Cancer & mental health

Right after a diagnosis, many people feel their life has been turned upside down. There may be new words, many appointments and big decisions all at once.

What can help

• Ask your care team questions, and ask for answers in writing
• Bring someone to appointments to take notes
• Focus on a simple daily routine
• Learn about your cancer from trusted sources, at your own pace

Fear is one of the most common feelings with cancer. People worry about pain, how they will look, their family, money, work and dying. Stress about insurance and day-to-day help is common too, during and after treatment.

What can help

• Ask your care team about a counselor, support group or stress-reduction class
• Name your fears out loud or on paper, so they feel more manageable
• Try relaxation, meditation or guided imagery

Anger is a normal response to cancer. It often sits on top of other feelings like fear, frustration or feeling helpless.

What can help

• Ask yourself what might be underneath the anger
• Move your body, as your energy allows
• Talk it out or write it down
• Tell loved ones it isn’t about them, when it isn’t

Many people blame themselves, or feel guilty about the strain on family. The National Cancer Institute is clear that you should not blame yourself for your cancer.

Kinder thoughts to try

• “I didn’t choose this, and I’m doing my best.”
• “Letting people help me is a gift to them too.”
• “My worth is not measured by how I cope.”

Loneliness is common during treatment, and again afterwards, when support from others may fade.

What can help

• Join an in-person or online support group
• Let loved ones know what kind of help and company you want
• Talk with a counselor or someone in your faith community
• Talk with other people who have had cancer

Many people feel more hopeful once they settle into a treatment routine. Some notice small joys more, or feel closer to the people they love.

In normal adjustment, a person slowly learns to cope with the emotional side of cancer and solve problems it brings. Coping needs change over time: from hearing the diagnosis, through treatment, to remission, recurrence or long-term survivorship.

Distress tends to be higher for some groups, including younger people, women, people with advanced cancer, and people with a history of childhood abuse. Hard physical symptoms, problems at home and unmet social or spiritual needs can add to it.

Your care team may screen you to see if you need help adjusting. They usually ask about how you feel, your energy, relationships, work and money. They may refer you to a social worker, a mental health professional, a palliative care specialist or a pastoral counselor.

Sadness can linger, and sometimes it becomes depression. If signs of depression last more than two weeks, the NCI advises talking to your doctor. Depression is treatable, and you should not have to manage it alone.

Anxiety can show up as a racing heart, headaches, or trouble sleeping or concentrating. If you notice these, talk to your doctor.

The NCI suggests that people having trouble adjusting to cancer try counseling first. Options include talk therapy, relaxation training, cancer education sessions, group support, and therapies that explore meaning.

Other things that may help

• Breathing exercises
• Cognitive behavioral therapy (CBT)
• Guided imagery
• Meditation
• Problem-solving
• Yoga

Cancer fatigue is exhaustion caused by cancer or its treatment. It is very common: over 80% of people having some common cancer treatments report it. It often eases after treatment ends, but for some it lasts months or years.

What can help

• Ask family and friends to help with cooking, driving and errands
• Keep daytime naps under an hour
• Save your most important tasks for when you have the most energy
• Try gentle movement you enjoy, like walking, after checking with your care team
• Try yoga, tai chi or relaxation

Some cancer treatments can cause problems with memory or concentration. They may start during or after treatment, and range from small lapses to bigger trouble focusing.

What can help

• Do demanding tasks when you feel most alert
• Keep a steady daily routine
• Keep important names and numbers in one place
• Tell your care team, and ask if an occupational therapist could help
• Use lists, a planner or voice notes

When so much feels out of your hands, focusing on what you can control helps. That might be keeping appointments, setting a daily routine, or making time for hobbies.

Ideas

• Be as active as you can, in ways that feel good
• Keep one small thing each day that is just for you
• Plan rest around treatment days

Relaxation, meditation and guided imagery can ease stress. Gentle exercise, yoga and hobbies can help too.

A 2-minute calm breath

1. Sit comfortably and let your shoulders drop.
2. Breathe in gently through your nose for a count of 4.
3. Breathe out slowly for a count of 6.
4. Repeat 5 to 10 times, maybe in a waiting room or before a scan.

Cancer can bring big worries about costs, insurance and getting daily help. The NCI suggests telling your care team about these concerns and asking the hospital billing office about financial questions.

Who to ask

• A hospital social worker or nurse, about local resources
• The billing office, about payment plans
• Cancer information lines (see “When and where to get help”)

The NCI encourages people to mourn their losses and know it is okay to feel sad, angry and frustrated about body changes. A counselor can help, and your doctor or nurse can help arrange one.

Ideas from the NCI

• Be active at your own pace, like walking, swimming or stretching
• Hobbies and volunteering can help rebuild self-esteem
• Join a support group or talk with other patients
• Try new ways to feel good about how you look, like a new haircut, makeup or clothes

Sexual problems are common after cancer and can last longer than other side effects. Tell your doctor or nurse. If they can’t discuss it, ask for a referral to someone who can, such as a sex therapist.

What can help

• Counseling, alone or with your partner
• Focus on closeness beyond sex: holding, hugging, cuddling and shared activities
• Talk openly with your partner about feelings and wishes
• Try new kinds of touch

You might choose to tell a new partner about your cancer once you feel some trust and friendship. Low-pressure activities can make dating feel easier. Rejection can happen with or without cancer.

