Coping with cancer that has spread or come back can involve an enormous amount of uncertainty. You may be worried about your treatment; pain or other symptoms; or not being able to do things for yourself or get around easily. You may be concerned about how you will be cared for as your cancer develops. You may have thoughts about death, people you would leave behind, or what happens after death.

Anxiety about the future is normal, especially when you have a serious illness that may focus your attention on your fears. There may be times when you feel that cancer is on your mind all the time, and you cannot think about anything else. But you don’t have to cope with your fears on your own. There are a number of sources of help you can turn to for practical advice, medical information, emotional support or spiritual comfort.

You may find that, when some of your worries have been addressed, you will feel less burdened, and more able to concentrate on living life the way you want to.

Some people with cancer say that they have a better appreciation of the ordinary things of life, such as family and friends, hobbies, a favourite book, picture or piece of music. Many people find their lives are more focused and they are less irritated by day-to-day problems.

Knowing that your illness may not be curable can give you an opportunity to decide what is important to you, and how you want to spend your time. You may have to give up some long-term plans, but you don’t have to abandon all your ambitions. You may find that you now have the time to take up an activity that you have always been too busy to do before. Concentrating on what you can achieve and enjoy can give you pleasure and may help you to cope when you cannot meet other aims.

'The quality of life becomes more important than the quantity. I began to enjoy listening to music and, most of all, taking time to read.'

Your worries about things like how your cancer may affect your daily life, or what symptoms you might have, may be eased with information. Your doctor, palliative care nurse or a specialist nurse at the hospital may be able to help to answer your questions. It might be helpful to prepare some questions you might like to ask. You can also contact our cancer support service and talk things through with a nurse.

You may find that you easily become very tired, and that your body is no longer as strong and reliable as it once was. This may be because of the cancer or because of the side effects of treatment. You may feel as though you have no strength and everything is more of an effort. It can be difficult to adjust if you can no longer drive or take part in sports, or have to walk more slowly than before. It will take time for you to get used to these changes and to accept having to rest, or the loss of activities that you once took for granted.

'When I ask my daughters over for a meal, I'm not really up to cooking it. They don't seem to mind – I buy the food and they cook it – but I feel I'm letting them down as I've always done the cooking.'

If your energy is limited, save it for the things you really want to do. Very often, re-organising your daily activities can be helpful – for example, by setting aside a time to rest every day. In addition, practical aids such as wheelchairs can be useful. You may feel that by using a walking stick, frame or wheelchair you are ‘giving in’ to your illness, but they can greatly improve your life, by allowing you to move around more than you could do on your own.

A very real fear for people with cancer is that they may lose their independence and dignity. Many people find the idea of being physically dependent on others deeply upsetting. It is often easier to accept help of an intimate kind (for example, being helped to wash, or go to the toilet) from a professional carer, than from your close family or friends. If you find this is the case, ask your GP or social worker to arrange help for you. Some organisations may also be able to provide services.

Even if you do need day-to-day care, you can still be independent in other ways and take the initiative in saying how you would like to be helped. For example, you could set a schedule for getting up, washing and dressing, or organise a rota for other family members.

Looking after someone who is ill is a practical way for families and friends to show how much they care. If you can tell them what you need, and how they can best help you, there will be less room for misunderstanding and resentment if things do not go right all the time. You will also feel that your life is still your own.

While some people prefer to stay in their own homes in familiar surroundings, some may choose to move, perhaps because they live alone. In making this decision it may help to discuss with your family and friends where you would like to be looked after. You should be able to obtain support and information from your GP or social worker.

Later on in this section, the page 'Who will care for me?' discusses the different places where you can be looked after and the support available.