Just diagnosed with cancer: the shock and the first weeks

Many people say they stopped hearing anything after the word “cancer”. This is your mind protecting you from too much at once. It does not mean you aren’t smart enough or strong enough.

What can help

• Ask for the main points in writing
• Ask if you can call back with questions
• Bring someone to take notes next time
• Let yourself go slowly for a few days

Having trouble believing or accepting the news is called denial. For a while it can help, because it gives you time to adjust and to feel hopeful. Most people work through it, and by the time treatment begins most have accepted that they have cancer.

Fear is one of the most common feelings with cancer. People worry about pain, how they will look, their family, money, work and dying.

What can help

• Name each fear on paper, one line each
• Pick one fear to ask your care team about
• Remind yourself that you don’t have to solve all of them this week

Anger is a normal response to cancer. It often sits on top of other feelings, like fear, frustration or feeling helpless.

What can help

• Move your body if you are able, even a short walk
• Tell loved ones when the anger isn’t about them
• Write it out without editing

Many people blame themselves, or feel guilty about the strain on family. The National Cancer Institute is clear that you should not blame yourself for your cancer.

Feelings can change from day to day, hour to hour, or even minute to minute. Fear, anger and sadness are all normal. So is hope.

You might ask

• Has it spread to other parts of my body?
• How serious is it?
• What stage is it?
• What type of cancer do I have?

You might ask

• Can you help me get a second opinion?
• Do I need more tests before treatment starts? Which ones?
• Which types of doctors will I need to see?

Family or friends can go with you to doctor visits so they can also hear what the doctors are saying. Later they can help explain things you missed.

Ask them to

• Ask your top questions if you freeze
• Help you remember next steps and dates
• Write down the answers

Stress makes it hard to remember what you heard. Keeping notes, names and numbers in one place can help.

Ideas

• A notebook or phone note just for cancer
• A folder for letters and results
• Asking if you can record the conversation
• Asking the team who to call with questions between visits

Insurance may limit your choices, so check that the doctor’s office accepts new patients through your plan. It also helps to think about how a doctor communicates and whether they offer telehealth.

Getting a second opinion is very common, and most doctors welcome it. Some insurance plans pay for one, or even require it. It can give you more information, more confidence and a greater sense of control.

How to ask

• Ask your doctor to send your records and test results
• Call your insurance company or ask a social worker about cover
• Say you are happy with your care but want to be fully informed

Nurses can tell you what to expect and talk with you about your worries. Your care team may also refer you to a social worker, a mental health professional or a pastoral counselor if you need help adjusting.

• American Cancer Society: 1-800-227-2345, any time of day or night
• Booklets from your cancer center
• NCI Cancer Information Service: 1-800-4-CANCER (1-800-422-6237), weekdays
• Your own care team

Some people want every detail. Others want only the next step. Both are okay, and you can change your mind as you go.

Ideas

• Ask someone you trust to read ahead for you
• Choose one question to look into each day
• Stop when you feel your body tense up

Searches can turn up stories and numbers that don’t fit your situation. Write the worry down instead and bring it to your care team.

Try instead

• A slow breathing exercise
• Calling a cancer information line the next day
• Writing your question in your cancer notebook

You may hear or read numbers about outcomes. If you want to know about your chances, it is okay to ask your doctor directly, and it is okay not to ask.

Telling the same story over and over is tiring. A trusted friend or relative can be the contact person for updates. Some families use sites like CaringBridge to share news in one place.

Family can mean a spouse, children, parents, a partner or close friends. Cancer affects the whole family, and loved ones may feel afraid or angry too.

How much you tell your parents may depend on how well they can understand and cope with the news.

Telling children the truth, in words they understand, is better than letting them imagine the worst. Give them time to ask questions, and tell them you will find out answers you don’t know.

In the U.S., people who have cancer are generally protected at work under the Americans with Disabilities Act. You can choose whether to share your diagnosis. You can ask for changes at work at any time.

Social workers can talk with you about local resources, insurance and support. Ask your doctor or nurse to connect you.

They may help with

• Counseling and support groups
• Local programs for rides, meals or childcare
• Questions about insurance and costs

The hospital billing office can answer money questions and talk about payment plans. CancerCare offers free counseling, support groups and some financial help for people with cancer and their loved ones.

The American Cancer Society runs Road To Recovery, a free rides-to-treatment program, and Hope Lodge places to stay during treatment. Call 1-800-227-2345 to ask what is available near you.

Examples

• A modified schedule or shift change
• Breaks, or a private place to rest
• Leave for appointments, treatment and recovery
• Working from home

1. Take one slow, deep breath in, tensing your muscles a little.
2. Breathe out slowly and let your muscles go loose.
3. Now breathe slowly and steadily, counting in your head: “In, one, two. Out, one, two.”
4. Keep going for up to 10 minutes, or as long as feels good.

Close your eyes and picture a place or activity that made you happy. Notice the colors, sounds and smells. When you are ready, count slowly to three and open your eyes.

Small daily activities can give comfort and pleasure: a morning drink, sitting with a pet, talking to a friend. Notice what makes you smile and make room for it.

Trouble eating and sleeping is common in the first weeks. Small, regular meals and a calm wind-down at night can help.

Ideas

• A short walk or stretch, if you are able
• One call or message to someone you love
• One small thing just for you
• Regular times to get up and wind down

A team of helpers means people can take turns with tasks. Online tools such as Lotsa Helping Hands or SignUpGenius can help organize who does what.

• “Could you drive me on Tuesday at 9?”
• “Could you take the kids on Saturday afternoon?”
• “I don’t need advice right now. Could you just listen?”
• “Would you be my person for updates?”

Turning to others can feel hard if you are used to helping everyone else. Many people find that the support of others helps them through a lot of hard times.

Some groups are for one type of cancer, and some for a certain age, culture or religion. Online groups can help if travel is hard or you live in a rural area.

Finding one

• Ask your care team or hospital social worker
• Ask an advocacy group for your type of cancer
• Try CancerCare’s free groups

Other people with cancer can talk with you about what to expect, share how they cope and help you find ways to enjoy each day. Let your doctor or nurse know if you would like to meet others.

Talking with someone in your faith or spiritual community is one way many people cope. Ask whether your hospital has a chaplain or pastoral counselor.

Free and confidential answers to cancer questions, Monday to Friday, 9 a.m. to 9 p.m. Eastern time, in English and Spanish. Live chat is at cancer.gov/contact.

The helpline is open 24 hours a day. Specialists can answer questions and help you find rides, lodging and support near you.

Free counseling with oncology social workers, support groups and some financial help, for people with cancer, caregivers and loved ones.