The diagnosis of lung cancer is a crisis in a person’s life, confronting them with changes in identity, role, social interactions and presenting them with an uncertain future. There have been two models suggested for the way in which coping is undertaken;⁷⁸ Moos and Schaefer applied crisis theory to illness and Taylor and his colleagues examined ways in which individuals adjust to threatening events.

Moos and Schaefer’s approach splits the coping process into three parts:

1. Cognitive appraisal, whereby the seriousness of an illness and it’s consequences are assessed.
2. Adaptive tasks, dealing with pain, procedures and the experience of being in hospital, whilst maintaining an emotional balance, preserving self-image, competence and mastery, sustaining relationships with family and friends and preparing for an uncertain future.
3. The use of Coping Skills, involves understanding the illness, confronting the problem and managing emotions.

So after assessing the illness and using adaptive tasks and coping skills the outcome is determined. There is variation in response and it is argued that demographic, personal, physical, social, illness factors all have an effect on the individual response.

Taylor’s theory is that coping with threatening events consists of three processes: (1) a search for meaning, (2) a search for mastery and (3) a process of self enhancement.

It has been suggested,⁷⁹ though research is limited, that psychosocial factors such as depression and personality traits can influence prognosis, this emphasises the need for emotional and psychological support for patients and their families.

For many patients the diagnosis of lung cancer is perceived as a terminal prognosis, and the statistics justify this in many cases. Elizabeth Kubler Ross has described the process of coming to terms with dying in detail.⁸⁰ She describes five stages: denial, anger, bargaining, depression and acceptance. Although Kubler-Ross describes them in this particular order it has been suggested that in fact the reactions can occur and re-occur throughout the dying process.

The impact of lung cancer extends beyond the individual to their family, effects are both emotional and financial. The family is important in providing support and caring for the patient and it is important to provide support in terms of home help, respite care, counselling on a continuing basis.

There are a large number of organisations able to provide support for people with lung cancer and their families. The Cancer Care Society provides social and emotional support for people with cancer and their families and friends, The Roy Castle Foundation has a network of lung cancer Support Nurses, Macmillan Cancer Relief provides Macmillan Nurses who are specially trained to help people with cancer by offering practical and emotional support. Cancer Link provide emotional support and information. Marie Curie Cancer Care runs several hospices and provides community nursing services.

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