You may have been expecting your diagnosis or it might have come completely out of the blue. Either way it's never easy. Here we look at ways of dealing with the emotional impact of an ovarian cancer diagnosis.
Coping with your diagnosis
You may be feeling a variety of emotions ranging from sadness to anxiety, or perhaps hopelessness and fear. It's also common to feel anger. It might be directed at your doctor if you feel the diagnosis was delayed, or perhaps at yourself for not sensing that something was wrong.
You may be desperately searching for the reason you got cancer. This is quite common, and is a way of trying to gain control over the situation. Unfortunately we don't always know why cancer occurs and this can be frustrating.
We're all individuals and cope with a diagnosis of cancer in different ways. Some people see cancer as a challenge to overcome. Others would rather not talk or think about it. All these emotions are very normal and understandable, particularly just after diagnosis. There's no right or wrong way to feel.
At the time of diagnosis, it's important to feel that you have support.
If you have close relationships with family and friends these can be particularly important at this time but things may not be straightforward. Your family and friends will be experiencing some of the same emotions as you. Although most relationships get stronger, some people won’t know what to say and may avoid you, which can make you feel hurt and rejected. Others may tell you to "stay positive". This is meant well but can be very tiring. Remember it's OK to feel sad and not very positive about anything.
The emotions you experienced when you were told you had cancer will not go away overnight. You may need some help to come to terms with your diagnosis and reduce some of those feelings.
It can help to find people, organisations or groups who have experience of what it means to have cancer. No one except you can truly know how you feel, but there are people out there who will have a good idea.
It may take you a while to find out what works for you. You may want to look into:
Feeling low following a cancer diagnosis is common and normal. However, if you find that your feelings start to have a big impact on your life, perhaps affecting your sleep and weight, please talk to your clinical nurse specialist (CNS) or GP. Just talking to someone who's a good listener can be a great relief.
Counselling or therapy can help you understand how cancer fits in with other major life events and why you are feeling the way you do. If you feel that counselling is not necessary at this point, simply writing about how you feel for 10-20 minutes a day has been shown to reduce psychological distress.
Exercise can also be helpful. You may not feel like exercising if you're extremely tired but even walking around the block is better than nothing.
Before your treatment
A variety of treatments lie ahead and sometimes in differing orders. If surgery is recommended you may want it done quickly so that the cancer can be removed, or you may be dreading it as it may mean the end of your fertility.
Facing the first dose of chemotherapy can be particularly hard as we all have an image in our heads of what it will be like. The doctors and nurses will tell you what side effects to expect, but each person will react slightly differently so let them know how you feel throughout your treatment.
At each clinic appointment the doctors and nurses will ask you how you are. One of the things you may be feeling is extreme tiredness. It may be tempting to play down side effects and keep them to yourself so that it looks like you are coping better than you are.
If you're unusually tired, or have other side effects, speak to the doctors and nurses about it as there may well be something they can do to help.
Coping with the side effects of treatment
If you're told you're going to lose your hair you may feel very upset. Having no hair constantly reminds us of our cancer and makes us feel different.
You may want to prepare by:
- getting a short haircut
- buying scarves and hats
- considering getting a wig.
This can be an emotional experience and you may feel particularly vulnerable at this time. You may wake up one morning to find hair on the pillow or in the shower tray. At this point many people shave their hair off.
Wigs can be hot and itchy but they are now excellent quality and look like natural hair. It's entirely your choice whether you wear one or not. Ask your CNS if there's a free wig service at your hospital.
Going out for the first time when your hair is gone takes courage. As time goes by, and you see that people react with kindness, it becomes easier. Remember – your hair will grow back.
Being more active can help you with some of the side effects, such as fatigue, and can improve your emotional wellbeing too. You may have worries about becoming active but it's proven to have fewer risks than being inactive.
- Start by doing some form of exercise little and often, perhaps ten minutes every day and gradually build up the amount you do.
- Walking is free – start walking to your local shops instead of taking the car, or walk up and down your stairs more often.
- Raise your legs and move your arms when watching TV, or put some music on and dance.
- Many cancer centres offer gentle exercises such as yoga, tai chi and qi gong, whose trainers will have skills in working with people who have had surgery and/or chemotherapy.
Give it a go and find out what exercise you enjoy and what feels right for you. Get advice from your CNS or oncologist if you are unsure how much and what exercise you are OK to do.
Macmillan Cancer Support has more information on physical activity.
Diet and nutrition
Many women find themselves wondering whether their diet is linked to their diagnosis and they may feel they must make considerable changes in their eating habits. This is a perfectly normal reaction.
There's very little evidence that supports a diet specifically for those with ovarian cancer, but a balanced diet and maintaining a healthy weight can help you sustain your energy levels and improve your response to treatment.
- Eat lots of fruits and vegetables
- Try to limit the amount of red meat, replacing it with lean white meat, fish, beans and pulses
Side effects and diet
If you're experiencing side effects of chemotherapy (such as nausea, vomiting and loss of appetite):
- try eating small frequent meals and snacks, rather than three large meals each day
- cold foods can help reduce cooking smells and therefore limit nausea
- try eating slowly and sitting in an upright position
- nourishing drinks such as fruit smoothies and milkshakes can help you maintain your weight.
Ask your CNS or a dietician if you have any concerns, or want to know more about whether nutritional supplements may be right for you.
Maggie's Community has a nutritional therapist to whom you can ask questions.
Penny Brohn UK has very good information on healthy eating.
The World Cancer Research Fund has excellent guides and downloadable cookbooks.
After your treatment
Finishing treatment can be frightening, and the emotional and physical side effects don't go away overnight. It can take a long time to start feeling better emotionally, and you'll still have bad days, so don't be hard on yourself.
Family and friends might be expecting you to be 'getting over it' or may want to wrap you in cotton wool and stop you doing anything. Either reaction can be frustrating. If people are treating you differently let them know you are the same person that you were before you had cancer – try to tell them how you feel.
As you adjust to your diagnosis and treatment the feelings of anxiety and depression will lessen and you may experience more good days than bad, but don’t feel pressured to be ‘back to normal’ as soon as your treatment is over.
Will the cancer come back?
No one will be able to give you a yes or no answer to this question.
There's always a possibility of the cancer returning but we don't know which women will relapse and which will not. The chance of recurrence will depend on a combination of a number of things, including the tumour stage and your response to surgery and chemotherapy.
It's normal to feel worried about your cancer coming back. No one can take these feelings away. Many women go through this experience and gradually begin to live with this worry in the background rather than thinking about it all the time.
If your anxiety about your cancer returning is getting in the way of everyday life, you might want to think about speaking to a professional about your feelings.
If your cancer does come back, the symptoms you might experience may not be the same as the first time. So it's important to get to know all the common symptoms of ovarian cancer so that you can tell your CNS or GP and get checked out quickly.
Symptoms you should always report:
- persistent pelvic or abdominal pain (that's your tummy and below)
- increased abdominal size/persistent bloating – not bloating that comes and goes
- difficulty eating or feeling full quickly
- urinary symptoms (needing to wee more urgently or more often than usual).
Occasionally there are other symptoms: changes in bowel habit, extreme fatigue (feeling very tired), unexplained weight loss. If you experience these symptoms or are worried about other symptoms tell your CNS or GP straight away. You don't need to wait for your next appointment.
This information is reviewed regularly and is in line with accepted national and international guidelines. All of our publications undergo an expert peer review and are reviewed by women with ovarian cancer to ensure that we provide accurate and high-quality information. To find out more take a look at our information standards.