Common reactions

The first reaction to a cancer diagnosis is often shock – you may feel numb, as if you aren’t feeling any emotion. It may take time to accept that you have cancer, especially if you don’t feel sick. This numbness can protect you as you gradually come to terms with the diagnosis.

Some people may never fully accept the diagnosis. Over time, denial can make it harder to accept the demands of treatment, so always talk to your cancer specialist and care team about how you are feeling.

Cancer treatments and outcomes have greatly improved in recent years, but it can still be frightening to hear the word “cancer”. It’s natural to worry about the treatment, side effects, test results and the long-term outcome, as well as how the cancer diagnosis will affect your family, work and other responsibilities. Most people cope better when they learn more about the diagnosis and treatment options, and then develop a plan for how they will manage the practical issues. The period before a new treatment begins can be particularly stressful, but you may find that you feel calmer once treatment is underway.

In times of stress, your body releases adrenaline, your heart might beat faster, your blood pressure often goes up, your breathing can become shallow and rapid, your hands may get sweaty, and your mouth can go dry. These natural reactions are part of the body’s “fight or flight” response to danger, allowing people to react quickly to a sudden threat. For most people, these feelings settle, but for others they can cause panic attacks or make you irritable and short-tempered. If stress and anxiety are ongoing, it can affect the way you think and react to events and people around you.

Panic attacks

For some people, severe anxiety or fear can lead to panic attacks. These might happen in a particular situation, such as having a medical test in an enclosed space or before a medical procedure, but sometimes there is no clear trigger.

A panic attack can happen suddenly and be very alarming. It can include symptoms such as shortness of breath, racing heartbeat, dizziness,  sweating, shaking, chest pain, a choking feeling and overwhelming fear. Some people feel a strong urge to escape a situation, even when there is no immediate physical threat or danger. In a panic attack, these sensations may be intense, but they will normally peak and pass within a few minutes. However, they can also be symptoms of a heart attack and other serious health conditions. Call Triple Zero (000) if symptoms occur unexpectedly, do not pass quickly, or if you are unsure.

If you have panic attacks after a cancer diagnosis, whether or not you have had them before, it is important to talk to your doctor or psychologist about ways to manage them. 

When faced with a cancer diagnosis, it is common to ask, “Why me?” You may feel angry with your family or friends, health professionals, the world, or even yourself, especially if the cancer is diagnosed late. Cancer often does not cause any symptoms in the early stages, or it may cause symptoms that are more likely to be explained by other conditions. This means it can take some time to get a diagnosis. It is natural to try to work out why the cancer started. We may know some of the risk factors for the cancer, but you may never have a clear answer. It is important to remember that no-one deserves cancer.

People with cancer often say that their main concern is for the people they love and that they feel guilty about putting them through such a stressful time. If you are worried about this, it may help to share your feelings with someone neutral, such as a psychologist.

Feeling sad after a cancer diagnosis is common. It is a natural response to loss and disappointment. You may be grieving the way cancer has changed your day-to-day life, your body or your future. If you have continued feelings of sadness, have trouble getting up in the morning, or have lost motivation to do things that previously gave you pleasure, you may be experiencing depression.

Cancer can be isolating, even with many people to support you. You might feel lonely if your family and friends have trouble understanding and coping with your diagnosis, or if you are too sick to work, socialise with others or enjoy your usual activities. You may also be at home more if you are concerned about viruses such as COVID-19 or the flu. This might be the time to consider new ways to connect with other people, such as through a telephone or online support group.

Being told you have cancer can be overwhelming and you may feel that your emotions are out of control. It may also seem that you are losing control of your life – some people feel helpless or powerless. This can be difficult, especially if you are used to being independent or being the one who takes care of everyone else. It can help to control those things you can, such as by creating a plan to manage side effects. Feeling physically better can help you to feel emotionally better too.

The physical and emotional effects of cancer and its treatment can influence each other. Let your treatment team know if you have any new or ongoing side effects.

Pain and fatigue

Cancer does not always cause pain, but if it does, tell your treatment team, as there are now many ways to relieve pain. The most common treatment side effect is fatigue – feeling exhausted and lacking energy for day-to-day activities. Fatigue differs from normal tiredness as it often doesn’t go
away with rest or sleep. This feeling can also be a symptom of depression.

Appetite changes

Your appetite might change if you feel unwell, anxious or depressed, or because of the physical effects of cancer or treatment. Some people lose their appetite, while others find they eat more. A change in your appetite or weight can leave you feeling distressed.

Appearance changes

Cancer treatments can cause changes to your appearance, such as hair loss or loss of a body part. Whether these changes are temporary or permanent, they can affect the way you feel about yourself (your self-esteem) and leave you feeling self-conscious and less confident.

Sexuality issues

Certain cancer treatments directly affect the body’s sexual organs or hormone balance, but any cancer treatment can reduce your interest in sex. You may feel tired and unwell, or you may be too worried to think about sex. You might also feel less confident about your body. A low sex drive (libido) can also be a symptom of depression. Libido often improves after cancer treatment finishes, but for some people the effect is ongoing.

Fertility issues

Some cancer treatments affect the reproductive organs, which may lead to temporary or permanent infertility. This means it may no longer be possible to conceive a child. You may feel devastated if you are unable to have children and may worry about how it will affect your relationship or future relationships. You may also feel a sense of loss even if your family is complete or you were not planning to have children.

Thinking and memory changes

Some people diagnosed with cancer notice changes in the way they think and remember information. This is often called “chemo brain”, but it can happen even if you don’t have chemotherapy. It is also known as “brain fog” or “cancer-related cognitive impairment”. These changes are often temporary and get better with time, but they can have a big impact on your emotional wellbeing.

Australia’s rates of cancer survival have greatly increased over time. Treatments are improving constantly, and if the cancer can’t be controlled, symptoms can be managed to make life more comfortable. Even so, it can be hard to feel hopeful just after a cancer diagnosis.

Worrying about the future is natural. It can be confronting to think about your own mortality, even if the outlook for your type of cancer is reassuring. Talk to your doctor about what the diagnosis means for you and what the future may hold. Knowing more about the illness may help ease your fears and give you a sense of control. Connecting with others who have a similar diagnosis can also help you find hope.

If you’ve been told the cancer is advanced, you may find it harder to feel hopeful. In some cases, advanced cancer can be controlled for many years. When time is limited, people often focus on goals such as finishing a special project or spending time with family and friends.

Does thinking positively help?

A common belief is that people with cancer need to stay positive. Hope is important, but trying to put on a brave face all the time can feel very  draining and often doesn’t work well. The reality is that cancer and its treatment can be unpleasant and frightening, and it is okay not to feel great about that. The pressure to be positive can sometimes make it hard for people to discuss their feelings and reach out for support.

Try to be realistic about what is happening. It is often a good idea to talk to someone about your fears and concerns and how you feel you are coping. Sharing your feelings with those around you may also help you get the support you need.