Emotional Distress and Cancer

This page is for people with cancer and the people who care for them. It covers the feelings many people have, the signs that need medical care, and ways to cope.

Just as cancer affects your physical health, it can bring up a wide range of emotions you're not used to dealing with. It can also make familiar feelings more intense. They may change daily, hourly, or even minute to minute. That is true whether you're in treatment, done with treatment, or caring for someone who is. The National Cancer Institute is direct about this: these feelings are all normal.

There is no one right way to cope. Some people feel they have to be strong and protect their families. Others turn to loved ones, other survivors, counselors, or their faith. What matters is doing what's right for you — not comparing yourself with others.

It can help to put a name to what you feel. Here are feelings many people with cancer describe.

• Overwhelmed. When you first learn you have cancer, it's normal to feel like life is out of control. Routines are disrupted and medical terms are new.
• Fear and worry. These can be about pain, about looking or feeling different, about family, bills, work, and dying. NCI says most people feel better when they learn the facts, because they feel less afraid and know what to expect.
• Stress and anxiety. Worry over insurance, rides, work, and daily routines is common. Anxiety can show up in the body. Signs include a rapid heartbeat, headaches or muscle pains, trouble eating, nausea, shakiness, sleep problems, or trouble concentrating. Tell your doctor about these signs. They're common with stress, but your team will want to rule out medicines or treatment as the cause.
• Anger. "Why me?" is a very normal question. NCI says anger often comes from feelings that are hard to show, such as fear, panic, frustration, anxiety, or helplessness. It's not healthy to keep it inside.
• Sadness and depression. Many people feel a sense of loss — of health, and of life before diagnosis. For some, painful feelings grow stronger and get in the way of daily life. That may be depression, which is common in people with cancer, and which can be treated.
• Loneliness and guilt. Friends may have a hard time dealing with cancer and may not call or visit. Even with people you care about, you may feel that no one understands. NCI's reminder: having cancer is not your fault. No one knows why some people get cancer and others don't.
• Hope and gratitude, too. Once treatment becomes routine, many people feel real hope. Millions of people who have had cancer are alive today.

Sometimes hard feelings become something more. Depression is a medical condition, not a character flaw. NCI lists signs such as sadness that doesn't go away, feeling emotionally numb, feeling guilty or unworthy, and feeling helpless or hopeless. Sleep problems and fatigue can also be signs. Thoughts of hurting yourself are a reason to get help at once. Use the steps in the next section right away.

NCI says depression can be treated, with medicine or a referral to other experts. NCI's advice: don't feel you should have to control these feelings on your own.

• Call 911 or go to an emergency department if you are thinking about ending your life and feel you might act on it, or you have already hurt yourself. Do not drive yourself.
• Call 911 or go to an emergency department if you are so frightened, agitated, or confused that you cannot keep yourself safe. Do not drive yourself.
• Call, text, or chat 988 right away if thoughts of suicide are in your head at all, even without any plan. The 988 Suicide and Crisis Lifeline answers 24 hours a day, every day of the year. You do not need to be in danger that minute to use it. Tell your care team as well, but reach 988 first. Do not sit on it waiting for a clinic to call back.
• Call your care team the same day if you have stopped eating, drinking, or taking your cancer medicines because of how you feel.
• Call your care team within a day or two if signs of depression have been with you for more than 2 weeks. Some of these symptoms come from physical problems or from medicines, which is exactly why they are worth raising.

Your care team can help with more than your cancer. Many people bring up these topics.

• Counseling and support groups. Ask your hospital social worker or nurse where to find resources, such as counselors, support groups, or a class on managing stress.
• Practical stress. Insurance, costs, rides, and help at home are real sources of stress. Raise them early with your care team.
• Physical side effects. Tell your team about pain, fatigue, and other side effects too, since they affect how you feel.

NCI describes strategies people find helpful:

• Talking about your feelings with family, friends, a counselor, or your faith community
• Not blaming yourself
• Letting yourself give in to your feelings sometimes
• Relaxation exercises, meditation, and guided imagery
• Gentle yoga
• Hobbies
• Joining a support group, in person or online