A Guide for Managing the Emotional Stages of Cancer

There are no wrong emotions to feel after a cancer diagnosis, and no universal stages everyone goes through. In fact, many people cycle through multiple emotions from one day to the next.

Everyone’s experience and circumstances are unique. Some people may feel sadness first, while others feel anger. You might not feel anything at all while you’re processing the information.

Fear and anxiety

A cancer diagnosis can be scary. Many cancers are unpredictable, and the uncertainty about what cancer means for your life moving forward can cause fear, worry, and anxiety. You might even feel panic or have a panic attack.

In addition to concerns about your health and quality of life, you may be wondering about finances, care for your family, or how treatments will impact your job.

For some people, a cancer diagnosis means preparing for the end of life sooner than they had thought possible.

Sadness and depression

Sadness is a common response to loss. With a cancer diagnosis, sadness about the possible decline of your health and the negative impacts cancer will have on your loved ones is natural.

When you’re sad, you may cry often. You might not feel like eating or spending time around others. Feeling tired and low energy is also typical.

If sadness becomes present nearly all day, every day, and is accompanied by low energy, a loss of self-motivated activities, and persistently low mood, you may be experiencing depression, formally known as major depressive disorder (MDD).

Symptoms of MDD

MDD is a mental health condition. It’s often diagnosed using the Diagnostic and Statistical Manual of Mental Disorders, 5th edition, text revision (DSM-5-TR).

According to the DSM-5-TR, you must meet five or more symptoms within a 2-week period. At least one of those symptoms must be a depressed mood or a loss of interest or pleasure. Symptoms may be felt nearly every day and include:

• depressed mood
• significant loss of interest or pleasure in almost all activities
• weight changes
• an inability to sleep or excessive sleepiness
• feelings of restlessness or of slowed movements
• low energy or fatigue
• feelings of inappropriate guilt or worthlessness
• an impaired ability to think, concentrate, or make decisions
• suicide ideation

Loneliness

Even if you’re physically near loved ones, cancer can make you feel lonely. Being unable to fully share what you’re going through mentally and physically can be isolating, as though no one is really able to be with you every step of the way.

Sometimes, it might feel like those around you don’t care enough or aren’t providing enough help. Certain friends may drift away because they aren’t comfortable dealing with cancer or don’t know what to say.

Anger

Let yourself feel angry if that emotion emerges. Anger is a valid emotion.

Cancer can cause major changes in your life. It can affect everything. You have every right to feel angry about how things around you are changing.

Guilt and regret

Guilt and regret often go hand-in-hand with a cancer diagnosis. You might feel guilty about how a cancer diagnosis affects your family or having to miss work. Or you may feel like you’re a burden.

You may also have regrets and guilt about lifestyle choices that have contributed to cancer or about hardships your loved ones will have to face in the future.

Resentment

It’s OK to feel resentment about being diagnosed with cancer. Many people wonder why they’re facing this battle when others can continue with their regular lives.

Grief

Grief comes after the loss of something deeply meaningful. It can be made up of many emotions, including sadness, anger, fear, guilt, and resentment.

Grief in cancer involves all of your emotional responses that make up a pervasive sense of loss affecting your life.

Positive emotions

Within the emotional stages of cancer, there are positive experiences, too.

Hope, for example, is a powerful feeling that can help you stay committed to treatment and can keep you optimistic about the future.

Joy is also present. There will still be times when someone makes you laugh, for example, or when you receive a thoughtful gift. With joy can come gratitude, a sense of great appreciation for what is still joyful in your life and for what opportunities are still available to you.

Coping mechanisms are the strategies you use to manage stress or challenges in life. There are positive coping mechanisms, behaviors, and attitudes that promote overall well-being, as well as negative coping mechanisms that aren’t beneficial and may be harmful.

Positive and negative coping mechanisms are both common after a cancer diagnosis.

