Emotions and cancer

When you are diagnosed with cancer, it is often difficult to take in the news immediately. You might hear the words, but not be able to absorb them or believe them. Most people feel overwhelmed at first.

The weeks after diagnosis can be stressful as you weigh up your options. You may feel like it is all happening too fast – or too slowly. People often feel anxious about treatments, side effects and whether they are making the right decision. You may also wonder about how cancer will change you and your life.

Cancer treatments can be physically demanding and disrupt all your usual routines. You may also need to deal with practical issues such as travelling to treatment, paying for tests and treatments, getting time off work, and managing family responsibilities.

The physical and emotional impacts of cancer are linked. Side effects of treatment can make it harder to cope emotionally, while emotional distress may make physical side effects worse. The good news is many side effects can now be well managed.

Many people are puzzled if their mood doesn’t improve as soon as treatment ends. This can be a time of great personal change as you think about your priorities and adjust to any long-term impacts. It is common to feel concerned about the cancer returning, especially when you have follow-up tests.

It can be devastating to find out that the cancer is advanced at first diagnosis, or that it has returned after the initial treatment. If this is the case for you, you and your family and carers may find it helpful to see a counsellor or call Cancer Council 13 11 20.

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.

A coping toolbox is a set of strategies or “tools” you can use to help you cope with a cancer diagnosis and treatment. Each person’s toolbox will look different, but it’s useful to consider a range of strategies.

Some of the tips below offer ways to solve particular problems; others aim to enhance your general wellbeing during this stressful time. If you’d like support with developing your coping toolbox, call Cancer Council 13 11 20.

Find out what to expect – Getting information about cancer and how it is treated can help you make decisions, plan ahead and feel more secure.

Be active – Research has shown that regular physical activity can help with feelings of anger, stress, anxiety and depression. It can also help boost your energy levels and improve sleep. Even a short daily walk can be effective. See our Exercise for People Living with Cancer booklet.

Seek support – Share your concerns with a family member or friend, or with your general practitioner (GP), nurse, social worker or psychologist. You could also call Cancer Council 13 11 20, visit the Online Community or join a support group. Accepting help with housework and other chores may also make it easier to cope.

Eat and drink well – Eating healthy food and drinking plenty of water will help your body cope with physical and emotional stress. This can be challenging when you are feeling unwell. Talk to a dietitian and see our Nutrition and Cancer booklet for tips.

Take a break – Make time each day just for relaxation and enjoyment. Think about things that help you to relax and feel good, such as reading, listening to music, taking a bath or having a massage. Keeping in touch with the world through work, hobbies, or time with family and friends may help you connect with your life outside of cancer and provide a break from your worries.

Sort out issues – A cancer diagnosis can cause or add to financial problems, work-related issues, accommodation difficulties, relationship concerns and family stresses. There is support available – talk to the hospital social worker or call Cancer Council 13 11 20.

Clear your mind – Complementary therapies, such as relaxation, massage, yoga and counselling, may increase your sense of control, decrease stress and anxiety, and improve mood.

Draw on spirituality – Some people find meaning and comfort in their faith. Others may see spirituality more generally. A cancer diagnosis can challenge deeply held beliefs. It could help to talk with a spiritual care practitioner or religious leader.

When you are first diagnosed, there is a lot of information to take in – and well-meaning family and friends may give you even more. This “information overload” can leave you overwhelmed and confused about what to do. You may need just the information that relates to your situation right now, or a way of dealing with the information that you already have.

Look for reliable information – Make sure your information comes from recognised cancer experts and is based on strong evidence. Cancer Council has booklets, online information and podcasts about different cancer types, treatments and issues.

Ask questions – If you are unsure or confused about anything, it can help to talk to your treatment team. Write down your questions beforehand and put them in order of how important they are right now. You can also call Cancer Council 13 11 20 to discuss your concerns with an experienced health professional.

