You may have come to this page because you are finding things tough. We want you to know that it is common to struggle with your mental health when you have cancer. This can happen at any time during your cancer experience. It might be:
- at diagnosis
- during treatment
- once treatment has finished
‘When diagnosed, the breast care nurse mentioned that I might feel down but that this is more later on due to a lack of appointments. But it did not match up to what I was experiencing. I felt like, am I the only one?’
How might cancer affect your mental health?
Cancer affects different people in different ways, but some of the common feelings can be:
- loss or lack of identity and direction in life
- lack of confidence or feeling useless
- feeling mentally weak and fatigued
Sometimes, feelings and experiences of living with cancer can develop into mental health problems. Some of the mental health problems can include:
- suicidal thoughts
- post-traumatic stress disorder (PTSD) around treatment or diagnosis experiences
- feeling like you are disconnected from reality, sometimes called dissociation
The mental health charity Mind has more information on these mental health problems. This includes treatment and self-care information.
When might cancer affect your mental health?
Struggling with your mental health can start at any time when you have cancer. It could be after diagnosis, during treatment, or after treatment has finished. Your experiences can vary. This can depend on your circumstances and your cancer type.
‘Within 24 hours I had to understand, digest and accept that I had cancer.’
When you’re diagnosed with cancer, your world might feel upside down with a mix of feelings. Feeling shocked, numb or angry is common. You have to come to terms with a very stressful life experience.
For some people, it can feel like grief for the plans they had for their life or what they thought their life would be. You might have a sense of disbelief and ask, ‘why me?’.
You might feel low, worried or panicked. This is a normal response. If you have these feelings a lot, for a long time, and they start to impact your daily life, it may be a sign of a mental health problem such as an episode of depression or anxiety.
If you have just been diagnosed with cancer, you can also read our Quick Guide on what to do.
‘For me, the worst period was during treatment. There is no health without mental health. Family, friends and community groups are important.’
Waiting to start treatment
You might feel anxious and uncertain in the time leading up to your first treatment appointment. Your cancer team can tell you how your treatment will work. They can also give you an idea about possible side effects.
Having clear information from your team can help you prepare, but you may still worry about:
- waiting for treatment to start and what is happening with your cancer during this time
- how you will feel during treatment, and what side effects you will have
- whether treatment will work
This can be an especially difficult time.
‘I was ok until my last two cycles of chemotherapy. I did not want to wear scarves or wigs, but when I lost my eyebrows, I looked ill. I then started to struggle with my mental health.’
Dealing with side effects of treatment
Many people go through cancer treatment and have side effects that will go away after a while. But unfortunately for some, cancer treatment can bring new challenges. This might include:
- getting used to the debilitating effects of treatment
- having to stop working or doing house chores because of side effects
These are major life-changing experiences, and they can affect how you feel about or see yourself. You might find that how you feel affects your quality of life and your relationships with people around you.
If this has been happening to you, ask your cancer team how you could be helped best with your side effects. Tell them if you struggle with your mental health because of the side effects.
Attending hospital appointments
Attending hospital appointments while having treatment can be physically and mentally exhausting. And it can go on for many months. Some people say it is like running a marathon or climbing a mountain. So, it takes a lot of commitment and energy, which can be draining in the long run.
Managing your expectations of yourself and prioritising self-care during this time is important. It is normal to feel like giving up at times but try to remember that it will eventually pass for most people.
Looking for more information about your cancer
It is understandable to want to look for more information about your cancer during treatment. Only look at trusted information sources, but monitor your research time. If you find yourself spending too much time, ask yourself whether it is helping you or making you feel worse.
Part of adjusting to cancer treatment is also accepting the uncertainty of it. Some people find focusing on taking it ‘one day at a time’ help them.
Ask your doctor or nurse questions if you are unsure of something. Your cancer team is there to support you during this time if you need more information. They can also direct you to trusted websites or organisations.
‘After surgery, everyone thought I should be OK because they saved my leg – you’ll be fine, but I wasn’t fine. Nobody asked how I was feeling. It would have been easier if I had information.’
Some people start struggling with their mental health after treatment. This might be because you have less support from the hospital or friends and family. You might also have more time and space now to reflect on your experience as you are no longer in ‘survival’ mode.
It is not unusual for others to think you’re OK once treatment has finished. They may not understand your current emotional state and the psychological recovery that you are about to begin.
