‘When I heard that word "cancer", my mind went completely blank. I don’t think I heard a single word the doctor said after that.’

When you first hear that you have cancer, however good the outlook may be, you can have very strong feelings of shock and disbelief. Most people feel this. You may feel numb and unable to take in what is said, or feel as though it is all happening to someone else.

Most people are not at all prepared for being told that they have cancer, even if they already thought that they may have it. The moment of being told is still very traumatic.

There are many reasons for this feeling of shock. Some of the following may apply to you:

• the common idea that cancer is a very serious disease
• the fear that you may die
• the feeling of your body being out of control
• not knowing what to expect
• the possibility of unpleasant treatment
• the fear of being in pain
• feeling useless (physically or emotionally)
• the fear of losing control of some parts of your life
• fear of being a burden to your family
• the possibility of losing the ability to work and earn money
• the worry about what other people will think of you.

Each person’s reaction will be very individual, but being diagnosed with cancer can cause feelings of concern and fear that are shocking and deeply distressing.

In many people there is a feeling of disbelief and also a wish to shut out and deny the news and pretend that it is not happening. This feeling is known as avoidance or denial and is a normal reaction to distressing or difficult situations. It helps people to deal with very threatening or overwhelming news when they first hear it. For many people it will help them to cope with their situation.

Sometimes, however, avoiding the reality of a situation can stop people from doing things that they need to do, like going for treatment or sorting out money problems. It can cause problems if relatives need to discuss particular issues and the person doesn’t accept that they have cancer.

Denial can be a very useful way of handling the news of cancer. It only becomes harmful if it goes on for many weeks or months or makes it impossible for the person with cancer and the people around them to talk. If you feel that you are using denial (or if someone close to you points it out to you), don’t blame yourself or feel that you must hurry to overcome it.

You may find that the shock, disbelief and denial make it difficult for you to talk about your situation. All these are natural reactions to a diagnosis of cancer. These, and other emotions, are discussed in our section on the emotional effects of cancer.

Some people are not used to talking about very personal and intimate issues. If that has been your way in the past, then you may find it difficult to talk about your feelings at a time of crisis.

Most people don’t like talking about their own needs. They don’t want to seem ‘pushy’ or demanding. However, there will often be friends and relatives who really want to help. So if you can start a conversation with them and say what you need or want, you may be surprised at how many people are willing to support you.

If you find it difficult to talk about your feelings with the people close to you, you may find it helpful to contact a support organisation who can talk things through in confidence.

Other feelings may make you want to be alone and not talk. You may be unsure about how you will react when you talk to other people – you may be afraid that you will cry and not be able to stop. You may feel that you want to stay strong when you talk to people and that it is not good to cry.

However, when you are dealing with something as difficult as cancer, it is natural to need to cry and it is fine if you do. Sometimes the other person may also get upset and cry with you. This can be very supportive, as though you are facing the situation together. Often, it is because the other person cares so much about you that they have become upset. Crying together can feel like a real release of feelings and can bring you closer together. It may be a relief to both of you.