Involve other people – Ask people you trust to help gather and make sense of new information. You could also ask your partner or a close family member or friend to come to your appointments with you. Let them know if you’d like them to take notes or join in the discussion.

Find out about suitable clinical trials – Your doctor or nurse may suggest you take part in a clinical trial. Doctors run clinical trials to test new or modified treatments to see if they are better than current methods. Over the years, trials have led to better outcomes for people with cancer. You can find trials at australiancancertrials.gov.au.

Get organised – Start a filing system for all your test results, information and records. You also have the option of using My Health Record, an online system provided by the Australian Government.

Keep a diary – You can use a paper diary or smartphone app to keep track of appointments and side effects. This will also be a useful record in the future (especially if you are seeing different health professionals).

Update your affairs – Many people with cancer review their insurance and superannuation policies and update their will and other legal documents. This doesn’t mean you have given up hope – everyone needs to do these things at some point and you might feel relieved once they are done. Cancer Council’s Legal and Financial Referral Services can connect you with qualified professionals – call 13 11 20 to find out more.

Find support – There are many ways to connect with other people in a similar situation. Cancer Council runs face-to-face and telephone support groups, or can put you in touch with someone who has had a similar cancer experience. You could also join our online discussion forum.

After a cancer diagnosis, you will probably need to make a number of decisions. These could include which treatments to have, how to involve or care for your family and friends, whether or when to return to work, and what to do about finances.

Know your options – Understanding the disease, the available treatments, possible side effects and any extra costs can help you weigh up the options and make well-informed decisions.

Take your time – Check with your specialist how soon treatment should begin. If it is safe to wait a short while, use that time to think about your decisions. Generally, people find it easier to make decisions (and have fewer regrets later) if they take time to gather information and think about the possible consequences.

Get expert advice – Ask your health professionals to clearly explain your treatment options, and the benefits and side effects of each. For non-medical concerns, you can ask to speak to the social worker at the hospital or treatment centre. The social worker can advise you and your carer about issues such as financial assistance, how to get extra help at home, and support for relationship or emotional difficulties. You can also call Cancer Council 13 11 20 for information and support.

Write it down – Organising your thoughts on paper can often be easier than trying to work everything out in your head. Start by identifying the purpose of the treatment (is it to cure the cancer, to control the cancer, or to keep you as comfortable as possible?), then list the pros and cons of each treatment option. You could rate how important each point is on a scale of 1–5, considering the short-term and long-term effects on you and others.

Decision aids are online or printed resources that help you choose between treatment options. You answer questions that help you focus on what matters most to you. There are decision aids for a range of cancer-related issues, such as whether to have breast reconstruction or whether to have treatment for early prostate cancer. Ask your treatment team if there is a decision aid for your situation.

Talk it over – Discuss the options with those close to you, such as your partner, family members and close friends. You may feel worried about how your decisions will affect them, so hearing their opinions could put your mind at rest. Sometimes you might prefer to talk to someone neutral, such as a member of your treatment team or one of the experienced health professionals at Cancer Council 13 11 20.

Consider a second opinion – You may want to get a second opinion to confirm or clarify your specialist’s recommendations or just to check you have explored all the options. Specialists are used to people doing this. Your GP or specialist can refer you to another specialist and send your test results to them. You can get a second opinion even if you have started treatment or still want to be treated by your first specialist. You might decide you prefer the second specialist.

Expect to have doubts – Feeling unsure does not mean you have taken the wrong path. Reassure yourself that you made the best decisions you could with the information you had at the time. And remember that decisions are not always final – it may be possible to change your mind even after you have started down a particular treatment path.

Remember it’s your decision – Adults have the right to accept or refuse any treatment that they are offered. For example, some people with advanced cancer choose treatment that has significant side effects even if it gives only a small benefit for a short period of time. Others decide to focus their treatment on quality of life. You may want to discuss your decision with the treatment team, GP, family and friends.

