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Emotions


The emotional impact of cancer

 

Most people experience a range of strong emotions after a cancer diagnosis. This may be when they first find out that it’s cancer, and also at various times during and after treatment.

The intense feelings may be constant, or they may come and go. You may find that some pass with time, while others last longer. It might feel like you’re on an emotional roller-coaster. There is no right or wrong way to feel. Everyone is different, and you need to deal with the diagnosis in your own way.

As you navigate this challenging time, it may be reassuring to know that your reactions are natural, and there are different ways to manage the emotional impact and seek support. 

Challenging times

Many people find that they cope better than expected with some parts of the cancer experience, but are surprised by how difficult other parts turn out to be. 

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Emotions throughout the cancer journey

  • Diagnosis – it is often difficult to take in the news immediately. You might hear the words, but not be able to absorb them or believe them. Most people feel overwhelmed at first.
  • Treatment decisions – the weeks after diagnosis can be stressful as you weigh up your options. People often feel anxious about treatments, side effects and whether they are making the right decision.
  • During treatment – cancer treatments can be physically demanding and disrupt your usual routines. You may need to deal with practical issues such as travel, finances, work and family responsibilities. 
  • Treatment side effects – side effects of treatment can make it harder to cope emotionally, while emotional distress may make physical side effects worse. The good news is many side effects can now be well managed.
  • After treatment – many people are puzzled if their mood doesn’t improve as soon as treatment ends. This can be a time of great personal change as you think about your priorities and adjust to any long-term impacts. It is common to feel concerned about the cancer returning, especially when you have follow-up tests. 
  • Advanced cancer – it can be devastating to find out the cancer is advanced at first diagnosis, or that it has returned after treatment. You, your family and carers may find it helpful to see a counsellor.

Common reactions

At any stage after a cancer diagnosis, you may experience times of distress and feel a range of strong emotions. 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
  • 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 them 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 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
  • 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 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. You may find it helpful to practice relaxation and mindfulness, or listen to the Managing Fear episode of The Thing About Cancer podcast.

Panic attacks

For some people, severe anxiety or fear can lead to panic attacks. These might happen in a particular situation, such as before a medical procedure, but sometimes there is no clear trigger.

A panic attack can happen suddenly and can be very alarming. It can include symptoms such as shortness of breath, racing heartbeat, dizziness, sweating, shaking, chest pain, a choking feeling and overwhelming fear. Some people feel a strong urge to escape a situation, even when there is no immediate physical threat or danger.

In a panic attack, these sensations may be intense, but they will normally peak and pass within a few minutes. However, they can also be symptoms of a heart attack and other serious health conditions. Call Triple Zero (000) if symptoms occur unexpectedly, do not pass quickly, or if you are unsure.

If you have panic attacks after a cancer diagnosis, whether or not you have had them before, it is important to talk to your doctor or psychologist about ways to manage them.

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 support group or our Online Community.

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.

 

Physical side effects and emotions

The physical and emotional effects of cancer and its treatment can influence each other. Let your treatment team know if you have any new or ongoing side effects. 

More common side effects

Examples of physical and emotional side effects

  • Pain and fatigue – cancer does not always cause pain, but if it does, tell your treatment team. The most common treatment side effect is fatigue, which can also be a symptom of depression.
  • Appetite changes – your appetite might change if you feel unwell, anxious or depressed, or because of the physical effects of cancer. Some people lose their appetite, while others find they eat more. A change in your appetite or weight can leave you feeling distressed.  
  • Appearance changes – cancer treatments can cause changes to your appearance, such as hair loss or loss of a body part. Whether these changes are temporary or permanent, they may leave you feeling self-conscious and less confident.  
  • Sexuality issues certain cancer treatments directly affect the body’s sexual organs or hormone balance, and can reduce your interest in sex. You may feel tired and unwell, or less confident about your body. A low sex drive (libido) can also be a symptom of depression. Libido often improves after cancer treatment finishes, but for some people it is ongoing. 
  • Fertility issues some cancer treatments affect the reproductive organs, which may lead to temporary or permanent infertility. This means it may no longer be possible to conceive a child. You may feel devastated if you are unable to have children and may worry about how it will affect your relationships.
  • Thinking and memory changes some people diagnosed with cancer notice changes in the way they think and remember information. These changes are often temporary and get better with time, but they can have a big impact on your emotional wellbeing.

Finding hope

Australia’s rates of cancer survival have greatly increased over time. Treatments are improving constantly, and if the cancer can’t be controlled, symptoms can be managed to make life more comfortable. Even so, it can be hard to feel hopeful just after a cancer diagnosis.

Worrying about the future is natural. It can be confronting to think about your own mortality, even if the outlook for your type of cancer is reassuring. Talk to your doctor about what the diagnosis means for you and what the future may hold. Knowing more about the illness may help ease your fears and give you a sense of control. Connecting with others who have a similar diagnosis can also help you find hope.

If you’ve been told the cancer is advanced, you may find it harder to feel hopeful. In some cases, advanced cancer can be controlled for many years. When time is limited, people often focus on goals such as finishing a special project or spending time with family and friends.

Thinking positively

A common belief is that people with cancer need to stay positive. Hope is important, but trying to put on a brave face all the time can feel very draining and often doesn’t work well.

The reality is that cancer and its treatment can be unpleasant and frightening, and it's okay not to feel great about that. The pressure to be positive can sometimes make it hard for people to discuss their feelings and reach out for support.

Try to be realistic about what is happening. It's often a good idea to talk to someone about your fears and concerns and how you feel you are coping. Sharing your feelings with those around you may also help you get the support you need.

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Emotions and Cancer

Download our Emotions and Cancer booklet to learn more

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Expert content reviewers:

A/Prof Anne Burke, Co-Director, Psychology and Allied Health Lead, Cancer, Central Adelaide Local Health Network and The University of Adelaide, SA; Hannah Chen, Psychologist, Cancer Council Queensland; Hazel Everett, Clinical Nurse Consultant, Cancer Services, St John of God Subiaco Hospital, WA; Shona Gates, Senior Social Worker, North West Cancer Centre, TAS; Dr Jemma Gilchrist, Senior Clinical Psychologist, Mind My Health and Crown Princess Mary Cancer Centre, Westmead, NSW; Sandra Hodge, Consumer; Dr Michael Murphy, Psychiatrist and Clinician Researcher, Prince of Wales Hospital, NSW; Caitriona Nienaber, 13 11 20 Consultant, Cancer Council WA; Dr Alesha Thai, Medical Oncologist, Peter MacCallum Cancer Centre, VIC; Alan White, Consumer.

Page last updated:

 The information on this webpage was adapted from Emotions and cancer - A guide for people with cancer, their families and friends (2021 edition). This webpage was lasted updated in March 2022.

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