Common reactions

At any stage after a cancer diagnosis, you may experience times of distress and feel a range of strong emotions, such as disbelief, fear, anxiety, anger and sadness. These can be seen as a form of grief.

Learn more about:

• Overview
• Shock and disbelief
• Fear and anxiety
• Panic attacks
• Anger, guilt and blame
• Sadness
• Loneliness
• Loss of control

Overview

Cancer often involves a series of losses, such as the loss of good health, temporary or permanent changes to your appearance, not being able to work or do your normal activities, changed finances, a loss of independence, changed relationships, and a shift in how you see yourself. There is no right or wrong way to react to these changes, but it usually takes time to adjust.

When your emotional health needs are met, you are in a better position to manage the demands of treatment. It is important to explore ways to cope with distress – talk to your treatment team about how you are feeling and seek professional support if the distress is ongoing. Let your treatment team know if you have a history of anxiety, depression or any other mental health condition, as you may be feeling more vulnerable now.

Many people say that their experience after a cancer diagnosis also includes feelings of hope and connection. For some, it can be a time of reflection and lead to new goals and priorities.

Shock and disbelief

The first reaction to a cancer diagnosis is often shock – you may feel numb, as if you aren’t feeling any emotion. It may take time to accept that you have cancer, especially if you don’t feel sick. This numbness can protect you as you gradually come to terms with the diagnosis.

Some people may never fully accept the diagnosis. Over time, denial can make it harder to accept the demands of treatment, so always talk to your cancer specialist and care team about how you are feeling.

Fear and anxiety

Cancer treatments and outcomes have greatly improved in recent years, but it can still be frightening to hear the word “cancer”. It’s natural to worry about the treatment, side effects, test results and the long-term outcome, as well as how the cancer diagnosis will affect your family, work and other responsibilities. Most people cope better when they learn more about the diagnosis and treatment options, and then develop a plan for how they will manage the practical issues. The period before a new treatment begins can be particularly stressful, but you may find that you feel calmer once treatment is underway.

In times of stress, your body releases adrenaline, your heart might beat faster, your blood pressure often goes up, your breathing can become shallow and rapid, your hands may get sweaty, and your mouth can go dry. These natural reactions are part of the body’s “fight or flight” response to danger, allowing people to react quickly to a sudden threat. For most people, these feelings settle, but for others they can cause panic attacks (see below) or make you irritable and short-tempered. If stress and anxiety are ongoing, it can affect the way you think and react to events and people around you. Learn about ways to reduce stress and anxiety.

Anger, guilt and blame

When faced with a cancer diagnosis, it is common to ask, “Why me?” You may feel angry with your family or friends, health professionals, the world, or even yourself, especially if the cancer is diagnosed late. Cancer often does not cause any symptoms in the early stages, or it may cause symptoms that are more likely to be explained by other conditions. This means it can take some time to get a diagnosis. It is natural to try to work out why the cancer started. We may know some of the risk factors for the cancer, but you may never have a clear answer. It is important to remember that no-one deserves cancer.

People with cancer often say that their main concern is for the people they love and that they feel guilty about putting them through such a stressful time. If you are worried about this, it may help to share your feelings with someone neutral, such as a psychologist.

Sadness

Feeling sad after a cancer diagnosis is common. It is a natural response to loss and disappointment. You may be grieving the way cancer has changed your day-to-day life, your body or your future. If you have continued feelings of sadness, have trouble getting up in the morning, or have lost motivation to do things that previously gave you pleasure, you may be experiencing depression.

Loneliness

Cancer can be isolating, even with many people to support you. You might feel lonely if your family and friends have trouble understanding and coping with your diagnosis, or if you are too sick to work, socialise with others or enjoy your usual activities. You may also be at home more if you are concerned about viruses such as COVID-19 or the flu. This might be the time to consider new ways to connect with other people, such as through a telephone or online support group.

Loss of control

Being told you have cancer can be overwhelming and you may feel that your emotions are out of control. It may also seem that you are losing control of your life – some people feel helpless or powerless. This can be difficult, especially if you are used to being independent or being the one who takes care of everyone else. It can help to control those things you can, such as by creating a plan to manage side effects. Feeling physically better can help you to feel emotionally better too.

Podcast: Managing Fear

Listen to more episodes from our podcast for people affected by cancer