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Your feelings
When I heard that word `cancer', my mind went completely blank. I don't think I heard a single word the doctor said after that.
When you first hear that you have cancer, however positive the future might be, you can experience very strong feelings of shock and disbelief. That is what most people feel. The fact of cancer, as a reality and something that is actually happening to you, is something most of us are really unprepared for. Even if we have been fearing that our problem is cancer, the moment at which that fear is confirmed is still very traumatic. There are many aspects to this feeling of shock -- the common perception of cancer as a serious and perhaps fatal disease, the feeling of being invaded by an alien enemy, the possibility of aggressive and unpleasant treatment, the fear of being in pain or useless (physically or emotionally), the fear of being a burden to one's family, the loss of earning capacity, social standing and so on. Each person's list is almost certainly different from everyone else's. But whatever is on that list, it almost always adds up to a sum of concern and fear that is, in total, shocking and deeply distressing.
In quite a lot of people the feeling of disbelief is accompanied by a desire to shut out the news. A lot of material has been written and broadcast about this reaction of denial which suggests that it is somehow harmful and must be confronted and broken down at once. In our experience that is simply not true. We find that most people use denial as a perfectly normal and valuable method of dealing with very threatening or overwhelming news when they first hear it. In fact, as the authors of this booklet, we both believe that denial is a normal human coping strategy which allows you to take serious news on board without having it swamp you totally. It is only when denial is prolonged -- going on for many weeks or months -- and causes breakdown in communications between the patient and family (or healthcare team) that it becomes a problem. So if you come to realize that you are using denial (or if someone close to you points that out to you), don't blame yourself or feel that you must hurry to overcome it. It may well be a normal reaction which in time (a few days perhaps or a couple of weeks) will allow you to accept the news and deal constructively with it.
Apart from shock, disbelief and denial -- all of which make it difficult for you to talk about your situation -- another factor is that you may not be used to talking about deeply personal and intimate matters. In fact, many people aren't. If that has been your pattern in the past, then of course you are going to find it difficult if you want or need to talk about your feelings at this moment of crisis. Again, being aware of this will help you a bit -- and the rest of this will help you even more.
There are other feelings that may make you want to withdraw and not to communicate with the people around you. You may feel guilty and think that in some way you have brought this on yourself (that is also a very common feeling). You may be unsure and embarrassed about how you will react when you talk to other people -- you may be afraid that you will cry (which, actually, is often a good thing because it allows easier communication). You may be worried about how your friends or family will react -- will they withdraw from you? Will they judge or condemn you? Will they blame you? Or you may be worried that talking about the disease might hasten its progress. Some people have a belief that the act of talking about future possibilities, will cause those eventualities to happen. For example, if you openly discuss your concern that the treatment might not work, then it won't. Of course that is nothing more than superstition, but it still worries quite a lot of people.
Then there are other worries that talking about things may change patterns within the family, or that you will alter the ways in which you have talked with each other for many years. This can happen -- and when it does it almost always brings tremendous improvement and great relief to all concerned.
Finally, there is the natural reluctance that many of us feel about talking about our own needs and wants. We are brought up (usually!) not to be pushy or demanding about what we want. Once a diagnosis like cancer has been given, there are people around who want to help and want to give you what you need. So you may have to overcome some of that inbred reserve and say what it is that you need or want. You'll be surprised how many people are really quite glad to hear clearly from you what your needs are.
These are just some of the things that contribute to your feelings, and which cause awkwardness and embarrassment when it comes to talking about your situation.
Other people's and society's attitudes
Now when it comes to the
people you want to talk to, you may be worried that they are a bit uncomfortable
talking about these things, and you are probably right. In our society serious
subjects such as cancer are widely believed to be unsuitable subjects for
ordinary everyday conversation. It's not the fault of your friends or family --
and it's certainly not your fault -- it's just the way things are at the moment.
Undoubtedly there are signs that things are changing, and our society is slowly
getting more accustomed to talking about serious personal subjects --
particularly if they involve health. But at the moment, there's a partial social
taboo in operation and nobody feels very comfortable talking about cancer.
Furthermore, the people around you may have no idea what to say, and to make it worse they may feel that they ought to know what to say. They may feel that they want to help you and may think that there is a magic formula which they can utter which will make you feel better, but they don't know what it is! So rather than face you without that imagined magic formula, they may tend to avoid you altogether. Also they have no experience to guide them. They may never have had a serious or threatening illness themselves or known anyone else with one. And they may be unsure of what you want, and not know how to ask you. They may also be worried about how you'll react -- they may think they won't know what to do if you cry and so on.
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