One of the first questions in the mind of every newly diagnosed cancer patient is ‘How long have I got?’ Whether or not you voice the question and however good your likely prognosis, it is an issue which will not go away. Even now when some cancers can be treated very effectively we tend to associate the word ‘cancer’ with impending death. When you are experiencing the initial shock of diagnosis, it is very difficult to take seriously a doctor’s view that treatment can be potentially curative or that a substantial period of remission might be achieved. From a patient’s point of view, a preoccupation with dying is partly a reaction to the shock of diagnosis and partly a tendency to think the very worst so that any future news can’t be any worse. It is as if in the early stages, we need to harden ourselves to bad news.
A fear of death is natural and inevitable, whatever your circumstances. Part of the process of coming to terms with your diagnosis is the fear that cancer is potentially a life-threatening disease, and that you are the person under threat. This is not at all the same as saying that all men with cancer have only a short remaining life span. It is rather that the experience of shock, disbelief and negative feelings is one of the stages of adapting to life with cancer.
As a society we shy away from talking about death, to the extent that it is regarded as a taboo subject. We use euphemisms such as ‘passing on’ to soften our words, rather than the harsher and final-sounding ‘died’. Discussing death is difficult and you may struggle to find the right words to express how you feel, wanting to acknowledge the seriousness of cancer yet avoiding brutal and harsh words: ‘This looks very serious and I’m frightened about the future’ or ‘I’m afraid the future is not looking too bright for me at the moment’. Your family and friends will find it a difficult subject to approach too, and you may find that some are unwilling or unable to discuss it. Responses like, ‘But you’re looking so much better, you’ll be well in no time’ or simply ‘Don’t talk like that’ can feel like a rejection of your need to talk about your fears. This is not a reflection on you, but an indication of other people’s inability (because of their own fear) to put your feelings before their own.
If you are willing to talk about fears for your prognosis, you may find that sympathetic family members and friends are relieved to have the opportunity to confide in you their own worries about your future, their fears of losing you and what that would mean to them. This can bring about some very emotional exchanges, but they can also bring huge relief that the subject is ‘permitted’ and that they can say what they really feel.
At times your feelings may become overwhelming and it is very important to have an outlet for them. If you do not feel able to talk to your close family or friends, then do try to speak with your doctors or nurses. They will be happy to spend time with you or to arrange for you to speak with a counsellor. Bottling up emotions on such a traumatic subject will not help you, either emotionally or in your efforts to maintain physical strength.
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