Between us and silence: cancer and mental health from the perspective of psycho-oncology

Between us and silence: cancer and mental health from the perspective of

psycho-oncology

When the word "cancer" comes to a consultation, a result, or a phone call, it doesn't arrive alone. It rushes into every room of life: the body, the calendar, the family table, work, faith, intimacy, and—very especially—one's emotional life. With my experience in psycho-oncology, I see how that moment inaugurates a before and after. Sometimes there is immediate crying; other times, a strange calm, as if everything were happening in slow motion.

The emotional processes that accompany cancer aren't linear . They don't function like a checklist. They're more like waves that come and go: fear , uncertainty , sadness , anger , guilt , and also relief when good news arrives, hope when something helps, and humor that appears in the midst of difficult times. All of these responses are human and expected; they're not a sign of weakness or a "lack of attitude." They're the emotional system trying to adapt to a major change.

There are usually understandable phases , though they are unique to each person. After the initial shock, comes the waiting period : tests, appointments, results. That "in-between" can be one of the most exhausting stretches. The brain is on "alert," trying to predict what it can't predict; that's why it's hard to sleep, concentrate, or "think about anything else." Then, with the start of treatments (surgery, chemo, radiation, targeted therapies), the routine is reorganized around the hospital: schedules, side effects, nutrition, support. Many women tell me they feel their identity narrows : they go from being "so many things" to being "patients," and it hurts. Later, if remission or the follow-up stage arrives, what we call "scanxiety" in the clinic appears : that nervousness before tests or each checkup. And if there's a relapse or the disease doesn't respond as we expected, emotions are reactivated with force; Therefore, we need a flexible emotional map that accompanies us in any of these scenarios.

There are also rarely discussed topics that directly affect self-esteem : bodily changes (hair, scars, weight, skin), profound fatigue, brain fog, hormonal changes, sexuality, and intimacy. It's not vanity; it's identity . The body is our visible home in the world, and when it changes, our reflection on ourselves can become very harsh. Here, psycho-oncology doesn't promise to avoid pain—it's not possible—but it does promise to help you look at yourself with less cruelty and more care , to reorganize your day so that emotional well-being can take place, and to build small tools that work in real life.

I also know that in our communities—in Indiana and so many places—there's a silent mandate to “be strong,” “give it your all,” “don't worry,” “be thankful.” Gratitude helps, of course. But it doesn't cancel out fear . And true strength isn't denying everything, but being able to say it without shame: “I'm scared today,” “I got tired today,” “I need someone to be with me today.” Naming what's happening doesn't make it bigger; it puts it in order. And when it's organized, we can better decide what to do.

If you're a caregiver , this paragraph is for you: Being with someone you love is an act of love… and also a huge emotional endeavor . You're not "extra" in this conversation. Your rest, your emotions, and your health also count. You're not an accessory to the treatment: you're part of it .

Asking for help is also treatment. There's no manual for dealing with cancer: every body and every story is different, so leaning on others isn't giving up, it's taking care of yourself .

I leave you FOUR emotional supports to evaluate and raise awareness of your process

1) Emotional thermometer (1 minute)

At the end of the day, ask yourself: “On a scale of 0 to 10, how uncomfortable am I today?”

0–3: Maintain your care routines.

4–6: Choose a specific support action (see below).

7–10: Prioritize rest, contact with someone you trust, and calming activities.

2) Breathing 4–2–6 (2 minutes)

Inhale 4 , pause 2 , exhale 6 . Repeat for 2–3 minutes.

It is used to lower the intensity in the waiting room, before a call, or while sleeping.

3) Small actions with great impact (choose one per day)

• A short shower + a gentle cream on an area of your body you're having trouble looking at today. • 10–15 minutes of gentle walking or stretching.

• Music that connects you with a version of yourself that you like.

• Open a window, breathe fresh air and look at something green .

4) Mini-log (3 lines)

• What tired me today:

• Something that gave me calm:

• A small achievement (even if it is minimal):

Cancer and Mental Health Workshop 2025

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Monica's Story: Learning to Live After the Diagnosis

Have you ever found yourself in a place so dark and unfamiliar that you felt you might lose your way?That’s where my journey began.

My name is Monica, and today I share my story—not just as a breast cancer patient, but as a woman who refused to hand control of her life over to fear or illness. In the darkness, I sharpened my senses to find my own path.

I remember the phone call that changed everything. The words are blurry now, except one: cancer. In that instant, my breath stopped. Coming home with that news in my chest felt like carrying a stone. Saying it out loud made it real. Hugging my loved one and crying together meant accepting that this was no nightmare—it was my new reality.

That first conversation with the doctor felt like entering a foreign language. They spoke in terms that were routine for them, but for me, everything was new, uncertain, overwhelming. Surgery, radiation, chemotherapy… They didn’t talk about fear, or the invisible pain inside me, or how my soul felt violated. Their goal was to save my life. Mine was to understand how to live it.

