Jim’s Experience of Cancer

Clinical Psychology for Physical Health: Jim’s experience of prostate cancer

Jim was a middle-aged self-employed construction worker who had been to see his GP for recurrent digestive problems and occasional bleeding when he went to the toilet. Initially, he had concluded that the problem was simply indigestion, but his wife encouraged him to see his GP when the problem became more frequent. Jim reluctantly agreed and following blood tests his PSA levels were found to be unexpectedly high.

He was referred to a specialist in the hospital and additional tests and scans were undertaken. Whilst the tests were not too bad, he did find the scan process something of a challenge as he was a little claustrophobic. After a week or so, he was asked to come into the hospital to discuss the results.

Jim was told that he had prostate cancer, something which he was not expecting to hear as he had not experienced any pain and there had been minimal signs of severe illness. He was also told that he had treatment options to consider which included hormone treatment, and eventually he may have to consider radiotherapy and possibly chemotherapy.

His consultant had taken the time to ask him about his background and support. She said she felt that given his situation and the fact that his treatment was going to be long with an uncertain outcome, she felt psychological support would be in his interest. Although reluctant, Jim accepted the advice and he agreed to meet with our Clinical Psychologist Dr John Donohue, who specialises in physical health.

When John first met with Jim, he had already been on hormone treatment for some time. He explained that since he had started treatment, he had experienced many changes in his physicality – he generally became tired much quicker than he had ever known of himself and the intensity of the fatigue was much more than he expected. For the first time in his life, he experienced limited control over his emotions – he found himself less patient, more susceptible to sadness and anxiety and would become tearful in unexpected situations.

In short, he felt out of control and was becoming a stranger to himself.

In addition to all of this, Jim acknowledged that the uncertainty of the treatment outcome troubled him. He understood that he was receiving the best care and although he trusted his consultant’s opinion, he did worry about the side effects he was experiencing. Jim had to see his consultant on a regular basis which often included test results and because of this, these consultations were usually preceded by sleepless nights. Although Jim was assured that the treatment was proving effective and was stopping cancer from growing, he acknowledged how hard it was to continue with treatment because of the side effects, and at times he considered ending treatment. 

Overtime and as their therapeutic relationship deepened, Jim told John about his life and upbringing. He recalled his father’s illness before he died and that he looked after him. He recalled that his father never complained despite the pain and discomfort he was in and that at times he felt ashamed about how he himself was dealing with this own illness. Jim had developed a story about how felt he ought to cope and his perceived ‘falling short’ of this standard at times left him feeling ashamed. Jim felt the side effects of the medications were changing his body and making him feel less of a man and generally physically weak.

Over the course of their work together, Jim found the space to give voice to the huge upheaval that illness had introduced into his life. Because of the circumstance of his situation, he did not really have space to freely discuss the impact of his illness on him to his wife and broader family as he did not want to worry anyone.

At the same time, Jim admitted that such was the depth of his worry and sadness that he would be awake for hours throughout the night, his thoughts going round and round with no relief. He also told John that he would try to take full advantage of days that he would feel physically stronger, but that these were followed by extended days of extreme fatigue and that he frequently fell into the trap of ‘boom and bust’ profile of activity.

One of the main benefits of the therapy was an increasing trust in the sense that if he did risk more open disclosure with his family, that this would be accepted. Jim eventually found ways and opportunities through which he could more authentically articulate himself and accept emotional support from loved ones.

Jim and John also explored the psychological obstacles to Jim obtaining a greater balance between taking appropriate rest and gaining a better balance between exertion and relaxation, the result of which was an observed and welcome restoration of resilience. Over the long term, Jim became more adaptable and more prepared psychologically to manage his treatment.


If you would like an appointment with Dr John Donohue you can call the clinic on 091 727777 or get in touch via the contact page.