A diagnosis of cancer means you will have to deal with issues and situations that may be very frightening and challenging.

Common fears and thoughts about cancer include:

• ‘I don’t want to lose my independence and freedom’
• ‘I don’t want my family or friends to treat me differently’
• ‘I don’t know how I’ll cope financially’
• ‘I might miss out on a promotion or lose important work contacts’
• ‘I may have to make big changes to my lifestyle’
• ‘I may die’.

These are likely to be very real concerns for you and those close to you. When life feels uncertain, it can help to talk about your hopes and fears. It’s fine to worry about and be upset by them. And it’s fine to cry and say how you feel when things get tough.

There are many benefits of talking about your feelings and organisations are available to offer support.

Most people feel overwhelmed when they are told they have cancer. There is no right or wrong way to feel – reactions vary and people have different emotions at different times.

You will probably have a variety of emotions, which may cause confusion and frequent mood swings. These changing emotions are part of the process many people go through when dealing with their illness.

When your doctor tells you that you have cancer, you may find it hard to believe. It’s common to feel shocked and numb. You may not be able to take in much information and find that you keep asking the same questions again and again.

At first, you might find it hard to talk to family and friends about the cancer. This usually gets easier as the shock wears off and it becomes more real to you.

You may find you can’t think or talk about anything but the cancer. This is because your mind is trying to process what you’re going through.

Some people cope by not wanting to know very much about the cancer and by not talking about it. If you feel like this, let your family and friends know that you don’t want to talk about it right now. You can also tell your doctor if there are things you don’t want to know or talk about yet.

Occasionally, this avoidance can be extreme. Some people may not believe that they have cancer. This is sometimes called being in denial. It may stop them making decisions about treatment. If this happens, it’s very important for them to get help from their doctor.

Sometimes, avoidance is the other way around. Family and friends may seem to avoid you and the fact that you have cancer. They may not want to talk about it or they might change the subject. This is usually because they are also finding the cancer difficult to cope with, and they may need support too. Try to let them know how this makes you feel and that talking openly with them about your illness will help you.

You may feel angry about your illness and sometimes resent other people for being well. These are normal reactions, especially when you feel frightened, stressed, out of control or unwell. You may get angry with the people close to you. Let them know that you are angry at your illness and not at them.

Some people feel guilty or blame themselves or others for the cancer. You may try to find reasons for why it has happened to you. Most of the time, it’s impossible to know exactly what has caused a person’s cancer. Over time, several different factors may act together to cause a cancer. Doctors don’t fully understand all of these factors yet. Instead of trying to find reasons, try to focus on looking after yourself and getting the help and support you need.

Some people feel alone or that they don’t have enough support. Family and friends may live far away, have other commitments or feel uncomfortable because of their own fears about cancer. We talk more about what you can do if you feel lonely and isolated.

One of the hardest things to cope with can be the feeling that the cancer and its treatment have taken over your life, and that you’ve lost control.

Cancer may take over certain aspects of your life, but there are often things you can do to help.

Cancer and its treatments can change a person’s role in their family or at work. You may not have the physical energy to do the normal, everyday tasks that you did before, such as going to work or doing jobs around the house. Things you used to find easy may now be much more difficult. These things plus the sense of no longer having control over your life may cause you to lose some confidence.

It’s natural to feel sad after cancer has been diagnosed. This feeling may be there a lot of the time, or it may come and go.

Cancer can often mean making changes that affect different areas of your life. As a result, you may feel sad that your future may not be as you had planned. You might need to grieve for this.

There may be times when you want to be left alone to sort out your thoughts and emotions. This is a very normal reaction for some people.

However, if you find that you would rather be on your own for long periods of time and avoid talking to other people, this could be a sign that you’re depressed. We have more information about depression and what can help.

There may be times when you feel too tired and helpless to think about what could help. You will have good days and bad days, and it’s important for you and your family to realise this. Over time, people usually find things they can do to help them feel better.

feelingsIf you have been told your cancer is advanced, you may feel shocked and find it hard to take in. You may feel frightened about the future, or angry with other people or yourself. With time, these feelings can become more manageable as you start making decisions and plans.

Although it is rare for advanced cancer to be cured, people may live with it for a long time – sometimes for years. During this time, many people carry on with their day-to-day lives and doing things that are important to them.

It’s common for anyone affected by cancer to feel lonely or isolated. These feelings can happen at any stage of the illness: at the time of diagnosis, or during or after treatment.

There are many reasons why you might feel alone. It may be because you feel like no one understands what you’re going through, or that other people are trying to be so positive that you can’t say what you genuinely feel. Or it may be that your appearance has changed as a result of the cancer or its treatment. For example, some cancer treatments can cause hair loss or weight loss. These changes can add to your sense of being isolated and different from those around you. You can feel lonely even if you’re surrounded by people close to you.

The sense of isolation can be made worse if you find it difficult to talk about your situation. It can be hard to tell your family and friends how you really feel, as you may want to protect them from a distressing conversation. You may tell them you’re fine even when you’re not. You might find yourself giving people other reasons for not being yourself, such as, ‘I’m just feeling tired’.

