The 5 Emotional Stages of People with Cancer

A cancer diagnosis can have a significant impact on the emotional health of you, your family, and your support system. You may experience fear, anxiety, sadness, anger and overwhelm. It’s completely normal to feel a wide range of emotions when facing a cancer diagnosis.

There are over 100 types of cancer, and an estimated 1.9 million people in the United States are diagnosed with cancer each year. Breast cancer, prostate cancer, and colorectal cancers account for nearly 50% of these cases.

When you are living with cancer, it's important to prioritize your emotional and physical health. Studies suggest that addressing the mental health concerns that people with cancer experience may lead to improved treatment outcomes and a better quality of life.

This article discusses the five emotional stages of cancer, how to cope, and how to help a loved one.

Common Reactions

You may feel like you’re on an emotional rollercoaster after getting a cancer diagnosis. The range of emotions you feel can change daily, or even hourly.  

Emotional Stages

Intense, varied emotions are common in people living with cancer—not just at the time of diagnosis, but at any point in your cancer treatment. You may grieve the loss of your good health, struggle with changes to your appearance, feel guilt over the impact your diagnosis has on your family, and worry about the future. 

Developed by psychiatrist Elisabeth Kubler-Ross in 1969, the five stages of grief—commonly known as DABDA, which stands for "denial," "anger," "bargaining," "depression," and "acceptance"—may reflect the emotions you feel as you navigate your cancer journey. The DABDA model is a good tool to describe the emotional responses of people when they’re facing a life-changing illness or situation. 

Although these stages are widely believed to happen in a linear fashion, these emotions can occur at any time, in any order, after a cancer diagnosis.  

Denial

Getting a cancer diagnosis can be an overwhelming experience. The overwhelm may trigger feelings of disbelief, numbness, or shock. You may want to avoid thinking about it or pretend it isn’t happening. Denial is a common response to life-changing events and is a normal emotion for people with cancer. Denial will fade over time, and you will begin to experience other emotions concerning your diagnosis. 

Anger 

Anger is a natural emotional response to perceived threats. Though often not seen in a positive light, anger can be a good thing. When it comes to a cancer diagnosis, anger can be a vital part of the emotional process. It gives you a way to express your difficult emotions, like anxiety, fear, frustration, and helplessness. 

It’s important to allow yourself to feel and express your anger in a healthy way rather than holding it all in. You may find it beneficial to talk about your anger with a trusted family member or friend (without taking it out on them), punch pillows, yell out loud in your car, write in a journal, or do a physical activity (e.g., dancing) to help you process your emotions.

Bargaining 

In the bargaining stage, you may feel like your diagnosis is unfair and want to do anything to “fix” it and return to life pre-diagnosis. You may bargain with yourself or a higher power as a way of finding some control over the situation, and think things like, “If I get through this, I will never complain about anything again.” If your loved one has cancer, you may think, “If she survives this cancer, I will never again be angry at her.” 

Bargaining and guilt often go hand in hand, and you may find yourself going through countless what-if scenarios, such as: What if I'd never smoked in my 20s? What if I'd never eaten junk food? What if I'd gone to the doctor six months earlier?

If you find yourself in an endless loop of bargaining, it may be helpful to talk through your emotions with a counselor or with peers in a cancer support group. 

Depression

Depression is a common mental health condition that involves persistent feelings of sadness, loss of pleasure in previously enjoyed activities, and low energy. Depression can lead to changes in your sleeping and eating patterns, difficulty concentrating, and low self-worth.

Depression affects up to 1 in 4 people with cancer. Talk to your healthcare provider if these feelings persist for more than two weeks. They may recommend treatment to help manage your depression such as medication and/or counseling. Studies show that people with cancer who get treated for depression respond better to cancer treatments and have a higher quality of life.

Acceptance 

Once you’ve given yourself the space to grieve and feel the emotions that come with a cancer diagnosis, it becomes easier to face your new reality head-on. This doesn’t mean you leave behind any difficult feelings or grief—rather, you learn to accept and find meaning in your current journey.

With acceptance comes hope. And there are plenty of reasons to feel hopeful—millions of people are cancer survivors. While there’s no evidence to suggest that a positive attitude can improve cancer treatment outcomes, there are still benefits to staying hopeful. A hopeful mindset is associated with stress reduction, lower blood pressure, and improved relationships.

