• Reference Number: HEY-1405-2023
• Departments: Cancer Psychological Service
• Last Updated: 1 November 2023

Introduction

This advice sheet has been produced to give you information about ways of coping after a cancer diagnosis. It is not meant to replace discussion between you and your doctor/health professional.  If after reading it, you require further explanation please discuss this with the relevant person who has been caring for you.

This leaflet is for anyone affected by a diagnosis of cancer.

Nothing can prepare you for hearing the word ‘cancer’ for the first time. It is devastating and can affect your life in many different and unexpected ways.

The purpose of this leaflet is to provide you with some guidance and resources that may be helpful in adjusting to your diagnosis and enabling you to live well as you go through treatment.

First of all, it is important to know that it is completely normal and really common to experience strong and worrying thoughts when you first receive a diagnosis. It can really throw you and leave you with a sense of uncertainty about your life that can, at times, feel overwhelming.

The diagnosis will also affect those around you who care about you – this might be family, friends or colleagues. You may find that you are managing the reactions of others as well as your own.

A diagnosis of cancer presents as a threat and, as humans, our usual way to react to threat is with survival mechanisms of fight, ‘do anything you can to get rid of the cancer’; flight, ‘try to avoid talking about cancer or not attend appointments’ or freeze, ‘pretend it’s not happening or shut down and withdraw’. Different people will respond in different ways depending on your life experiences.

After a diagnosis of cancer, you may find yourself worrying about the past and the future. You may find yourself trying to understand why you got cancer, what went wrong? why you? You may also worry about how you will cope with treatment, and what you can do to stop it coming back. You may find yourself worrying more about other bad things happening to yourself or others.

When you become ‘hooked’ by all these thoughts, your attention is pulled away from the here and now and the things that matter to you. You might feel quite stuck. It’s easy to become caught up in trying to control the threats.

There are four steps ideas you might find helpful in finding a way to live your life alongside cancer rather than feeling like the cancer is controlling your life.

1. Be present – coming back to the here and now, rather than being hooked in by thoughts about the future, difficult feelings, physical sensations or situations. You can do this in different ways – it might be about taking a walk and tuning into your senses – noticing what you can hear, see, smell and touch. It might be about doing a task mindfully such as having a shower. There are also several apps available that can help you be more present such as headspace and calm.
2. Opening up – noticing and making space for painful and difficult feelings when you need to. This might involve writing your feelings down, for example in a journal or talking to someone you feel safe to open up to. It might also involve simply acknowledging your thoughts and feelings.
3. Doing what matters – thinking about what is truly important to you and the sort of person you want to be. Taking steps to do things in your life that matter, despite the cancer, can give you back a sense of purpose and meaning. This might mean saying ‘yes’ to the things that you want to do but also being able to say ‘no’ to those things that don’t serve you or cause you distress.
4. Being kind to yourself – we are often our own worse critics and talk to ourselves in a way that we wouldn’t talk to others. Developing self-compassion can help you show yourself kindness in the face of pain.

If you would like to learn more about these coping strategies there are several resources that you may find helpful:

1. Living your life with cancer through acceptance and commitment therapy Johnson, Anne, Delduca, Claire and Morris Reg (2021) – A workbook.
2. The compassionate mind workbook (2017) Chris Irons and Dr Elaine Beaumont
3. https://www.getselfhelp.co.uk/ – a website that provides CBT self-help resources
4. https://balancedminds.com/ – self-help based on compassion focused therapy
5. https://workingwithcancer.co.uk/resources/videos/the-psychological-impact-of-cancer/ Provides a link to a series of articles written by Dr Jane Clark, Consultant Clinical Psychologist
6. https://www.hey.nhs.uk/psychology/cancer/ – Link to our service website which contains resources and worksheets as well as recordings you may find helpful.
7. Coping with Breast Cancer, a book written by Dr Sarah Swan (2023) ACP

If you feel that you are struggling to cope and would like to speak with someone then please talk to your clinical nurse specialist in the first instance. You can also contact Macmillan living with and beyond team who provide a survivorship programme https://www.hey.nhs.uk/queens/services/living-with-beyond-cancer/ and provide free counselling via Bupa Macmillan https://www.macmillan.org.uk/bupa-counselling.

If you feel it would help to connect with other people going through similar experiences then you might find it helpful to look at the services that are in your area:

• If you put your postcode in the link below you will be able to find out more. You can also ask your clinical nurse specialist for advice. https://www.cancercaremap.org/

• If you would like mental health support from services that are not specific to cancer, you can put your postcode into the link below https://hubofhope.co.uk/

If you or your carer needs information about your health and well-being and about your care and treatment in a different format, such as large print, braille or audio, due to disability, impairment or sensory loss, please advise a member of staff and this can be arranged.