You may find that the less you talk about it, the more the cancer becomes all you think about, and the more alone you feel. Finding the courage to talk to just one person can be the first step towards helping you feel better.

If you live alone

If you live by yourself, you can feel even more alone and unsure of who to turn to. You may also have practical things to sort out. For example, you may need to work out who will look after your pet when you’re in hospital, or how you will do everyday tasks like shopping when you’re back at home.

Some people have family and friends who live nearby. But if you don’t have anyone near you, it may be hard to know where to get help. You may find it helpful to join a local cancer support group, where you can meet people in a similar situation.

The internet has become a common way of socialising and keeping in touch with people. There are a number of online groups for people affected by cancer.

Some people find they feel less alone after seeing someone in a similar position with tips and advice on how to cope. Cancer Stories is a free online collection of real life stories showing how people coped with their cancer. Visit Cancer Stories to watch videos of people affected by cancer. We also have lots of videos of people talking about their cancer experience. You can watch them all on Macmillan's Youtube channel.

What may help

There are things you can do to help you feel less isolated and also help you manage your emotions. These may include:

• talking to family and friends
• joining a self-help and support group
• finding online support
• speaking to healthcare professionals.

Different things work for different people, so you may need to try a few to see what you find the most helpful.

You can use our online community to talk to people in our chat rooms, blog your journey, make friends and join support groups.

fear-and-anxietyFeeling frightened and anxious is a natural reaction to an uncertain situation. Cancer is a serious illness, so it’s normal to worry about what will happen in the months or years ahead. You may feel overwhelmed with information about treatment options, possible side effects, and changes to your family and work life. You may be struggling to take all the information in and feel worried about making important decisions.

You may also be scared about the body changes that cancer treatment can cause. Whether these changes are temporary or permanent, they can affect your self-image and confidence. You may feel vulnerable if you can no longer do everything you used to do.

Our content on body image and cancer explains how cancer treatment can affect the way you see your body. It suggests ways of dealing with these thoughts and feelings.

Talking about your fears or concerns can often help. Discussing them with someone can help you understand them better and put them into perspective. It can also help you make important decisions. This can leave you feeling more in control of your situation and less fearful.

Uncertainty

Feeling that we have some control over our lives gives us a sense of security and allows us to enjoy the things we do. It’s natural to want to know what is likely to happen to us next, so that we can make plans for the future. But being diagnosed with cancer can take away that sense of security, and leave you feeling uncertain about what’s ahead.

Uncertainty can be one of the hardest feelings to deal with, and it may make you feel irritable, angry and frightened.

Some people find it helps to find out as much as possible about their illness and what is likely to happen. This can help reduce feelings of stress, although not everyone feels this way. However, by talking through your fears, you may find the situation is better than you first thought. It’s best to discuss this with your doctors and nurses, as they know your situation and are involved in your treatment.

Try to be clear with your doctor or nurse about how much you want to know about your illness. You could write down a list of the questions you want to ask before you see them.

You may find that doctors can’t answer your questions fully, or that their answers sound vague. For example, it’s often impossible for them to say for certain how effective a treatment will be. Doctors know approximately how many people will benefit from a treatment, but can’t predict the future for a particular person with certainty.

Many people find this uncertainty hard to live with. We discuss things you can do to help you manage your feelings.

Anxiety

It is natural to feel anxious when you have been diagnosed with cancer. But some people may have strong feelings of anxiety that are more difficult to manage. You may find that you can’t concentrate, are irritable and easily distracted, sleep badly and get tired easily. These feelings may be there all the time, or they may come and go.

You may also experience some uncomfortable physical changes if you have anxiety. These can include tense muscles, breathlessness, dizziness, sweating or a dry mouth.

Reassurance from family and friends that ‘everything will be alright’ can sometimes make the anxiety worse. You may feel they do not take your concerns seriously. Or they may be struggling to accept your illness. Talking to someone who can listen to your fears objectively can be a great help. This may be your doctor, your nurse, a family member, a friend or a professional counsellor. Finding the right support and information may greatly reduce your anxiety.

If you feel that your anxiety is getting worse, speak to your GP or specialist nurse, or to a counsellor or psychologist. They can help you look at the reasons for the fear and find ways of coping with it. You may also find it helpful to contact Anxiety UK.

Many people who have anxiety may also have depression.

Panic attacks

If you’re very anxious then you may have a panic attack. This is a sudden and intense feeling of fear, along with physical symptoms of anxiety such as sweaty palms and a fast heartbeat. Panic attacks can feel overwhelming, but there are ways to help control them.

Techniques to help you manage panic attacks include breathing exercises and visualisation. You can read more about relaxation and visualisation in our complementary therapies pages.

You may like to write down your hopes and fears. Even if you don’t want to share these with other people, it might help you talk to other people about them.

You may find it helpful to use the 'Hopes and Fears' person-centred thinking tool, a table taken from Think about your life, which was developed by cancer survivors. The website has examples, stories and support to help you use the tool. There’s also space for you to think about the next steps you could take that may help you manage your concerns.