Coping with your cancer is hard enough without added concern for your finances – which is a frequent source of stress and discord at the best of times. This is not an easy matter to face but one which cannot be ignored and it is worth saying at the outset that seeking early advice if you believe you are facing financial problems can save you worry later.

If you have a job and your ability to work is not too badly affected so that your employer continues to pay you as usual, a loss of income may not be an issue. If this is not the case, you will need to find out whether you are able to claim any State benefits to help you. You may find this difficult, particularly if you are accustomed to supporting your family financially, either alone or jointly. The idea that you are no longer able to guarantee to ‘provide’ for them in the same way is not easy to accept. In spite of this, it is important to ensure you receive any benefits you are entitled to – this is not a time to allow pride and your sense of independence from the State to stand in the way of financial help.

If you were not working or were retired, then your usual sources of income may be unaffected but it is nonetheless important for you to establish whether you are now entitled to any benefits as a result of your cancer.

You may feel disinclined to wade through booklets and forms when you already have enough on your mind. There is likely to be a social worker attached to your hospital whom you can consult fof help in determining whether you qualify for any financial help. Do draw on their expertise – they may be able to save you time and effort by advising you and providing you with booklets and the relevant forms to fill in, and help you with the forms if you wish. If you prefer, information about Social Security is available by phone on Freeline Social Security 0800 666 555. The Benefit Enquiry Line on 0800 88 22 00 also exists for information on benefits for people who are sick or have a disability. The Benefits Agency produces a number of booklets containing information about these benefits, and you may be able to obtain these from your hospital.

For me initially the Benefits Agency appeared a complete mystery. I had never had any direct dealings with the DSS (from a personal rather than a business perspective) and their whole manner and method – not to mention the thickness and complexity of the application forms – was enough to make me feel that the whole exercise could not be worth the effort. The level of questioning and intrusion into what had previously been private matters was very disconcerting. However, I was very lucky to be referred to the hospital social worker who immediately – and correctly – identified those benefits to which I and my partner were entitled. (Neither of us was working now – I was not physically able to and my partner was spending all the time she could with me in hospital or supporting me at home.) The social worker also guided us through the application forms. The moral is to use the resources which are available to you as a patient. Do seek out the key social worker who will be on ‘your side’, don’t accept any initial rejections by the Benefits Agency if you are sure you have a good case and hold out for those benefits to which you are legally and morally entitled.

The details which follow give an outline of the more common benefits available. They are not exhaustive, and you may be entitled to more help depending on your circumstances.

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Both our self-image and the way we are perceived by others are built up over years and develop gradually. A cancer diagnosis can have a damaging effect on how you perceive yourself and affect how well you cope with your cancer. There will be times when you feel isolated from the world around you, as if you are not playing the role you want. You might fear that others will perceive you as weak or helpless, unable to manage for yourself, even if you had previously viewed yourself as a strong and independent person.

In fact, this fear is more likely to be imagined than real. Of course your family and friends will be sympathetic about your cancer and want to do all they can to help you. But this does not mean that they perceive you purely as a cancer patient, and no longer as their husband/son/brother/friend, etc. You will almost certainly feel that you have ‘changed’ as a person as a result of your cancer, in terms of your outlook or changed perspective on life. This is not the same as becoming a lesser person!

Keeping in touch is one of the best ways to guard against losing your confidence and sense of self. Your cancer will necessarily be on your mind for a large proportion of your time, either because you are thinking about it or because it has practical implications for your deeds and actions. This can increase your sense of isolation. Try to ensure that your family and friends keep you informed about what is happening in their lives, so that you continue to feel involved. Seemingly trivial details about what A said to B or how your friend’s new job is progressing are valuable for keeping you in touch and ensuring that you continue to have the same conversations you always had rather than talking always about your cancer. Of course, you will talk about your cancer too – it is part of your life – but a balance can be struck so that you do not become shut off in a restricted world of your own.

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It is tempting to put off telling other people about your cancer because the task of breaking the bad news simply feels too much. You may also feel that if you tell no one, then your cancer feels less real – if you don’t acknowledge it to the outside world, then somehow it doesn’t exist. After coping with your diagnosis and trying to absorb the news yourself, finding the right words to tell other people is not easy. Men can be less forthcoming than women in talking about their health and less accustomed to sharing and discussing such personal details with family, friends or the medical profession. Whether or not your family and friends were aware that you had a health problem, you know that they will be deeply shocked and upset by your cancer diagnosis and this makes the news harder to break.

