but also became very aware of my own mortality and that of people around me. I felt a responsibility to make the most of every second which also brings pressure.

If you could give one piece of advice to yourself before your treatment what would it be?

My advice to my pre-treatment self would be to value more the support of friends and family and to accept that you’re not going to be on top form when they see you; it won’t matter to them anyway. Oh, and to ditch the red paisley head scarf!

What excites you about working for Shine?

I’m really excited about joining with Shine to be able to contribute to others’ awareness of the help available through treatment, while recovering, and adjusting to the aftermath of cancer and also how it changes you. I appreciate how having cancer early in life interrupts everything, alters your outlook and future, and I also feel the unfairness of incurable diseases limiting lives that are just beginning. I’m motivated to make sure that others going through this are aware of all the great events and support Shine provides. I’m really looking forward to helping young people feel they’re not alone, that they can face this together, and to help them forget for a while the battles they’re having.

Any big plans for 2017?

2017 marks 10 years since my diagnosis. Although the tumour has left me partially sighted I’m enjoying better eyesight following a recent operation. I’ll also be testing a new drug to improve my hormonal jiggery-pokery. I’m making the most of moving from London to Dorset, where my parents and sister (and new nephew) live, and can’t wait for summer by the sea!

The lowdown on eating well after cancer

“Have you tried wheatgrass? How about kale smoothies?”

There is unlikely to be a cancer patient out there who hasn’t been on the receiving end of diet or nutrition advice – whether they asked for it or not. But what does “eating well” actually mean, and how can we do it? And does being healthy mean going raw or cutting out all the fun stuff (Gwyneth Paltrow, we’re looking at you!)?

Last month, we asked the members of our private Facebook group what questions they had about diet and nutrition and we were thrilled that registered dietician Victoria Francis took on the challenge of responding to them!  In her first blog for us, she’s answered 10 of questions and also given us a few healthy recipes (scroll to the bottom if you just want these).  Take a read and let us know what you think. Please do share the post – and share any yummy recipes you have with us as well!


1. You’re a registered dietitian. Can you tell us the difference between a dietitian and a nutritionist?

The key differences are the qualifications and regulations imposed on the two titles.

victoria-francis

Guest blogger and registered dietitian Victoria Francis

Dietitians are the only nutrition professionals regulated by law and governed by an ethical code. This means that dietitians will always work to the highest standard, using the most up-to-date public health and scientific research on food, health and disease when advising people. Currently, due to a lack of regulation, anyone can practice under the title of nutritionist/nutritional therapist/nutrition advisor/ nutritional coach (etc., etc.!). There are many qualified nutritionists, some of who are also registered dietitians.  By no means am I suggesting you shouldn’t seek advice from a nutritionist – but you should check that they are registered with a professional body such as the UK Voluntary Register for Nutritionists.

Dietitians primarily work in a clinical setting in the NHS or the private sector in a variety of settings. Seeking advice from a Registered Nutritionist or Registered Dietitian is the gold standard and you can be assured that all advice discussed will be based on scientific evidence – not pseudo-science! Below, I’ve outlined the qualifications and registration with governing bodies the different nutrition titles need:

Dietitian
Qualification: BSc Hons. in Dietetics, or a related science degree with a postgraduate diploma or higher degree in Dietetics.
Governing body: Health Care and Professions Council

Registered nutritionist
Qualification: Undergraduate or post-graduate nutrition degree
Governing body: Association for Nutrition

Nutritionist/Nutritional Therapist/Holistic Food Coach
Qualification: None
Governing body: None

2. I’m looking for nutrition advice. How do I know that someone is legitimate and knows what they’re talking about?

To guarantee that the advice you receive is credible and evidence-based check what professional body people are registered with and what up-to-date insurance they have. In order to practice as a dietitian, a person has to be registered with the Health Care and Professions Council. Dietitians can also be found on the Freelance Dietitians website (www.freelancedietitians.org). This website lists all the dietitians registered with the HPC.

When looking for a nutritionist ensure they are registered with the UK Voluntary Register for Nutritionists (regulated by the Association for Nutrition).

3. So, what do you think about “clean eating”? 

Clean eating is facing a huge backlash in the media by health professionals who have a big issue with what it stands for and what it can create. The fundamental problem with clean eating is that it is not evidence-based. Food and health bloggers who promote clean eating tend not have any nutritional qualifications but rather want to share their own experiences. This isn’t science!clean-eating

The essence of “clean eating” is flawed as it suggests there is a single perfect way of eating which is essentially setting people up to fail. There are numerous “rules” such as the removal of whole food groups including dairy and gluten, which can lead to very restricted diets with likely nutritional deficiencies. Unless you have Coeliac disease you will not benefit from removing gluten from your diet. Many “clean eating” advocates advise you to replace sugar with “healthier alternatives” such as coconut sugar or maple syrup. To set the record straight: these are all sugar! The body will handle them all in exactly the same way. They are not a superior alternative, just a very expensive one!