In that darkness, I lost my direction. I had a tumor, but no pain. I was asked to undergo treatments whose side effects might last forever—lymphedema, radiated lungs, fragile bones, neuropathy, memory loss. How could I make sense of so many difficult choices? I felt trapped between impossible paths.

Despair brought me to the edge of the abyss. And at that edge, a light appeared: a friend. Not just anyone, but someone who had survived her own tumor. Hesitantly, as if confessing something shameful, I told her my story. She listened quietly. Instead of advice or pity, she asked one question that changed everything: “How can I help you?”

I didn’t have an answer—but she had intuition. She knew I needed understanding in order to decide. She offered her time to help me research and translate the science. She didn’t send me random Google links—she shared solid clinical studies and real medical advances. She wanted me to trust the system, but what she truly gave me was far greater: she showed me I still had power—the power to act, to decide, to take the reins. She empowered me.

That was the turning point. I stopped feeling like a passive victim. I began to educate myself, read studies, ask questions, seek options aligned with my values and beliefs. I found a support group that taught me how to nourish my body, heal my spirit, forgive, move, and let others help me. I learned that hope is something we build.

When results came in, I was ready to discuss them, to ask, to challenge the “standard treatment.” I was tired of being led by a system that treats everyone the same. With respect, I made my own choices—based on science, but also on intuition, values, and my goals for life.

It wasn’t easy. I had to stand up not only to doctors but also to family opinions. I asked for respect—respect to choose quality of life over quantity, to reject the idea of being a “warrior” in a war I never chose. This is not a battle; this is my life, my body. To respect a patient is to ask, “How can I walk with you?” Even if that means walking in silence. That is respect. That is love.

The path after diagnosis is lonely. Those who love you want to help, but often don’t know how. As a patient, you feel no one truly understands—and maybe they don’t, but they don’t have to in order to walk beside you. I learned to ask for help when I was ready—from my husband and family, who cared for me with love and patience; from my friends, who cheered me on; and from professionals who guided me through the emotions and fears. I have felt alone many times, but I never truly was.

Today, nine months after my diagnosis, I’ve accepted and followed the treatment that made sense to me. I took risks, yes—but they were mine to take. I’m not chasing a magic cure. I’m still here, transforming. I’ve changed my diet, lost 30 pounds, and adopted a mostly vegan, natural lifestyle, free of processed foods, sugar, and dairy. I meditate daily, exercise, and take evidence-based supplements. I feel better than I have in fifteen years.

And though I grieve for those who have lost loved ones to this disease, I can say this: in some ways, I’m grateful for my diagnosis. Not because I wanted it—never—but because it forced me to face how I had neglected my body, mind, and spirit. Today, I live differently—not driven by fear of dying, but by an immense desire to live.

I live for my daughter, to be there when she needs me, to hold her, to share her joy. I live to keep my promise to my husband—to grow old together. I live to be present, whole, aware. Cancer took away my certainty, but it gave me back strength, clarity, and the power to choose my own path.

A path where I embrace life with gratitude every day. A path where I no longer have patience for harmful company, where I no longer postpone joy, where I am my own priority.

But don’t think that means everything is fine. Some days I look in the mirror and struggle with my reflection. I’ve bought countless bras, hoping one will make me feel like myself again. Every time I feel a pain, I spiral into fear—what if it’s back?

I have bright days full of gratitude, and dark ones filled with fear, anxiety, even anger. The road isn’t easy—it rises and falls—but I keep walking, with faith, humility, and self-love.

So remember:Find your voice. The voice to ask for help, to say what you need.Listen to your inner voice—the one that tells you what feels right and what doesn’t.Listen to your body—no one knows it better than you.Take responsibility for your today and your past. Ask your body for forgiveness for neglect or harm, and do it with love, not guilt.Take action to help your body be in its best state to heal—whether or not you follow medical treatments.

To the loved ones of a patient:Respect and give space. Supporting someone means honoring their decisions, even when you don’t agree.

Ask, “How can I help you?” Sometimes it’s not about cooking a meal or driving to an appointment; sometimes it’s simply sitting together under the stars. Listen without judgment, blame, or criticism. Don’t try to fix them—they don’t need saviors; they need presence, empathy, and genuine love.

To the doctors:You who took the Hippocratic Oath—remember, it’s not only about saving lives, but about respecting the wishes, goals, and beliefs of each patient. Explain, inform, offer options—but don’t reduce a person to their disease.

We are more than a diagnosis. We are human beings with stories, fears, dreams, and reasons to keep living. And we have the right to choose how we live.

Because cancer may change our bodies and our routines—but it should never take away our voice, our autonomy, or our hope.

Thank you,

Monica