Helping breast cancer patients cope

The Report: September / October 2001 vol.22 num.4


Liz Dohan
Social Worker / Practice Leader
Vancouver Cancer Centre

On the scale of things that can shake you and force a pronounced revaluation of your life, being told you have breast cancer has to be close to the top. But learning to cope with that is only the beginning of a process that involves the support provided by a multi-disciplinary team of professionals whose goal it is to ensure breast cancer survivors make the most of the rest of their lives.

In her 21 years experience, Liz Dohan has seen breast cancer counselling progress to reflect the emotional as well as material needs of patients who must often make serious adjustments to accommodate their new reality.

-Health care has gone through lots of changes," said Dohan, a social worker/counsellor and acting professional practice leader at the Vancouver Cancer Centre. The patient and family counselling department she heads -helps people through all angles of the journey. My job has become much more a part of the multi-disciplinary team because the emotional response of the cancer person has become recognized.

-In the old days, people might think I was there to give them money or make judgements about parenting. But theres a huge impact on their emotional well-being, and the need to address those aspects is far more recognized today."

While more of her time is taken up with administrative duties these days, Dohan still practices her profession. It mixes psychological counselling with advice on material needs such as where to find a breast prosthesis and how that fits in with Pharmacare, advice on income replacement, and references for home care and community resources.

As for counselling, that can range from talking with women whove just found out they have breast cancer through to those in the post-treatment stages, as well as women coping with a recurrence.

Between 1995 and 2000 she participated in a national study into the effects of group support on metastatic (recurring) breast cancer women, discovering a positive effect from group interaction on stress statistics. -The group is a very powerful reinforcement for some," Dohan said. -Others might not like that experience." Dohan sees survivors on both a one-on-one basis and in groups.

In dealing with the post-treatment stages, Dohan stresses to survivors that it is not -the end of the book. Its another chapter. They are learning to live more present-focused, as much for the moment as for the future."

-The post-treatment person might have to deal with feeling fatigued. There are the challenges of figuring out, ‘When can I go back to work? What about the possibility of relationships? There are many losses, including grief for the loss of a carefree, healthy life. As counsellors, we have to acknowledge what comes from peoples hearts."

The Vancouver Cancer Centre, a branch of the BC Cancer Agency, employs five full-time social worker/counsellors, one vocational rehab counsellor, two part-time social workers, and two part-time art and music therapists, as well as front-line support staff.

-The multi-disciplinary team reflects the agencys commitment to good, psychosocial care," said Dohan. -Im lucky. I do love my job and I work with a wonderful group of colleagues."

Victoria-raised Dohan is parent to three young adults, and daughter to two aging parents. She was inspired to enter her line of work after a session of globetrotting following graduation revealed to her some of the worlds poverty. -I wanted to do something for others," said Dohan, who attended the University of Victoria and McGill University and had her Masters in social work by age 23. She performed relief work at the Cancer Agency until full time work became available.

A typical day consists of anything from facilitating groups, counselling upset patients, assisting a needle-phobic patient with relaxation techniques, and making arrangements for a -young women with breast cancer" networking group. Its challenging work, but rewarding, said Dohan quoting from a letter praising one of her services: -‘The caring and support that goes on in this group are magic."

The same writer expressed support for HSA in its struggle for a decent contract, stating, -‘I would strike for these people in a heartbeat.\

-We were given a bad deal," Dohan said of the Liberal governments recently imposed contract that enshrines a two-tiered wage hike for HSA members. For Dohan, that means two per cent per year with a cost-of-living adjustment in the third year. -What would you expect from this sort of government? After they gave a carrot by lowering income taxes, someone had to suffer. A legislated contract after the governments first and only offer is outrageous. Its awful, and makes a farce out of the process of collective bargaining."

In the meantime, she is dedicating her energies to her patients. Counselling people reeling from the shock and grief that frequently accompanies breast cancer can be tough, but -I feel very honoured to do it," Dohan said.