Following a “set of rules”, for some people, can impact on their mental health. If they don’t conform to the rules then they feel that they have failed. If you want to eat healthier, reach your 30g fibre a day, reduce your sugar intake, etc. then go back to the basics. Its not sexy or new but it is realistic and achievable. Try to use fresh ingredients where possible, watch your intake of fat and sugar, and look at your eating habits. Aim for small realistic changes.

4. What are your thoughts on processed and fermented foods – especially processed meats and products like Actimel?

What do you think of when you hear the words “processed food”? Most of us think of unhealthy, high fat, high sugar and salty foods. While this may be true for some processed foods, there are many that provide good nutrition also.

Processed foods are “any food that has been altered from its natural state for either safety reasons (e.g. milk is pasteurised to remove bacteria), convenience or to preserve the availability of nutrients”. So breakfast cereals, cheese, milk, yogurts, bread, and tinned and frozen vegetables can all be called processed foods but do we don’t typically consider them unhealthy.

If we focus on red meat, there has been some recent guidance on how much we should be eating. The Department of Health has advised that people who eat more than 90g (cooked weight) of red and processed meat a day to cut down to 70g per day (or 500g per week). This is equivalent to two or three rashers of bacon, or a little over two slices of roast lamb, beef or pork, with each about the size of half a slice of bread.

Some fermented foods, such as yogurts, are sources of probiotics. The research into the health benefits of friendly bacteria from fermented foods is ongoing but evidence does show a healthy gut flora plays an important role in immunity and may offer protection against infections.

5. If you’re fighting fatigue and looking for an energy boost, what foods would you recommend (aside from sugar and caffeine!)?

Before we look at specific foods we need to first take a look at eating patterns. A slump in energy can be a sign that your blood sugar level has dropped a little. Eating little and often (e.g. three small meals with a couple of healthy snacks in between) can ensure that your energy and blood sugar levels are topped up. Try to eat something every 3-4 hours.

The foods you choose have a big impact on your energy levels and many of us fall for the “quick sugar fix” but when you’re looking for an energy boost you need the right balance of carbohydrates and protein.

When choosing carbohydrates, choose foods with a low Glycaemic Index (GI) such as lentils, oats, nuts, seeds, wholegrain bread, and brown pasta. These foods are broken down slowly by the body and their energy is released over a longer period of time whereas foods with a high GI (think sugar, honey, fizzy drinks, white bread, potatoes) are broken down quickly and the sugar released quickly. Protein is also known to be broken down slowly so adding protein to a carbohydrate snack/meal will ensure a slower release of energy

Good snack ideas include cheese and apple, a handful of nuts and fruit, a slice of wholegrain bread or oatcakes with hummus/nut butters/boiled egg, and Greek yogurt with fruit and sprinkling of seeds such as pumpkin or sunflower.

Also, make sure you stay hydrated! Dehydration is thought to be the cause of one in 10 cases of unexplained tiredness. Alcohol also dehydrates you. Aim for 6-8 glasses of fluid per day.

 6. A lot of people claim that sprouting foods like alfalfa and broccoli are extremely high in nutrients. Is this true?

Sprouting is the process whereby seeds germinate and are eaten either raw or cooked. Bean sprouts tend to be the first that come to mind when we think of sprouting but many foods can be sprouted including barley, wheat, spelt, rye, oats, lentils, peas, and pinto and kidney beans, sesame and sunflower seeds, almonds and broccoli.

These foods are all nutrient rich but are not always superior to their non-sprouted counterpart. Rather than focusing on sprouting seeds, a good starting point is to aim for your five-a-day and to include more plant-based foods in your diet where possible. This can be done by adding nuts and seeds to your salads or adding beans to your soups and stews etc.

