Cancer and Grief

Grief and loss are often associated only with death in our society, yet there are so many other losses that occur and must be acknowledged. It is important to understand that loss is the event, and grief is the internal emotions and reactions to this loss. Mourning is the external expression we show the world regarding our feelings about the loss.

Layers of Loss

A cancer diagnosis is the event (loss), and from this there are multiple layers of loss. Many people I have worked with over the years initially worried about dying and leaving behind those they love. Therefore, this is a loss of security and confidence in one’s health.

The ability to make future plans without worry about treatment schedules or about future feelings is taken away from people the moment they are diagnosed with cancer.

I believe that loss related to cancer involves 3 levels—emotional, physical, and spiritual. Emotions are a powerful component after a cancer diagnosis, but they are not spoken about enough. My patients have often explained that their bad mental health days are harder than the physical days that bring pain and discomfort.

Why? We live in a society that does not honor people talking openly about mental health. We are labeled and judged for having any struggle with our mental health. Indeed, emotions are not discussed enough when people are going for their appointments, or at family gatherings.

Don’t Forget Emotions

Instead, physical health, albeit important, becomes the main focus. Yet it is important to acknowledge that people’s physical wellness is affected by their emotions. People can feel a sense of loss for who they were before their cancer diagnosis. This certainly is true physically as well as mentally.

I have heard people say that they miss the “happy go lucky” part of their personality after a diagnosis. The longing for joyful disposition that would pick everyone else up and be happy. They grieve the ease of their former days, and not constantly analyzing their mood. When physical and mental energy changes, there are absolutely losses related to not feeling well enough to attend social events.

I have met with a father who had to miss his son’s wrestling match, because his anxiety was so profound that he could not leave the home. The losses are multilayered. He could not watch the meet, and he missed his son’s senior night and the parent march. He worried that as his son looked back on his high school years, he would only focus on this one moment when he was unable to attend this event instead of all the others he did attend.

Shame and Isolation

After the fact, he spent days shaming himself for not going to the match. He told me that he told his family that his stomach was upset, and that was why he could not attend. He felt lonely and isolated, because he didn’t feel that others would understand his anxiety. He believed that he would be told to come, believing that it would help him “get over” the panic.

Many patients living with cancer feel isolated and embarrassed when it comes to their mental health, especially if they are physically okay. They believe that they should “feel lucky” that they are physically okay. Instead, it is both/and. They can feel grateful, as well as sad at the same time. We have the capacity to have both feelings at the same time. We need to hold the space for all the physical, emotional, and spiritual experiences people have.

For religious people, when they question their faith and feel abandoned by their God, this is accompanied by deep grief. A source they always relied on, now feels distant and possibly even gone for them. “Who will I turn to, to get me through this?” they wonder.

Certainly there are many physical losses that come with a cancer diagnosis as well. Loss of energy, hair, sexual desire, relationship changes, restful sleep, taste, body parts, feeling in shape, and more. These are incredibly important things to honor and acknowledge as well.

There are many unspoken or hidden physical losses that are not talked about. We are accustomed to hair loss, fatigue, and weight loss or gain. It is important that people have opportunities to speak about everything.

Don’t Judge Losses

I once worked with a woman who was ashamed that she struggled with the loss of strong nails. The chemo destroyed all her nails. She no longer got her monthly manicures, and felt less beautiful. She would often say, “This is so ridiculous, as there are people fighting for their lives.”

What is important with grief is that no loss is diminished or judged. Yes, perspective is helpful at times, yet when it feeds shame, or is diminishing people, it is not useful. A loss is hardest when it is happening to you.

It is important to have an outlet to express yourself without being judged. You will grieve anything that is different from the life you knew before diagnosis. Humans like familiarity and consistency. Look for the areas in your life that remain the same—the people you love and who love you, or your values, for example. This is easy to lose sight of: you are still you, even within the scary and uncertain times.

Be Authentic

You do not need to be “strong”; rather be authentic. Allow the sadness, anger, and confusion to surface. Let yourself give voice to what you feel. Let people know they are not there to fix, but rather to be with you. Every loss has the potential to be soothed with the support of another person. Although people cannot make it go away, they can certainly walk with you on the path.

We know that death is often the initial fear, and is seen as the greatest loss. What’s important to acknowledge is that many losses occur when a diagnosis happens. The weeks that follow a diagnosis can be vulnerable, as one becomes less numb and realizes the implications of this diagnosis.

If your cancer is curable, you still have every right to grieve and feel concerned. This is where authenticity comes into play. If you feel scared or upset that this will always be part of your story, it is yours to feel. We get through these experiences only when we allow ourselves to feel them.

Give Yourself Permission

I honor all the stories of loss by those of you reading this article. There are no rules on how one “should” go through cancer. Allow yourself to ride the wave of all emotions. You can only know how you feel when you arrive at the moment.

Much peace to each of you. Please honor the feelings that are present for you. This will allow for an overall feeling of well-being. We are a mind, body, and spirit. You are worthy of the feeling and the healing.