Survivor's Guilt - It's Real and How You Can Cope

by Jane Ashley

Survivor’s guilt happens to many people — survivors of an airplane crash where other passengers died, September 11th survivors of the Twin Towers, survivors of mass shootings. Most cancer survivors have never thought about survivor’s guilt . When we are diagnosed, we are focused on our treatment and hoping that we’ll survive. The thought that we’ll feel guilty about surviving never enters our minds.

Every Person Is Different

But then, someone who was in treatment at the same time succumbs to their disease or they have a recurrence where the prognosis is not good. Survivor’s guilt and grief go hand-in-hand when we learn that someone we know is probably going to die from their cancer. It seems especially challenging to cope with when they had the same kind of cancer as we had.

Survivor’s guilt among cancer survivors is not unusual. Sometimes, we don’t feel that we are “worthy” enough to have survived when the mother or father of school-age children dies. It’s normal to feel grief and sorrow when someone we know dies of cancer, but we shouldn’t feel guilty that we survived.

Cancer is one of the most challenging diseases to treat. Billions, yes, trillions, of dollars of research have yet to find a way to prevent cancer or a 100 percent “sure cure.” So how do we cope when we experience survivor’s guilt?

Every cancer patient’s disease is unique to them.

“But wait, isn’t lung, colon or breast cancer always lung, colon or breast cancer?” NO. It’s not. There are three major kinds of lung cancer and subsets of those kinds. There are at least eight kinds of breast cancer; although rare, even men develop breast cancer. Rectal cancer is lumped into the colon cancer category, and there are three types of colorectal cancer.

Genetic and acquired mutations are common in many kinds of cancer. Some of these mutations produce aggressive subtypes of cancer — usually seen as a failure to respond to treatment and spread to other parts of the body.

Our overall health influences our treatment options. Some patients develop severe, life-threatening allergic reactions to treatment and are unable to tolerate the treatment that may have been potentially curative.

So even though we all have cancer, there are many variations within each person’s diagnosis.

It’s not our fault that a relative, friend or co-worker develops cancer.

Just as when we were diagnosed, researchers don’t fully understand why one person develops cancer and another person doesn’t. There is some randomness — some smokers don’t develop lung cancer while some non-smokers are diagnosed with lung cancer. It’s difficult for us to see others suffering from cancer because we know firsthand how hard treatment is, but there is no reason for us to feel guilty about someone else’s diagnosis.

Your friend isn’t angry because you’re in remission.

Sometimes, we are reluctant to continue our friendship when our friend’s cancer worsens. We fear that they are angry or jealous because you are in remission. But, we, as cancer survivors, are always beacons of hope for those in active treatment. We shouldn’t cut ourselves off from fellow cancer patients because we feel guilty that we survived. Admittedly, it is stressful and sad for us as survivors to watch someone suffer, but they are grateful that we understand what they are experiencing.

Pay it forward.

Offer help with meals or transportation. We know how we appreciated a casserole or special dessert while we were in treatment. If your friend or loved one lives a far distance away, email or text them encouragement or offer them a sympathetic ear.

Pay It Forward


If you are emotionally able to lend a compassionate ear and listen, you’ve done more than enough for them. Sometimes, a family member who hasn’t experienced cancer can’t emphasize with the emotional issues facing someone with terminal cancer. But we understand. However, don’t feel guilty if you’re not able to sit down and listen in person.

Be A Friend Listen

Funnel your survivor’s guilt into advocacy.

Become proactive about screenings. Talk about symptoms and how to recognize cancer at its earliest stage. There should never be any shame associated with some of the “private” or “embarrassing” symptoms of cancer, like rectal bleeding, lumps on your breast or testicle, or blood in your urine. If we only help one person get diagnosed at an earlier stage, then we have fulfilled our role as a cancer survivor.

Live your best life.

The death of a friend, relative or co-worker serves as a reality check for all cancer survivors. It could have been us — we could have died, but we didn’t. We’re still here. We have a second chance at life. Instead of feeling guilty, allow another’s death to inspire you to live your best life. Your best life might include a career change, retirement, a new hobby or a move to another part of the country. Your new best life might be as a volunteer or paid employee of an advocacy group. Your insight as a cancer survivor helps others. Honor the lives of those lost by remembering your friendship and how they would have wanted you to continue living your best life.

We Dont Understand

Feel gratitude even in the sadness of loss.

None of us can ever fully understand why we survived while others didn’t. But if we are still here, don’t feel guilty about your survival. Feel grateful — for cancer survivors and others who have undergone a near-death experience — life is a beautiful gift if we allow our hearts to be open to the small, simple joys of living.


Don’t be afraid to ask for help.

If you can’t shake those guilt feelings, see a therapist or join a support group that specifically addresses survivor’s guilt. Remember that you didn’t do anything to cause your friend’s death. Cancer is, indeed, a thief in the night. Don’t try to go this alone if you are deeply distressed by survivor’s guilt.


Each of us adjusts and adapts to our new life as a cancer survivor. Take time to be reflective of your life’s experience with cancer. We can never undo that part of our life. It’s part of who we are now. Many of us discovered that we were stronger and braver than we ever imagined. We must go out and live our life with gratitude and gratefulness while never forgetting our friends who did not survive.

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