It's OK to Be Alive: Learning to Deal With Cancer Survivor's Guilt


Accepting feelings of guilt is not only normal, but it's a part of life.

She was 66, just a few years older than I. We’d become fast friends and laughed at the fact that we shared not only the same breast cancer diagnosis, but the same first names. She died last week after a valiant fight. When I heard the news, I became extremely depressed. I didn’t realize that what I was feeling was normal. I wasn’t only suffering from grief at the loss of a friend, I was also suffering from survivor’s guilt.

Survivor’s guilt, according to the is, “a feeling of sadness or personal responsibility for managing to live through a terrible event in which others didn't manage to survive.” It felt odd to feel guilty about being alive. Shouldn’t I be happy? But no one explains how to deal with the guilt of surviving, especially where cancer is involved.

Why was I feeling guilty? There was nothing I could have done to have prevented the death of my friend. I knew I’d done all I could to help her through her journey. I’d spent time with her. I’d talked with her on the phone and became a sounding board when she needed a listening ear. I’d sent funny cards in the mail to cheer her when she was down. I’d taken her flowers. I was there for her in good times and in bad and she’d been there for me. We compared notes on our diagnoses and treatment. We talked about our doctors. We understood that cancer had made us more than friends. It had made us sisters.

As I began to process my grief over her death and the fact that I was still living, I was overcome with emotion. For days, I cried. The tears were a healing balm washing over me and allowing me the release I so desperately needed. When I’d cried all the tears I had left to cry, I felt numb. There was nothing more to do or say, or so I thought. That’s when I began writing.

Journaling about my feelings became cathartic. I had no idea how to process what I was feeling, so I just wrote allowing whatever was bottled up inside me to come out. As I wrote, I didn’t try to analyze what I’d written. I didn’t try to compare my way of processing grief with anyone else. As I wrote, my feelings changed from sadness to anger to betrayal to forgiveness and then finally to acceptance. I was surprised at all the emotions I had kept tightly inside.

After letting my words flow freely, I lay my pen down and realized it was okay to still be living. Although I still felt a tiny twinge of guilt, I knew my friend would have been happy to know I’d survived even though she had not. When I came to this realization, I knew I wanted to find a way to honor my friend’s memory but how could I do that?

The first thing I could do was think back on all the special moments we’d shared together. When we’d gotten together to talk about our diagnoses, we’d played a kind of one-upmanship game. We’d giggled over the number of lymph nodes we’d had removed. We’d cackled at the number of medical bills and argued about whose stack was taller. I also could remember all of the wonderful qualities I admired in her. She was resilient and a valiant fighter. She took the punches cancer threw at her and gave them right back anyway she could. When chemo knocked her down, she clawed her way back up. I could also laugh at the way she tried to find humor in awkward situations, like the time I was taking her to the bank and she’d had an accident. She’d lost control of her bowels. Her diaper needed changing. Instead of being embarrassed at the putrid odor filling the car, she asked if we could stop by the closest drugstore to buy a can of air freshener. She even told me she’d spring for it since she’d been the one to cause the need for it. As I began to think about all those memories, I found myself feeling a little less guilty, in fact, I found myself smiling.

Survivor’s guilt isn’t easy to understand, but it’s normal. It’s normal to wonder why you survived and someone else didn’t. It’s OK to be upset and hurt. When we aren’t able to be in control, it’s challenging. Learning to process our feelings takes time. Each person has to find a way to work through their feelings of guilt. For some it will become easier with time. Others may need to talk with a professional counselor who can help guide them through each stage of grief, but the first step toward acceptance is realizing survivor’s guilt is real.

In her book, “If I Stay,” author Gayle Forman says, “I realize now that dying is easy. Living is hard.” And I’d have to agree with her. Survivors have the hard part but we also have the best part.

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