SUPPORT GROUPS FOR FAMILY AND CAREGIVERS OF CANCER PATIENTS

Family and caregivers of cancer patients often times seek out support groups to help them cope. Cancer patients don't just depend on their doctors and nurses to guide them through treatment and recovery. Most also lean on caregivers such as a spouse, other family members or dear friends. And if you are one of these pillars of support, you probably know you can suffer from what some therapists call "compassion fatigue." In time, generally after the initial crisis has passed, you may simply become overwhelmed.

Just consider the job: You have to keep going, remaining optimistic, often with no sense of when your job might be over. In addition to helping your loved one with cancer, you're probably still working your own job and taking care of countless other responsibilities. You might feel like you've put your life on hold -- and you may begin to resent that, no matter how selfless you are. Luckily, as support groups for cancer survivors have become more common, so have groups for their caregivers and loved ones. Here's what you should know.

What's Available
Most organizations that offer support groups for cancer survivors, such as the Wellness Community (http://www.thewellnesscommunity.org), the City of Hope (www.cityofhope.org) and the American Cancer Society (www.cancer.org), also offer groups for family members and other caregivers.

Some offer outreach to co-workers, as well. "Years ago, one of the [Hollywood] studios called us," says Michael States, a marriage and family therapist at the Wellness Community in Santa Monica, Calif., who facilitates support groups. "One of their employees, a single parent with a young child, had breast cancer. The department was a basket case. We did a support group with the entire department."

For family, friends and co-workers, support groups can achieve the same goals as they do for cancer patients, States says. "They can reduce unwanted aloneness, loss of hope and loss of control."

The Research
Just how stressful is it helping a loved one cope with a serious illness? So stressful that it can make you sick. The American Medical Association (AMA) even has a name for overburdened caregivers: "the patients behind the patients." And the AMA is urging doctors to provide preventive services to this at-risk population.

Among the recent research findings:

• Study after study has documented adverse immune system changes in those who care for people with chronic and serious illnesses. Their resistance is down, and they can't fight off common ailments such as colds and flu as effectively as they once did.
• Support can help. While studies on the effect of emotional support on caregivers are not as common as those on cancer patients, some research does exist. These studies have found that caregivers do better with emotional support. In an article published March 1, 2001, in the journal Cancer, researchers evaluated 148 newly-diagnosed patients with colorectal cancer and their partners. The researchers measured the amount of social support each caregiver received (such as hugs from loved ones and other positive interaction) and found that those who got little emotional support were more depressed over time. In another study, published in the July/August 2000 issue of the journal Psychooncology, a sampling of partners of breast cancer patients who participated in an educational and support group was compared with a control group that did not get support. After three months, those who attended the group reported being in a better frame of mind and mood than those who did not. Furthermore, the patients of the partners who went to the group program reported greater marital satisfaction, among other improvements.

When to Go
If you are feeling out of control, hopeless or fatigued, therapists agree that you might benefit from some group support. If you resist the idea at first, you're not alone. Jane W., a 52-year-old physician, initially shelved the suggestion of joining a support group, even though many people recommended it after her husband (whom she'd recently married) learned he had prostate cancer. She figured she could handle the situation on her own. Finally, however, she went. The emotional turning point that inspired her to seek group support? "I was really scared," she says. Her husband was relieved. He realized, as she did after going to the group, that they had different issues, and they could both benefit from support groups.

Finding the Best Group for You
How to choose the group for you? Here are some tips:

• Look for groups where you feel like people are listening to you -- and where you're getting practical suggestions.
• Ask for suggestions from your loved one's therapist -- he or she may facilitate groups for patients as well as groups for their loved ones.
• Visit more than once, if possible. The group could be having an off-night and you might walk away with the wrong impression.
• Follow your gut. After the initial session, ask yourself if you feel helped and comforted.

"Family members and friends need their own place to talk about their own fears and anger," says States. At support groups, you can learn how to better communicate with the cancer patient these fears and other feelings. And you can deal with those common feelings of guilt and inadequacy, such as being reluctant to leave on a trip, even if it's business, or feeling as if you are not helping enough.

Talking about these fears and frustrations might help your relationship with the survivor, as well. Danielle G's husband went to a caregiver support group about four months after she was diagnosed with breast cancer at age 30. "It was helpful for him to go and vent about my crankiness, the bills, me being sick," she says. "I think it was very helpful to our relationship for him to go."

Sometimes it might be easier to open up to the group about a relationship issue before discussing it with your mate. Jane W., for instance, recently shared with group members a painful reality: Her husband's cancer treatment and its side effects were having an adverse effect on their physical relationship.

In support groups for loved ones, there's also likely to be talk about talking care of yourself physically and emotionally, especially in the wake of recent research suggesting that long-term caregiving is tough on the immune system.

Expect to learn one of the toughest lessons for most caregivers: It's OK to ask for help. Norm S., now in his 60s, went to support group meetings at the City of Hope for two years, starting shortly after his wife was diagnosed with breast cancer and continuing until some months after she died. "The people in there fed my soul," says Norm, who now volunteers at the medical center and talks to other family members of cancer patients about coping.

What Not to Expect
As helpful as support groups might be, they won't solve all your problems.

• To get the most out of the group, says Norm S., you must be keyed-in and abreast of your loved one's medical information. He went with his late wife to all her medical appointments. If that's not possible, go as much as you can, he advises. "If you never go the doctor, you are going to be lame in that support group," he says.
• Consider the group a two-way street. Go with the expectation that you will be helped and that you will also offer insights and help whenever possible.

Caregivers, whether a family member or another loved one will most likely benefit from seeking out cancer support groups that will assist you in dealing with a cancer patient.