Finding out your illness is terminal

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 may 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. If you need a shoulder to cry on, having someone you can talk to nearby can be a huge help. Most people will understand. They will just want to be there to help you in any way that you want them to. 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.

If you don’t feel like talking straight away, you don’t have to. Just let the people around you know that. As hard as it can be, try not to push your emotions aside completely. If you can manage it, it is better to express how you feel and allow your emotions to come to the surface - even if that is uncomfortable and hard to cope with.

Over the first few days, you are likely to go through a range of very strong emotions. The emotions may change very quickly and sometimes you may feel numb or as though everything is happening to someone else. Everyone is different and copes in their own way. Some people say they feel very calm and detached when they are first told they don't have long to live.

At times, you will probably feel shock, anger, and sadness. The sadness can be overwhelming and this is understandable. This news will mean that you can’t plan your future in the way you had hoped. Dying may mean leaving behind a partner, children, and other important people in your life. You may wonder how they will cope and won't want to see them upset.

These thoughts may be too painful to cope with at times. You might feel as if you are going mad. You may be unable to stop crying and worrying. All this is perfectly normal and understandable.

You may feel very frightened and anxious. Most people are frightened when they think about dying and wonder what will happen - will it be peaceful? Will it be painful? Be reassured that for most people it is possible to keep pain well controlled so they can be kept comfortable.

You may find it difficult to look around and see life going on as normal for most people. It can feel very strange to watch people going about their daily lives as usual - shopping, driving and working. Coping with this roller coaster of feelings can be very exhausting. You may feel as if you are stuck under a huge black cloud and that there is no point in doing anything.

Most people will have some or all of these emotions. This usually changes gradually. Many people say that the intensity and distress lessens in time. This doesn’t mean that you stop worrying, or feeling upset. But the feelings get a bit more bearable and you might be able to think about your situation a little more calmly and plan what you want to do.

It can be helpful to find out what support is available. Some people want to make plans about what they would like to do before they die. You may like to ask your doctor about

• How to control cancer symptoms
• What is likely to happen
• Who to talk to about your concerns

Having some idea about what to expect can help you feel less anxious. You may also want to think about where you want to be at the end - we have information about choosing where to die .

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. There is more information about talking about dying in this section of CancerHelp UK.

If, after some time, you still feel overwhelmed and that you can’t cope, try speaking to someone outside your immediate family and friends. Our advanced cancer organisations section lists counselling organisations that offer this kind of support. They also have information about coping with grief, terminal illness, and dying with cancer. There is information about counselling in our counselling section.

If you don't have people nearby to help with practical things, you can ask for help from social services. Social services 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.

You may be wary of letting people you don’t know into your life. But most people find that they do need support at some stage from other people or organisations. And people that social services put you in touch with will be very understanding and aware of your feelings and need for personal space. They will just want to support you in the best possible way they can.

You might find help and support at your church or through other organisations you are involved with. Some of the organisations related to advanced cancer and dying can provide people to help support you.

It is important to make sure that people nearing the end of their life - and those close to them - are aware of what is likely to happen. But everyone needs to have some sense of hope for their future. When you are dying, this hope may be that you can visit a place that you love. Or that you can enjoy being with your family and friends for a time. Some people believe that there is life after death and find that this gives them hope. Everyone has their own beliefs and feelings.

It may help you to share your hopes with other people, so they can help you fulfil them. Many people hope for comfort, dignity, friendship and love to surround them in their final days.

There is more information about hope and how it can help in the difficult questions and important decisions section.