Some people worry that their cancer will come back after treatment. Seeing a healthcare professional regularly can be reassuring and help with these feelings. But once treatment has finished, you might see them less often. This might increase your worries about your cancer.
You might be especially anxious before your follow-up scans. This is a normal and common response. For many people, anxiety will gradually get less over time. If you struggle with worries about your cancer coming back, speak to your specialist nurse or cancer team.
I have an existing mental health problem, how might cancer affect it?
‘I felt very isolated. I had longstanding depression and hopelessness. I’ve survived previously. I felt how can I survive again?’
A cancer diagnosis can affect people with an existing mental health problem in different ways. Some people might feel their mental health worsens with a cancer diagnosis. Others might feel it doesn’t change much. Your feelings can change at any time during or after treatment, and that is OK.
After a cancer diagnosis, some people living with a mental health problem have experienced:
- triggering of previous trauma or mental health symptoms
- an increase in ongoing anxiety or panic
- worsening of longstanding depression and hopelessness
- feelings of isolation
- relapsing from an addiction
You may find your mental health problem impacts your treatment and recovery.
A severe mental health problem means your symptoms have been going on for a long time, severely affect various areas of your life and you might:
- find it hard to function on a day-to-day basis
- not be able to work
- need treatment from a mental health team as an outpatient or inpatient
Researchers looked at people with severe mental health problems and who were treated for bowel (colorectal) cancer. They found that this group is less likely to overcome (survive) their cancer in some situations. This is compared to people with no history of mental health problems. This was because they:
- did not always receive treatment according to the treatment guidelines for their cancer
- couldn’t advocate for themselves because of their mental health problem
Talk to your cancer team about your situation or ask someone you trust to act on your behalf. Your mental health team should also be involved. Together you can decide on the best cancer treatment for your situation.
If you’re having mental health treatment
It is important to let the people treating you know about your cancer. This includes your mental health team, therapist, or GP prescribing your medication. They can then discuss:
- what kind of support you might need during this time
- any changes that are needed to your treatment
Mental health medication
If you are taking medication for your mental health problem, you should not stop taking it suddenly. Talk to your cancer team about what medications you are taking. They can tell you how cancer treatment might affect this.
It can also be helpful to get your mental health medication reviewed. This will ensure it helps with the new challenges you’re dealing with.
‘When coming out of the hospital, I thought what now, what do I do? People with mental health issues don’t generally ask for help. They just suffer in silence’.
When your mental health symptoms may need specialist support
‘I had episodes of dissociation. I was terrified and couldn’t function.’
There is no right or wrong way to feel during this time. What you feel is what you feel. But mental health symptoms can become a problem when they interfere with:
- how well you can do your normal day-to-day activities. For example, you might become too low in mood (depressed) to eat or get dressed
- your motivation. This means you don’t enjoy life or feel like taking part in it
- how well you cope with treatment. For example, you might be too anxious to go to the hospital for treatment
If you recognise some of the above feelings and experiences, seek support. Support is available, but we know that it is not easy for everyone with a mental health problem to get the treatment and help they need.
If you have been struggling with your mental health, let your cancer team know if your cancer treatment is affecting your mental health. You may be able to get mental health support through cancer services.
Some cancer hospitals are linked with Macmillan Information Services or Maggie’s Centres. They are available throughout the UK. These services can be a place to start when seeking mental health support when you have cancer. You can contact them by phone or email or visit in person.
Factors that might affect your mental health when you have cancer
‘My body didn’t respond to treatment and I had financial troubles. It had an impact on my mental health – the uncertainty about the present and the future.’
Many factors can affect your mental health. You might not be able to control or resolve all of them. But it can help to know what they are so you know they might affect you.