7. If you’re looking to boost your iron intake, what foods would you recommend?

Iron is an important mineral, needed to make red blood cells which carry oxygen around the body.  Simple ways to boost your iron levels include:

  • Consuming iron rich foods such as red meat, fish, poultry, beans such as kidney or haricot, eggs and fortified breakfast cereals daily.
  • Adding a handful of nuts or seeds such to your bowl of cereal, your pot of yogurt or salads.
  • Ensuring you have fruit and/or vegetables with every meal as vitamin C helps your body to absorb iron. You could have a small glass of juice with your breakfast, a bowl of fruit salad after your meals or just an extra helping of leafy green vegetable such as kale with your meals.
  • Try adding haricot or kidney beans to your stew or soup to bump up the iron. A great tasty alternative to mashed potato is parsnip and cannellini bean mash.
  • Eating breakfast cereals are fortified with iron (except for muesli and granola).
  • Adding a boiled an egg or two to your breakfast for an iron boost. Or take a boiled egg for a snack later in the day

Some foods can make it harder for your body to absorb the iron in your diet such as tea and coffee (due to tannins), milk and some wholegrains. Try to avoid drinking tea or coffee at least 1 hour either side of your meal.

8. If you’re avoiding sugar, are alternatives like honey a good idea?

In a word, no.

“Sugar” loosely refers to several sweet carbohydrates such as monosaccharides, disaccharides or oligosaccharides. The sugar that you put in your tea or on your cereal is made up of two simple monosaccharide units (glucose and fructose) joined together to form the disaccharide sucrose. Honey similarly contains both glucose and fructose and has similar caloric content to sugar. Honey and maple syrup are often promoted as “natural” or “unprocessed” and therefore healthier or superior. But sugar is a natural product, made from sugar beet and sugar cane. The body does not differentiate between maple syrup, coconut sugar etc. and so all of them still raise blood sugar levels similarly to sugar.

Instead of searching for a “healthier alternative”, a starting point could be reducing the cereal-fruitoverall amount of sugar your currently use. You can do this by gradually reducing the amount of sugar you have in your tea or, if you like honey on your porridge, try adding stewed fruit instead.

9. What are your thoughts on raw food diets?

The principle behind raw food diets is that all foods should be unprocessed, unrefined and not heated to above 44c. The theory is that if the enzymes within foods are preserved, this will aid digestion and offer health benefits to your body. Foods allowed on a raw diet therefore includes whole foods such fresh fruit and vegetables, nuts, seeds, sprouted grains and some pulses and grains. Raw diets are largely vegan, although some advocates do include raw unpasteurized milk, raw meat and raw fish.

So, does the evidence stack up? It is widely agreed that a diet rich in plant-based foods including fruit, vegetables, nuts, seeds, legumes and pulses, with less reliance on meat and fish, can offer protection against some diseases such as cancer and heart disease. BUT the evidence is scarce for choosing uncooked, raw foods only. In fact, we know that cooking increases the bioavailability of some nutrients such as lycopene (highest concentration in cooked tomatoes) and betacarotene (carrots).

Choosing a raw food diet could put you at risk of specific nutritional deficiencies including vitamin B12 (found mainly in animal products), calcium and iron, and protein intakes tend to be low on such a diet.

Coconut oil is often promoted on raw diets, but despite the recent health claims, coconut oil is still 90% saturated fat. Eating uncooked foods or unpasteurized milk/cheese should be avoided if you have a compromised immune function and, from a food safety point of view, eating uncooked foods can put you at risk of food poisoning.

Another fad diet? I think so! Take the sensible principles such as increasing your intake of plant-based foods but have an extra portion of pumpkin seeds sprinkled over your pan-fried salmon salad.

10 Do you have any tips on sneaking in your 5 a day?

Before we discuss how to reach your 5 a day lets remind ourselves what is classed as a portion.

The following class as a portion (80g):

  • 1 medium sized piece of fruit e.g. 1 apple/orange
  • 2 small fruits e.g. 2 plums
  • 80g beans and pulses such as chick peas, kidney beans
  • 80g fresh, frozen or tinned vegetables
  • 30g dried fruit

berries-and-porridgeThe obvious way is to reach your 5-a-day is to choose fruit or vegetables as a snack. As much as I know this, however, I personally like a biscuit with my cuppa…so I need to ensure my meals are packed with portions of fruit or vegetables. Here are a few tips:

  • Add chopped dates, apricots or stewed apples to a bowl of porridge. Add sliced strawberries to your bran flakes or banana to your Weetabix.
  • Make pancakes with added blueberries in the mixture.
  • Have chopped crudités with your sandwich at lunch such as cherry tomatoes (x8) or carrot sticks (1/2 medium carrot)
  • Serve all main meals (where appropriate) with a side salad
  • Add a tin of haricot beans or chickpeas to slow cooker meals
  • Mix mashed potato with a tin of cannellini beans for a Shepherd’s pie topping or mix mashed carrot and swede.
  • Try to have have three different vegetables with your main meal.
  • Bulk out your Bolognese mix with a good couple of handfuls of frozen vegetables (this means the meat goes further, you lower the fat, and you increase the fibre too!)
  • Make your own tomato sauce with fresh or tinned tomatoes, chopped carrots, courgettes, onions and herbs. Once blitzed no one will know!
  • Remember that soup is such a great vehicle for veggies.

