Things Cancer Patients Feel They Cannot Say Out Loud

This page is for people with cancer who have thoughts they feel they cannot share. It covers the most common ones, why keeping them in has a cost, and where they can safely be said.

The thoughts people swallow during cancer turn out to be remarkably similar from person to person. That is the most useful thing about them. A reaction shared by that many people comes from the situation, not from a flaw in you.

Among the most common:

• Relief, when a diagnosis finally explains months of being told nothing was wrong.
• Resentment of healthy friends whose plans continue while yours are on hold.
• Boredom. Cancer is often tedious, and nobody warns you.
• Anger at a partner or caregiver who is clearly doing their best.
• Not wanting visitors, or wanting them to leave.
• Envy of someone with an earlier stage.
• Wanting to skip a treatment cycle.
• Wishing the whole thing would just be over.
• Not caring about someone else's news.
• In people who are told constantly how well they are doing, a flat refusal to feel inspired by any of it.

Holding these in is not free. Researchers call the feeling of being unable to talk about your illness "social constraints." Self-editing takes continuous effort and removes any chance of the thought being met, shared, or corrected.

NCI says that if you are having trouble coping with cancer, it may help to talk with a professional about your worries. It also lists group support and self-help groups as approaches that can ease anxiety and low mood.

Usually for kind reasons. You do not want to frighten your family. You have noticed that certain sentences make people flinch, so you stop saying them. You have been cast as the one coping well, and breaking out of that role takes energy you do not have. Some of it is protective. People fear that saying a dark thing out loud will make it more real, or will be read as giving up.

None of these thoughts are predictive. Wanting to skip a cycle does not mean you will. Resenting a friend does not end the friendship. Feeling nothing at a moment when everyone expects emotion is common and usually temporary.

Some places are built for this. Your doctor can refer you to a social worker, a mental health professional or a pastoral counselor. Ask your team for a referral. It is a routine request.

Support groups have a different advantage. Other members may have had the same thought, so it may need less explaining.

If the whole idea of speaking is too much, writing works. A private note, unsent and unread, still gets the thought out of the loop it is running in.

If a thought is too raw to state directly, a smaller version often opens the same conversation:

• "I'm finding this more boring than frightening, which surprises me."
• "I don't have anything positive to say today and I don't want to try."
• "I'm having a resentful week. It isn't about you."
• "Can you not tell me about anyone else's cancer for a while?"

These are complete and they do not require the listener to fix anything.

Wanting treatment to stop, or wanting the uncertainty over, is different from wanting to be dead — though they can sound similar out loud.

If the thought is about ending your life, call or text 988 now. The Suicide and Crisis Lifeline answers around the clock, and you do not need to be in crisis to use it. If you have worked out how you would do it, or you have the means nearby, call 911 or go to an emergency department instead of waiting. Do not leave this for a clinic call the next morning.

Tell your oncology team as well, once you are safe. That is a medical situation with treatment available, and raising it does not change your cancer care.

• NCI PDQ: Adjustment to Cancer — Anxiety and Distress
• NCI PDQ: Depression