Why Am I Feeling Guilty After a Cancer Diagnosis?

If you have just found out you have a disease which you know will inevitably affect most aspects of your life in one way or another, experiencing overwhelming, intense emotions is absolutely natural. From denial to rage, every individual will have a different psychological and emotional response to a cancer diagnosis, as such news is very distressing and often requires a lot of time to get adjusted to. Unlike anger, which most people who are prone to it experience upon hearing the word cancer in relation to them from a medical professional, guilt rarely sets in immediately.

While anyone struggling with a malignant disease may feel this emotion at some point during their treatment or even afterwards (which is commonly known as survivor’s guilt), studies indicate that people who suffer from lung cancer are significantly more susceptible to guilt due to the widespread stigma associated with their illness. In fact, the majority of concerns expressed by newly diagnosed lung cancer patients are psychological in nature, whereas those who have other types of cancer are mostly preoccupied with their psychical health.

The feelings of guilt and shame lung cancer patients tend to experience stem primarily from the stigma surrounding this disease. Shame ensues as a consequence of blaming a character trait for your illness, whereas guilt is usually related to a behavior or activity which might have caused or contributed to it – in this case, cigarette smoking. Both smokers and non-smokers who developed lung cancer experience stigma, as lung cancer has unjustly become almost synonymous with cigarette smoking. 70% of the participants involved in a 2010 study attributed blame to lung cancer patients, as opposed to breast cancer and leukemia patients, who were assigned it by only 15% and, respectively, 9% of those asked.

According to a large-scale study conducted by the Lung Cancer Project, a movement whose ultimate goal is to abolish the stigma people struggling with this disease face, 3 out of 4 people have a negative bias towards lung cancer patients, while 86% of the 3,000 participants correlated lung cancer with smoking. When asked to associate lung cancer with a feeling, their answers were as follows:

• lung cancer was correlated with hopelessness by 75% of the participants
• 67% of the responses included the word "shame"
• 74% of the participants linked it to stigma

In addition to stigma, the portrayal of lung cancer in the media also has a negative impact on patients’ mental health. Although lung cancer is the leading cause of death worldwide, it is severely underrepresented in the news. Moreover, the existent media coverage concerns primarily non-smokers, which further perpetuates feelings of shame and guilt among patients, as it covertly states that only non-smokers with lung cancer deserve sympathy.

The consequences of the stigma surrounding lung cancer are very serious. Because shame and guilt can easily lead to a sense of social anguish, as a 2008 study focusing exclusively on these two emotions among lung cancer patients reveals, the quality of life of individuals diagnosed with this illness may decrease considerably. Over time, guilt and shame can also give way to depression and, implicitly, social withdrawal, which can limit the support lung cancer patients receive from their families and friends.

Additionally, stigma is likely to prevent some people from seeking medical help and appropriate treatment, which will affect their prognosis dramatically. According to a series of studies conducted by the researchers behind the Lung Cancer Project, 1 in 4 people suffering from advanced lung cancer were not examined directly by a specialist, whereas 1 in 10 patients did not receive any type of cancer-targeted treatment.

However, although guilt is more prevalent among those who struggle with lung cancer, it is not restricted to this group of patients and there are numerous other reasons why one may feel guilty about their diagnosis, such as:

• worrying that you are a burden to your family, friends or caregivers
• not having sought medical attention sooner for your symptoms
• believing that cancer is a form of punishment or divine retribution for something you have done in the past
• causing financial difficulty to your family
• not being able to work due to your symptoms or the side-effects you experience as a result of cancer treatment

Regardless of the type of cancer you were diagnosed with, guilt is very distressing and may linger for unhealthy amounts of time, which could put your mental health at stake. For this reason, we have selected three tips which will hopefully help you overcome or at least cope better with the feelings of guilt brought about by your diagnosis.

1. Remind yourself that you are not at fault for your cancer diagnosis

Although there are a series of factors, including certain lifestyle choices, which have been proved to increase the risk of developing cancer, the causes of this disease are very complex and not completely known. It is important to remember that cancer – even when personal choices like smoking might have contributed to it – does not occur as a result of a single factor. Some people have a genetic predisposition to cancer, which is why less than 10% of lifelong smokers will develop lung cancer and approximately 25% of people diagnosed with this illness worldwide have never smoked a cigarette.

Whether your past actions have somehow increased your cancer risk, forgiving yourself and letting go of any unfortunate decision you might have made is essential to easing your guilt. A compassionate attitude towards your past self can alleviate feelings of shame and guilt tremendously. Try not to be too harsh on the person you were back then, as it would have been impossible for you to know how your choices could impact your current situation. Putting your thoughts on paper and making a habit of using creative outlets such as painting, dancing or playing music might help you cope with the feelings of guilt associated with your diagnosis in a more healthy way.

2. Express your feelings of guilt openly

Benefitting from permanent emotional support throughout your cancer journey is vital for plenty of reasons. If you are experiencing cancer-related guilt, having open discussions with your loved ones regularly will help you overcome negative feelings more easily and will also bring you closer as a family. A positive, non-judgmental environment can work wonders on your mental state, as it will encourage you to talk about what you are going through openly and also offer you the support and understanding you need in such delicate moments.

Communication is even more important if guilt comes from your believing you are a burden to your family, emotionally or financially. We highly encourage you to reach out to your loved ones if this is your case, since bottling up your feelings will only increase your levels of distress. They will reassure you that supporting and taking care of you is by no means a huge inconvenience as you might be imagining.

A cancer support group can provide you with invaluable emotional support as well. Discussing with people who are facing similar hardship and opening up to them is bound to relieve your feelings of shame and guilt at least partially. You can find general or cancer-specific support groups to join by visiting your local cancer center or online.

If, however, your feelings of guilt are not subsiding or, on the contrary, are worsening, we strongly recommend you to talk with a counselor. They will teach you how to navigate your emotions more gracefully and how to direct your negative feelings to constructive purposes. For cancer patients, counseling services are usually free of charge and you do not even need a referral to benefit from them.

3. Improve your lifestyle – it is never too late

Not only will making healthy lifestyle choices improve your prognosis and speed up your recovery, but it will also boost your mood and ease some of the guilt you are tempted to feel towards your past habits. Moreover, leading a balanced lifestyle and avoiding risk factors can decrease the chances of cancer recurrence considerably, as well as prevent you from developing other serious illnesses. Here are some practical ideas you can implement in your life right away:

• cut back on processed foods, as well as on those high in fat, cholesterol, sugar, and salt
• include more raw fruits and vegetables in your daily diet
• schedule an appointment with a nutritionist, who will be able to provide you with an individualized diet plan according to your specific needs
• take up a form of moderate-intensity physical exercise such as swimming, yoga or walking (however, you should discuss with your doctor before deciding on a certain activity)
• limit your alcohol intake or give it up entirely
• quit smoking – if you have difficulty, there are numerous support programs which can help you
• eliminate major stress factors from your life, if possible
• learn some relaxation techniques you can apply when you feel overwhelmed
• start practicing mindfulness meditation – studies suggest that this type of meditation is particularly useful when it comes to managing the guilt associated with a cancer diagnosis