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Navigating Emotions

Coping with Cancer-Related Uncertainty

As humans, we have a natural tendency to fear the unknown. We see ambiguity as a threat, and we are wired to want to control our future.  

Cancer can come with many uncertainties and a sense of loss of control. There are many outcomes we just can’t know, from small ones such as how long we will wait for a medical appointment, to big ones including the effectiveness of treatment and the length of our life. 

Worrying about the future may feel like a useful way to prepare. However, worrying over something beyond our control can lead to a helpless feeling of anxiety.

Counterproductive "Strategies"

Below are some common short-term strategies for managing uncertainty that may actually just increase your apprehension. While these might provide some temporary relief, they can become recurrent thoughts or behaviors that may not reduce your worry. 

  • Searching the internet for unanswerable questions   

  • Playing out possible scenarios in your mind repeatedly   

  • Trying not to think about the cancer/avoidance  

  • Looking for someone to rescue you (different than finding support) 

If you have used any of the above strategies (which you may not have thought of as “strategies”) and are feeling overwhelmed, consider it might be time to try different approaches.

Accept the Lack of Control

A helpful starting place is to acknowledge that you have the capacity to relinquish control. Many of our cultural norms and goals infer that we have complete control over our future. In fact, research shows that human brains are wired for control to survive. However, many aspects of the future are beyond our control, including the way our cells divide, whether a treatment works, how long our life will be, and how soon a new treatment will be available. We cannot control the behavior of other people and natural phenomena. Trying to control your thoughts and emotions can make them stronger and more intrusive. Trying to control them takes a great deal of time and energy. 

One reason you might be feeling overwhelmed is that you are not giving yourself the opportunity to admit the things that are beyond your control. By not considering your entire situation you may be “protecting” yourself from what is difficult to acknowledge, but in doing so, you also rob yourself of the opportunity to examine what you can control.

Focus on the Controllable

The question then becomes “How do I manage my anxiety in the context of these uncertainties so that I can continue to live fully?” Step one: acknowledge what is worrying you.  

There are many things in your life and in the cancer experience that you can control. For example, if your worry increases in the days leading up to scan results, consider how you can support yourself during that time. You can try noticing your thoughts and practicing letting go by saying to yourself, “This thought is a need for certainty which is not possible.” The anxiety may still be there, and still be unpleasant. However, by acknowledging that certain things cannot be controlled, you avoid wasting your time and energy struggling with them. This makes it possible for you to put your energy into something you value and that has meaning.     

Building awareness of your thoughts will help you to reflect on your experience more fully. This awareness will help guide you to what other “coping tools” can be of assistance to you.  

As you explore letting go of what you cannot control, you will learn your own capacity for acceptance. Acceptance is allowing your worries and anxiety to be as they are, even though they are unpleasant and painful. Acceptance is a voluntary and intentional response –something you control.   

Acceptance consists of:  

  • Being aware: You recognize the stressful situation, thoughts, and emotions  

  • Being non-judgmental: You do not judge the situation, thoughts, emotions, or yourself  

  • Making room: You allow a distressing emotion, thought, memory, or situation to be present   

Even though acceptance has only three parts, embracing them fully is not easy and won’t happen overnight.

Remember that changing your approach to living with uncertainty takes practice and patience. Open yourself up to some new strategies. An Iris mental health therapist can help introduce you to additional strategies to cope. Exploring personal values with a therapist can help refocus your attention and develop skills to stay present in the moment while living with uncertainty.

This article meets Iris standards for medical accuracy. It has been fact-checked by the Iris Clinical Editorial Board, our team of oncology experts who ensure that the content is evidence based and up to date. The Iris Clinical Editorial Board includes board-certified oncologists and pharmacists, psychologists, advanced practice providers, licensed clinical social workers, oncology-certified nurses, and dietitians.