Survivor's Guilt - Do You Have It?

by Jane Ashley

People on the outside of the World of Cancer believe that those of us who have completed our treatment will be joyous and happy and just jump back into life with both feet and never look back. Unfortunately, that’s not always the case.

No One Should Feel Guilty

Most of us realize that we’ve changed during treatment. We are more aware of the value of time and the wonder and beauty of life. And we’ve gotten to know other people with cancer; we’ve made in person friends and online friends. And then we will learn that someone has died, and we experience survivor’s guilt.

Survivor’s guilt is defined as “surviving a life-threatening experience when others have not survived.” We hear about it on television – the people who survive an airplane crash, the soldiers who survive an enemy attack or the sole survivor of a horrific automobile crash. Survivors often wonder, “Why me?” They ask themselves why they were “more worthy” of surviving than the people who succumbed to their injuries or illnesses.

Survivor’s guilt can be debilitating and deprive us of our quality of life. So, we, as cancer survivors have to learn to live with the reality that we have survived while others have not. WhatNexters are not immune from survivor’s guilt. We see it brought up every few months on our questions section.

What causes cancer patient survivor’s guilt?

There are several causes for the guilt that cancer patients feel.
Just plain guilt. We just don’t understand why we survived our cancer and our friend, who had the same type of cancer did not survive. These guilt feeling are accompanied by the unfairness and unjustness of the situation. “Why me?” we ask ourselves, “We had the same chemo.”
Guilt because we didn’t do enough. We may feel guilty over the financial costs to our family. We may feel guilty that our caregiver had to juggle too many tasks and still work their regular job.
Guilt over believing that we are not living a full enough life after cancer treatment. Our family, friends, and co-workers may expect us to be giddy with joy and plan trips, travel and create a bucket list of things to do. Yet we find that we need time to adjust to the enormity of what we’ve experienced. We just want “things to seem normal again” – and we feel guilty that we don’t have more grandiose plans.

Asking Why Me

Why are there differences in outcomes?

First of all, recognize that survivor’s guilt is a normal feeling. But for some people, survivor’s guilt becomes all-consuming robbing them of living a full life. Some people fall into a deep depression while other survivors develop anxiety. So what can we do to cope with the reality that not everyone survives a cancer diagnosis? Consider these reasons that influence the outcome of cancer treatment.
Every person’s cancer is different, even with the same diagnosis. Cancer is a complex disease. Breast cancer is not “just breast cancer.” There are genetic differences. Ductal breast cancer is totally different from a large solid tumor. There are differences in the hormonal influences. Most times, we don’t know the exact details of someone else’s cancer – there may have been mitigating circumstances that make their cancer more difficult to treat.
Response to treatment varies among patients. Remember those scans that we had during our treatment? They were to evaluate “response to therapy.” Typically, after 4-to-6 cycles of chemotherapy, patients have an imaging test (CT, PET or MRI) to evaluate their response to therapy. If a patient does not respond to their first chemotherapy drug, their oncologist will change their treatment plan. This is a situation where “luck” plays a role in surviving cancer. The subtle differences of genetics and grade of tumor cells is something that we have no control over. We’re just “lucky” if we don’t have mutations and respond to treatment.
Co-existing health problems. If a cancer patient has diabetes, a heart condition or other serious health problem, these co-existing health issues complicate their treatment. Chemotherapy often has rare, but serious side effects, like heart problems, blood clots or extremely high blood pressure. Surgeons may be reluctant to operate on a person with a serious heart condition or who still smokes (due to slower healing and more surgical complications).

How do we learn to cope with survivor’s guilt?

Once we recognize and acknowledge that the development of cancer and its treatment is complicated, we begin to realize that we can’t change our particular diagnosis and our treatment outcome.

So what next? These tips may help you cope.

Giving back. Many patients, me included, find that giving back helps us with survivor’s guilt. We may join a support group to offer encouragement to those newly diagnosed. We may knit caps for the local cancer center. We might volunteer at a local soup kitchen. We might even get training to become a “cancer buddy.” All of these altruistic actions help us pay it forward.
Express your feelings. Begin to journal or start a blog to express your feelings. Write poetry or use art to allow your feelings to surface, rather than letting them fester beneath the surface.
A support group or counselor. Free counseling is available through Cancer Care. Just a few sessions may be all you need to cope with your survivor’s guilt.
Spirituality. Talking to your minister, priest or rabbi may help you understand that your surviving cancer should be a source of joy and comfort, not guilt and despair.
Acknowledge your grief and then permit yourself to move on. When a friend, relative or online acquaintance dies, allow yourself some quiet time to acknowledge your grief and reflect on that person’s value – grieving is important. Then, move on mentally.

Give Back

The truth about survivor’s guilt is no one should feel guilty for surviving. Everyone’s cancer is different, and their response to treatment is different. We wouldn’t be the compassionate and caring human being that we are if we didn’t feel sad when anyone passes away because of cancer, but we shouldn’t ever feel guilty because we survived.

Just remember – we survivors bring hope to those who are newly diagnosed.

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