Mental Health Side Effects

A cancer diagnosis can affect the mental health and well-being of people with cancer, their families, and caregivers.

Depression

Many people with cancer experience significant sadness and grieve the life they had before diagnosis. You may feel tired, have a reduced appetite, and find it difficult to get through your daily routine. This is normal, and it may take time for you to work through your feelings and accept your new way of life. Some cancer treatments may change your brain chemistry and increase the likelihood of depression.

Getting support from family members and friends or joining a cancer support group may help you process your emotions. If your feelings of depression persist, ask your healthcare provider about your options for treating depression. This may include medication and counseling.

Anxiety

Up to 45% of adults with cancer experience anxiety. Anxiety is feeling worried, afraid, tense, and/or unable to relax. Physical symptoms include a rapid heart rate, loss of appetite, nausea, dizziness, headaches, muscle pain, tightness in your chest, or changes in your sleep patterns.

It’s completely normal to feel anxious when you or your loved one is facing cancer. If you’re feeling anxious, it’s important to recognize this feeling and take the steps needed to manage how you feel. 

Studies show that mindfulness-based activities (e.g., meditation, breathwork) are associated with a reduction of anxiety and depression in adults with cancer. Your doctor may suggest antianxiety medications and/or talk therapy to help manage anxiety.

How to Cope

Coping with cancer and the associated emotional toll is important. Though people cope with their emotions in different ways, you may find these strategies for coping helpful:

• Recognize and be honest about what you’re feeling.
• Talk about your feelings with a trusted loved one.
• Seek out community, such as a cancer support group. 
• Eat a balanced, nutritious diet.
• Get plenty of sleep.
• Engage in physical activity (e.g., walking, swimming).
• Try relaxation techniques, such as meditation, mindfulness, breathwork, or yoga 
• Write your feelings down in a journal.
• Look for positive experiences—whether that’s with a beloved pet, friends, or a solo activity that brings joy.
• Talk to your healthcare providers if your feelings of depression and/or anxiety persist.

How to Help

If your family member or friend has been diagnosed with cancer, you may be wondering what you can do to help. Here are some ideas on how to support a loved one with cancer:

• Listen: Ask how they’re feeling and provide a listening ear.
• Offer to help: Whether you cook meals, do their laundry, or provide transportation to their appointments, helping with day-to-day tasks is often appreciated.
• Treat them the same: Your loved one is the same person they were before the diagnosis, and treating them as you have in the past is a way to provide normalcy. 
• Give them a cancer break: People with cancer often need a break from talking about all things cancer-related. Share interesting stories, some laughs, or sit down for a cozy movie night together. 
• Learn about cancer: Taking the initiative to learn about your loved one’s cancer type and treatments is a way to show you care.
• Show up: Stay consistent with your relationship—call, text, or take time for visits to let them know you’re a reliable friend. 

Remember that you can’t pour from an empty cup. If you are a caregiver, be sure to carve out time for self-care—being there for a loved one with cancer can take an emotional and physical toll on caregivers, too. Taking care of your own needs can give you the strength you need to continue providing support.

When to See a Healthcare Provider

If your emotions are affecting your day-to-day life or lasting a long time, your cancer care team can help. Ask your healthcare team for mental health support. Your oncologist may refer you to a counselor who can help you learn how to cope with your diagnosis. They may also prescribe medication, such as an antidepressant or antianxiety medications. 

Summary

Receiving a cancer diagnosis is an emotionally overwhelming experience that can lead you to experience feelings of denial, anger, bargaining, depression, and eventually acceptance. However, the journey is not linear, and not everyone experiences each of these emotions.

That said, receiving a cancer diagnosis or learning your loved one has cancer can contribute to feelings of sadness, anxiety, and hopelessness. It's normal and okay to feel sad, but if you or a loved one is experiencing these emotions for an extended period of time and/or are having trouble coping, it doesn't hurt to ask for help.

A Word From Verywell

Coping with a cancer diagnosis—whether it is your own or a loved one’s—can take a psychological toll. Give yourself the space to acknowledge and express all of your feelings openly and honestly. 

If you feel your emotional health is negatively affecting your daily life, talk to your healthcare provider. There is no shame in asking for help—even the strongest, most resilient people need support. Asking for mental health support is one of the best things you can do for yourself as you navigate your cancer journey.