Examples of positive coping mechanisms include:

• Social orientation: Seeking camaraderie, support, and connectedness with loved ones or those sharing a similar cancer experience.
• Cognitive acceptance: Accepting the thoughts and feelings of cancer without judgment, suppression, or attempting to change them.
• Positive thinking and reframing: Consciously focusing on what’s positive in life, even during a cancer diagnosis.
• Spirituality: Finding comfort and peace in spiritual beliefs and supports.
• Emotional expression: Practicing controlled emotional expression, like through journaling.

Examples of negative coping mechanisms include:

• Avoidance: Not addressing important needs in cancer because it means thinking about it, like skipping appointments.
• Fatalism: Believing that cancer is your “fate” and there is nothing you can do about it.
• Isolationism: Staying away from others because you believe it spares them or spares you from the thoughts and feelings associated with cancer.
• Projection: Directing negative emotions related to cancer onto others.

Coping mechanisms aren’t only psychological. Behaviors can also be coping mechanisms. Exercise, meditation, and mind-body arts are several examples of positive behavioral coping mechanisms.

Substance misuse, overeating, and self-harm are examples of negative or maladaptive behavioral coping mechanisms.

You can improve your coping methods during the emotional stages of cancer by keeping the following tips in mind:

Be patient — with yourself and others

Feeling frustrated or upset with yourself because you’re experiencing an emotion perceived as “negative” will only make you feel worse. Be patient and kind to yourself.

At the same time, extend that courtesy to your loved ones. Even though there may be times when you think they don’t care or aren’t doing enough, they’re most likely doing the best they can while also navigating their own life’s challenges and responsibilities.

Actively seek joy

While cancer can mean many things regarding lifespan, you can make the most of your time by doing things you enjoy and spending time with people who make you happy.

For many, a cancer diagnosis becomes the reason they finally pick up a new hobby or visit a destination that’s always been on their list.

Control what you can

You can’t always control your emotions, but you can control aspects of life with cancer that contribute to emotions.

Keeping up with your appointments and treatments, for example, can help you maintain your physical health and stay on top of treatment side effects.

You can also take a proactive approach to improving your diet, getting quality sleep, and being physically active. These efforts support your overall well-being, which promotes resilience during cancer.

Be honest with your feelings

You don’t have to hide the emotional stages of cancer. Expressing your feelings helps them pass. If you’re uncomfortable sharing with loved ones or an outside support network, you can write down your thoughts or pour your emotions into an art form, like painting.

Allow others to help

It’s natural to want to continue doing everything you’ve always done in day-to-day life. The truth is, though, that the stress and responsibilities that come with a cancer diagnosis can make it hard to keep up with chores and everyday tasks.

Allowing others to help you isn’t a sign you’ve failed as a parent, spouse, or friend. Let people step in and help where they can, just as you would for them if the situation were reversed.

Acceptance doesn’t mean “giving in” or “giving up.”

Acceptance of cancer is taking a practical approach to what life means moving forward. It’s the recognition that, yes, cancer is now something you must face, but you’re still in control of your life.

A 2019 research review found that acceptance in cancer was associated with lower rates of emotional distress, including symptoms of anxiety and depression.

If your loved one has been diagnosed with cancer, understanding the vast emotional experiences they’re facing isn’t always easy.

You might not fully comprehend what they’re going through, but you can still express empathy and show support by:

• offering help but respecting their boundaries
• learning as much as you can about their emotional journey during cancer
• listening, without judgment, if they need to talk or express their feelings
• encouraging positivity without giving false hope
• initiating contact and communication regularly
• celebrating small achievements in life (not just those related to cancer) to help build joy
• remembering negative outbursts are often redirected emotions
• encouraging professional guidance, counseling, or support

As a loved one, it’s also important to take care of yourself. You’ll be going through your own emotional journey during this time on top of providing care for your loved one.

Pick up some new relaxation strategies, take time for self-care, and focus on healthy lifestyle habits to help fortify your own resiliency.

The emotional stages of cancer are different for everyone. Sadness, anger, loneliness, and fear are just a few emotions you might experience during this time.

It’s OK and natural to feel a variety of emotions. Be kind to yourself, express your feelings, and embrace the positive when possible to help neutralize the negative.