Coping with your feelings

Friday 29 January, 2010

Reviewed by: A/P Michael Jefford MBBS, MPH, MHlthsevMt, PhD, MRACMA, FRACP, Consultant Medical Oncologist, Peter Mac; Dr. Carrie Lethborg, MSW, PhD, St. Vincent's Hospital

On this page: Common feelings and questions | Understanding your feelings | Accepting your changed feelings

During your cancer treatment it may have been hard to imagine that it would come to an end. Maybe you were too scared to believe it would end, or too anxious to think that your treatment would be successful. You and your family may have focused on just getting through each day: getting to hospital appointments on time, having tests and dealing with side effects of treatment. You may have coped with so many emotions and changes in your life. You may not have thought much about life after cancer treatment.

Common feelings and questions

You probably feel your life has been turned upside down. You may think that you should be able to just pick up where you left off before your cancer diagnosis. You may have thought now is the time to return to a ‘normal' life, feel happy and positive about your future, or feel relieved you no longer have regular hospital visits.

For many people who finish their cancer treatment, it isn't that simple. You may no longer feel sick because of your cancer, but you might not be feeling that great either. Knowing what to expect after treatment can help you and your family cope with the future and any changes to be made.

‘Every cancer sufferer needs to go through an extraordinary process of re-adjustment after the treatment.' (Neil)

Most people go through a mixture of good and bad feelings after their treatment's over. Perhaps you feel relief and happiness that you have made it this far and your treatment seems to have been successful. But it isn't uncommon to feel frightened and lost, especially during the first few months. You no longer have the regular attention and support from your nurses and doctors. Even if they may have told you to call them if you're worried, you might not want to do that. Your family and friends may not visit or call you as much. You may get the feeling that the people around you are assuming that you're doing ok!

Many survivors say that they can feel very lonely and angry about this. But, at the same time, you may think that you should be able to cope now your cancer has gone. It can become confusing.

‘As soon as the treatment finished, that was more of a shock. All of a sudden you're on your own. Having spoken to quite a few other people, they felt the same. Not that people have left you: I could call on anyone, I could call on the hospital, I could call on my doctors - but it wasn't the same, there wasn't active treatment going on.' (Patricia)

After completing treatment, it is normal to have concerns about your future and how you'll cope. Like many cancer survivors, you may feel:

  • Isolated, alone and abandoned: where have all the nurses and doctors gone? Who can you talk to now and who'll answer all your questions?
  • Unsure about relationships with your family and friends: they may lack understanding and may be expecting too much from you.
  • Uncertain, not daring to believe that your treatment really has worked: is the cancer really gone? How can you be sure? Will the cancer come back?
  • In limbo: unsure how to start your life again or even if it's what you want right now. Nothing feels secure or stable.
  • Anxious and frightened about how you'll be followed up: what tests will you need, how often will you have a check-up?
  • Worried about possible long-term side effects and how these may affect your work, social life, relationships and hobbies.
  • Lacking in confidence: how will you cope with the changes in your body image and sexuality that your cancer and its treatment may have caused?
  • Angry and frustrated because you don't feel that you can plan ahead any more: what if your cancer comes back before that holiday comes around or your child gets married?
  • Different about your body and health: many people say their self-confidence gets shaken up a lot. They also don't trust their body as much as they used to now that it ‘has let them down'.

‘[Following treatment] I felt very scared in a lot of ways, very nervous about what things held for me, because you're seeing somebody every day, day after day, and then suddenly it's goodbye, we'll see you in three months. So you're left there on your own to cope with things.' (Rosemary)

Understanding your feelings

Some people will adjust fairly quickly after their treatment finishes. But for many people their problems and fears won't just go away. You may need a lot of love and support: maybe even more than you did during your treatment.

Be kind to yourself during this time. Don't expect to feel great about everything. Go slowly so you can come to terms with all you have been through and what lies ahead. You may have possible long-term side effects that you will have to deal with as well as finding the confidence to have a social life again. You may feel sad that you can't do some things that you used to enjoy. You may no longer feel certain about your health and the future.

‘Survival keeps on going; every day brings a new challenge. I think it's been both a curse and a blessing, when I look back on it.' (Neil)

It can be exhausting to try to act as if you're fine. You may have days when you feel awful: very down, sad and alone. Other days you may feel angry, fearful or frustrated. This is ok. Try to listen to your feelings and accept them as they happen. It's better not to ignore negative thoughts but try to work through them. Most cancer survivors say that they do feel better with time. But it usually doesn't happen overnight - so don't expect too much from yourself too soon. Also, don't be surprised if, some time after your treatment (sometimes a few years), you have periods of feeling down. This is not uncommon.

Friends and colleagues may keep advising you to ‘think positive'. This is very difficult when you're dealing with what has happened and how your life has changed. There's no scientific evidence that ‘being positive' has any effect on surviving cancer (although many survivors say that being positive helped them to cope through their illness.)

If family and friends think that you should be doing more and feeling happier, let them know that you still have a lot to deal with. You may get sick of others telling you that you look so well. It's normal to feel like this. You need those close to you to try to understand your fears and be there to listen and support you. Remember: go at your own pace, not theirs.

If you feel very low for long periods of time, see your doctor. You may have depression. This is different from the sadness and low moods that many cancer survivors have soon after their treatment. Learn more about depression and its symptoms.

Accepting your changed feelings

You may have negative feelings for months after your treatment. Remember there is no right way to feel. Each person has different concerns and long-term worries.

Feeling negative a lot of the time takes up a lot of energy. You, and those close to you, can get worn down by this. Family and friends may not be as understanding as you want. They may try to tell you how you should be feeling. This can put a lot of strain on your close relationships.

Try not to see it as a weakness if you're having trouble coping on your own. Lean on those close to you. Don't be afraid to ask for help. See this as a positive move towards your recovery. Support from others will not only give you comfort but also practical ideas on how to cope.

If you don't feel like talking to those close to you about your feelings, a trained counsellor may help.

‘People did shy away from it [the cancer] a bit, and that there was an element of having to manage those relationships in a sense that you had to bring it to the table and make people feel comfortable.' (Jason)

As well as talking to others about how you feel, there are other things that you can do. For example, try:

  • being active and getting daily exercise to help improve your mood
  • eating well and staying healthy
  • avoiding alcohol and other drugs: the after effects often make you feel worse
  • trying some form of relaxation, such as meditation, visualisation, yoga, massage or deep breathing
  • reading about other people's journeys: this helps some people understand their feelings better and not feel so alone
  • writing about your feelings in a journal.

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