At Diagnosis: Dealing With Emotions

How to recognize normal reactions at diagnosis and know when help is needed 

The emotional response to cancer will depend on various factors, including the patient’s support system, coping style and perception of illness. As patients struggle with issues of diagnosis and treatment, they may also face the social pressures that come from well-meaning friends who want more than anything for them to be OK. Psycho-oncologists, who address the emotional needs of cancer patients, have determined that a healthy emotional response to a cancer diagnosis includes three phases—initial reaction, distress and adjustment—that will take patients through a typical grieving process.

The initial reaction to a cancer diagnosis is often shock and disbelief, followed by a period of distress characterized by mixed symptoms of anxiety, anger and depression. As patients learn about their options and begin to see a treatment plan form, they will enter into an adjustment phase. During this early time, they may experience persistent sadness, in addition to anxiety or depression; decreased interest in sexual activity; fatigue; difficulty concentrating, remembering or making decisions; insomnia or oversleeping; weight and appetite loss; and restlessness or irritability.

Many of these symptoms might be considered unhealthy, but they are a normal part of the process of dealing with a new cancer diagnosis. However, feelings of hopelessness and guilt, or feeling stuck in one of the stages above, may indicate more serious distress.


Cancer patients participate more today than in past years in determining their treatment plan. But with that power comes the anxiety of making a decision, particularly when they have multiple options and no clear advantage to any one choice. The number of therapy options depends on the type of cancer. In addition, doctors may disagree about the best course of action when a standard of treatment does not exist for a certain cancer, adding another layer to a complex decision.

Some people find that researching their cancer helps alleviate anxiety. The Internet has made it easier and faster for people to find cancer information and support online, but it can also expose people to false and misleading claims. Many hospitals and treatment facilities have libraries or patient education centers that provide reliable resources, and nonprofit organizations may have support groups that enable patients to talk with others who have shared their diagnosis.

Many patients cope with their situation by concentrating on the things they can control, such as taking good care of their body by eating a healthful diet and exercising. Some patients find relief in completing practical tasks, such as setting up a system to deal with insurance, making sure wills and other legal issues are finalized, or talking with family about unresolved problems or feelings.

Talk about this article with other patients, caregivers, and advocates in the CURE discussion group.
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