If you are struggling for a healthy snack then below is a recipe for a fruit and nut bar that I like to make. The combination of whole grains, fruit, nuts and protein make for a healthy, nutritious and sustaining snack!

Nutritious nut, fruit and oat barbars

Ingredients
100g dates
50g semi-soft apricots (chopped)
50g walnuts (chopped)
1 tbsp sunflower seeds
150g oats
60g ground almonds
100g honey
100g low sugar/salt peanut butter

Method

  1. Heat dates in a saucepan with a few tablespoons water until soft and then mash (you may need to add more water)
  2. Heat honey and peanut butter gently in a pan and then add oats, almonds, apricots, walnuts and seeds.
  3. Add dates and stir well
  4. Spread into greaseproof paper lined baking tray and press down firmly
  5. Bake at 160 for @20 minutes
  6. Remove and leave to cool completely before cutting into squares


Midweek meatloaf

This meatloaf uses turkey mince instead of beef, so it’s a great choice if you are trying to reduce your red meat intake. The basic recipe was inspired by a recipe on the BBC Good Food website but I tweaked it to boost the nutrient content. I use whole grain oats and oatmeal to increase the fibre content and whole grains and more tomato puree (an excellent source of the antioxidant lycopene) than originally suggested.

Ingredients
500g turkey mince
1 large onion
2 garlic cloves
1 tsp Dijon mustard
2 tbsp tomato puree
Dried oregano
75g old fashioned oats
25g oatmeal
1 egg, beaten

Method

Pan fry onion and garlic cloves in rapeseed or olive oil until soft (5 minutes). Then combine with all other ingredients and place into a prepared loaf tin (greased or use greaseproof paper). Cook at 180C (160C fan) for 30 to 40 minutes. Serve with green vegetables and potatoes.

Victoria is a freelance dietitian who splits her time between NHS work, her private practice and bringing up her young family. She firmly believes that when it comes to diet and nutrition there is no “one-size-fits-all” approach. She works with clients to help them achieve their diet and lifestyle goals, using evidence based nutrition advice!

For more information about her services see her website here.  You can follow her on Twitter here or on Instagram here

 

It’s Breast Cancer Awareness Month – meet Emma!

October is Breast Cancer Awareness Month and, having shared the story of one of our Directors last month (for Blood Cancer Awareness Month), we thought we would share the story of Emma, our other founding Director this month. Diagnosed with breast cancer in 2006, Emma experienced the isolation that often comes with a cancer diagnosis and is all the more acute when you’re young. Way back in 2008, Emma started meeting up with other young adults with cancer and the roots of Shine took hold. Today, Emma runs Shine with Ceinwen and is Shine’s Director of Operations and Training. Read on to learn more about Emma and why Shine does what it does!

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Emma (left), with Ceinwen at Shine’s 2016 Great Escape

When were you diagnosed and what with?

I was diagnosed with breast cancer in June 2006. I had two tumours and the cancer had spread to five of my lymph nodes. I also had unconfirmed spread into my breast bone and the lymph nodes in my chest so I’m still not 100% sure what stage my cancer is/was!

How did you find out you had cancer?

Early in 2006 someone drove their car into the back of mine while I was stopped at some traffic lights. I had whiplash and sprained ribs and was having physio. I found a lump in my breast that was next to one of my ribs so the GP thought it was a bleed caused by the accident but said he would refer me to the hospital anyway. When I finally got my letter from the hospital, the soonest they could see me was in 12 weeks time (this was before the two week wait was introduced in the NHS). While waiting for my physio appointment at a private hospital (I had BUPA through work), I noticed a sign for a specialist breast centre so I figured I’d get an appointment there as I had already paid my insurance excess! I was seen the following week and was sure that they were doing all of the tests to get more money from the insurance company!

I was so unconcerned about the follow up appointment that I went to receive the results on my own on the way home from work. The words from my doctor – “I’m really surprised but it is a little cancer” – will always stay in my mind. I remember thinking ”what’s a LITTLE cancer??”

What did you think and feel when you were diagnosed?

Because I had come in alone, the consultant suggested that I call my partner and come back in when he arrived. I was in shock. I can only remember certain phrases like “you’re so young that we’ll throw all of the possible treatment at you” and “normally we aim for five years survival but, with your age, we are going for 20”. I remember thinking that I would still be in my 40s after 20 years and that that wasn’t long enough.

