You don't need to be affected by cancer to understand the relevance of World Cancer Day (on 4th February 2016). According to Cancer Research UK "1 in 2 people born after 1960 in the UK will be diagnosed with some form of cancer in their lifetime".

The recent spate of celebrity deaths from cancer is a sad and timely reminder of this grim reality.

However, if you are or have been affected by cancer (including relatives and friends) you may not necessarily want to hear or read about cancer - World Cancer Day or not. It may all feel too much, too dark, too difficult, too late.

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The emotional world of cancer is often hidden and not talked about enough to help people know what to expect and how to cope well - with diagnosis, treatment, living with cancer or beyond, living with recurrence, with a terminal diagnosis and how to die well.

The emotional impact can also be cancerous and steadily reduce the emotional life force we have. Yet it is exactly that emotional energy which we need to cope well (physically and mentally) with cancer, treatment and the life that may lie ahead or come to an end.

The emotional themes are common and similar to bereavement: traumatic disbelief, numbness, anxiety, anger, irritability, hopelessness, loss of confidence, loss of trust in self / one’s body / others, blame, relational difficulties, post traumatic stress, to mention some. Problems we may have had before the diagnosis may now feel more acute.

While these emotional experiences are common, they are not linear. They do not follow an exact and predictable pattern. Every cancer experience is as unique as the person affected by cancer. The journey, however short or long, can be lonely and isolating.

Even after successful treatment people may not feel the same ever again. The loss of (perceived) certainty and having a solid say in one's life can be shattering. Treatment side effects may have left visible or less visible physical wounds and changes in the body (including incontinence, infertility, nerve damage and cognitive impairment like heightened sound insensitivity, to mention some).

Whether you are the one with cancer or a close relative and friend, you know things have changed - with little forewarning or debate. Life is blunt, life is brutal, life is precious. What to do?

Counselling and therapy can be instrumental in finding a suitable way of coping well. Having a witness and someone impartial listen to your story can help you start processing the heavy dark cloud that may have formed.

So what? I hear you ask. It does not make the cancer go away. It does not undo what has happened. It does not stop death.

Quite right. Counselling or therapy does none of that. However, what it can help achieve, if it's what you want, is finding ways of coping, of living and possibly of dying, that are about you and that you feel good about.

Utter nonsense! I hear you say. Feeling good about living with cancer and even dying from it?!

No – to utter nonsense, yes – to feeling good, which means having made peace. Not passively giving up, but making choices about what you want to happen, even if this is limited.

Often people feel reduced to cancer – nothing else matters anymore, and that is all that is left is what others see and feel about them: fear, pity, helplessness, uselessness.

Cancer, as much as other traumatic and life-threatening and life-shortening experience, can overwhelm your sense of identity. The challenge is to find a way of reconnecting with who you are – essentially, in terms of values and beliefs, even if you should choose to change them in light of the cancer.

One of the key issues with emotional cancer trauma is the realisation of just how little control we have. That may leave us with a constant and very real sense of uncertainty and vulnerability. What may have given us meaning, purpose, status and safety has gone. We may have little choice and time in literally handing over our destiny to medics, strangers, people we might not even feel comfortable with. And there are few guarantees as to what might or might not happen next.

While the cancer journey is as individual as the person who goes through it, the following are some key moments, when you may opt for counselling or therapy:

  • During a lengthy diagnosis process and before confirmation of a cancer diagnosis: to help deal with the fears and prepare for potential scenarios.
  • After diagnosis: to help deal with the emotional impact, provide some grounding and help think through coping strategies for what may lie ahead.
  • During treatment: to assist with treatment difficulties (e.g. needle phobia, or an aversion to intravenous chemotherapy, anxiety attacks) or treatment side effects.
  • After treatment: to assist with the start of life with or beyond cancer; having no more regular medical appointments, treatments or check-ups can leave you feeling insecure and unsure about how to continue with your working and personal life. The emotional impact of cancer can be felt long after treatment has finished and can resurface especially around check-up times.
  • In case of a cancer recurrence: to help you deal with the impact of this news, make choices about treatment and how to live the rest of your life.
  • In case of terminal cancer: to help you decide what needs and can be done to prepare you well for dying.

Whether you choose to actively participate or donate on World Cancer Day or not, whether you affected by cancer or not, you might want to ponder the following:

  • Emotions matter, a lot, cancer or no cancer.
  • Emotions can be healed and can be healing in themselves.
  • Emotional and mental health and resilience are essential at times of physical, psychological or existential crisis, such as cancer or facing death.
  • Even with cancer or other chronic diseases, we retain the entitlement and ability to make choices, albeit limited, depending on the circumstances of our health.
  • Skilled counselling and therapy can help you strengthen your emotional resilience and assist you in exploring and deciding on the choices that work for you.