Many patients appreciate having a family member or friend with them during a medical appointment or treatment. You can help by keeping the list of questions the patient would like the doctor or other members of their health care team to answer during the appointment or treatment. Talk to the patient before the appointment and ask them how they might like to be reminded of their questions during the visit. It can be helpful if you write down the most important information discussed during the appointment so the patient can review it later.

The best support you can provide to a patient during treatment is just showing up and being present. You can bring snacks, water or just provide company during lengthy appointments. You can bring a deck of cards or magazines to help the patient and you pass the time while waiting. If the patient wants to talk, don’t hesitate to discuss topics other than cancer - patients often appreciate the distraction.

A cancer diagnosis and the plan of treatment impacts the patient and their family and friends. The diagnosis may bring up doubts, uncertainty, anger, sadness and possibly other uncomfortable feelings, which are all normal reactions. It can take time to sort out your feelings and adjust to the news.

Many resources at Stanford, in the community and on the internet are available to help you understand and cope. Ask a member of your patient's health care team or the Stanford Health Library to help you find the resources that can be most useful to you. They can usually recommend a variety of services, including online resources, support groups, and exercise and stress-reducing classes. It can also help to talk about your feelings with someone close to you, like another family member, a friend, a therapist, a social worker or a clergy member.

Our medical librarians and specially trained volunteers at the Stanford Health Library (http://healthlibrary.stanford.edu/ and located at 875 Blake Wilbur Drive, Palo Alto) can help you find materials about a specific diagnosis, condition, or related issues such as coping and caregiving. They can conduct a comprehensive literature search related to your specific questions, accessing many resources that are not available to the general public. For hours and other locations, refer to the Stanford Health Library website.

Consider participating in one of the cancer-specific support groups or classes. The support groups meet regularly for individuals who have similar diagnoses, along with their families and friends, to share experiences and concerns, to gather information and receive emotional support and advice. The Caregivers Workshop focuses on how to manage stress and maintain emotional balance.

A list of our support groups and classes is available on the Cancer Supportive Care Program website.

We encourage you to practice self-care. Eat healthfully, exercise and rest. Try to maintain your hobbies, interests and social activities. These will help you manage your feelings so that you will be able to best support the patient.

Some of our patients and families have also found the following external websites helpful:

• The Cancer Survivors Network is a free online program created by and for people with cancer and their families. 
• I Can Cope is a free online program of self-paced classes on topics ranging from managing treatments to healthy eating.
• The Cancer Support Community provides a support helpline, distress screening and online cancer support groups.
• Cancer CAREpoint offers assistance to patients and their families through the cancer journey. One-on-one private consultations are available, free of charge.

As a family member of someone diagnosed with cancer, you might be feeling emotionally strained. If so, it is vital to have access to support that will help to relieve you by providing a safe environment for you to explore your new feelings and concerns.

For some people, dealing with the emotional strain can be helped by speaking with the patient's doctors, other members of the health care team, other family members, close friends, clergy and/or other community members. If you are having a hard time handling your emotions, tell the patient's health care team and ask to meet with the team's social worker. Social workers can often refer you to other mental health professionals and additional support services. They can also help you find support groups where you can meet other patients and family members who are learning to cope with many of the same difficulties you are experiencing.

Finding a balance between your needs and the needs of the patient can be challenging. Remember that while the patient might be going through a crisis, you are, too. Taking good care of yourself is essential. Make a to-do list and put the most important tasks on top of the list. Create a schedule for these tasks and include time for yourself in the schedule. If possible, take even a few minutes each day to do something for yourself - something that helps you stay connected with life outside of cancer.

Develop a "back up" team of family members, friends, neighbors and community members who you can trust to help when needed. Write their names and contact information on a list that is easy to find – for example, put a copy on the refrigerator, on your desk or dresser, by a telephone, and in your car. If there is a conflict between the patients' needs and yours, or if you need a break, call your "back up" team so you can get the rest, care, and support you need.