Download our booklet ‘Cancer Care and Your Rights’

Complementary therapies, such as relaxation, meditation, massage, art therapy and counselling, are widely used alongside conventional cancer treatments such as surgery, chemotherapy and radiation therapy. Many complementary therapies focus on a mind–body connection. They may offer physical, emotional and spiritual support, help reduce side effects from medical treatment, and improve quality of life.

Relaxation and meditation – These therapies can help reduce stress, anxiety and fatigue, and improve quality of life.

• Relaxation usually includes slow breathing and muscle-loosening exercises to physically and mentally calm the body.
• Meditation involves focusing on a single thing, such as breathing, to clear the mind and calm the emotions.
• Mindfulness meditation helps you to take things one day at a time. It allows you to focus more easily on the present moment, rather than worrying about the past or fearing the future.
• Body-based practices such as yoga, tai chi and qi gong combine a series of movements with breathing and meditation exercises to improve strength and flexibility while reducing stress and anxiety.
• Hands-on therapies such as massage and reiki are available in some cancer centres. In a massage session, the therapist helps release tension by applying pressure to your muscles. In a reiki session, the therapist gently places their hands on or slightly above your body – many people find this calming and relaxing.

Counselling – Through discussions with a counsellor, social worker or psychologist, you can identify problems and explore ways of managing unhelpful thoughts and feelings.

Counselling sessions allow you to express your emotions in a safe and supportive environment and learn new coping skills. They can provide an opportunity to talk about thoughts and feelings that you might not feel comfortable sharing with family and friends.

Art therapy – This technique uses visual art (e.g. drawing, painting, collage, sculpture, digital work) to express feelings. It can be done individually or in groups, and some hospitals run programs. You do not need artistic talent to join in or benefit – the focus is on the process of making the artwork, not the end result. An art therapist helps you explore the images you have created to encourage understanding of your emotions and concerns.

Let your doctor know about any other therapies you are using or thinking about trying. Some may not be helpful and could cause problems if used with some medical treatments.

Complementary therapies are used alongside conventional medical treatments, while alternative therapies are used instead of conventional medical treatments. Alternative therapies are unlikely to be scientifically tested, may prevent successful treatment of the cancer and can be harmful. Cancer Council does not recommend the use of alternative therapies as a cancer treatment.

Download our booklet ‘Understanding Complementary Therapies’

People affected by cancer may find themselves going over and over the same distressing thoughts about the past, present or future. Ignoring such thoughts or trying to distract yourself may work at first, but they often return once you are no longer distracted – for example, during the middle of the night or early in the morning. The strategies listed below may be a helpful starting point if you are finding it hard to manage your thoughts. To learn more, you can explore resources such as apps and podcasts or seek support from a professional.

Identify where the thoughts come from – Ask yourself if your thoughts are the result of an underlying belief, such as “The world should be a fair and just place”, “If I can’t do everything I used to do, I am useless” or “I am a burden to my family and friends”. Or perhaps you tend to give personal meaning to everything that is happening, even to events that are beyond your control. For example, if you arrive at the treatment centre and can’t find a parking spot, you might think, “Nothing ever goes right for me. I don’t know why I’m bothering with the treatment, I know it won’t work.”

Consider your own advice – Think of someone you love and imagine what you would say to them if they felt the same way. Check your thoughts – Ask yourself if you are jumping to conclusions or exaggerating the negatives. If so, is there something you can do to change the situation or improve it?

Write down your thoughts – This helps slow down your thinking and improves your ability to focus. It may also make it easier to work out if a thought is based on facts and if it is realistic or helpful. This can create an opportunity for you to challenge unhelpful ways of thinking.

Recognise the little positives – Some days it might be hard to find something positive. This is understandable, but if you feel like that every day, check whether you are ignoring any little achievements or happy events. Some people make a habit of writing down three good things that have happened to them each day. These don’t have to be major life events – they could just be an encouraging smile from a radiographer or a nice chat with a receptionist on a tough day.