Over the next few days, I went into planning mode to deal with work, friends, family and the huge number of hospital appointments that I suddenly had to fit in. Looking back, I coped by focusing on the practicalities such as finding pyjamas for hospital that buttoned up at the front (surprisingly difficult!).

How did the people around you react?

My partner and family were as shocked as I was. We had no family history of cancer and I hadn’t met anyone who had dealt with cancer at my age before. I really thought that it only happened to older people.

Everyone tried to help with practical arrangements but I avoided a lot of my colleagues and friends as I felt awkward dealing with their reactions. I lost count of the number of times I heard phrases like “but you’re too young for that” (I know!) and “my uncle’s brother’s wife’s sister had that – oh, she died” (thanks, that’s really helpful!).

emma-1

Emma during treatment

What treatment did you have?

I started with surgery to remove the original tumour but, when I went into surgery, they found another one. I had a lumpectomy rather that the mastectomy that would have been recommended if they’d known about the second tumour. I decided not to go back for the full mastectomy as my surgeon had got clear margins (it’s amazing how much jargon you learn!).

My oncologist then recommended a CT scan and a PET scan both of which showed up “dodgy bits” in my breastbone and the lymph nodes in my chest. At the time, I didn’t really understand the difference that made to my diagnosis but as the next lot of treatment would have been the same anyway, we went ahead with chemotherapy.

We also discussed the fact that I hadn’t had children and talked about options to preserve my fertility. My partner and I discussed it and decided not to take any of the options as they meant delaying chemo. I started my treatment with injections into my stomach to send me into a chemical menopause.

All together, I had 8 rounds of chemo, given every three weeks (FEC-T) and also started on infusions of Herceptin that went on for a year. I also had six weeks of daily radiotherapy to the remaining breast tissue and into my neck and I also started taking Tamoxifen tablets, (though I later switched to Exemestane). I stayed on the injections and tablets for 7 years in total. I used to say that I would rattle if I was shaken!

How did you feel through treatment?

The surgery wasn’t too bad as I was in a lovely, swanky private hospital with three course meals and a wine list! It was a bit scary having the anaesthetic though – and a bit weird coming round and finding myself halfway through a conversation that I couldn’t remember!

Going straight into menopause was also bit of a shock to the system. Overnight I developed massive hot flushes and sweats and felt like an old person when I tried to get up from the sofa.

The chemotherapy wasn’t as bad as I expected it to be but it did get worse as I went through all eight rounds. By the end of it, I had absolutely zero energy and felt like I’d been hit by a truck. My veins also decided to stop working so I agreed to have an operation to implant a portacath. This meant that the Herceptin could be given straight into a port under the skin in my chest which had a tube leading straight to my heart (sounds scary right but it definitely made life easier!).

My treatment went on for 7 years in total and I still take some tablets to deal with the after-effects of the treatment. After each type of treatment finished, I was worried about the cancer coming back as I felt like I was losing some protection they gave me. I still find the regular scans frightening though. I haven’t found a way to remove that ‘scanxiety’ completely but it is much easier with my Shine family around me.

Throughout treatment I thought that, once I was done with the main treatments, that my life would go back to normal. That never happened and when the hospital visits slowed down and treatments came to an end, I felt as if I had been abandoned to work out what came next. I felt like I was living in a ‘should be’ era – I should be feeling amazing that I’d come this far, I should be able to pick up my life from where it left off…. I am naturally a very positive person and I didn’t initially recognise that the feelings that I was having were of isolation, anxiety and depression.

It took nearly three years for me to admit that I was still struggling and to take steps to get help. It is not an understatement to say that my amazing counsellor, Kathy, changed my life completely. With her, I was finally able to sort through the mess of everything that I thought I ‘should be’ feeling and to talk through the experiences I’d had through treatment and beyond. At first I couldn’t understand how talking about it would help but it enabled me to face the anxieties I had been holding on to and to feel more empowered about my future, whatever that holds.

Tell us about your work with Shine

Throughout treatment, the “you’re too young” comments kept coming and the support groups that I attended were full of people showing me photos of their grandchildren! Eventually, I met the amazing Justine through a random breast cancer chat room. She was just a few years older than me and had also been through treatment for breast cancer. We met for coffee which ended up lasting four hours and I suddenly realised just how isolated I had been.

emma-2

Emma and Justine at the first Shine party in 2008

That meeting led us to start Shine (although we didn’t have a name!) and we decided that we should reach out to other younger adults with all types of cancers. In the first year we connected with over 100 people in Dorset and it felt amazing to make sure that other people didn’t feel as isolated as we both had. We had fun too, doing things that suited us (mainly bars and coffees!) rather than the standard cancer support group format. And thus, Shine was born….

