Understanding your feelings

While most people adapt well over time to life after cancer treatment, many people experience ongoing fears or concerns. You may find you need a lot of support with how you’re feeling.

Common reactions to finishing treatment

1. Relief – You might be relieved that treatment has finished and seems to have been successful. You may welcome the chance to focus on the things you like to do.
2. Isolation – You may feel lost or nervous when regular appointments with your health care team reduce or stop. This can feel like losing a safety net. You may also feel lonely if your relationships have changed or people don’t understand what you’ve been through.
3. Fear – You may worry that the cancer will come back.
4. Uncertainty – You may avoid making plans for the future because you feel uncertain about your health. This is very challenging, but you can learn to manage it effectively.
5. Frustration – You may feel frustrated because you think your family and friends expect too much from you. Or you may feel discouraged because you can’t do the things you want to do.
6. Hopeful – You may feel hopeful about the future, and happy to be getting back to your regular routine.
7. Survivor guilt – You may feel guilty or question why you survived cancer when others didn’t. This can be confronting.
8. Anxiety – You may be anxious before follow-up appointments and feel these appointments “bring it all back”. Waiting for test results can also be an anxious time.
9. Worry – You may be concerned about treatment side effects: how long they’ll last and whether they’ll affect your life. Many survivors are worried about their finances or being a burden to their family. Other survivors worry about returning to work and dealing with questions from colleagues.
10. Lack of confidence – You may feel differently about your body and health. You may not trust your body and think it has let you down. You may not be physically able to do some of the things you did before treatment. Or you may worry about the impact on your ability to remember things and process information. Many people feel vulnerable and self-conscious about their body image and sexuality.
11. Heightened emotions – You may become tearful or emotional very quickly, particularly when someone asks how you are. It is normal to feel like this.
12. Anger – You may be angry about your cancer experience and how it has affected your life.
13. Delayed emotions – You may find your emotions catch up with you now that treatment is over. Many people do not expect negative emotions once their  treatment ends and find this confusing.

Recognising your feelings

Acknowledging how you are feeling may help you to work through your emotions. Try to develop a sense of your personal coping style (the things that work best for you). Remembering how you have coped with difficult situations in the past may give you some clues about helpful ways to cope with your emotions. Most cancer survivors find that they do feel better over time.

Friends and family may advise you to “think positively”. It is almost impossible to be positive all the time; everyone has good and bad days, before and after a cancer diagnosis. There is no scientific evidence to suggest that positive thinking has any impact on surviving cancer. However, many survivors say that feeling hopeful helped them to cope with their illness and make positive changes, such as doing more exercise or improving their diet.

Feeling down or depressed

It is common to feel low or depressed after treatment ends. Cancer survivors often experience worry or periods of feeling down for months or even years after treatment.

Cancer survivors may feel sad or depressed because of the changes that cancer has caused, fear that the cancer will come back or worries about the future. Many people feel disconnected from their life before cancer. Others wonder if they will be able to work again and whether their family will cope if they can’t earn enough money. Sometimes you may feel down for no particular reason.

Support from family and friends, other cancer survivors or health professionals may help you manage these periods.

Warning signs of depression

At any stage after a cancer diagnosis, it is natural to have days when you feel sad or worried. Sometimes a person may begin to feel “stuck” in their distress and become depressed or anxious. Depression is more than feeling down for a few days. Seek help from your general practitioner (GP) if you:

• find it difficult to function on a daily basis
• have lost the desire to do things that previously gave you pleasure
• feel very sad and low most of the day, nearly every day
• begin to rely on alcohol or drugs
• eat more or less than usual
• are sleeping too much or having a lot of trouble sleeping
• feel restless, agitated, worthless, guilty, anxious or upset
• think you are a burden to others
• worry that you might hurt someone
• think about self-harm or taking your own life.

Some of these symptoms can also be caused by other medical conditions. Talk to your doctor about how you are feeling and ask for help. Anxiety and depression are quite common among people who have had cancer, but there is no need to face this experience alone.

Getting help with depression

Depression generally won’t go away by itself – specific treatment is needed. Treating depression early may mean that you can deal with the problem quickly and avoid symptoms becoming worse.

There are ways to treat depression, which don’t necessarily involve medicines. Treatment may include therapy provided by a GP, psychologist, psychiatrist, social worker or counsellor. Some people are able to get a Medicare rebate for these sessions under a Mental Health Treatment Plan. Ask your GP if you are eligible. You can also call 13 11 20 to find out more about Cancer Council SA’s free counselling program.

Some people find online programs or smartphone apps helpful in managing depression and anxiety. Examples include moodgym.com.au, mycompass.org.au or mentalhealthonline.org.au.

For information about coping with depression and anxiety, call Beyond Blue on 1300 22 4636 or visit beyondblue.org.au. For 24-hour crisis support, call Lifeline 13 11 14 or visit lifeline.org.au.

If you are having intense thoughts about hurting yourself or others, seek immediate assistance by calling Lifeline 13 11 14. In an emergency, call Triple Zero (000).

How to manage your mood

• Take care of yourself. Eat a well-balanced diet, drink plenty of water and limit alcohol.
• Do some regular physical activity. This can help with feelings of anger, stress, anxiety and depression, manage fatigue and improve sleep. Even a short daily walk will help.
• Connect with other people doing things you enjoy.
• Spend time with a pet.
• Share your fears and concerns with someone close to you. This can help you feel less alone.
• Spend time outside in the fresh air. A change of scenery might lift your spirits.
• List activities you would like to do and plan to do one of these activities each day.
• Write down your feelings or express yourself in painting, colouring, music or singing.
• Establish a routine. Get up at the same time each morning. Make an effort to have a shower and get dressed.
• Allow yourself a “low mood day” every now and again. You don’t have to be “up” every day.
• Practise letting your thoughts come and go without getting caught up in them. Try to focus on the present moment, rather than worrying about upcoming check-ups or tests. You may find Cancer Council’s ‘Finding Calm During Cancer podcast’ helpful with this.
• Keep a record of positive things that happen each day. These don’t have to be big things, it could just be an encouraging smile from a neighbour.

Download our booklet ‘Emotions and Cancer’