Survivor’s guilt after cancer treatment can compound feelings of grief and loss. Alice-May Purkiss shares five steps to help manage this strong and complex mix of emotions.

A few weeks ago, I learned that my friend Saima had died. It was a Sunday evening, and I’d spent the day pottering around my flat, getting frustrated about inconsequential things when a friend sent me a voicemail to let me know.

Suddenly, all the annoyances of the day slipped away. What a privilege it was for me to be able to worry about the tiny details of life. What a privilege it was for me to be alive and get irritated by stupid things like shoe storage and walls that needed painting when our girl took her final breath at 31.

Saima was an absolute tour de force who had been diagnosed with stage 4 lung cancer before she even turned 30.

She was well known within the cancer community for speaking passionately and articulately about what it was like to be a person of color living with cancer. She spoke about the disparities within her community and the white community. She strived to break the taboo of talking about cancer that is so prevalent within many cultures.

She was a trailblazer and a game-changer, and a really good human. We all feel her loss very, very keenly.

And I felt very guilty.

What is survivor’s guilt?

Saima’s isn’t the only loss I’ve experienced over the last few years. The cancer community, particularly the young cancer community who use Instagram as a tool for connection, is a tight-knit group, and one of the problems with being in that community is that people die.

People you know die.

I am 31, and I have seen far too many of my peers die from a disease that, for some reason, spared me. And that brings an abundance of complex emotions that takes a long time to unpick every time someone I know dies. Sadness, anger, fear, and heartbreak merge into one big mess to work through.

In addition to that, there is always guilt.

My survivor’s guilt after cancer has been a big issue over the last few years. It’s a common problem defined by the Cambridge Dictionary as “difficult and painful feelings caused by the fact that you are still alive after a situation in which other people died.”

Generally, it’s connected to post-traumatic stress disorder (PTSD), which used to be thought to relate to only serious accidents or global conflicts. Still, it’s becoming more frequently associated with cancer survival too.

It’s tricky.

If you stay in the community, you will meet and connect with people who will not survive. So do you protect yourself from survivor’s guilt by removing yourself from the situation, or do you stay and meet the brilliant people living with and beyond cancer?

For me, it’s a no-brainer. I have met so many amazing people, so I’ve chosen to try managing survivor's guilt rather than avoid situations where I may feel it.

5 Tips for managing survivor’s guilt after cancer 

For quite a while now, I’ve been working through some of the trials and tribulations that come with surviving cancer with my friend Sophie Trew, who also happens to be a Cancer and Mindset Coach. I’ve gathered five things about managing survivor’s guilt that I learned through working with her.

1. Talk to yourself like you would a best friend

Firstly, when these feelings of guilt come in, it’s so important to talk to yourself like you would someone you love. I am much more empathetic to others than myself, and I imagine I am not alone in that.

I think about what I’d tell someone else dealing with the dual dilemma of grief and survivor’s guilt after cancer and apply that to myself. I tell myself it’s okay to feel how I do, and no one is to blame.

Cancer is a wily beast that takes lives without rhyme or reason. Surviving is not something you should feel shame for.

2. Share your thoughts with someone you trust

It’s an age-old adage, but a problem shared is a problem halved. When we talk about complicated issues with friends, we can feel less isolated in these feelings.

Chances are, if you’re talking to a fellow cancer survivor, they’ll be feeling or will have felt, at one time or another, exactly the same. Sophie is often my go-to person for this kind of chat. Honestly, talking it through always makes me feel lighter.

3. Take time to process your grief

We’re often guilty of telling ourselves we shouldn’t feel a particular way, but sitting with our emotions is a vital part of dealing with them.

It’s also true that survivor’s guilt is an emotion innately embedded in grief, so it’s crucial to take time out to actively process the sorrow you're feeling.

In the days after Saima died, I went for several swims to remind myself what a gift it is to be a living, breathing human. I dedicated each of those swims to her.

4. Regain a sense of control by following a daily routine

When things feel out of control, try setting up a routine that includes doing something you enjoy every day. It might be cooking or running, or doing yoga. You might find comfort in reading or writing out your feelings. Whatever makes you feel more level-headed, schedule some time for those things daily.

Keeping busy is a great tool for managing survivor's guilt. It makes the overwhelm feel less overwhelming, and the productive distractions help.

5. Remember that others have also struggled or known someone with survivor’s guilt – reach out to them

And lastly, even though it may feel like you are, you are not alone. So many people have walked in similar shoes to yours, and they'll know how you’re feeling. Ask yourself if you feel ready to talk about guilt, trauma, or depression, whether it be with someone personal or professional.

The information presented is solely for educational purposes, not as specific advice for the evaluation, management, or treatment of any condition.

The individual(s) who have written and created the content in and whose images appear in this article have been paid by Teva Pharmaceuticals for their contributions. This content represents the opinions of the contributor and does not necessarily reflect those of Teva Pharmaceuticals. Similarly, Teva Pharmaceuticals does not review, control, influence or endorse any content related to the contributor's websites or social media networks. This content is intended for informational and educational purposes and should not be considered medical advice or recommendations. Consult a qualified medical professional for diagnosis and before beginning or changing any treatment regimen. 

NPS-ALL-NP-01078 AUGUST 2023