Survivor Guilt After Cancer Treatment


Survivor Guilt After Cancer Treatment

I’ve never wondered why I was diagnosed with cancer. Many people have asked me, “Why on earth would you, a young, healthy, happy person with no family history get breast cancer?” Even when other people wondered, I never have. I guess I figured that “Why?” wasn’t the point. I had cancer. I had to deal with it. I had to look ahead.

Since my diagnosis, I have had one friend die of cancer and another one who will die soon. Both were young, healthy and happy people with no family history. Parallel stories. My question (to which there is absolutely no answer) is:

“Why did I get what I got (a F-bomb crappy, but treatable cancer) and they get what they got (a life limiting form of cancer)?”

I think about this Every. Single. Day. Sometimes this thought makes me feel sad. Sometimes it makes me feel scared. Sometimes it makes me feel guilty.

This is another instance when I am so glad to be a nurse (Silver Lining) because I am able to self diagnose what’s going on here: I am experiencing a version of survivor guilt.

Survivor guilt is often experienced by those who have survived a major disaster. It is common to feel guilty about having survived when others died. Now, this typically refers to catastrophic events such as 911 or a tsunami or some other disaster (no reason to go on with examples and make myself feel worse!).  I happen to think that a cancer diagnosis (of any kind!) is pretty darn catastrophic.  I know without a doubt that my world stopped. Completely.

Anyone who has had a cancer diagnosis is forever changed. There are no two ways to say it. What I know from my clinical experience is that this feeling of guilt is a normal part of being human. It is a way of searching for the meaning of my survival vs. another person’s death. Normalizing these feelings doesn’t necessarily make me feel better, though. FBC keeps on giving (or perhaps taking is a better word).

Unfortunately, survivor guilt brings with it a host of issues that can cause depression, anger, and self-blame that may even compromise health. UGH. I certainly don’t want to go down any of those unproductive and paralyzing paths.

Don’t get me wrong. I’m thrilled to be where I am. I don’t know what’s in my future. None of us does. But through this ordeal, I have faced fears, challenges, and heartbreak. I know that I have also learned lessons I couldn’t have learned any other way.

What I now know for sure is that life is a precious gift; however after my hospice work, I actually already knew that…I guess it’s just been reiterated – in a BIG WAY. I have been given the opportunity to recommit myself to it (Silver Lining). My time to go will come around again, but for now, it is my time to live.

In the Apache language there is no word for ‘guilt.’ Our lives are like diamonds. When we are born we are pure and uncut. Each thing that happens to us in our lives teaches us how to reflect the light in the world; each experience gives us a new cut, a new facet in our diamond. How brilliantly do those diamonds sparkle whose facets are many, to whom life has given many cuts!

– Travelling Light by Daniel J. O’Leary quoting Bearwatcher, an Apache medicine man.

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  1. emily mason says

    Hi Hollye, I live in England and am now 15 months on from diagnoses having had all the treatment and am still having Herceptin. I can so relate to your dislike of the term 'fighting cancer', in fact it was one of the nurses at the hospital who told me to FIGHT! I was so bemused and scared I didn't take what she said on board until much later! I don't see myself fighting so much as having a journey away from the person I was to who I am today (though still evolving) each day is a discovery of who I am deep down which I never appreciated before. I so value the time with my wonderful husband of 40 years,I am not that young at 58 but realise in a funny way I had been preparing myself throughout my life for this! I hope this makes sense as I do find myself struggling with finding the right words (chemo brain) I used to spend so much time looking at my 'faults' now I couldn't care less in fact the new me can say quite happily 'I am not so bad!' I just wanted to say I fell across your article and so related . Much love and good wishes Emily

    • says

      Dear Emily,
      Thank you so much for your note. I really appreciate it. Your journey image is spot on. A lifetime of preparation makes perfect sense. I'm so amazed by how all of my education trained me for what I am doing now, both personally and professionally. Thanks again, Emily. Please take care and stay in touch!

