There’s no right or wrong
There is no right or wrong way to react when you are told your cancer is too advanced to cure. Everyone responds in their own way. For most of us, of course, this is very shocking news. Even if you thought it might happen, hearing it from your doctor can still be devastating. Some people become silent. They cannot believe what they are hearing and don’t know what to say or do. Some start to cry and feel as though they won’t be able to stop.
Others may become very angry and scared. Some people feel numb and as though they have no emotions. These are all very common reactions. You might find that many questions come into your mind. Why me? Do I deserve this? Why can’t you find a treatment to help me? There must be something that will stop this cancer – can’t you just try anything?
It is natural to feel desperate, upset, angry, or that you don’t believe the news. Be sure to give yourself the time and space to take in what is happening. You may want to be on your own. Or you may need to spend time with your partner, family or friends to help you deal with the news. Of course they may also be very upset and feel that they don’t know what to say. Even if all you can do at first is get upset together, that can be a huge help.
You may find that you have different feelings from other people with cancer. Everyone is different and you will deal with things in your own way, so you can take what you need to help you from this section. Ignore anything that doesn’t seem to apply to you or help you.
Shock is often the first reaction when a doctor tells someone they have life-threatening cancer. You may:
• Feel numb;
• Not believe what is happening;
• Be unable to express any emotion;
• Find that you can only take in small amounts of information; and
• Need to have the same information repeated to you.
Needing to have information repeated is a common reaction to shock. You just can’t take anything in at first. You may remember small amounts of information but do ask again if you cannot remember details. Your disbelief may be so strong that you find it difficult to talk about your illness with your family and friends, or you may find that you need to talk about it over and over again to help the news to sink in.
At times, it may feel like an emotional roller coaster. One day you might be quite positive and able to cope. But the next day you could feel so sad and anxious that coping might not seem so easy. All these feelings are completely natural.
Some people choose to cope with their situation by pretending it’s not happening. It’s not that this is necessarily a conscious decision. It can be a gut reaction. You may just feel overwhelmed that you can’t think about it whenever anyone brings the subject up. You may find that you:
• Don’t want to know anything about your cancer or treatment; or
• Prefer to talk about it as little as possible or not at all.
This is another completely natural reaction. If you feel this way, you can tell the people around you quite firmly that, for the time being, you don’t want to talk about your illness. But in extreme cases, denial can be unhelpful. Some people deny their cancer so firmly that they convince themselves that either they aren’t ill at all, or that their illness isn’t cancer. If this reaction makes your overall situation even worse, you may need professional help from a psychologist or counsellor.
Sharing your feelings
Sharing your fears and sadness with people you love and trust may be a great relief for you. Many people say that talking about their feelings helps them to cope. It also helps your friends and family to understand more about your situation. In turn, this will help them to help and support you. Other people find sharing their thoughts and emotions too difficult, and would rather keep things to themselves. It is important to do whatever feels best for you.
Don’t let other people pressure you into talking if you don’t feel ready. This is a very personal, emotional time. You can choose how you handle things. If you would like to talk, make sure you choose people you can talk to easily, who will understand how you feel and be able to support you. If, after some time, you still feel overwhelmed and that you can’t cope, try speaking to someone outside your immediate family and friends.
If you are by yourself
If you don’t have people nearby to help with practical things, you can ask for help. One of your health care team may be able to arrange volunteers to help out at home, or come to visit you in hospital. Ask your specialist cancer nurse or doctor about this.
Other people being in denial
Sometimes you may find denial happens the other way around. You may need to talk about your cancer, but your family and friends may be the ones in denial. They may:
• Try to dismiss the fact that you are ill;
• Seem to ignore the fact that you have cancer;
• Play down your anxieties and symptoms; or
• Deliberately change the subject.
People can react in this way because they are frightened of cancer themselves. They may be embarrassed by talking about it, or they may be terrified that someone they love has a life threatening condition. If they don’t talk about it, they can try to pretend it isn’t happening.
But if you want their support, and to share how you feel with them, this behaviour may hurt or upset you. If you feel like this, try to:
• Tell them how you feel;
• Reassure them that you know what is happening; and
• Explain that talking to them about your illness will help you.
If you are a friend or relative
Relatives and friends can help by:
• Listening carefully to everything the person with cancer says; and
• Not rushing into talking about the illness.
Sometimes it is enough just to listen, letting the person with cancer talk when they are ready. Take your cues from the person. If they get upset, that is okay. It can be a relief for them to be able to cry and say if they are finding things difficult. if the situation is very advanced, you may also find our Talking to Someone who is Dying page helpful.
Your feelings when you have advanced cancer
If your cancer is very advanced and you are facing the possibility of dying, all these feelings are likely to be very intense.
Understanding your feelings
Having negative feelings is very normal especially at diagnosis and can be very draining for you and the people around you. You might find that family and friends don’t understand, or they may try to tell you how you should feel. This can put a big strain on your close relationships. Having an open and frank discussion can help some people to become closer, more understanding and are therefore in a position to support you even more.
Asking for help
Talking about your situation really can help. If you would like to share your feelings with someone, but don’t feel you’re able to talk to your friends and family, it may help to talk to a counsellor.
Don’t feel you are being weak by asking for help or letting someone know how awful you feel. It is not a weakness. Talking about how you feel is more likely to help you and the people around you than staying silent.
Doctors and nurses in cancer care are very aware of the range of reactions people can have to cancer. There may also be counsellors or psychologists in the cancer team at your centre. They can help you through difficult, emotional times after your diagnosis and during treatment. They will be
ready to listen to you and give you support.
It is also worth finding out what support is available at your local hospice. Going to a hospice does not mean that you are about to die. Hospices offer skilled, compassionate care for people of all ages in calm, comforting environments. They often have lovely grounds and tranquil gardens. Many hospices offer all sorts of help to people with advanced cancer. This includes:
• Complementary therapies;
• Counselling; and
• Short stays to give you and your family a break (respite care).
To be admitted to a hospice or to access hospice home care, a patient must be referred by their GP or hospital consultant. If the matter has not yet been raised and you are wondering about it, don’t be afraid to bring it up yourself with your doctor or nurse. Hospice care is provided free of charge, regardless of the patient’s circumstances. Where patients have private medical insurance, their insurer may be asked to contribute towards the cost of their care.
Support outside the family
In the section ‘Supportive personnel,’ there is information about psycho-oncology and complimentary therapists at cancer support centres in Ireland. If you would like to talk to someone outside your own friends and family, look at this section.
Coping with advanced bowel cancer
Download a copy of the Marie Keating Foundation’s booklet, Coping with Advanced Bowel Cancer.