People feel so many emotions when they find out that their cancer has come back. Shock, fear, anger, and denial are just a few. The new diagnosis hits them as hard as it did the first time, or even harder.
Regardless of your first reaction, starting cancer treatment again can place even more demands on your mind and spirit. You'll have good days and bad days. So just remember that it's okay to feel a lot of different emotions.
Some of these emotions may be ones you have had at other times in your life. But you may be feeling them more intensely. If you have dealt with them in the past, you may be able to cope with them now, too. If some of the feelings are new, or are so strong that it is hard to get through everyday activities, you may want to ask for help.
There are many people who may be able to help you. These include health psychologists, oncology social workers, other mental health experts, and leaders in your faith or spiritual community. They know many ways to help you cope with your feelings. See Ways You Can Cope for other ideas on how to cope.
Stress is a normal reaction to cancer. After all, you're dealing with a lot: treatment, family, your job, money, and day-to-day living. Sometimes, you may not even notice that you are stressed. But your family and friends probably see a change.
Anything that makes you feel calm or relaxed may help. So try to think of things that relax you and that you enjoy doing. Some people try deep breathing, listening to tapes that have nature sounds, or listening to music. See below for more ideas on how to relieve stress.
While you may be sad or depressed about your cancer recurrence, you do have reasons to feel hopeful. Science has advanced and cancer treatments have improved. So more people are surviving cancer than ever before. Nearly 10 million people who have a history of cancer are alive today.
In other words, cancer is becoming a disease that doctors can manage. To help build your sense of hope:
- Plan your days as you have always done.
- Don't limit the things you like to do just because you have cancer.
- Look for your own reasons to have hope.
Some people see their cancer coming back as a "wake-up call." They may realize the importance of enjoying the little things in life. They go places they've never been. They finish projects they had started but put aside. They spend more time with friends and family. They mend broken relationships.
It may be hard at first, but you can find joy in your life. Take note of what makes you smile. Pay attention to the things you do each day that you enjoy. They can be as simple as drinking your morning coffee, sitting with a pet, or talking to a friend. These small, day-to-day activities can give you comfort and pleasure.
You can also do things that are more meaningful to you. Everyone has special things, both large and small, that bring meaning to their life. For you, it may be visiting a garden in your city or town. It may be praying in a certain chapel. Or it could be playing golf or some other sport that you love. Whatever you choose, embrace the things that bring you joy when you can.
Cancer takes a toll on both your body and your mind. You are coping with so much now. You may feel overwhelmed. Pain and medicines for pain can also make you feel anxious or depressed. And you may be more likely to feel this way if you have had these feelings before.
Here are some signs of anxiety:
- Feeling very tense and nervous
- Racing heartbeat
- Sweating a lot
- Trouble breathing or catching your breath
- Having a lump in your throat or a knot in your stomach
- Feeling fear.
Feeling anxious can be normal. But if it begins to disrupt your daily life, tell a member of your health care team. They can suggest someone for you to talk to. Or they can give you medicines that will help. Some of the nondrug choices for pain may work for your anxiety as well (see above).
It's normal to feel scared and worried. You may be afraid of pain or other side effects, either from the cancer or the treatment. You may worry about looking different as a result of your treatment. You may worry about taking care of your family, paying your bills, and keeping your job. You may be afraid of dying.
It's hard to deal with the fear of so many unknowns. Some people say it helps if you know what to expect in the future. Ask your health care team questions, so you can understand more about your cancer and treatment choices. Also, update your will and other legal papers, if you haven't already done so. Then you won't have to worry about them.
Fear can be overwhelming. Remember that others have felt this way, too. It's okay to ask for help.
Sadness and Depression
Sadness is a normal response to any serious illness. You may feel sad that you have to go through treatment again. You may feel sad that life won't be quite the same from now on.
It's okay to feel blue. You don't need to be upbeat all the time or pretend to be cheerful. Many people say that they want the freedom to just give in to their feelings sometimes. But others say that it helps to look for what is good in life, even in the bad times.
Depression can happen when sadness or despair seems to take over your life. Some of the signs listed on the next page are normal at a time like this. But if they last more than 2 weeks, talk to your doctor. Some symptoms could be due to physical problems. This is why it's important to let your doctor know about them.
