Understanding Your Reactions After a Cancer Diagnosis

If you have recently found out you have cancer, you are probably experiencing a lot of different emotions which might make you wonder whether you are coping in a healthy way with your diagnosis or not. You may feel overwhelmed, in complete disbelief or simply numb, all of which are very common and perfectly normal reactions. The emotional response to cancer depends on of multiple individual factors, such as your coping style, your support system, your comfort level in expressing feelings, and your personal perception of the illness. There is no right or wrong reaction upon receiving such devastating news. However, psycho-oncologists have concluded that a healthy reaction to a cancer diagnosis follows three phases: initial reaction, distress, and adjustment.

Coping with cancer is often compared to a grieving process, as there are numerous similarities between the emotional stages the two journeys involve. Most patients recall feeling shocked when they were first told about their illness, while others were not able to accept what was happening to them. Some people, on the contrary, tend to react violently and even take their anger out on the doctor who delivers the news or on the health care team, as they are overpowered by fear. Other frequent emotional responses to a cancer diagnosis include anxiety, withdrawal, guilt, a loss of control, and uncertainty.

Although these feelings may seem counterproductive, harmful or toxic, they are in fact part of a healthy coping process. Nevertheless, persistent negative emotions and inability to eventually adjust to your diagnosis are usually signs of depression. Thereby, if you experience severe distress throughout your battle with cancer or find yourself unable to manage your emotions, we advise you to seek professional help from a counselor or psychologist who can provide you with the support and coping strategies you need. The majority of cancer centers have at least one mental health specialist whom you can arrange an appointment with.

The following are some of the most common initial reactions of people who were diagnosed with cancer, regardless of the type and severity of the disease. Ultimately, it is important to remember that everyone receives their diagnosis differently and if you cannot relate to any of the emotional responses described below, this does not mean your reaction was inappropriate or invalid.

Shock

Being informed that you suffer from cancer is undoubtedly some of the most stressful news a person can receive. Numbness, inability to express any emotion, and feeling suddenly detached from reality are typical signs of shock. People often report that they could not perceive what the doctor was saying after hearing the word “cancer” due to the heavy impact it had on their emotional state. Not rare are the instances when the person delivering the news has to repeat what they had just said, as disbelief prevents the patient from taking in the information. Moreover, shock can also discourage you from reaching out to your loved ones for support, as you may feel unable to acknowledge or talk about your diagnosis.

Shock usually wears out within several weeks and it is recommended to not force yourself to overcome your feelings if you are not ready. You should take all the time you need to get accustomed to this unexpected change while the information sinks in. Even though communicating with your family is fundamental and can help you enormously in such difficult moments, you do not have to immediately reach out for support if you do not feel comfortable sharing the news. However, we highly encourage you to talk to someone as soon as you are ready, as openly expressing your emotions is generally very beneficial when you are struggling with cancer.

Denial

Although not quite as common as a shock, denial is a frequently encountered reaction among recently diagnosed patients as well. Due to the overwhelming nature of the news, some people will either refuse to believe they are ill, insisting that their test results are not accurate or have been mistaken for someone else’s, or will pretend the situation is not really happening to them. Most of the time, this is not a conscious decision and denial occurs as a natural protective reaction. Once you begin adjusting to the changes your diagnosis brought about and realize your illness is, unfortunately, real, denial will gradually wear off and may subsequently be replaced by a healthier coping mechanism.

Some of the most typical signs of denial are rejecting any information regarding your diagnosis, being unwilling to hear about treatment, and not wanting to talk about it with another person. While denial can be a very effective coping strategy until you become fully aware of the presence of your illness, it may also represent a counterproductive or even dangerous adaptive mechanism. Thus, when people convince themselves that their disease does not exist or that they are perfectly healthy, as well as when they refuse to seek treatment, believing cancer will spontaneously disappear, this coping mechanism becomes detrimental to their wellbeing.

Guilt

Even though guilt is more widespread among cancer survivors, newly diagnosed people can experience it as well. The main reason for which patients tend to blame themselves refers to the cause of their illness. Some forms of cancer are correlated with certain behaviors which have a negative impact on health in the long run. For instance, a smoker who has just found out they developed lung cancer may feel very tempted to blame themselves for the unhealthy lifestyle choice which caused or contributed to their disease. Other patients may experience guilt because they know their diagnosis will affect their family, which makes them feel like a burden to their loved ones.

Nevertheless, dwelling on aspects you cannot change, regardless of whether your concerns are valid or not, will only result in additional distress. Intense feelings of guilt will also prevent you from focusing on important matters such as your treatment and will eventually cause you a great amount of unnecessary grief. If you are unable to overcome these emotions, it might be a good idea to discuss with a counselor or find a support group who could help you move forward with your journey.

Anxiety

Anxiety can arise in a recently diagnosed patient for numerous reasons, from having to make an important decision regarding their treatment plan to feeling as if they lost control over their life, health or body. Moreover, not knowing what the future holds will often exacerbate anxiety, as the fear of the unknown is very persistent for most people struggling with cancer. Being diagnosed with a potentially terminal disease, particularly if cancer is considerably advanced, also brings to the surface the fear of death for many patients, which will implicitly determine them to be more aware of their own mortality.

In addition to experiencing fear, worry, irritability, nervousness and anger, anxiety also entails a series of physical symptoms, including:

• shortness of breath
• fatigue
• sleep disturbances
• loss of appetite
• tense muscles
• dizziness
• nausea

Focusing on aspects you can control, such as your diet or exercise program, and completing practical tasks have proved to alleviate anxiety to a great extent for some patients. However, if your anxiety is severe and you find yourself unable to cope with your diagnosis, it is highly recommended to seek help from a counselor or mental health professional, as these feelings can affect your quality of life tremendously in the future.

Anger

Another common emotional reaction to a cancer diagnosis is anger. Whether it stems from overwhelming feelings of powerlessness and vulnerability or represents a form of projection, anger ensues as a natural response for numerous people upon hearing about their illness for the first time. Sometimes, a person who has just found out they have cancer will experience unbearable feelings which they cannot immediately deal with. As a consequence, they will subconsciously resort to anger in order to reduce pain. In other cases, it may be a way of projecting negative emotions onto others as a coping mechanism.

When this feeling is persistent and does not seem to wear off after a while, it may indicate the onset of depression. Nevertheless, if anger is directed towards positive and productive aspects, it can easily become a useful emotion and a healthy coping strategy.

Withdrawal

Withdrawal as a reaction to a cancer diagnosis is more frequent among people who find it difficult to overtly express their feelings when confronted with a distressing situation. Patients who want to protect their loved ones from experiencing painful emotions also tend to isolate themselves in an attempt to make their illness seem less visible. However, withdrawal is a natural response for those who have a hard time adjusting to their diagnosis as well. Spending more time alone may help you come to terms with your illness and allow you to gain a better understanding of what a cancer diagnosis means for you so that you will eventually be able to let go of negative feelings and accept it.

On the other hand, similarly to anger, isolation may be a sign of depression. If you find yourself spending more and more time on your own and your mental state does not improve, you should try reaching out for the support of your family and friends or discuss with a counselor who can provide you with effective and healthy coping strategies.