Coping with Your Feelings During Advanced Cancer

Hope

You can feel a sense of hope, despite your cancer. And what you hope for may change with time. If you have been told that remission may not be possible, you can hope for other things. These may include comfort, peace, acceptance, and even joy. Hoping may give you a sense of purpose. This, in itself, may help you feel better.

To build a sense of hope, set goals to look forward to each day. Plan something to get your mind off the cancer. Here are some tips from others with advanced stage cancer:

• Plan your days as you’ve always done.
• Don’t stop doing the things you like to do just because you have cancer.
• Find small things in life to enjoy each day.
• Set dates and events to look forward to.

Don't limit yourself. Look for reasons to hope while staying aware of what's at hand.

Inner Strength

You may have felt overwhelmed when you first learned that your doctors couldn't control your cancer. But your feelings of helplessness may change. You may find physical and emotional reserves you didn't know you had. People often find strength in finding things they can do for themselves, no matter how small. Calling on your inner strength may help revive your spirit.

People work on their inner strength in different ways, such as:

• Some people find it helpful to focus on the present instead of the past or future. They accept that their daily routine may have to change.
• Others like to think ahead and set goals. They make plans for places to go and things to do that they enjoy.
• Some focus on the relationships they have with people close to them.

Inner strength is different for each person. So draw on the things in your life that are meaningful to you.

Sadness and Depression

It's normal to feel sad. With an advanced cancer diagnosis, you may feel sad more frequently than ever before. Feeling sad may cause you to have no energy or not want to eat. It's okay to cry or express your sadness in other ways. Know that you don't have to be upbeat all the time or pretend to be cheerful in front of others. Do what feels natural to you.

Depression can happen if sadness or despair seems to take over your life. Some of the signs of depression listed below are normal during a time like this. But it's a good idea to talk to your doctor if they last for more than 2 weeks. However, some of these symptoms could be due to physical problems. It's important to tell someone on your health care team about them because they can be managed, whatever the cause.

Signs of Depression

• Feeling helpless or hopeless, or that life has no meaning
• Having no interest in family, friends, hobbies, or things you used to enjoy
• Losing your appetite
• Feeling short-tempered and grouchy
• Not being able to get certain thoughts out of your mind
• Crying for long periods or many times each day
• Thinking about hurting or killing yourself
• Feeling “wired,” having racing thoughts or panic attacks
• Having sleep problems, such as not being able to sleep, having nightmares, or sleeping too much

Grief

We all cope with loss or the threat of loss in different ways. You may feel grief about having advanced cancer and the thought that you could be facing impending death. Grief can be expressed through constant feelings of sadness, loneliness, anger, fear, and guilt. Or you may find it affects the way you think from time to time. For example you may:

• Get easily confused or feel lost
• Have thoughts that repeat themselves over and over again
• Feel low in energy or really tired
• Not want to do things or see people

These are all normal reactions to grief. Do your best to pace yourself and accept that you're going through a lot right now.

What you grieve for is as varied as how you think and feel. You may grieve for:

• The loss of your body as it used to be
• The things you used to be able to do
• Plans you made that may not get fulfilled
• Leaving your family and friends

It's okay to take time for yourself and look inward. It's also good to surround yourself with people who are close to you. Let your loved ones know if you want to talk. Or 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.

Fear and Worry

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. 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.

If you struggle with these fears, know that you’re not alone.  All these fears are normal for many cancer patients.

Some people say it helps if you:

• Know what to expect.
  Learn more about your illness and care options by asking questions of your health care team.
• Update your affairs.
  If you have not already done so, make sure your will, advance directives, 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. Or ask for help from the hospital social worker or counselor.

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

Guilt and Regret

It's normal for people with advanced cancer to wonder if they did anything to add to their situation. They may:

• Blame themselves for lifestyle choices
• Feel guilty because treatment didn't work
• Regret ignoring a symptom and waiting too long to go to the doctor
• Worry that they didn't follow the doctor's advice in the right way

It's important to remember that the treatment failed you. You didn't fail the treatment. We can't know why cancer can be controlled in some people and not others. In any case, feeling guilty won't help--it can even stop you from moving forward with life plans or interacting with others.

So, it's important for you to:

• Try to let go of any mistakes you think you may have made
• Focus on things worthy of your time and energy
• Look at what you can control, not what you can't
• Forgive yourself

Some patients feel guilty that they’re upsetting the people they love by having advanced cancer. Others worry that they will be a burden on their families. If you feel this way too, take comfort in this: Many family members have said it is an honor and a privilege to care for their loved one. They 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 rethink their priorities.

Maybe you feel that you can't talk openly about your feelings with your loved ones. If so, counseling or a support group may be an option for you. Let your health care team know if you would like to talk with someone.

Loneliness

As your cancer progresses, you may see family, friends, or coworkers less often and find yourself alone more than you would like. Or even if people are around, you may feel that they can't begin to understand what you're going through. Some people may even distance themselves from you because they have a hard time coping with your cancer. Others may think that you prefer to be left alone if you don’t feel well.

Although some days may be harder than others, remember that you aren't alone. Keep doing the things you've always done, the best you can. If you want more company, tell people that you don't want to be alone. Let them know that you welcome their visits. Ask that they reach out through mail, email, and telephone. You may also want to try joining a support group. There you can talk with others who share your feelings.

For more about feelings during cancer, see our Feelings and Cancer section.