Some patients are at a greater risk for not following the doctor's orders than others. Patients might not always do things the way you think they should. Your relationship with the patient can be a delicate balance between being supportive and adding stress for the patient by insisting they follow their doctor's orders.

It is important to keep the health care team involved in all aspects of the patient's care. If you are concerned that the patient is not following medical orders, contact the patient's health care team. They may be able to suggest ways for you to approach the patient about specific issues, or they may be able to provide direct help. 

Patients and family members often have different priorities and varying degrees of willingness to discuss the challenges of diagnosis and treatment. Several strategies might help the patient feel more prepared and less pressured when talking about things they don't seem to want to discuss. Let the patient know, in advance, that there are particular topics or issues that you need to talk about with them, and set aside a specific time to have the discussion.

You can ask the patient's health care team to help you choose the best approach for you and the patient. The health care team can participate if you and the patient feel it would facilitate a more productive and supportive discussion. 

There are many appointments, medications, doctors and other details to manage when helping someone diagnosed with cancer. While each person may have different standards for record keeping, you can use this list as a starting point:

• Doctors' names and contact information (clinic name, phone number)
• Nurses' names who are involved in the patient's care (clinic name, phone number)
• Day-time clinic and after-hours contact numbers
• A list of the patient's current medications and preferred pharmacy, location and phone number. (Update this list when medications change.)
• Appointment schedule and doctor who will be seeing the patient.
• Questions to ask the doctor. Revise and prioritize the list of questions before each appointment.
• Treatment schedule and medication names, where appropriate.
• Symptoms the patient is experiencing. (Keep the list updated.)
• Names and phone numbers of your "back up" team – people you can call for help (e.g., to pick up children, bring you and the patient a meal, give the patient a ride).

Choose whatever system works best for you. Some people find it helpful to use a traditional day planner or a notebook to keep track of this information. Others find that an electronic note-taking system or application is most useful. 

Common side effects include fatigue, constipation, loss of appetite, and nausea. Other side effects depend upon the type of medication or treatment. The health care team can prepare you to help the patient look out for and manage side effects.

We encourage you to keep a written log of treatment side effects and symptoms. Include the date, time, side effect or symptom, and how long each side effect or symptom lasts. Ask the health care team which symptoms or side effects should be reported right away, and be sure to contact them if the patient experiences those symptoms or side effects. It is also important for you or the patient to alert the patient's doctor if the symptoms or side effects get worse or become difficult to manage. 

Only you and the patient can decide the right time and the right words to use to tell family and friends about the cancer diagnosis. Who you tell and when you tell them is a personal decision. There's no set time when you feel comfortable enough to discuss the patient's cancer with others.

Before you speak with others about the patient's cancer, think about what the patient is feeling, what you are feeling, why you want to share the diagnosis, and what you need from family and friends. As you disclose information, your family and friends will have many different feelings too. Don't be surprised if you receive a wide range of reactions. Talking about cancer can be uncomfortable for many people. Some friends may not know what to say or how to act. Some may have a lot of questions, while others may keep their distance. It may take some time for everyone to adjust to the diagnosis and get more comfortable talking about it. Giving your family and friends information can help them support you and the patient.

Some people find it useful to keep their friends and families updated online. These are some of the websites that some patients and family members have found useful for keeping friends and families updated:

Taking care of patient who has cancer is a big job, and it can be exhausting. When you begin to feel overwhelmed, ask for help. Your family, friends and community probably will want to help, but they need your guidance about what to do. Make a list, and allow them to help when they offer.

Caregiver "burnout" is an important issue, and particularly challenging for family members living with patients. Identifying a back-up personal caregiver who can support you and the patient can be very helpful in reducing the physical and emotional challenges of treatment.

Make sure that you take even a little time every day to do things that you enjoy doing. Be kind and gentle with yourself.