Signs of Depression
- Feeling helpless or hopeless, or that life has no meaning
- No interest in family, friends, hobbies, or things you used to enjoy
- Loss of appetite
- Feeling short-tempered and grouchy
- Not being able to get certain thoughts out of your mind
- Crying for long periods of time or many times each day
- Thinking about hurting or killing yourself
- Feeling "wired," having racing thoughts or panic attacks
- Sleep problems, such as not being able to sleep, having nightmares, or sleeping too much.
You may also feel angry or frustrated. It's normal to ask, "Why me?" You may be mad at the cancer, your doctors, or your loved ones. If you are religious, you might even be angry with God. If you feel angry, it's helpful to remember that you don't have to pretend that everything is okay.
Try to figure out why you are angry. Anger sometimes comes from feelings that are hard to show. These might be fear, panic, frustration, worry, or helplessness.
It's not always easy to look at what is causing your anger. But it's healthy to try. Being open and dealing with your anger may help you let go of it. It's also good to know that anger is a form of energy. You can express this energy through exercise, art, or even just hitting the bed with a pillow.
It's normal for some people to wonder whether they did things that caused their cancer to recur. People feel guilty for a number of reasons:
- They worry about how their family and friends feel.
- They envy other people's good health and are ashamed of this feeling.
- They blame themselves for certain lifestyle choices.
- They feel guilty that their first treatment didn't work.
- They wonder if they waited too long to go back to the doctor. Or they fear that they didn't follow the doctor's instructions the right way.
But it's important to remember that the treatment failed you. You didn't fail the treatment. We can't know why cancer returns in some people and not others. So, it's important for you to try to:
- Focus on things worthy of your time and energy.
- Let go of any mistakes you think you may have made.
- Forgive yourself.
You may want to share these feelings with your loved ones. Some people blame themselves for upsetting the people they love or worry that they'll be a burden to others. If you feel this way, take comfort knowing that many family members say that it is an honor and a privilege to care for their loved one. Many consider it a time when they can share experiences and become closer to one another. Others say that caring for someone else makes them take life more seriously and causes them to reevaluate their priorities.
If you don't feel that you can talk openly about these things with your loved ones, getting counseling or joining a support group may also help. Let your health care team know if you would like to talk with someone about your feelings.
You may feel lonely, even when lots of people support and care for you. Here are some common feelings:
- You feel like no one else understands what you're going through, even those you love and care about.
- You feel distant from others. Or you find that your family and friends have a hard time dealing with your cancer.
- You realize that you aren't able to take part in as many events and activities as you used to.
Although it may be harder some days than others, remember that you aren't alone. Continue to do the things you've always done as best you can. If you want to, tell people that you don't want to be alone and that you welcome their visits. More than likely, your loved ones have feelings like yours. They may feel isolated from you and lonely if they are unable to talk with you.
You may feel that this is not happening to you. It's tough to accept that the cancer has come back. Feeling that you need more time to absorb everything is natural. You may need more time to adjust to the news. But this can become a serious problem if it lasts longer than it should. It can keep you from getting the treatment you need or talking about your treatment choices. As time passes, try to keep an open mind. Listen to what others around you suggest for your care.
Ways You Can Cope
Your feelings will come and go, just like they always have. If you have some strategies to deal with them, you have already taken a step in the right direction.
Know that many other people have been where you are. Some do better when they join a support group. It helps them to talk with others who are facing the same challenges. You may prefer to join an online support group. That way you can chat with people from home. Be sure to check the privacy issues before you join.
If support groups don't appeal to you, there are many experts who are trained to give cancer support. These include oncology social workers, psychologists or health psychologists, counselors, or members of your faith or spiritual community. For more information, see the Resources section.
A Word About Support Groups
You may have heard about support groups in your area for people with cancer. They can meet in person, by phone, or over the Internet. They may help you gain new insights into what's happening, get ideas about how to cope, and help you know that you're not alone.
In a support group, people may talk about their feelings and what they have gone through. They may trade advice and try to help others who are dealing with the same kinds of issues. Some people like to go and just listen. Others prefer not to join support groups at all. Some people aren't comfortable with this kind of sharing.
If you feel like you would enjoy outside support such as this, but can't get to a group in your area, try a support group on the Internet. Some people with cancer say that Web sites with support groups have helped them a lot.
Ways You Can Cope
You may be able to continue many of your regular activities, even though some may be more difficult than before. Whatever you do, remember to conserve your strength for the things you really want to do. Don't plan too many things for one day. Also try to stagger them during the day.
Here are some things other people with cancer say have helped them cope. As you can see, even the little things help!