Survivor's Guide
Loss and Grief

Loss, Grief & Change

Loss means losing someone or something meaningful. Everyone experiences loss at some time in their life. Some losses or changes are more difficult to cope with than others. A major loss or change can have a significant effect on a person's life. It can involve relearning or rebuilding important aspects of their lives.

Such losses or changes include loss of:
  • someone important, for example, when someone close dies
  • a close relationship, including through divorce or separation
  • a sense of control over your life
  • health
  • a job or home
  • a pet
Grief is a reaction to any loss or major change that is painful. When people lose someone or something important to them they face one of the greatest challenges of their life. A major loss or change can affect people physically, psychologically, emotionally, financially, socially and spiritually.

Grief has been described as the most painful of all human emotions. Its intensity can go up and down, allowing people to live with it despite having moments when they think they can't. Depending on the type of loss, grief may only last a short time. But certain losses are so painful and overwhelming people may feel they'll never be able to deal with their grief. However, most people say the painful feelings do reduce with time. They may never disappear but people are likely to find a way of living with their grief.

Loss and transition
Any loss usually involves a ‘transition' time. Transition means moving away from a familiar place where we know what is going on, how things are done, and what to say and do, into unfamiliar territory, either physically or emotionally. Suddenly everything is different and strange. You may find you have no language to describe what's going on. Being in transition can be very unsettling, confusing and uncomfortable.

You may go through a transition time if you:
  • receive a cancer diagnosis
  • go through cancer and its treatment
  • care for someone who goes through cancer and its treatment
  • find out the cancer has come back
  • find out the cancer can't be cured.
You may be grieving for the past, the dreams you had for the future and the things you feel you have lost. You may feel you are in limbo, with your mind seeming to be half in one place and half in another. Life may no longer seem certain and it may be difficult to make sense of it all.

Does everyone feel the same way?
In the past a cancer diagnosis often meant someone did not have long to live. This meant people would begin grieving and preparing for death at their diagnosis. For most types of cancer, this is no longer the case. Improvements in treatment in the past 20 years now mean many people survive for years after their diagnosis. 

However, although people often live longer, they may still face major changes, losses and uncertainties because of cancer. People grieve for the loss of health or their life as it was before cancer. Some losses are obvious to friends and families; others are not.

Researchers have studied grief to try to understand how people work through a major loss and come to accept what's happened. For many years it was thought people generally went (in order) through the phases of denial and shock, confusion, anger, bargaining, depression and, finally, acceptance.

Recent studies show coping with loss and grief is a more varied and individual experience. Some people never reach acceptance and have strong emotions about their loss for the rest of their life. Others continue to deny their loss, never wanting to talk about it or act like it has changed them. Both these situations can be very painful, both for the person with cancer and those close to them.

For some people, acceptance may lead to gratitude, wisdom and potential personal growth after a loss.

Many now believe we should view grief a bit like a roller coaster ride: lots of ups and downs and highs and lows, with the beginning often being the roughest ride! There's not necessarily a set order in how people experience grief. 

When does loss and grief begin?
Everyone is different and their life and losses are unique. When and how people affected by cancer begin to grieve varies from person to person. Generally people begin to feel some loss at diagnosis. For others, it begins when they feel unwell, before the diagnosis. Others start to feel their losses after treatment is over.

The types of losses and how they may affect you may change from day to day or month to month. 

How long does grief last?
This also varies from person to person. Grief may be painful but pass quickly. Or it may be a long, drawn-out process. For some it may never end; people just find a way to cope with grief and manage their daily lives. Some losses cannot be resolved and acceptance may not be possible. Some people need to continue to remember how things once were. This doesn't mean they can't get on with life, and still enjoy it.
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.