  2. says

    Hi again, Hollye:
    This last post was particularly poignant. My "real" biological birthday is coming up, and I have now survived my stage 2 breast ca. for 8 1/2 years (double mastectomy, chemo, and radiation). It has only been the last two years that I've almost forgotten to think about Ca. on a daily basis. ( I very much dislike terminology about cancer "birthdays.")
    I haven't thought much about survivor guilt, per se, but every day when my elevator passes the third floor, on its way to my fourth/top floor apt., I remember my friend who lived ON THE THIRD and died of stage three breast Ca., She left a single daughter in the age bracket of you and my two daughters.
    I've avoided my yearly oncology appt. the last two years. I adore my female oncologist AND surgeon (first female surgeon grad. from UCLA). I have NO symptoms, but don't want any tests that might reveal that I do. Even though I am a psychotherapist, I've lately chosen avoidance, repression etc. and still worry about symbolism in my dreams that might mean Ca. is returning.
    Even before FBC, I practiced – hard – living in the moment with gratitude. But, the truth is, FBC has made it harder – another big "something" added to the complicated equation of trying to live a meaningful life..
    My Silver Lining is the never imagined joy that I have received from my two little grandsons here in L.A., and greeting at the airport today, the first newborn little boy from my younger daughter!!!! I guess I could acknowledge the Silver Lining of not getting FBC at a younger age, but I felt young until it appeared, and it's cast a shadow ever since. I am not grateful for having had it. I do the best I can and feel, often, that I fall short.
    Glad you've made it your task to keep reminding us of the SL's. I do thank you.
    Pat Dunn

    • says

      Thank you so much for your note, Pat. I am so thrilled to hear about your Silver Lining grandsons and new granddaughter. How wonderful! Enjoy every minute with them…and your continued good health. Thank you, again!

  3. Margret Duchsherer says

    The initial diagmosis was devastating and I felt as though I had been handed a dearh sentence and that fear, anguish and torment was further magnified by the necessity of chemotherapy, radiation and being bald.I never asked GOD, why me? Why not me? I changed my attitude and I was glad that it was me and not one of my sisters or my parents. No, I am not courageous. I knew that I could handle my own demise but the thought of losing a family member was more than I could bear.Changing my thinking and accepting the reality of cancer gave me the strength and fortitude to combat the disease and now, I am a 15 year survivor and, although I know that cancer lurks in the shadows, I am not afraid.

    • says

      Wow, Margaret. Thank you for sharing your story. I had the exact same feeling of gratitude that I was the one diagnosed and not my daughter or my husband. Thank you again for sharing. Wishing you continued good health!

  4. Kim C says

    I can identify with survivor guilt, Hollye. I grew up with two younger sisters who were chronicly ill for most of their childhoods. I was never seriously ill until my cancer diagnosis. In surviving cancer, I felt the sting of survival guilt in another way. The day I left the cancer agency, I cried for my oncologist and the work he'd 'chosen to do (of all the crazy things) because he looked particularly exhausted on that day. I actually felt guilt (and relief) because I was able to leave the cancer agency for the last time, but when I looked around me, on that day, I was leaving behind so many sick people. It was very difficult to attach feelings to it all but it was a very rough day or weeks I think. I'm working on those feelings by helping cancer patients now. I felt the need to give back and help others who are going through the difficulties of the medical system and the emotional devastation of a cancer diagnosis. In helping them, I'm helping myself. We're all in this together and I've been forever changed too.

    • says

      Thanks for your comment, Kim. I can also appreciate your sympathy for your oncologist. It is incredibly hard work, indeed. My hospice experience reminds me that even though the work is always incredibly challenging, the oncologist or nurse or social worker gets to go home everyday. In other words, it was always harder for the patients and their families.

      Thank you for the work that you do of cancer patients. You're so right that we are indeed all in this together!

      • Kim C says

        Thank you for your kind response, Hollye. You are right and I think you said it best with your reply to Frances above. The reconciliation is hard at times like these. I find it helps to be aware of why I'm feeling this way. I'm also working very hard to be a more empathetic person, rather than sympathetic, although sympathy has it's place too.

  5. says

    Dearest Hollye. Your being sick won't make others well, and your dying won't bring others back to life. This kind of "survivor guilt" carries over into everyday life as well: How can I be happy when so many in the world are suffering? Well, my being depressed/miserable/sick isn't going to help them. In fact probably just the opposite – so we may as well be as happy and healthy as we can be, right? Then we've got more energy and love to give to help lessen the suffering of others. And you, Hollye, do this everyday. Love, from a fellow survivor.

    • says

      Thank you, dear Frances. I couldn't agree more with your reflection. It's been hard to reconcile the mental understanding of this with the emotional feelings. Working on it, though. Everyday!