Six common reactions to cancer

For 18 months, I worked as a counsellor for Macmillan Cancer Support. In that time I noticed that the same feelings and reactions to the illness were shared by many of my clients, in the weeks and months after diagnosis and treatment. Here are six typical responses. Maybe, if you have had cancer, you recognise them too.

What do I do now?

Cancer treatment can be all-consuming. From the second you are diagnosed, there are appointments, scans, surgery, chemotherapy, and radiotherapy. This can be scary and debilitating, but you may also feel cared for and contained by the support of a large team of doctors and specialists. You are also tackling the disease, which can feel proactive. Loved ones, friends and colleagues may all be rallying around, helping you feel loved.

Once treatment stops, though, what happens? Unfortunately, this can be the start of a new and equally difficult chapter, full of anxiety and vulnerability. Reality settles in and you have time to reflect on what you have lived through. Perhaps you feel frightened, furious, dismayed, unable to believe it or depressed. Family and friends may assume that the crisis has passed and you are OK. Congratulations! Treatment has finished, and you can get on with your life. It can result in you feeling isolated, but unable to talk about how you feel.

Loss of trust in your health

After a cancer diagnosis, you may suddenly doubt your body, your health, and your strength. Perhaps you feel your body has betrayed you. If you were fit before or were hardly ever ill, hearing you have cancer rocks your sense of self. If there were no symptoms, the knowledge that cancer was growing inside you undetected can feel disturbing and scary. Your confidence can be significantly damaged.

Fearing recurrence

The fear of cancer coming back is real for almost all cancer patients. It can influence how they feel about all aspects of their life, from their body to their future, work, and relationships. Everybody lives with uncertainty, but a cancer patient lives with it vividly and intimately. Most of us accept that we may be ill at some point in the future, but this understanding feels vague and hypothetical. For a cancer patient, it has already happened and it could happen again.

Wanting life to return to normal

Many of the cancer patients I worked with wished to go back to how they were before being diagnosed with cancer. They wanted to package cancer up, store it away somewhere and resume life as if the illness and treatment had never happened. It was an understandable longing for normality after a debilitating experience. It was also, of course, impossible.

For anyone going through cancer and feeling this way, a better option is to engage with what you have experienced. It is a grieving process, for all the losses that cancer brings, both emotional and physical: losses to earnings and career stability, to self-esteem, security, confidence, and the dream of more children. Grieving is painful but necessary and through that process, it becomes possible to come to some acceptance of what has happened and some sense of a ‘new normal.’

Guilt

Cancer patients often experience guilt. They feel guilty for worrying their family, for not visiting the GP as soon as symptoms began, and for taking up valuable NHS time. They might feel guilty about not being as energetic, dynamic, or motivated as before. Or because they still feel sad, and have lost their libido or appetite for life. Guilt in any form can weigh heavy on cancer patients and stifle self-compassion.

Feeling lonely 

Being seriously ill is often a deeply isolated experience, irrespective of the support you have around you. Only you know what it is like to feel as you do, to have those symptoms, to go through surgery and treatment. Only you carry the unique and personal scars that cancer leaves, and the work of returning to life or even accepting what time you have left. It can be extremely lonely. Family and colleagues may offer unhelpful ‘If I were you…’ advice. They may encourage you to be positive or to laugh about what you have been through. They may also simply avoid speaking about it altogether.

Some cancer patients feel they cannot share their true feelings – rage, depression or fear, a sense of ‘why me?’, even jealousy towards those who are healthy. They may feel shame about not having ‘got over it’ yet. They may believe – sometimes correctly – that loved ones are tired of hearing about cancer.

Shouldering these difficult emotions alone can take an enormous emotional and physical toll, but talking to a therapist can help. It is an opportunity to be heard in a contained, confidential space, without judgement. It can help make sense of the emotional debris that a bombshell like cancer can leave behind. In addition, talking with a therapist usefully models how you can speak to others about your experience and feelings, building the potential to reconnect with friends and family, feel understood, and gently heal.