Meeting Ceinwen in 2010 was the next brilliant coincidence. Ceinwen had been diagnosed with cancer shortly after having a baby (you can read her story here) and was looking to do something similar to Shine in London. We met for coffee, which again lasted 4 hours (be careful if we ever have coffee together!), and we realised that we had a lot of similar ideas about the lack of support that was available to younger adults diagnosed with cancer. Together we started work on the ‘Small c’ Project, the first research project in the UK to look at the needs of young adults with cancer. We then went on to develop a programme of activities and events that aim to meet those needs.

emma-3

Emma and Ceinwen with Shine Trustees Laura and Christopher

We also started setting up Shine Networks in other parts of the UK, giving people the chance to meet others in similar situations much more quickly that we had been able to.

The feedback and stories we heard from the people that Shine supported in the early days quickly made my career (banking – sorry!) seem much less important and certainly less rewarding. I eventually left my career in 2012 to fully focus on Shine. I have never regretted any part of that (despite the massive impact on my bank balance!) and absolutely love my job, even on a Monday morning – and at 2am on a Sunday as it’s not really a 9-5!

Nowadays, we are both still working hard to reach the 30,000 young adults diagnosed with cancer each year in the UK and to develop more programmes to fill the gaps in support that still exist for young people dealing with cancer.

What difference has Shine made to you?

Personally, I now have a huge network of people around me that just “get it”. I can talk to people about things I wouldn’t put on my “normal” friends. I also have people that also get the dark humour and the fact that you’re definitely not being ‘negative’ by talking about your funeral music or not planning too much for the future!

I love to feel like what we do makes a difference to peoples lives, and I still sometimes can’t believe what we have achieved in just a few years (mainly because I’m always thinking about the things that we need to do in the future!). In short, Shine has definitely changed my life for the better!

How do you feel now about your experiences? What‘s been the biggest change you’ve faced?

I’ve just passed my ten-year ‘cancerversary’, but the fear of my cancer returning is still there. Certain things still trigger the trauma of some of my experiences through treatment and I don’t think that will ever go completely. However, I am much more able to deal with the scary bits now and, of course, know amazing people who help and support me.

I don’t feel grateful for having cancer. Instead, I feel grateful that I have been able to channel my experiences into something that helps other people and also brings me personal joy and fun. I try not to stress over the small stuff and I honestly appreciate much more about the wonderful people that surround me.

emma-4

Emma in 2016!

If you could give one piece of advice to yourself before your diagnosis what would it be?

This is hard! I felt invincible before I was diagnosed with cancer and I think most people in their 20s (or 30s or 40s!) feel the same way unless they have personally experienced something really scary. I’m not sure I would have taken my own advice anyway but it would probably be to appreciate the people around you and the things in life that actually matter – and to make sure that you are living the life that you want, not the one that is expected of you.

More information about Shine’s impact and our history, staff and Trustees can be found on our website here. If you’d like to get in touch, please drop us a line at hi@shinecancersupport.org. 

10 ways to help a friend coping with cancer

We often post articles on Twitter and Facebook about what to say to a friend or family member who has cancer, or how you might help them. We’ve also noticed that these often get a huge number of hits! That got us wondering how the members of our growing Shine community have been helped by family and friends when they’ve been ill – so we asked them! We got some great responses and we’ve summarised them below. Have a friend in need? Take a look below and see if we can inspire you!


Message1. Let them know you’re thinking of them

“One of my friends sent me a card every week that I was in the hospital – and I was in there for a long time.  It was so nice to receive a surprise in the mail and to hear all her news.  I’m not sure she knows how much it meant to me but I’ve kept all the cards as a reminder of what a great friend she is”.

When you’re ill, sometimes just knowing that you’re still part of the land of the living is all you need. A text, a card, a phone call – no matter how brief – can make a huge difference to someone who hasn’t been out and about much, especially if you’re clear that you don’t expect a reply.  Being ill can be very lonely so knowing that your friends and family are still thinking of you can make a huge difference.

2. Cook

“A friend bought 12 homemade freezer meals at two separate points during chemo. Even though I didn’t feel like eating most of the time at least I knew there was something quick, easy and on hand for my husband and daughter. I was very touched at her kindness and effort”.