Tips

• Ask friends or other survivors how they handled it
• Practice what you might say
• Treat dating as a learning process

Children notice changes, even when no one tells them. The NCI says telling the truth is better than letting them imagine the worst. Use words that fit their age.

Key messages

• It’s okay to feel upset, angry or scared
• Many people live with cancer for a long time
• Nothing they did or said caused the cancer
• They can help in small ways, like drawing a picture
• Their routines, school and activities will carry on

Watch for changes. Children may feel guilty, confused or lonely. They may act out, act younger, cling to you or struggle at school. Teachers, relatives and faith leaders can be extra support.

• Encourage them to share feelings and ask questions
• Involve them in decisions when you can
• Let friends and other trusted adults support them too
• Respect their need for independence
• Share as much information as they want

Adult children may start helping with care decisions, bills, chores or appointments. Including them in conversations about treatment and your wishes can help. Remember they are adjusting too.

Under the Americans with Disabilities Act, people who have cancer, or cancer in remission, are generally protected at work. You can choose whether to share your diagnosis, and you can ask for changes at any time, even if you didn’t ask before.

Examples of reasonable changes

• A modified schedule or shift change
• Breaks, or a private place to rest
• Leave for appointments, treatment and recovery
• Moving minor tasks to a coworker
• Working from home

During treatment, your care team watched you closely. Afterwards, you are more on your own, and that can feel scary. Recovery takes time, emotionally as well as physically.

Friends and family may treat you as if everything is back to normal, or expect you to move on quickly. Your support may also change as people return to their own lives.

What can help

• Join a group of survivors who had the same cancer
• Reach out to friends, even if they have gone quiet
• Share your feelings with loved ones

Some changes last after treatment: scars, different eating habits, trouble with tasks that used to be easy, or worries about body image and sexuality.

What can help

• Ask a dietitian about eating well and keeping your strength
• Talk with your care team about side effects that linger
• See “Body changes, self-image and intimacy” in this guide

• Journaling to let worries out
• Moderate exercise like walking, biking or swimming, as your care team advises
• Relaxation, meditation or yoga
• Social activities, clubs or classes that aren’t about cancer
• Spiritual practices or faith, if they matter to you
• Volunteering or helping others

• Ask for a written follow-up care plan, so you know what to expect and when
• Ask how long side effects usually last
• Ask which symptoms really need a call
• Keep a notebook of symptoms, feelings and questions for visits
• Tell them about your fears

Staying busy while you wait for results can help. So can focusing on what you can control, like keeping appointments and a daily routine.

Ideas

• Ask when and how you’ll get results
• Bring a calming playlist or a friend
• Plan something kind for yourself after the scan
• Plan walks, films or time with friends during the wait

Try giving fear of recurrence 15 minutes a day in a set place. When it shows up at other times, gently tell it, “Not now, I’ll see you at 5 p.m.” Then return to what you were doing.

People with cancer can choose when they want to talk about it. Some days they will want to talk, and some days they won’t.

Helpful things to say

• “Do you want to talk about it, or would you rather not today?”
• “I’m here, whatever you need.”
• “That sounds really hard.”

Try not to say

• “Everything happens for a reason.”
• “I know exactly how you feel.”
• “Stay positive!” (They may need to have a bad day.)

Help with tasks like cooking and driving can ease cancer fatigue and stress.

• “Can I drive you to Tuesday’s appointment?”
• Help with calls, forms or insurance
• Organize a meal rota with friends
• Take the kids for an afternoon

Support often fades after treatment, just when loneliness and fear of recurrence can rise.

Ways to show up

• Ask about feelings, not just results
• Mark scan dates and check in before and after
• Try not to say “You must be so relieved it’s over.” It may not feel over

Supporting someone through cancer can be tiring and frightening. Looking after yourself is not selfish. It helps you keep going.

What helps

• Join a caregiver support group
• Keep up your own friendships and interests
• Take regular breaks and accept help from others
• Talk to a counselor if you feel overwhelmed

Support groups let you share feelings with people who understand. Some are for a specific cancer, some for survivors, and some for family members.

Finding one

• Ask your hospital social worker or nurse
• Call a cancer information line (see “When and where to get help”)
• Try online groups if travel is hard

Peer groups with survivors who had the same type of cancer can be especially helpful after treatment ends.

Peers can help with

• Fear of recurrence
• Hope for the future
• Returning to work and daily life
• Talking with family

Many people find strength in faith or spirituality. Talking with someone in your faith community is one way to cope with your feelings.

Volunteering or helping others can bring a sense of meaning and purpose after cancer.

Ideas

• Mentor someone newly diagnosed
• Share your story, if and when you want to
• Volunteer in small ways that fit your energy

The National Cancer Institute’s free, confidential line answers questions about cancer, including living and coping with cancer. It is open Monday to Friday, 9 a.m. to 9 p.m. Eastern time, in English and Spanish. Live chat is at cancer.gov/contact.

The American Cancer Society’s cancer helpline is open 24 hours a day. Information specialists can answer questions and help you find support in your area.