Practise letting your thoughts come and go – It is important to remember that thoughts are fleeting. We tend to notice some, but there are many we don’t notice. Try to let your thoughts come and go without getting caught up in them. You could imagine they are clouds in the sky or leaves floating down a stream. Cancer Council’s Finding Calm During Cancer podcast may help you practise this.

Be kind to yourself – Use encouraging thoughts to talk yourself through difficulties, rather than criticising yourself (e.g. you could congratulate yourself for getting through a treatment session). This does not come naturally to most people, but counsellors and psychologists can teach you techniques to help you be kinder to yourself.

Seek professional help – Social workers, psychologists and other health professionals are trained to help people manage how they’re feeling. Check what support is available at your treatment centre or ask your GP for a referral.

It can be helpful to track how you’re feeling, and some people use free online self-help programs or smartphone apps to do this. You could visit moodgym.com.au, mindspot.org.au or thiswayup.org.au, or see the list of health and wellbeing apps at healthdirect.gov.au/health-and-wellbeing-apps.

Sleep can help your body cope with the physical and emotional demands of cancer treatment. You may find your sleep is affected by worry, pain, nausea, menopause symptoms (e.g. hot flushes) and some medicines (e.g. steroids). If you are less physically active during treatment, your body may not be as tired and you could find it harder to sleep. Feeling sad or depressed can also make it difficult to sleep well at night.

Ways to improve sleep

• Try to go to bed at the same time every night and get up at the same time every day.
• Do some physical activity each day, but avoid vigorous exercise just before bed.
• Put screens away an hour before bedtime and do something relaxing – have a bath, read, or listen to music.
• Avoid coffee, tea, chocolate, cola and energy drinks after early afternoon.
• Avoid alcohol before bed. It may seem to help you relax and fall asleep, but it can keep you from getting quality sleep and feeling rested when you wake.
• Eat medium-sized meals in the evening. Your sleep can be disrupted if you go to bed hungry, but also if you have indigestion after eating a big meal.
• Limit naps to 10–30 minutes and take them before 3pm.
• Use relaxation practices before bed. Our Finding Calm During Cancer podcast has a sleep track.
• Keep your bedroom as dark, cool and quiet as possible.
• If you can’t sleep, get up and sit on the couch until you feel sleepy. Keep lights low and try doing something boring that you can easily put down when you are
  ready to sleep again.

When you feel ready, decide who to tell and what to say. To prepare for these conversations, you could:

• choose a quiet time and place, if possible
• ask your partner or another close support person to be with you when you are telling others
• think of answers to likely questions (but only answer if you want to – you don’t have to share every detail) accept that the person you are telling may get upset – you may find yourself comforting them, even though you are the one with cancer
• get help finding the right words – for example, you could meet with the hospital social worker or call Cancer Council 13 11 20 to talk through what you might say.

The reactions from your family and friends will depend on many factors, including their previous experience of cancer and their own coping styles. Sometimes people respond in ways that may make you feel hurt, angry or frustrated. Their reactions may include:

Becoming very distressed – People often have a strong emotional reaction to the word “cancer”, but they may not be aware that cancer treatments and outcomes are improving all the time.

Saying the wrong thing – People often don’t know what to say. They may appear too positive or make light of your situation, or they may even say something tactless or ill-informed. Try not to take their initial reactions as a sign that they don’t care. They may need as much information, support and advice as you do. They might be fearful of losing you, frustrated they can’t do anything about the disease, or worried about how the illness will change their life.

In some cultures, cancer may be seen as contagious, sent to test you, caused by bad luck or always fatal. People may not want to talk about it openly and may not want to use the word “cancer”. If it is hard to talk about cancer within your community, try approaching a community leader to help you, or call
Cancer Council 13 11 20 for confidential support.