You may also feel a sense of guilt at causing them so much worry about such a serious health issue, and that you are responsible for inflicting this pain upon them. Perhaps you also feel guilty that your cancer is in some way your fault, that you have ‘allowed’ it to happen and you fear that people will blame you for it. This may be irrational, but when you are under such stress your thoughts and emotions will be very confused. However, putting off telling people is more likely to make these problems worse than better for you, and people who thought they were close to you may feel hurt and upset that you didn’t feel able to talk to them sooner.

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Chemotherapy might be proposed either as your sole form of treatment, or in combination with radiotherapy and/or surgery.

Chemotherapy literally means ‘chemical therapy’ and involves the use of cytotoxic (cell poisoning) drugs. There are many types of chemotherapy drugs, which, in broad terms, work by preventing cancer cells from growing and dividing, interfering with the reproduction process so that the cells become damaged and cannot reproduce themselves. The reason why there are so many different drugs is that they damage cancer cells in different ways. Different combinations of drugs have been shown to be effective in treating different cancers, and the drugs which you are given will be chosen on the basis of that research and experience.

The effectiveness of the drugs varies depending on your type of cancer and how advanced it is, and how sensitive the cancer cells prove to be to the chemotherapy drugs. This is difficult to predict until the chemotherapy is underway, and you will be carefully monitored throughout your treatment. In some cases, a complete cure may be possible and in others the aim may be to shrink the cancer as much as possible while not eliminating it completely. Your doctors will be best placed to advise you on the anticipated outcome for your particular treatment, although they will not be able to provide you with any guarantees.

Chemotherapy drugs can be given in different ways:

by mouth in tablet form;

by injection, into either the skin, the muscle or a vein. An intravenous drip into a vein is the most common route. This involves the insertion of a needle into a vein in your arm, and this is attached to a fine tube through which the drugs flow. The drugs will often be diluted in liquid, and administered by a pump which carefully controls the rate at which you receive the drugs: this may be a few hours or up to a few days. The needle and tube are removed at the end of each treatment. In some cases, a tube is inserted into a vein in your chest (under anaesthetic, usually local), and this can be kept in place for the duration of your course of chemotherapy. This avoids the need for needles to be inserted in your arm for each treatment. You will be shown how to keep the line clean and to prevent it blocking between treatments;

by infusion pump. This is similar to an intravenous drip, but involves using a portable pump which you can take home with you. It is small enough to be carried around with you in a bag or special belt, and allows controlled doses of drugs to be released into your bloodstream over a longer period – often 24 hours a day, seven days a week, for weeks at a time – without the need to stay in hospital for the duration of the treatment.

Depending on your chemotherapy regimen, you may have your drugs as an out-patient or you may need to stay in hospital for a few days. Chemotherapy is generally given as a number of cycles of treatment, each one lasting from between less than an hour to a few days. You will then have a rest period of up to a few weeks which allows the normal healthy tissue in your body to recover before your next treatment.

There is a general perception that undergoing chemotherapy is a particularly nasty experience, and that unpleasant side-effects such as prolonged nausea and vomiting cannot be avoided. It is worth remembering that not everybody suffers from all the side-effects of any given treatment, and that the medical staff will be trained and experienced in caring for patients having chemotherapy. They will do all they can to make you as comfortable as possible, and if you do suffer any problems, you should let them know as they may well be able to give you drugs to counteract your side-effects.

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Kidney cancer tends to be slightly more prevalent in men than in women, and there appears to be a similar link with smoking. The kidneys act as a hugely powerful filter of the blood, separating the ‘good’ elements which are needed by the body from the waste, which is passed out of the body as urine. The kidneys are extremely efficient and although we have two, the body could manage perfectly well with only one.

The main type of kidney cancer is renal-cell carcinoma. Its main symptoms are bleeding, which will be noticed in the urine, and possibly pain, discomfort or swelling in the kidney region – in your back and side of the abdomen, below the ribs. Again, it should be stressed that blood in your urine may result from a cause other than cancer, but it should nonetheless warrant an appointment with your doctor.

Kidney cancer can spread via the lymph nodes, but may also travel to other parts of the body via the bloodstream. Diagnosis is likely to involve physical examination, urine tests and various X-rays (with dyes to show unusual features in the kidney), and scans to check whether the cancer has spread.

Surgery is generally the mainstay of treatment in kidney cancer. Treatment is likely to involve surgery to remove the affected kidney, sometimes even when the cancer has spread further. If it has not spread, then the hope is for a complete cure. Even if it has spread, the surgery can be worthwhile to relieve any pain and discomfort.

Other therapies might be proposed, such as hormone therapy or chemotherapy, and if so these should be discussed with your doctors.

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