What to Expect with a Cancer Diagnosis

What to Expect with a Cancer Diagnosis

In my work helping people affected by cancer in Atlanta, people often ask if their feelings are normal.  There seems to be some general assumption that there is a prescribed reaction that you “should” have when faced with the life-altering diagnosis of cancer.  Given the range of human emotions and personal experiences, any number of thoughts and feelings can and do bubble up - some just under the surface and some like a geyser, and others becoming a fluid wave between the two.  I do find some common themes with people who have been recently diagnosed with breast cancer, colon cancer, multiple myeloma or other cancers.

A rush of emotions - Do you feel like your emotions are having a shouting match in your head?  

Often denial and disbelief turn to fear and even anger pretty quickly. You may feel intense sadness and fear as you are faced with a great deal of uncertainty.  Humans generally prefer certainty over uncertainty, even if it’s bad. Not knowing can be very stressful as our minds survey the situation for threats increasing anxiety.  Once you have a plan, which doctors to see, what’s involved in the process, etc. your mind can focus on the logistics of the situation which often settles emotions. When you’re busy juggling doctors’ appointments and procedures along with everything else in your home and work life, there isn’t much room for emotions.  That space is taken up by the massive to-do list that develops with waves of emotion filling in the gaps.

A sense of urgency - Are you rushing to find doctors and schedule procedures and treatment?

In the wake of the diagnosis, there is often a sense of urgency to see doctors, begin treatment, or schedule surgery which is fueled by the discomfort of uncertainty. Doing something helps us feel more in control. Often there are multiple doctors involved including medical oncologists, radiation oncologists, surgical oncologists and other specialists.  Your initial physician may refer you to colleagues. When you meet them, you may or may not feel like they’re a good fit. It is okay to ask your doctor about interviewing other specialists to be part of your team. Take the time to find doctors you trust who fit your needs. Your doctor can give you a clear picture of an appropriate timeline for your particular situation and how quickly you need to select other providers.

Confusion about the process - Everyone is speaking gibberish and I don’t know what to do next.

With a cancer diagnosis comes a lot of new words - each type of cancer seems to have its own language of tests, procedures, and treatments.  This language doesn’t always follow the same sentence structure either. For example, with breast cancer, surgery, chemo, and radiation are all possible, but the order and need for each varies greatly depending on the type and stage.  Many hospitals and oncology practices now have nurse navigators and social workers to help you navigate the process of finding doctors, receiving treatment and paying for care. When you receive so much information at the beginning it can be difficult to remember everything.  Write things down and seek out the navigator or social worker to help you make sense of it all. While turning to Google is a go to for most things these days, most doctors recommend staying off the internet initially or being careful to stay on reputable sites rather than chat or message boards.

A push-pull with friends and family - With so much information and emotion swirling around, it’s common to need friends and family around you, but also want to protect them.

Receiving a diagnosis may or may not be the thing you rush to share on social media.  Some people feel supported by sharing their story, others prefer to keep things more private and offline. While you may need family and friends around you for practical reasons, having cancer is a very personal, private, and sometimes lonely experience.  It is hard enough to process your own emotions around it let alone trying to care for loved ones as they process the news. It is okay to pace yourself and make decisions about what information you want to share, as well as how and when you want to share it.

Many parents want to protect their children from knowing about their disease.  There are age appropriate words to discuss cancer with children that don’t have to be scary or threatening. What’s most important with children is that they hear it from you (rather than peers or social media) and that they have the opportunity to ask questions and share their understanding so you can correct any misconceptions.

Take the time to talk with your partner or person close to you about what would feel supportive to you.  If you don’t want to be the one conveying the information, consider Caring Bridge or other similar sites as a way to inform family and friends.

Pressure to think positive, be positive, and not be sad.

Whether this pressure is external or internal, it’s real.  For some it is a coping strategy. Ignoring the trials of treatment or focusing on “winning the battle” can be a source of strength, but it can also invalidate your experience.  Acknowledging that you’re sad or angry, or that you hate chemo or are scared of dying is not the same thing as being negative. Family and friends may respond by telling you to “think positive.”  This is often more about their own discomfort and helplessness than it is about you. It is difficult to be present to someone else’s strong emotions. If you find you can’t or don’t want to express your true emotions or be authentic with someone in your life, seek out a professional.  Being able to express the feelings that are scary and hard to talk about actually lessens their intensity and makes the journey a little easier.

Karen Whitehead, MS, LCSW, CCH is a clinical social worker providing counseling and hypnotherapy in Alpharetta, GA. Through compassionate person-centered care, Karen has helped hundreds of clients regain balance, overcome anxiety, and improve their quality of life. Her personal experiences have empowered her to help people experiencing anxiety along with chronic illnesses such as cancer (and their caregivers too) throughout the greater Atlanta area. Learn more about Karen and reach out here.