Giving unhelpful advice – In their eagerness to help, people might offer confusing advice or want you to try new “miracle cures” that aren’t evidence-based. Let them know that you are making treatment decisions based on discussions with your medical team. Explain that every cancer is different and you need to follow the advice of experts.

Withdrawing from you – Some friends may seem to avoid you. They might feel like they can’t cope with what you’re going through. If you think not knowing what to say is stopping a friend visiting you, you could call them to put them at ease. You may find that talking openly about the illness and treatment helps everyone. Give your family and friends time to adjust to the diagnosis. After the initial shock, most people will be supportive.

How to manage misunderstandings

After a cancer diagnosis, communication becomes even more important in your relationships. If you feel hurt by the reaction of someone close to you, a conversation may help clear the air:

• Make time to talk. Don’t wait for the “right” time – it may never come.
• Be honest about what you are thinking and feeling.
• Focus on understanding each other – at least at first, this can be more important than trying to solve the problem.
• Really listen to what the other person is trying to say and try to understand where they are coming from.

When you are diagnosed with cancer, one of your concerns might be how to tell any young people in your life. Talking to young kids and teenagers about cancer can feel difficult and overwhelming. Parents and other adults can feel overcome by their own anxiety and fears, and their first impulse may be to protect children from feeling these same strong emotions. Some parents avoid telling their children about the cancer. Others wait until treatment starts and side effects, such as hair loss or nausea, are noticeable. Most children sense that something is wrong and may imagine the worst. They may also feel angry and confused if they find out from someone else.

Research shows that when someone close is diagnosed with cancer, children usually cope better if they are told about it, in a way that suits their age and stage of development. With planning, practice and support from family or health professionals, most parents and other adults are able to talk to kids about cancer. If you have children, your treatment team can set up an appointment just for them to ask questions.

Try not to pressure yourself – there is no “perfect” way to tell children, and the way children react to your diagnosis and treatment will vary. The important thing is to have open communication over time so there are lots of opportunities to talk.

Older children may be worried about burdening you with how they are feeling, so make sure they have a trusted person outside their immediate family circle who they can talk to about the situation.

Download our ‘Talking to Kids About Cancer’ booklet

Download our ‘Cancer in the School Community’ booklet

Listen to our ‘Explaining Cancer to Kids’ podcast

Your own physical health and emotions are likely to change during and after cancer treatment. It may be hard to let your friends and family know how you’re feeling, and they may find it hard to ask.

Decide how much to share – Sometimes you will switch between wanting to talk about what’s going on and wanting to avoid difficult thoughts and feelings. It is okay to say no – whether it is about discussing your personal concerns or in response to an offer of help.

Choose a key contact – Repeating the same information to everyone in your network can be draining, and you may not always feel up to phone calls or visitors. It can be helpful for one carer, family member or friend to act as the main point of contact. They can answer inquiries, monitor calls, or keep visits to more suitable times.

Get creative – If you are having trouble expressing how you are feeling, you could try keeping a journal or blog, or you may prefer to make music, draw, paint or craft. You can choose whether to share your writing or artworks with those close to you or to keep them for yourself.

Use technology – You could leave a message on your voicemail or answering machine giving a quick update; send text messages or emails; or share the latest news through social media, such as a closed Facebook group or apps.

Many people feel anxious and frightened about the cancer coming back (recurrence), especially in the first year after treatment finishes. For some people, this worry may affect their ability to enjoy life and make plans for the future.

People often say that with time their fears lessen, but the worry tends to return at particular times, such as:

• before any follow-up appointments, tests and scans
• special occasions (e.g. birthdays, holidays)
• anniversaries of their diagnosis, surgery or end of treatment
• when they read or hear of someone else’s experience with cancer.

