Coping With Emotions

When Your Cancer Life Expectancy Shifts: The Emotional Impact of a Change in Prognosis

A change in prognosis is like a new diagnosis. You have to develop a new understanding of your body and its relationship with this cancer.

After a diagnosis of cancer, life expectancy varies with the stage and type. People diagnosed with some early stage cancers, such as in situ or cancers diagnosed at stage I, II or III, can often undergo treatment and then go on to live many years after their cancer experience. And sometimes you outlive what your doctor’s original life expectancy for your diagnosis, which can feel like a miracle.

Despite that good news, it’s still an emotional shock and causes many to confront their own mortality. Cancer can progress during treatment or recur years later, so even after treatment has been completed, cancer still looms, causing anxiety and affecting the way you process emotions and make life decisions.

When Your Emotions Crash Into You

People often go through a number of different emotions in the time following this type of diagnosis. Disbelief, anger, fear and sadness are very common, as are feelings of intense love and gratitude for the beauty in your life. You may feel like you’ve wasted a few years or your life or that you can’t waste anymore. There are counselors who specialize in cancer and dealing with the end of life. Some people find it useful to talk to someone who can help them sort through their feelings and beliefs during this time.

As you adapt to your new situation and learn more about what to expect, the intensity of your feelings will likely taper. It’s often the changes in your experience that trigger emotional fluctuations.

Planning Ahead

A change in prognosis is like a brand new diagnosis; you have to develop a new understanding of your body and its relationship with this disease. Over time, some treatments may stop working or the cancer may progress. You may have to change plans and reevaluate what you want to do with the time you didn’t originally think you had.

Fairly early on in this new stage of your life, select someone to manage communication with your loved ones. This may be a spouse, a close friend or family member. They can take over your Facebook account, respond to emails and control the flow of traffic when people ask how you’re doing. You might select different people for different tasks, but let them know who you expect to do what in advance, so there’s no confusion.

Figure out how to spend the time and energy you have left. To the extent that you can, take charge and set your own agenda. Spend your time in a manner that’s meaningful to you, whether it’s a trip, writing letters, changing careers, spending time with family or something else that’s close to your heart. It’s also OK to revert to your old routine, go back to work, join your gym again, reactivate your dating profile and enjoy the sense of normalcy.

Getting Good News

Sometimes, the cancer stops growing. It would be easy to assume this turn of events would be joyous, but it’s also confusing. When you’re expecting months and they turn into years, it’s a gift of more time, but it’s also a challenge to not let it go to waste. It’s completely normal to be frustrated, anxious or wary. These emotions are normal.

When you have cancer, life expectancy is always on your mind. Many people have found that working with a therapist can ease distress and help you figure out ways to enjoy however much time you have. Battling cancer takes its physical toll on your body, but it also takes an emotional toll. Especially when your prognosis changes, talk to your doctor to make sure you understand your condition and don’t be afraid to reach out for emotional support.

UVA Cancer Center has therapists and chaplains on staff to help patients discuss the emotional impact of cancer.

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Judy Schwartz Haley
Judy Schwartz Haley