If you’re a whizz icookn the kitchen, there’s nothing quite like a homemade meal to perk up someone who isn’t feeling great. And even if they don’t feel like eating because treatment has done a number on their appetite, you might be easing their stress by making sure other members of their family have something quick and easy to eat when the hunger pangs hit.

3. Clean

cleaningNot big on cooking? How about cleaning? A lot of our Shine members mentioned that they’d had friends who had popped in to clean the bathroom and kitchen, or put fresh sheets on the bed (and do the laundry) while they flaked out in front of the tv.  There’s nothing quite like clean sheets and a nice fresh towel – and it doesn’t take very long either!

4. Hang out

“For me, I was happy just to have people to keep me company. I think as a young lad people don’t know what to say and some people found it easier to avoid me.  I was happiest when people just came round and played computer games or chatted, especially when I couldn’t do much else beyond letting them in!”

super-1138462_1920Your mate may not be up for a heavy night down the pub, but heading over to his or hers with a movie, a computer game or even a pack of cards can really boost someone’s spirits. Something that doesn’t require a lot of mental or physical energy – like hanging on the sofa – but keeps them involved in the world around them is often really appreciated.

 

 

5. Get them out and about

“I went to Glastonbury festival after my treatment and all my friends had to take it in turn to carry all my belongings and helping me hobble around. I felt guilty about ruining their fun, but in reality I genuinely felt they were happy to have me there.  This reassurance was enough for me.”

We get it – being around really sick people can be scary. But helping a friend by taking them out, even if they’re going to need extra support, can help them feel like they’re still participating in all the things that they should be doing.  Keep in mind that they might not be able to walk long distances or stay out late, but if you can pick them up and drive them to a restaurant, or help them carry their stuff without making them feel bad, you’re more than half way to making their day!

6. Entertain the kids

playground-691129_1280

Let’s face it, kids can be exhausting at the best of times. If your friend has little ones, why not take them out for an afternoon or come over and cook them dinner while your friend has a nap? If they’re old enough, an afternoon movie or a trip to the park could give your friend a much needed break.  Or invite your friend and the kids over. You entertain them while your friend chills out with a cup of tea!

7. Head to the hospital

Something that everyone with cancer knows is that it’s time consuming – and hospital appointments can take ages.  If your friend is spending more time with the nurses and doctors than his/her mates, why not offer to keep them company? Ask if they’d like someone to take them to the hospital, pick them up, or hang out in between.  Having someone to gossip to can be a great distraction from the blood tests, scans and doctor chats.

8. Walk their dog

12376834_10156672952605263_2785600398398241687_nDoes your friend have a pooch? Why not ask if you can help walk the dog a few times a week? If your friend is happy for you to do it, see if you can get a few other friends together and organise a walking roster. On a good day, your friend might just want company for the walk. On a bad day they’ll be glad to have someone do the walking (and poo scooping!).

9. Organise a treat

“One of the most helpful things was planning something nice for my husband and I to do or go for a treat on the week before my next chemo. These did not cost much or sometimes nothing at all but it was something to focus on in the rotten days”.

“My friends always organised a get together on “chemo eve”, which was lovely.”

Cancer can be expensive! Not only are you missing work, but you’re spending your money heading to and from the hospital, on parking charges, and on extra blankets and heating to keep you warm. If you’re looking for a simple way to cheer someone up, why not plan a night out to the cinema or a comedy show? Book tickets when you know they’re free and either take them yourself or organise for others to go with them. (One minor note of caution: if you can, check if there’s cancer in the movie at all. You’d be surprised how many people in movies die of cancer. It’s not what you need when you’re going through treatment!).

10. Help them celebrate

easter-eggs-lst035137.jpg-pwrt3

Having the energy for Christmas, Easter or a birthday can be tough when you’re coping with a cancer diagnosis.  Does your friend need help buying a tree or getting the decorations out? It can be hard for people to know what they need but asking specifically how their planning for a holiday is coming can open up whole new possibilities for help! Buy the Easter eggs, plan the hunt, decorate the tree, light the candles, buy the cake….the options are practically endless.

Got more ideas? What have we missed? Let us know! Comment below or Tweet us @shinecancersupp

 

 

Coping with anxiety after a cancer diagnosis

As we dive deeper into 2016, we’ve noticed a lot of talk on our social media sites about anxiety.  Is it normal to feel anxious after a cancer diagnosis? What about after cancer treatment? To help you kick off the new year and get the best out of the next 12 months, we’re delighted that our longtime friend, supporter and all round Shiny person Emily Hodge (aka Coaching Emily) has written a blog about coping with anxiety after cancer. Take a read below, try out some of the techniques – and know that you’re not alone.