People with cancer say the following affected their mental health:
|Diagnosis||• having a delayed or wrong diagnosis|
|• having a poor prognosis (outlook)|
|• dealing with the stigma and guilt around certain cancers, such as smoking and lung cancer|
|• struggling to understand the ‘language of cancer’ and feeling overwhelmed by all the new information and words|
|• having advanced cancer and preparing for death|
|Treatment||• getting bad news|
|• having complex side effects of treatment|
|• having to cope with uncertainty|
|• waiting for the results of tests, or upcoming appointments|
|• certain treatments, such as steroids, affecting their mood|
|• their relationship with their healthcare professionals|
|Family and friends||• having difficult family relationships and not getting enough support from them|
|• dealing with how others react to their cancer diagnosis|
|• dealing with the denial of others about their diagnosis|
|• protecting their family or friends by not saying how they feel|
|• withdrawing from others because they don’t want to talk about their cancer or appear vulnerable|
|Living with cancer||• having financial worries|
|• having complex support needs if living with a disability and cancer. Some people found that people in day-to-day life saw their disability as more important than their cancer|
|• being unable to engage with enjoyable activities such as sport and food because of their cancer or its treatment|
Can a cancer diagnosis be a positive experience?
'Acknowledging when I’m feeling low and down is a positive. I now allow myself to feel fed up instead of trying to force those negative feelings under the carpet. It is so important to admit to yourself when you're struggling. So that in itself is a very big positive for me.’
You might not yet be in a position to think about your cancer diagnosis and treatment positively. But it may help to know that it can be possible in the future.
People with cancer said that their cancer diagnosis changed them in the following ways:
- gave them a new and more positive perspective on life
- helped them to know what matters most in life
- let them experience the support from other cancer survivors
- forced them to take the time to appreciate the small things
- let them experience the rewards of being involved in charity work and giving back to the community
- taught them about their own strength and resilience
Tips for looking after your mental health when you have cancer
Below are some suggestions to help you look after your mental health. Not all of them might be useful to your situation. It can be helpful to try and look after your mental health in more than one way. So, try several things and see what works for you.
- Knowing how cancer can affect your mental health can help you to take control.
- Acknowledge the difficult feelings you might experience – they are normal responses.
- Be kind to yourself. Ask yourself what you would say to a friend in your circumstances and apply it to yourself.
- You can ask for mental health support at any time. You don’t have to wait until you feel really bad to ask for help. It is helpful to form these links for when you need them.
- Think about how you coped in difficult situations before. See whether these strategies can help you now. For example, painting, dancing, gardening or knitting.
- Try to avoid habits that will worsen your mental health. This might be drinking too much alcohol or caffeine or staying up late and overworking.
- Milestones in your treatment are important for mental health. It can help to focus on them and celebrate once you’ve reached them. For example, your hair growing back after chemotherapy.
- Make time for self-care. Include regular physical activity at a level and pace that is safe for you. It can boost your mental health.
- Get mental health support early if you feel you are not coping.
- Bring up mental health during appointments. The focus is often on the physical symptoms of cancer. Healthcare professionals might not ask you about your mental health, but they are trained for these discussions and can signpost you.
- Find a healthcare professional you trust and talk about your mental health with them. Please see the link to the Mind website below on how to talk to a health care professional.
- If you have an existing mental health problem, discuss it early on with your cancer team. Tell them what you may need to feel supported.
- Talk about your mental health with someone you trust. They will be able to support you better if they understand how you feel.
- Understanding and getting information about your cancer can help some people feel more in control and cope better. Ask if there are things you don’t know or understand.
- Only use trusted and reliable resources for mental health and cancer information. Please see ‘Where to get support for mental health’.
- Online support through chat forums or helplines can be a safe space to talk.
- Support groups for your cancer type can give practical and emotional support.
- Try and support your mental health through complementary therapies. This can be acupuncture, massage or meditation. You can also use NHS mental health apps to help with anxiety, depression or sleeping problems.
- Counselling can be a safe space to talk things through with a professional. A counsellor or psychologist can teach you ways to deal with stress. These include help with breathing, muscle relaxation, meditation, guided imagery, problem-solving and ways of coping, hypnosis or mindfulness.
- Local support in your community that is specific to your culture can help with loneliness and isolation.
- Giving back by doing cancer charity work can feel supportive to some people.
‘I got involved in advocacy work following my cancer diagnosis and that’s really helped with my anxiety and panic attacks which I still struggle with now. Being involved in the cancer community really helps me.’
With special thanks to Mind for their expert knowledge during the development of this information.
Dying with cancer
Receiving the news that your cancer is advanced and that you may be dying soon can be very difficult. Many people receiving end-of-life care struggle with their mental health. Palliative and end-of-life care teams specialise in treating people with advanced cancer. They are aware that people might struggle with their mental health at this stage of their cancer and can provide support.
We have more information on dying with cancer and what can help you to cope.