Emotional impact of advanced pancreatic cancer

A diagnosis of pancreatic cancer is difficult for anyone affected by the disease. It can affect every aspect of your life and it can feel as though your world has been turned upside down. People who you would expect to be supportive may become distant, others may be more involved and helpful.

You may feel a sense of disbelief or that you need to be strong for others. You may feel as though you need to pull away from others for a time, to be alone and introspective. Or, you may feel as though you want to have friends and family around you all the time and are afraid of being alone. You may experience a mix of these emotions. There is no right or wrong way to react to what is happening to you. If you respect your feelings then you are doing the right thing.

Being open and honest with friends and family about how you are feeling is the best way to support them and yourself. Remember that they may need time and space occasionally as well.

Fear

Fear is common when people think about dying. It may help to try and find out the cause of your fear. Is it the idea of being alone? Is it the thought of being in pain? Or what happens after you die to yourself and the people you care about? It may be a mixture of these things. Once you can turn your fear into questions you know who you have to go to and what you have to do to answer them.

Anger

You may feel angry that this is happening to you. That is understandable and expected, your life is ending sooner and taking a different path to the one that you imagined for yourself. It can be difficult to know what to do with your anger, to try and find a way to make it something productive. Directing your feelings, the right way can help you make sure that you prioritise the things you want from life as much as possible.

Regret

Sometimes you may view things that have happened in your life with regret. Some people blame themselves for not going to the doctors sooner or look back at their past with regret. Try and remember that this diagnosis is not your fault. Making memories and strengthening your relationships in the here and now may help to build bridges.

Grief

You may feel a sense of grief or loss at what is happening to you. Talking to loved ones may help you share those feelings. Feeling sad and grieving is normal, if you feel a sense of hopelessness or you take no pleasure from things you used to enjoy for a long period of time this may be depression. The link between pancreatic cancer and depression
is complicated. Rates of depression are high in people with pancreatic cancer, but it is not a normal part of the end of life process. If you are worried about depression it is important that you speak to your medical team.

Loneliness

You may feel as though you are isolated and alone following your diagnosis. It can feel as though you are the only person in the world who can understand how you are feeling. It may feel as though you cannot talk to other people, either because they cannot relate, or you will upset them. There are people who can support you through this time, family, friends and health care professionals. There is no right or wrong person to talk to or way of dealing with loneliness, as long as you talk to someone.

Difficulty sleeping

Difficulty sleeping is called insomnia. Many people with cancer struggle to sleep at various times. It may be due to medication side effects, poorly managed symptoms or anxiety. Not sleeping well can make you feel worse and make any anxiety or worries greater.

Tips for better sleep include

• Having a regular bedtime routine
• Being as active as possible
• Avoiding caffeine and alcohol
• Avoiding screen time such as smart phones or computer screens in the hour before bed
• Meditation or mindfulness

If you are still unable to sleep well then discuss it with your GP. You may need a short term prescription or adjustments in your medication to help you sleep.