Overcoming cancer survivor guilt

Survivor guilt means feeling guilty or ashamed or that you have done something wrong in order to survive a trauma that killed others. This sometimes happens to people who have survived a plane crash, an automobile accident, a fire or a natural catastrophe. It can also happen to people who stay well after being treated for cancer.

I hear about this discomfort quite often and note that it can be especially intense when someone has been in a support group or been friends with another cancer person who then dies of her disease. In all honesty, I often have felt some variant of this when I sit with people who have Stage IV cancers or consider all the wonderful people whom I have known and loved and lost to cancer. Why have I been lucky? In some ways, this is the opposite of Why me? It is not difficult to wonder Why not me? when acknowledging the seemingly random bad luck that inflicts a return of cancer on some while others, and, so far, me, have stayed well.

Although I never think I have done something wrong in staying healthy (always with the so far caveat), I do understand that neither have I done something to earn my good fortune. Yes, I have been a compliant patient and taken all the surgery and radiation and drugs that have been offered. But so have many others who have gone on to die from their disease,

If you have been treated for early stage breast cancer, for example, you may not feel entitled to express worry about your health when others are living with recurrent breast cancer. If you have been treated for early stage prostate cancer, you may not feel justified in complaining about the difficult after effects of surgery or radiation. If you have endured a bone marrow or stem cell transplant for leukemia and are doing well, you may not want to express your exhaustion and worry when others are living with a relapse of their illness.

Of course you have earned and are fully entitled to all of your feelings, whatever they may be, but here are some strategies to help you contend with survivor guilt and move forward with your one wild and precious life (thank you, Mary Oliver, for that phrase).

Strategies to overcome cancer survivor guilt

• Yes, your cancer situation could have been worse. However, remind yourself that whatever the specifics were, your experience has been bad enough. Most people in the world don’t have to contend with cancer at all.
• You have gotten through a disease that terrifies most people. Pat yourself on the back for your strength and accomplishment.
• Make a list of the changes that cancer has brought to your life, including the good and the bad. Emphasize the positives while acknowledging the negatives. The point here is that you have paid your dues.
• When you were initially diagnosed, you may have wondered "Why me?" or "Did I do something to bring this on?" As time passes, a new version of those questions may haunt you: "Why have I survived?" Just as there were no answers in the beginning, there are no answers now.
• Talk about your feelings. The most empathetic listeners are likely to be other cancer survivors or an oncology-savvy therapist. Your friends and family may find it more difficult to appreciate and understand your complicated feelings. There are excellent oncology social workers at BIDMC who can talk with you about these feelings or refer you to a therapist in the community. https://www.bidmc.org/centers-and-departments/social-work/clinical-services/hematology-and-oncology
• Don't assume that all cancer survivors will be the best listeners or will even want to talk about this. In spite of your common experience, you may have very different perspectives and coping strategies. Avoid anyone whose comments make you feel worse.
• Remember and honor your friends who have died of cancer. Running from your sadness and fear will not help.
• Above all, cherish your life.