Ways to manage the fear of recurrence

• Talk to a medical professional about your risk of recurrence.
• Focus on what you can control – for instance, being involved in your follow-up appointments and making changes to your lifestyle.
• Recognise the signs of stress, such as a racing heartbeat or sleeplessness, and manage these in a healthy way. For example, you could try meditation, relaxation or exercise.
• Join a support group to discuss your concerns with other people who have had cancer. Ask your treatment centre or call Cancer Council 13 11 20 to find out about face-to-face, telephone and online support groups.
• Speak to a counsellor, psychologist or social worker if you are finding that the fear of recurrence is overwhelming. They may be able to help you balance your thinking or have a more helpful frame of mind.

People are often willing to help if they know what you need. Family and friends can support you in different ways. Some people will be able to talk about the cancer and comfort you if you are upset. Other people may prefer to offer practical support. If you have a partner or another person providing most of your care, an important role for other family members and friends may be to support that carer.

Some people like to use an app on their smartphone or computer, such as CanDo, LOVLIST or Caringbridge. These apps allow you to list tasks and set up a roster so people can choose activities that match their availability and interests. The apps can also be a convenient way to share updates with your social circle.

The suggestions below may be a useful prompt when people say, “Let me know if you need anything.”

Provide practical support

• prepare meals
• do household chores
• go grocery shopping
• drive you to appointments
• share an after-school roster
• help you exercise

Keep others informed

• screen calls and emails
• act as the main point of contact for family and friends
• coordinate offers of support
• update social media

Offer companionship

• keep you company
• listen patiently without trying to solve your problems

Keep you involved

• get you out and about
• talk about other things apart from cancer

Listen to our ‘How to Help Someone with Cancer’ podcast

It’s not unusual for people to find themselves alone at some points in their life. Having a serious illness when you feel that you have no close family or friends can be especially hard, but you don’t have to cope by yourself. The hospital social worker can link you with local services. Other sources of support could include not-for-profit organisations, including Cancer Council SA and cancer-specific groups (such as Breast Cancer Network Australia and Prostate Cancer Foundation of Australia), and community and faith-based groups. If you have children, their school may have a school counsellor or offer other types of support.

If you want to talk about the diagnosis or how you’re coping with treatment and side effects, you may want to connect with a support group, either in person, over the phone or online. In a support group, people can share tips and insights with others who have gone through, or are going through, a similar experience. Some people say they can be more open and honest in a support group because they aren’t trying to protect those close to them. You may find it easier to talk about your diagnosis and treatment, your relationships with friends and family, and your hopes and fears for the future.

To find out which support groups are available in your area, call Cancer Council 13 11 20 or ask your nurse or social worker.

While almost everyone with cancer experiences distress at some point, it can be hard to know if how you are feeling is a typical reaction or something more serious. If you talk to a health professional about your concerns, they are likely to use a standard method to measure how you are feeling. For example, you may be asked to rate your distress over the past week on a scale of 0 to 10 (often known as a “distress thermometer”) and complete a checklist of problems.

Warning signs of anxiety and 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 anxious or depressed. If this is the case for you or someone you care about, it is important to seek help. You may need to seek professional help if you:

• find it difficult to function on a daily basis
• have lost the desire to do things that previously gave you pleasure
• find you are feeling depressed most of the day, nearly every day
• begin to rely on alcohol or recreational drugs
• stop eating regularly (unless the loss of appetite is an expected side effect of the cancer treatment)
• are sleeping too much or having a lot of trouble sleeping
• are worried you might hurt someone because of your anger
• think about self-harm or taking your own life.

Anxiety and depression are quite common among people who have had cancer, but there is no need to face this experience alone. Talk to your cancer care team or GP and discuss whether counselling or medicatGPion – even for a short time – may help. You can also call Cancer Council 13 11 20, or get in touch with Beyond Blue on 1300 22 4636 or at 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).

GP – Your GP can assist you with treatment decisions and works in partnership with your specialists in providing ongoing care. They can refer you to other health professionals for support with managing emotions or thoughts. Check with your GP to see if you can access Medicare rebates for sessions with a psychologist or social worker.

