Talking about cancer
Living with cancer – emotions
Emotions and cancer
When you have cancer, it is normal to experience different emotions, depending on whether you have just been diagnosed, have completed treatment or are facing a recurrence of the disease.
Each person reacts in their own way to a cancer diagnosis, adapting to the situation with varying degrees of ease and in varying amounts of time.
Often, people deal with the disease in the same way as they deal with other problems or crises. Being better informed about the emotional effects of cancer may help you to cope.
It can also help you to understand what other people are going through and to support them during difficult times. You may experience some or all of the emotions described below at some point.
State of shock
When you are told that you have cancer, that the disease has returned or that it has reached an advanced stage, the first reaction is often shock.
This can lead to a state of confusion, a kind of numbness that prevents you from thinking or feeling anything.
When you are in shock, it is very difficult to absorb information or perform simple tasks.
You may not even know where you are or feel as if time has stopped.
A cancer diagnosis can be frightening. At times you may feel as if you are losing control of your life, not knowing what the future holds. This is especially true in the early days after diagnosis, but it can also recur from time to time during treatment and even afterwards.
Many people find that their fears, anxieties and doubts dissipate as they learn more about cancer and what to expect during treatment.
Denial is a way for the mind to cope with painful realities, such as a cancer diagnosis. It is not a conscious choice. In some ways, a short period of denial can be helpful as it gives time to feel less overwhelmed by the news.
This reaction often fades with time. However, denial can become a problem if it lasts for more than a few weeks or months, and prevents you from receiving treatment or making important decisions. It can become a barrier to a frank discussion about the cancer diagnosis.
True denial is when a person never accepts or acknowledges the diagnosis. This is very rare.
Anger is a common reaction to a reality that seems completely unfair. You might be angry at the cancer itself, at health professionals, or even at your family and friends who are healthy or who don’t understand what you are going through. You might also be angry at your god or turn that anger against yourself. Some people get angry rather than expressing emotions like fear or sadness.
Often we have been taught by our upbringing that we should not show our anger. However, this is a normal reaction to cancer. You don’t have to pretend that everything is fine if it isn’t. But you should reassure your loved ones that you are fine. However, reassure your loved ones that if you seem angry or moody at times, you are not blaming them.
Some people feel guilty about having cancer. You may wonder if there is anything you could have done to prevent the disease or to have it detected earlier. You may also feel responsible for the impact of your illness on those close to you.
Carers, family members or friends may also feel guilty. They may resent being healthy when you are ill, feel guilty that they cannot help you feel better, or feel that they are unable to support you properly.
Guilt is sometimes described as an unnecessary emotion. This may be true, but it is a very real feeling that many people experience. What is also true is that you are not responsible for getting cancer. No one deserves to be sick.
ANXIETY AND STRESS
Anxiety is a feeling of unease, worry or fear about something. Anxiety can lead to symptoms such as rapid breathing, a rapid heart rate or feeling like you have butterflies in your stomach. You may also feel dizzy or start to sweat, or find it hard to concentrate or fall asleep. It’s normal to feel anxious when you have cancer, but sometimes this feeling can become so overwhelming that it takes over completely. If this is the case, anxiety can be considered a medical problem and should be treated.
Stress is our body’s way of reacting to something that feels dangerous or threatening. We tend to think of stress as a mental state, but it is actually a physical reaction that prepares the body to escape danger or defend itself. In a stressful situation, your body releases hormones to get into action: your breathing speeds up, your heart beats faster and your blood sugar levels rise to meet the increased needs of your brain and muscles.
Stress is not necessarily negative; it can help you take control of an emergency situation or avoid an accident. It is what keeps you alert and fully awake during an important event. Once the source of the stress, good or bad, is gone, the body returns to normal functioning. However, high levels of stress over a prolonged period of time can be damaging to your health and cause problems such as depression, high blood pressure, heart problems, headaches and stomach aches.
solution and isolation
When you have cancer, you can feel very lonely. Your loved ones may not visit you or phone you as often as you would like. You may feel too ill to work or take part in social activities. Even when you are with people, you may sometimes feel that no one understands what you are going through.
Family or friends may also find it difficult to cope with the illness and may not visit or contact you as often as they used to. This does not mean that they do not care about you. They may simply be afraid to see someone who looks ill or to say the wrong thing.
Family and carers may also feel lonely. They may feel that they have lost their best friend or that they have no one to talk to about what they are experiencing. They may feel overwhelmed by their new responsibilities and feel that they no longer have time to see people or do activities they enjoy. They may also feel neglected by the care team, other family members and friends, who are more likely to focus on the person with cancer.
It is not uncommon to feel alone or left to fend for yourself once treatment is over. You may actually spend a lot more time alone, especially if you are off work. Even if you are well surrounded, you may feel isolated if you feel that the people around you cannot understand what you are going through.
Changes in your physical appearance, if any, can lead to feelings of loneliness because they now make you feel different from others – even if these changes are not obvious.
It is not uncommon to feel sad after a cancer diagnosis or during treatment for the disease. You may feel sad that you are no longer healthy or that you cannot spend as much time with your loved ones as you used to. It can also be difficult to give up enjoyable activities, such as travelling or playing sports, for a while. It is normal to cry or feel grief, frustration or discouragement when dealing with stressful or upsetting events.
Although it may seem strange, it is normal to feel sad at the end of cancer treatment. You may be grieving for what you have lost or thinking back to the difficult times during treatment. You may feel sad about the changes in your body or your lack of energy. Knowing that the treatment is over can also make you feel bad, because it was a way to fight the cancer.
Many people with cancer feel like crying or feel unhappy, hopeless or demoralised at times. This is normal. However, if these emotions are present all the time or are prolonged, become more intense or affect daily life, they may indicate what is called ‘clinical’ depression. Other signs of depression include
– changes in appetite, weight or sleep
– feelings of worthlessness or guilt
– difficulty concentrating
– frequent thoughts of death or suicide
Signs of depression can easily go unnoticed, but recognising them is the first step to getting better. Depression can and should be treated. It is not a sign of weakness. A person with depression is not able to ‘get over it’ or ‘smile again’ by sheer force of will. Cancer treatment or the disease itself can cause depression. You may be at greater risk if you have advanced cancer, have suffered from depression in the past, or do not have a network of family or friends to support you.
If you think you may be depressed or have suicidal thoughts, talk to a member of your healthcare team. You may be referred to a specialist, such as a psychologist or psychiatrist, who can recommend medication or therapy.
If someone you know tells you that they are thinking about suicide, take this seriously, even if it seems like a spontaneous comment. If the person refuses to talk to a doctor, then notify the health care team so that help can be given.