Many people when confronted with cancer struggle with feelings of guilt. Maybe it was my lifestyle. Maybe it's because I did some things I'm not proud of. You're not alone.

Cancer? I can't deal with it. The treatments make me feel terrible. I'm such a burden on my family. It's enough already. I feel hopeless.

What can you do when you feel hopeless?

Many people when confronted with cancer struggle with feelings of guilt. Maybe it was my lifestyle. Maybe it's because I did some things I'm not proud of. You're not alone.

Guilt is a common feeling in the cancer community. Patients feel guilty; so do caregivers, family members and loved ones. They say things like, "I should have…” “I shouldn’t have…” “I wish I had said…” “This is all my fault…” If thoughts along those lines are keeping you up at night, you may find it helpful to talk to a chaplain or another trusted counselor.

Some of these thoughts may be legitimate. We have regrets, and sometimes we need to make amends. But some of them are probably your own desperate attempts to make sense of a senseless circumstance. Faced with the unthinkable, our minds naturally try to produce an explanation. For most people, it's better to have a reason -- any reason -- even if that reason doesn't make a whole lot of sense -- than no reason at all. It's part of being human.

This is especially true of lifestyle choices and cancer. “If only I had stopped smoking when my wife begged me." "I just didn't have the time to exercise, what with work and taking care of the kids." "I knew there was too much stress in my life..." It's tempting to look backwards and try to make sense of it all. Try to fight the temptation. You've made choices, and they were probably the right choices for you at the time. You can't undo what you've done already. What you can do is to make different choices going forward.

Sometimes people feel that they "deserve" cancer. Not true! No one deserves to suffer from cancer. Cancer is a physical disease involving unchecked proliferation of certain types of cells. It is not a moral judgment. You are not being punished. God is not testing you. Cancer is not the result of “sin.” So, what can you do with these feelings?

When you’ve done things you're not proud of, you might consider taking a moment to reflect on them. Maybe you decide to confess to the person you think you have wronged. If you're a religious person, most traditions have rituals that formalize the process of confession. People who have religious support often believe that they can be forgiven and that they can forgive themselves.

But you don't need a religious framework to ask for forgiveness or to make amends. When you're ready, start by reaching out to others. Begin a process of reconciliation. Open conversations, even if it feels difficult at first. What you're trying to do is to bring yourself (and others) a sense of peace. A chaplain or another trusted counselor can help you sort out what’s yours and what’s not. And then make a plan from there.


Cancer? I can't deal with it. The treatments make me feel terrible. I'm such a burden on my family. It's enough already. I feel hopeless.

When you’re in treatment for cancer, people probably tell you not to lose hope, or to keep the faith. They mean well, but maybe the pragmatic side of your brain feels like there isn’t much worth hoping for. That’s because cancer is different from most other diagnoses. The first thought that springs into most people’s minds when they hear it is, "I'm going to die" -- before any discussions about treatment or survival statistics. The challenge of cancer, what makes it so hard, is that it forces us to think about our mortality. We don't live forever. Most of us live our daily lives without thinking about our deaths. Certainly not when we're young, and often not when we're older. With a cancer diagnosis, all of a sudden death is present in our lives.

Everyone comes to the cancer journey with different attitudes. Some people have a positive attitude, but most do not. It's nearly inevitable that your mood will shift dramatically over time, sometimes many times in a single day. You may feel that you're living life on a roller coaster. You get a good lab result and you feel very hopeful. The next month, there’s a questionable mass on your scan and your attitude nose-dives. Or you're just worn down from the grind of the treatments, week after week, month after month. You don't want to feel so bad so often. You don't want to impose on your family any more. You feel like giving up.


What can you do when you feel hopeless?

First, understand that these feelings are completely normal. Then, take a look at where you are right now. Where did you find the strength to get out of bed this morning? If you didn't get out of bed, what might help you to? If the doorbell rang, who would you be happy to see? What do you look forward to? Can you think of something greater than the present moment? Hope is not something that someone else can hand to you. It's uniquely yours. The universal symbol for hope is a butterfly. Think about a butterfly alighting on your arm. What does your butterfly look like? Is it a brightly colored red and orange? Are its wings shaded in calm blues and greens? Trace its journey -- and yours.

The next step is doing. Doing gives most people a sense of satisfaction. So think about what you want to do first. What's important to you right now? What can you do about it?

If you are a religious person, you may find solace in worship, prayer and text study. Most religious traditions touch on hope and hopelessness. Many have liturgies that move beyond the physical world into other realms, like Heaven or the World to Come. Some people draw strength from the idea of life beyond death. Do some exploring, on your own or with the help of clergy or a chaplain. What does your faith tradition teach about guilt, forgiveness and mercy? How can you apply these teachings to your own situation?

Other people might strength from networks of family, friends or community. Maybe spiritual exercises can boost your mood. Take a look at the section on this site called Spiritual Exercises for some ideas. Remember that it's not a one-shot deal. It's something that you will have to work on over and over. Sometimes you might feel like you're a train wreck waiting to happen, and you have no control over when the train will derail. That's normal. Don't get angry at yourself when you feel bad. Try to live in the present, from moment to moment. And when sometimes you can't do that, that's okay too.

Life is a journey. Where we go on that journey can change from day to day. Some days you'll be fine, and you'll be able to do what you need to do. Other days, you won't be able to do anything. On those days, try to step back and think about the better days. Do whatever you need to do to get through the bad days. Don't judge yourself. As trite as it sounds, remember that life is precious. Take nothing for granted. Your life can change in unexpected ways at any time. In the time you have, try to do what you want to do to the extent that you’re able.

When the future looks bleak, you may wonder what anyone – including a chaplain – could say to make you feel better, and the answer may surprise you. No chaplain is going to try to candy-coat your situation and convince you there’s a silver lining. But if you feel like you’re at the bottom of a well, and you want someone to be there with you, it’s a good time to call a chaplain or another trusted counselor.