Cancer care team – The team at your hospital or cancer treatment centre will often include social workers, psychologists, psychiatrists and spiritual care practitioners. If you let your cancer specialist, cancer care coordinator or cancer nurse know how you are feeling, they can arrange for you to see these other health professionals as needed.

Psycho-oncologist – A psycho-oncologist is a social worker, psychologist or psychiatrist who has specialised in the field of cancer care (oncology). They provide support to people with cancer and their families and carers, and often work in hospitals and cancer treatment centres.

Counsellor – Counsellors can listen to what is going on in your life and offer strategies for dealing with issues you are facing. They do not need to have any qualifications to practise, although many do, so it’s a good idea to check before making an appointment. Cancer Council SA provides a free counselling program. Call Cancer Council 13 11 20 for more information.

Social worker – Social workers provide emotional support, arrange practical and financial assistance, and help people find support services. They must complete a four-year undergraduate or two-year postgraduate degree.

Psychologist or Clinical Psychologist – Psychologists use evidence-based strategies to help you manage emotional conditions, usually in the long term. A registered psychologist must complete four years of psychology at undergraduate level, followed by either postgraduate studies in clinical or health psychology or two years of supervised clinical practice.

Psychiatrist – A psychiatrist is a trained medical doctor who specialises in the diagnosis, treatment and prevention of mental illness. As well as providing psychological support and discussing issues with patients, a psychiatrist may prescribe medicines to help manage a range of emotional conditions. You need
a referral from your GP to see a psychiatrist.

Mental Health Nurse – The role of a mental health nurse includes assessing people, giving medicines and assisting in behaviour modification programs. They must be a registered nurse who has completed further study in mental health nursing.

Spiritual Care Practitioner – Also known as a pastoral carer, a spiritual care practitioner is often a member of the team at hospitals and cancer treatment centres. They can discuss emotional and spiritual matters and help you reflect on your life and search for meaning. They can also arrange prayer services and other religious rituals, if appropriate.

Cancer Council  – If you want to talk through your concerns or you’re not sure where to go for help, you can talk to an experienced health professional by calling Cancer Council 13 11 20.

A cancer diagnosis can affect every aspect of your life and often creates practical and financial issues.

There are many sources of support and information available to help you, your family and carers navigate all stages of the cancer experience, including:

• information about cancer and its treatment
• access to benefits and programs to ease the financial impact of cancer treatment, such as help with the cost of prescription  medicines, transport costs, utility bills (e.g. electricity, gas, water, phone, internet) or basic legal advice
• home care services, such as Meals on Wheels, visiting nurses and home help
• aids and appliances to make life easier at home
• support groups and programs
• counselling services.

The availability of services may vary depending on where you live, and some services will be free but others might have a cost.

To find good sources of support and information, you can talk to the social worker or nurse at your hospital or treatment centre, or get in touch with Cancer Council 13 11 20.

Download our ‘Cancer and Your Finances’ booklet

Download our ‘Cancer, Work & You’ booklet

Cancer Council SA offers a range of services to support people affected by cancer, their families and friends. 

Cancer Council 13 11 20 – Our experienced health professionals will answer any questions you have about your situation and link you to local services.

Information resources – Cancer Council produces booklets and fact sheets on more than 25 types of cancer, as well as treatments, emotional and practical issues, and recovery. Request your free copies by calling 13 11 20, emailing resourceorders@cancersa.org.au or order online.

Legal and financial support – If you need advice on legal or financial issues, we can refer you to qualified professionals. These services are free for people who can’t afford to pay. Financial assistance may also be available. Call Cancer Council 13 11 20 to ask if you are eligible.

Peer support services – You might find it helpful to share your thoughts and experiences with other people affected by cancer. Cancer Council SA can link you with individuals or support groups by phone, in person, or online. Call 13 11 20 for more information.

Practical help – Cancer Council can help you find services or offer guidance to manage the practical impacts of cancer. This may include helping you access accommodation and transport services.