Survivor's Guide
Loss and Grief

Different types of Life Changes & Losses

Reactions to losses or changes because of cancer and its treatment may change over time; they can even change from hour to hour or day to day.

Some losses are more affecting than others. Some are temporary (e.g. hair loss or tiredness) and others are permanent (e.g. loss of fertility or loss of a body part through surgery), making them more difficult to deal with. A loss that affects one person may not affect someone else in the same way.

You may worry about how particular losses will affect your:
  • job
  • family roles
  • independence
  • confidence, self-esteem and self-respect
  • financial state
  • social life
  • relationships
  • sex life
  • ability to take part in sports and hobbies.
In this section we outline some changes caused by cancer and its treatment.
Physical changes caused by cancer and its treatment can be difficult to cope with. They may include:
  • the loss of a body part such as a breast, limb or internal organ (such as a woman's ovaries or uterus or a man's prostate gland or testicles)
  • having a bag for urine or faeces (colostomy, urostomy or ileostomy)
  • hair loss
  • changes in speech
  • changes in taste, smell, hearing or sight
  • breathing difficulties
  • visible scars
  • having a hole in the neck to allow breathing (tracheostomy)
  • weight loss or gain
  • swelling in arms or legs due to removal of lymph nodes (lymphoedema)
  • changes in mobility: needing a wheelchair, walking stick or prosthesis (artificial limb) to get around
  • loss of concentration and memory.
Some changes may not be obvious to others but they can still have a big emotional effect:
  • weakness, tiredness and fatigue, making things harder to achieve
  • changes in sexual interest, abilities or activity
  • loss of fertility
  • dietary changes
  • changes in breathing
  • pain: physical or emotional
  • scars or body changes that others can't see
  • hormonal changes due to removal of ovaries or testicles or side effects from medications
  • bladder changes (frequency or urgency)
  • bowel changes (diarrhoea or constipation).
These changes can make a significant difference to how a person feels and what they can do. They can affect a person's ability to enjoy a hobby, play sport, work or drive. Relationships may be affected. Any physical change, no matter how big or small, can lead to a sense of loss.

Everything may feel different. For example, if affected by bladder or bowel changes, you might have lost the freedom to go somewhere without help or worrying where the next toilet stop is. You may feel you have lost your sense of dignity if you need help to eat, drink or dress.

Many people say they feel they have lost a sense of who they were. This can be painful to come to terms with. Physical changes can take time to deal with. Although you may never completely accept the changes, most people find a way of dealing with them. It's often easier with help and support from family or friends, or people who have been through a similar experience.
Cancer and its treatment can greatly affect emotions. Each loss can bring yet another roller coaster of feelings. Although everyone is different, most people with cancer say they go through many intense emotions from the time of diagnosis right through until well after their treatment finishes. Many of these emotions are due to feelings of loss brought about by their cancer and its treatment. They include loss of:
  • relationships (friends, family, work acquaintances, partner)
  • how a relationship used to be (you may now be the person receiving care rather than your usual role of giving care to those close to you)
  • confidence and security in your future (not feeling you can plan ahead or dream about your future in the way you used to)
  • confidence in your abilities
  • independence (you may now have to depend on others to do many things)
  • sexuality, self-image and self-esteem
  • patience
  • the ability to enjoy life as you used to due to sadness or depression
  • time to do what you want (your days may be filled with hospital appointments, having treatment and coping with side effects).
Certain relationships may change and leave you feeling lost, angry or upset. Although those close to you can try to understand, they can never fully understand or feel the losses as you do.

With grief, some people seek support, while others withdraw from those around them. This can cause problems within close relationships as each person struggles with their feelings and the need for the other to understand.
Cancer and its treatment may affect your social life. Your lifestyle may change due to physical or financial changes. Many people say they feel isolated and alone. There may be times you feel alienated from others because your life has changed so much. Your values and beliefs may change because of what you've been through. You may feel like withdrawing from close family and friends. Tiredness, pain, sadness or depression can stop you going out and doing things with others like you used to. Birthdays, anniversaries, Christmas and other special events may be difficult. You may now associate some of these events with pain and loss.

Your loss of social contact and activity may be temporary. However, for some people their grief stops them returning to any kind of social life. Remember: it's important you have support and know where you can go if you need help. Talk to a close friend or ask your GP where you can get support. You can also call NCSM’s Resource and Wellness Centre at 03-26987300 for support and information.
Spirituality is not dependent on religious beliefs. It relates to a person's sense of meaning and purpose in life: why we're here and what's important to us. Spirituality brings with it a sense of belonging.

During times of physical and emotional stress, illness, loss and bereavement, people often become more aware of spirituality. They may question what life is about, how things happen, their purpose and their future. Cancer and the losses it can bring may strengthen, change or weaken spiritual beliefs.

Spirituality can help people get through grief. Some research has shown people with strong spiritual beliefs are able to resolve and cope better with grief. If you need spiritual support, talk to someone you trust: a close friend, counsellor, pastoral care or church or other religious group.
Cancer can affect your financial situation. If you're caring for someone with cancer or have cancer yourself you may need to cut down your working hours or stop work all together. Your financial state may change because of this. There may be extra expenses. Financial losses can have a major effect on your life and family.

Call NCSM’s Resource and Wellness Centre at 03-26987300 for more information about getting financial assistance and coping with financial loss due to cancer.
Written by Annie Angle, cancer nurse (Dip. Oncology Nursing, Royal Marsden, London). Reviewed by Voula Kallianis, Social Worker, St Vincent's Palliative Care Unit; Eugenia Georopoulos, Project Officer, Centre for Culture Ethnicity and Health; Wendy Thurling, Senior Bereavement Counsellor, Australian Centre for Grief and Bereavement; Jane Fletcher, Deputy Head, Cabrini Monash Psycho-oncology Research Unit and Director Melbourne Psycho-oncology Service; Associate Professor Michael Jefford, Medical Oncologist, Peter MacCallum Cancer Centre; Marie Craw; Nadia Montibellar; Neil O'Loghlen; Lesley Bawden; Meg Rynderman, Cancer Connect and Australian Cancer Survivorship Centre Volunteer; Majella Franklin.