Cancer and Emotional Wellbeing

Hearing the word cancer, for yourself or someone you love, can feel like the ground falling away. Fear, numbness, anger, sadness and even guilt are all normal. You do not have to be brave all the time, and it helps to talk.

What is happening

Cancer and its treatment affect the whole person. Surgery, chemotherapy, radiation and other treatments can bring tiredness, pain, nausea, hair loss, changes in appearance and poor sleep. These affect mood, and worry affects how your body copes.

Many people go through waves of emotion: shock at diagnosis, anxiety while waiting for results, low mood during treatment, and fear that the cancer will come back once treatment ends. Anxiety and depression are common and treatable, and getting help for them can make treatment easier to get through.

In South Africa, cancer treatment in the public sector is usually through referral to a regional or academic hospital, which can mean travel, long waits and time off work. Money, transport and caring for family all add stress. Organisations like CANSA (cansa.org.za) offer information, support groups and care.

Signs to notice

• Feeling constantly anxious or on edge, especially around scans and results
• Sleeping badly or sleeping all the time
• Losing interest in things and people that matter to you
• Feeling hopeless or like a burden to family
• Pulling away from others or keeping the diagnosis secret
• Carers who are exhausted and not sleeping
• Feeling cut off from your body or how you look

30-second self-check

Answer yes or no to each question.

• Have you felt low or hopeless most days for two weeks or more?
• Is worry about cancer taking up most of your day?
• Is your sleep poor most nights?
• Have you stopped seeing people or doing things you value?
• Are you struggling to cope with side effects?
• Are money, transport or work adding a lot of pressure?
• Have you had no one to talk to about how you really feel?

0-1 yes: You are coping in a hard situation. Keep leaning on your support.
2-3 yes: It is getting heavy. Tell your treatment team and consider a support group or counsellor.
4 or more yes: You need more support now. Please ask for counselling this week.

What you can do next

• Today: Tell one person honestly how you feel. You do not need to protect everyone.
• This week: Keep a simple sleep and energy diary, then plan important tasks for your better hours.
• This month: Join a support group, in person or online. Ask the hospital social worker about transport, grants and practical help.
• Move gently if your team agrees: short walks help tiredness, mood and sleep.
• Write questions down before appointments, and take someone with you to listen.
• Carers need support too. Share the load with family, church or community, and let people help with meals, lifts and childcare.

Your tool

Sleep Diary - a simple private record of your sleep, rest and energy each day that helps you spot patterns and gives your treatment team useful information.

When to get professional help

Talk to your treatment team if low mood, anxiety or poor sleep last more than two weeks. During treatment, go to the hospital or call 10177, or 112 from a mobile, for fever or chills, bleeding that will not stop, severe breathlessness, chest pain, sudden weakness or confusion, or vomiting that stops you keeping fluids down. If you have thoughts of ending your life, call the Suicide Crisis Helpline on 0800 567 567 now.
Who can help: doctor, nurse, psychologist, counsellor, social worker, dietitian, physiotherapist, occupational therapist, emergency services

Getting help in South Africa

Your oncology team, hospital social worker and clinic can guide treatment and practical help. CANSA offers support groups and information. For emotional support, call the Cleared Mind 24-hour Careline on 0800 212 146 or SADAG on 011 234 4837.