Coach Emily Hodge

Coach Emily Hodge

Having worked in both the NHS and health charities and then experiencing cancer myself, I have seen how prevalent anxiety is among the general population. It can be event more prevalent within the cancer community, given the uncertainty and the threat to life that a diagnosis brings.

In my coaching and therapy work with clients, we discuss and use a range of techniques that look at supporting ourselves with anxiety and moving forward in spite of it. They’re not ‘cures’ for anxiety but rather activities or routes to take depending on someone’s circumstances. Here are a few of the many.

Recognise anxiety

Being aware of how you’re coping and what reactions you have to certain situations are a start to recognising anxiety. Often we get so used to a state of mind that we forget to assess it, but understanding our tolerance for it is important. We might think it’s normal to cry in the toilets at work once a week, or to feel anger and guilt all the time but it doesn’t have to be – this might be anxiety rearing it’s head and you might need support with it.

Take a look here and here for trusted sources regarding signs and symptoms of anxiety.

Talk about anxiety

If you’ve recognised it and realise it’s not something you can cope with right now, please see your GP or another trusted person for guidance. Talking about it with someone you feel comfortable with might be the step that helps you next.

Slow down and breathe

Before we can take any big action, we may need to catch ourselves and slow down. Stopping, breathing and slowing our racing thoughts can be the first thing we choose to do when we recognise something uncomfortable. We might want to run (the so-called fight or flight response) but if we can stop rather than rush around, it can be the beginning of a different relationship with our thoughts and feelings.

One quick technique to try is the “5-5-5” breathing technique:

  • Stand up with both feet stable on the floor
  • Look forward with eyes into the distance or closed and hands by your sides
  • Take a deep breath in for 5 seconds
  • Hold this breath for 5 seconds
  • Exhale for 5 seconds
  • Repeat this 10 times (or as long as you feel comfortable) and then check out how you’re doing

Recognise when we last felt less anxious

When we’re in a calmer state (maybe after the breathing or perhaps completely separately), take a moment to think about the times when your anxiety is less present. What are these situations, what time of day do they occur, what happened just before and just after? These indicate times that you feel different, bringing in an awareness of how your mood changes and can help you to recognise that you don’t feel the same way all the time.

Recognising how you’re feeling is important with anxiety because it can trick us into thinking that we’re always like this, and it never changes. If we’re able to see that it does indeed change over time, then we can start to understand our triggers and think about how we could respond differently in the future.

Work out what you love 

Similar to the above, spend some time thinking about what you love. What is it that makes you lose track of time, the thing that helps you forget yourself, the activities or places that you simply love? How possible is it to go to or get more of these in your life? If it doesn’t feel very possible, what might need to be moved or changed to make it more possible? What does even just thinking of this activity do for you?

Get outside

People can get evangelical about being around nature but there’s a reason for it! Evidence shows that being around and able to see green aids feelings of calm. Find the bush at the end of your street if there’s no park to go to – what is it doing? How does it smell, look, feel? It’s a small, small thing but have a go and see what happens.

Equally, go outside and look up – what do you see, hear, smell, and feel? When did you last look up outside?

Finally – walking (however you enjoy it – on your own, with friends or family, a dog, a podcast, music) is a great way to move us into a different state.

Therapy

More formal support can come in many forms – there are talking therapies such as counselling and Cognitive Behavioural Therapy (CBT) which may be available through your local NHS, other therapies such as mindfulness, or body work like acupuncture, the Emotional Freedom Technique, massage, or Reiki. We’re all different and knowing what suits us is important, but you don’t have to do it alone. If you need help to find the right support, try talking with a friend, asking a therapist for a free 20-minute phone consultation, or making a GP appointment.

Medication

Many people might think of anti-anxiety drugs or anti-depressants as a last resort, but they can be a brilliant way to help with the change in chemistry that is going on in the body, particularly following chemotherapy, radiotherapy or surgeries. Medication may not be for everyone, but for others it might be just the route to be able to access other support in the first place.

Finally we might feel pressure to ‘solve’ our anxiety because there are so many apparent routes to doing so. But it can be important that we first understand what it is we are dealing with, and how we’re coping before we’re ready to do anything about it. Give yourself a pat on the back for reading this and look at it again when you’re ready.

Emily is a health psychology specialist who worked in the NHS before her own cancer diagnosis. She now runs private one-to-one, group coaching and therapy to support people during and after challenging times in their lives. She’s worked with Shine for over five years and regularly sees cancer clients. Check out her anxiety vlog and website here www.coachingemily.com