Advanced Cancer : Grief, Denial, Anger, Stress, Fear and Worry

by National Cancer Institute

(Page 7 of 11)

Grief

"I heard the doctor say, 'I'm so sorry, but . . .' and then I heard nothing else. My head was spinning, and I kept saying to myself, 'No, the doctor must be making a mistake.'" — Rosa

We all cope with loss or the threat of loss in different ways. You may feel sadness, loneliness, anger, fear, and guilt. Or you may find the way you think changes from time to time. For example, you may get easily confused or feel lost. Or your thoughts may repeat themselves over and over again. You may also find yourself low in energy. You may not want to do things or see people. These are all normal reactions to grief.

What you grieve for is as varied as how you think and feel. You may be grieving for the loss of your body as it used to be. You may grieve for the things you used to be able to do. You also may grieve losing what you have left: yourself, your family, your friends, your future.

It's okay to take time for yourself and look inward. It's also okay to surround yourself with people who are close to you. Let your loved ones know if you want to talk. Let them know if you just want to sit quietly with them. There is no right or wrong way to grieve.

Often people who go through major change and loss need extra help. You can talk with a member of your health care team, a member of your faith community, or a mental health professional. You don't have to go through this alone.

Denial

"I feel like the reality of this cancer isn't going to go away if I deny it. If I did that, I might miss the comfort I get from sharing fears and concerns. I don't want to miss the sense of well-being I have knowing I have taken care of my loved ones." — Carrie

It's hard to accept the news that your cancer has spread or can no longer be controlled. And it's natural to need some time to adjust. But this can become a serious problem if it lasts longer than a few weeks. It can keep you from getting the care 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.

Anger

The feeling of "No, not me!" often changes to "Why me?" or "What's next?" You have a lot to deal with right now. It's normal and healthy to feel angry. You don't have to pretend that everything is okay. You may be mad at your doctor, family members, neighbors, and even yourself. Some people get angry with God and question their faith.

At first, anger can help by moving you to take action. You may decide to learn more about different treatment options. Or you may become more involved in the care you are getting. But anger doesn't help if you hold it in too long or take it out on others. Often the people closest to us are the ones who have to deal with our anger, whether we want that or not.

It may help to figure out why you are angry. This isn't always easy. Sometimes anger comes from feelings that are hard to show, such as fear, panic, worry, or helplessness. But being open and dealing with your anger may help you let go of it. Anger is also a form of energy. It may help to express this energy through exercise or physical activity, art, or even just hitting the bed with a pillow.

Stress

"Just because I love God and know where I'm going, doesn't mean I'm not stressed. I worry all the time about what's to come. I try to focus on the things I can control, but it's not always easy." — David

Everyone has stress, but most likely you're having a lot more now. After all, you're dealing with many changes. Sometimes, you may not even notice that you're stressed. But your family and friends may see a change.

Anything that helps you feel calm or relaxed may help you. Try to think of things that you enjoy. Some people say it helps to:

• Exercise or take a walk.
• Write thoughts and feelings in a journal.
• Meditate, pray, or do relaxation exercises.
• Talk with someone about your stress.
• Do yoga or gentle stretching.
• Listen to soothing music.
• Express yourself through art.

Fear and Worry

"I have people around all day, but there's nothing worse than waking up alone and upset at 3:00 in the morning in a quiet, dark room. You have to have someone you can call right then." — Jamal

Facing the unknown is very hard. At times, you may feel scared of losing control of your life. You may be afraid of becoming dependent on other people. You may be afraid of dying.

If you struggle with these fears, remember that many others have felt the same way. Some people worry about what will happen to their loved ones in the future. Others worry about money. Many people fear being in pain or feeling sick. All these fears are normal.

Sometimes patients or family members worry that talking about their fears will make the cancer worse. This is not true. Thinking about getting sicker or dying is not going to make your health worse. But it's good to be hopeful and positive. It's better for your health to express your feelings, rather than hold them in.

Some people say it helps if you:

• Know what to expect. Learn more about your illness and treatment options by asking questions of your healthcare team.

• Update your affairs. If you have not already done so, make sure your will and other legal paperwork are in order. Then you won't have to worry about it.

• Try to work through your feelings. If you can, talk with someone you trust.

If you feel overwhelmed by fear, remember that others have felt this way, too. It's okay to ask for help.

About the Author

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