Your emotions and cancer

Going through many emotions is a normal part of having cancer, whether you’ve just been diagnosed, finished treatment or found out that cancer has come back. Many describe this as being on an emotional roller coaster.

Everyone reacts to a cancer diagnosis in their own way. It’s hard to predict how quickly or easily someone will adjust to the situation. How you react and adjust to living with cancer often depends on how you face other problems and crises. Learning about the emotional effects of cancer can help you cope. It can also help you understand and support others through these hard times.

You may feel any or all of the emotions described below at some time or another.

Shock is often the first reaction to finding out that you have cancer, your cancer has come back or your cancer is advanced. It can make you feel confused and numb, unable to know what to think or feel. Shock can make it very hard for you to take in information or complete simple tasks. You may even forget where you are or feel like time has stopped.

A cancer diagnosis is scary. You may feel at times as if your life is out of control and you don’t know what the future holds. This is especially true soon after diagnosis, but these feelings can come and go at times during your treatment and after.

For many people, fear and uncertainty fade as they learn more about cancer and what to expect from treatment. You may also feel more in control once you are into a treatment routine.

Denial is the mind’s way of coping with painful facts, such as the diagnosis of cancer. No one chooses to be in denial. In some ways, a short period of denial can be helpful because it can give you time to feel less overwhelmed by the news.

Denial usually fades with time. But it can be a problem if it lasts more than several weeks or months and stops you from getting treatment or making important decisions. It can also get in the way of talking openly about a cancer diagnosis.

True denial is when someone never accepts or acknowledges the diagnosis. This is very rare.

Anger is a common response to something that feels very unfair. You may feel anger toward the cancer itself, healthcare professionals, or friends and family who are healthy or don’t understand what you’re going through. You may also feel angry with your god or even yourself. Sometimes people get angry instead of expressing other emotions like fear or sadness.

Many of us grow up with the idea that it’s not OK to express our anger. But anger is a normal response to cancer. You don’t have to pretend that everything is fine if it’s not. You might want to reassure friends and family that if you seem angry or moody sometimes, it’s not because of them.

People sometimes blame themselves for their cancer. You may wonder if you could have done something to prevent it or to discover it sooner. You may also feel guilty about how your illness affects your loved ones.

Caregivers, family members or friends may also feel guilty. They may feel guilty for being healthy while someone they love is ill, or that they can’t make you feel better, or that they aren’t doing a good job of helping or supporting you.

Guilt is sometimes described as a useless emotion. This may be true, but it’s an emotion many people feel. It’s real, even if it’s not helping you. It’s also true that cancer is not your fault. No one deserves to be sick.

When you are anxious, you have a sense of being uneasy, worried or fearful about something. You may have symptoms like rapid breathing, an increased heart rate or a feeling of butterflies in your stomach. You might feel dizzy or start sweating. You may also have problems concentrating or falling asleep when you feel anxious. Feeling anxious when you have cancer is normal, but sometimes anxiety can get so bad that it overwhelms you. When that happens, anxiety can be diagnosed as a medical condition that needs treatment.

Stress is our body’s way of reacting to something that we think is dangerous or that is a challenge to us.  You might think of stress as something in your head, but it’s a physical reaction that gets your body ready to run away from the danger or to fight it. When you are stressed, your body releases hormones to get it ready to act, your breathing and heart rate increase, and the levels of sugar in your blood increase for your brain and muscles to use.

Stress isn’t always a bad thing. It can help you respond during an emergency or avoid an accident. It keeps you alert and excited during an important event. Our body functions return to normal when the stressful event – good or bad – is over. But if you have high levels of stress for a long time, it can have a negative effect on your health. It can cause depression, high blood pressure, heart problems, headaches and stomach problems.

Cancer can make you feel very alone. Friends and family may not phone or visit as often as you’d like. You may feel too sick to work or enjoy social activities. Even when you’re with people, you may feel that no one understands what you’re going through.

Sometimes family or friends have a hard time dealing with cancer and may not visit or contact you as often as they did before. This doesn’t mean they don’t care. They may just be afraid to see someone looking sick or worry they will say the wrong thing.

Family and caregivers can also feel lonely. They can feel as though they’ve lost their best friend or that they have no one to talk to about what they’re going through. They may feel overwhelmed by new responsibilities. They may feel like they don’t have time to see friends or do activities they enjoy. They may also feel overlooked by the healthcare team or family members and friends, who tend to focus on the person with cancer.

It’s very common to feel lonely or have a sense of being on your own after treatment ends. You may actually be spending a lot more time on your own now, especially if you took time off work and haven’t gone back. Even if you’re surrounded by family and friends, you may still feel lonely if you feel that the people around you don’t or can’t understand what you’ve been through.

Coping with changes to your appearance can make you feel lonely because you may find that you now feel different from other people – even if the changes aren’t obvious to everyone.

Many people feel sad after a cancer diagnosis or while being treated for cancer. Maybe you feel sad about the loss of your good health or unhappy because you can’t spend time with your family as you used to. Some people feel sad because they have to give up something they enjoy, like travel or playing a certain sport, for a while. It’s normal to feel sad or to be tearful, frustrated or discouraged when dealing with stressful or upsetting events.

As strange as it seems, it’s also normal to feel sad at the end of cancer treatment. This is a time when you might grieve for what you’ve lost or think about the hard times during treatment. You may be sad about the changes to your body or your energy levels. You may also be sad that your treatment has finished, because it was something that was working against the cancer.

Many people feel unhappy, tearful, hopeless or discouraged at times when they have cancer. These feelings are normal. But if they don’t go away or last a long time, get worse or get in the way of day-to-day life, they could be a sign of depression. This is also called clinical depression. Other signs of depression are:

• changes in appetite, weight or sleep
• feeling worthless or guilty
• finding it hard to think clearly
• thinking regularly about death or suicide

It’s easy to miss the signs of depression – but recognizing it is the first step to feeling better. Depression can and should be treated. It is not a sign of weakness. A person who is depressed can’t “snap out of it” or “cheer up” through willpower alone. Depression can be caused by cancer treatments or by the cancer itself. You may be at a higher risk of depression if you have advanced cancer, if you have had depression before or don’t have a support network of family or friends.

Talk to someone on your healthcare team if you think you may have depression or are thinking about suicide. They can refer you to a specialist such as a psychologist or psychiatrist for medicine or therapy.

If someone you know says they’re thinking of suicide, take it seriously, even if it seems like an offhand comment. If the person refuses to talk to a doctor, then talk to the healthcare team about getting help.

Hope is the feeling of wanting something to happen. Some people find it easy to be hopeful – it helps them cope with the hard things happening right now. But you might find it hard to find any hope in what is a tough experience. And that’s OK. You don’t have to pretend to feel a certain way if you don’t.

Hope is very important to many people with cancer and their loved ones, but it’s also important to keep a balance between realistic hope and false hope. Having a realistic picture of the future helps you make better decisions about your treatment and any long-term plans you may have.