The Many, and Healthy, Ways to Live With Cancer

Merely telling patients to be optimistic can be demoralizing. What seems to work is specific training to improve people's ability to cope, said Kevin Stein, who studies how patients cope with a cancer diagnosis at the American Cancer Society.

Stein teaches patients three key steps: Stop. Think. Focus. When a patient feels overwhelmed by thoughts such as "I can't do this," "I am not strong enough" or "I can't make it through this," the technique teaches them to consciously tell themselves, "Stop!" The next step is to deliberately seek out positive aspects of the situation, such as "I am a strong person" or "I have great support from family and friends." The last step is to focus on the positive thought.

"You have to be based in reality, but in that realm you can still be positive," Stein said.

One technique that seems to be crucial for both newly diagnosed patients and those who suffer a recurrence is to learn to stay in the present, rather than drifting into the "what if's" of the future and the "if only's" of the past.

Stein tells the story of a breast cancer patient who was furious because her doctor had not conducted a proper breast exam and had not caught the cancer early. Now, she faced a mastectomy. He advised her to stay focused on the positives, but she could not let the anger go. Three months later, she suffered a stroke that left her paralyzed.

"She said to me, 'Dr. Stein, you were right. I still had a wonderful life and wonderful things in my life and I should have appreciated what I had left, because now I am in this wheelchair,' " Stein said. "I said, 'You know what? You still have to find the positive things. You are still alive, you can still communicate. Be in the moment and appreciate what you do have, because it is fleeting.' "

One study, in the Journal of Consulting and Clinical Psychology, found that cancer patients who were taught how to manage stress and were given training in problem-solving, constructive thinking and how to plan pleasant activities coped far better than those who were merely part of a support group or got no psychological intervention at all.

A federally funded study last year found that cancer patients who actively sought help and developed a plan of action were more likely to find meaning in their experience than those who were passive. Doing something about a worry -- calling a nurse or a doctor, for example -- was useful not just in alleviating the worry, but in giving patients a sense of control, said Barbara Andersen, a Ohio State University psychologist who conducted the study.

Some caution that it's important to maintain some balance.

"I would spend hours in the Internet, or in the bookstore, trying to get as much information as I could," Krimstein said. "You can get kind of obsessed. You need to be armed with information, but you can drive yourself kind of crazy, too."