If you’ve ever found yourself saying “I’m fine” to someone who asked how you were doing, when you were very much not fine – this is for you.
A strange thing can happen when you’re living with cancer, or getting through treatment, or trying to find some kind of new normal afterwards. You become, without really choosing to, the person who seems to be expected to hold it all together. The one who tries to reassure everyone that you’re coping. Sometimes the one who has to make the appointments, chase the referrals, manage the side effects – and still tries to show up for the people around you.
It’s exhausting. And for many people the heaviest part isn’t the physical toll of treatment – it’s the emotional weight that accumulates around it: the worrying, the pretending, the not knowing what the future holds, the hanging on in there.
What the evidence shows
Research by Maggie’s, the cancer support charity, found that 3 in 5 people living with cancer feel the mental and emotional challenge is harder to cope with than the physical treatment and side effects. The same research found that half of those people felt there was support available for the physical impacts of cancer – but not for the emotional ones.
That gap – between the physical support people receive and the emotional support they actually need – is something I hear about regularly from clients. The NHS and the cancer charities do extraordinary work. But there’s only so much anyone can offer within the constraints of limited sessions and a busy treatment schedule. And when an appointment is really about your bloods, there isn’t much room for how you’re sleeping, or what you’re not saying to your family.
Those 3 in 5 people aren’t exaggerating or being dramatic. They’re describing something real – something you almost certainly already know from the inside. The harder question is often why the people around you, including some medics and well-meaning family and friends, don’t always see it. Especially once someone has been given the all-clear, and the world seems to expect that everything can now go back to normal.
Being strong when you didn’t sign up for it
Perhaps people keep telling you how brave you are. How strong. And that can be lovely to hear, but it also feels like a role you’ve been handed without being asked. Because you don’t feel strong – you just feel like you’re getting through the day. One appointment at a time. One cycle at a time. What other choice have you got?
One of the things I hear quite often from people living with cancer is that they’re holding back the full story from the people around them. Shielding a partner who’s already worried. Not wanting to frighten the children. Not wanting to upset a friend who’s been so kind. So you edit yourself, and you carry the unedited version alone.
That’s a significant weight to carry. And it’s one of the reasons that having a genuinely neutral person to talk to can make such a difference. I’ve heard the cancer stories of many people, at every stage – so I get it. And because I’m not part of your life in any other way, you don’t have to worry about how I feel about what you’re telling me. You can say the un-sayable things. And yes, sometimes sessions include dark humour and swearing, which is also completely fine.
When cancer becomes your whole identity
Cancer has a way of taking over your whole life. And not just in the obvious, scheduled ways – the appointments, the medication, the forms. It’s the unexpected things too. The sudden new symptom that needs chasing. The urgent call you weren’t expecting. The plans that fall apart because your body had other ideas. It doesn’t leave much room for anything else, and somewhere along the way it can start to feel like being a patient has become a bigger part of who you are than being a parent, a partner, a worker, a friend – the person you actually were before all of this.
That feeling of not quite knowing who you are any more – outside of being a patient – doesn’t get talked about enough. It’s something Maggie’s heard loud and clear – that for many, it isn’t the chemotherapy or the surgery that feels most overwhelming.
And it doesn’t only happen during treatment. For some people it becomes sharper once treatment ends – because while treatment was happening, there was at least a structure, a team around you, a sense that something was being done. Afterwards, that can feel like it’s been abruptly withdrawn, and you’re suddenly expected to just get on with things – when actually you’re still making sense of everything that’s happened, and living with the fear that it might come back.
The fear that doesn’t necessarily disappear
Perhaps you’ve learned that you’re in remission, that treatment has been successful. And that’s wonderful news. And yet the fear doesn’t simply pack up and leave when the all-clear arrives. For many people it lingers, coming back with every check-up, every unexplained ache, every time someone they know gets a diagnosis.
The Maggie’s research gave voice to exactly this – that the emotional aftermath doesn’t follow the same timeline as the physical one, but can hit hardest once treatment is over rather than during it. It can feel bewildering and frustrating, especially when everyone around you is celebrating and expecting you to feel relieved.
It’s really natural and normal to feel like this – however it shows up for you, and whenever it arrives. It doesn’t mean treatment hasn’t worked, or that you need to think more positively. You’ve been through something that has turned your world upside down, and you’re only now starting to process that.
In counselling, this is somewhere we can go gently. Not to try to completely banish those worries – some level of vigilance is entirely natural after what you’ve been through. But to find ways of living with them that feel more manageable, and to notice when the fear is getting in the way of things that matter to you.
Life on the sidelines
Living with cancer can be really isolating. Life carries on around you – people at work, friends making plans, ordinary things happening – and yet you can feel completely cut off from it. Like you’re watching from the outside looking in, stuck on the sidelines of your own life.
Some of that isolation is practical: you may not have the energy, or the immune system, to do the things you used to do. Underneath that is the same gap – that half of people with cancer feel the emotional support simply isn’t there. And isolation tends to grow in that space. Keeping things to yourself to protect others. Putting on a brave face because it seems easier. Gradually saying less and less about how things really are.
In counselling, you don’t have to translate yourself for someone who doesn’t quite get it. I won’t be shocked, disappointed or lost for words, or looking for the bright side when you don’t need one. You can bring the whole story, all the details if you wish, no editing needed.
You don’t have to justify seeking support
One of the things that stops people from reaching out is a feeling that they’re not bad enough to justify it. That other people have it worse. That they should be managing better given the circumstances. That wanting help is somehow an indulgence.
It absolutely isn’t. The Maggie’s research found that the gap in emotional support for people living with cancer is real and widespread – not because people are failing to cope, but because the provision simply isn’t there like the physical side of care is. You don’t need to reach a crisis point to talk to someone. In fact, it’s much easier – and more useful – to have somewhere to process things before you reach that point.
If you’re living with cancer, at any stage – from diagnosis through treatment and into whatever comes after – and you’re finding the emotional side of it harder than you expected, that’s enough of a reason to reach out.
Sessions are by phone or video, so there’s no travelling to fit around appointments. I’m happy to work around your treatment schedule, to keep sessions shorter if an hour feels like too long, and to be flexible about last-minute changes for health reasons. Because none of those things should be one more barrier when you’re already dealing with enough.
You can find out more about how I work with people living with cancer on the cancer counselling page, or if you’re ready, you’re welcome to book a first session directly online.
Caroline Midmore is an accredited counsellor working online and by phone with clients across the UK. She specialises in supporting people with anxiety, insomnia, cancer, and sight loss. Her relational approach draws on evidence-based tools when helpful.