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Ovarian Cancer

Psychological impact

The diagnosis of ovarian cancer evokes many different emotions. A few had suspected they might have cancer and had not been particularly surprised, although some were taken aback to hear that it had spread. However, many were shocked. 

Several women described a sense of numbness, confusion or disbelief. Some could not concentrate on what their doctor was saying or even remember their own address or phone number. Two women said that on leaving the hospital after learning their diagnosis they went shopping in a daze and bought things they did not need.

 

Couldn't believe her diagnosis was real.

Couldn't believe her diagnosis was real.

Age at interview: 48
Sex: Female
Age at diagnosis: 46
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In beginning I told them they must be dreaming, it cannot happen to me, because in my family there's nobody who has ever had it. Even up to this day I believe it's a dream, and to me it's a dream, it's a bad bad dream. And when I went out of the doctor's hospital, I ran off from that doctor, I didn't want to see her again because I thought she was just trying to mess my life around. So I kept away 2 months but in the long run she caught up with me again so I had to go and have my operation done.

Although women sometimes felt relief that their symptoms had been explained, others felt frustrated or angry that the cancer had not been found sooner. One woman could see no escape from the cancer and felt trapped.

 

Was angry that her ovarian cancer symptoms had not been recognised sooner.

Was angry that her ovarian cancer symptoms had not been recognised sooner.

Age at interview: 49
Sex: Female
Age at diagnosis: 48
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I felt that, I was quite angry that I had been with so many symptoms for so long and that I wasn't diagnosed. And that, you know, people assumed things like it's Irritable Bowel Syndrome. Quite angry that it's not, there's not a higher awareness of the symptoms of it. You know, ovarian cancer perhaps should be one of the things that's checked for, particularly for women of my age with these particular symptoms.  

 

Could see no escape from her cancer and felt trapped.

Could see no escape from her cancer and felt trapped.

Age at interview: 46
Sex: Female
Age at diagnosis: 39
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I think the feeling that, the worst feeling that happened for me, especially over those first few months, was feeling trapped. It was this sense that, you know, always in the past whatever awful thing that happened, there was some way of escaping. I could run away, I could quit my job; there was always a way of escaping it. And the realisation that this was happening to my body and there was nothing I could do to escape it, just made me feel desperately trapped. And it was very, very important to me to be not in a physical environment where I felt trapped, so I was in one hospital room where I was in a tiny, tiny little cubicle and I was already feeling emotionally so trapped, and then I got severe claustrophobia, and I had it so badly that my family actually managed to convince them to move me to another hospital. So as long as my physical environment wasn't oppressing me too much I was okay, but as soon as I got into any kind of closed space, that feeling of being trapped just got too much.  

Some had reacted quite calmly to the diagnosis and decided it was something they just had to deal with. People who receive the diagnosis calmly sometimes react emotionally later. One lost her appetite for five days and was prescribed an antidepressant. Another had to wait five weeks for her diagnosis after having a biopsy, which she felt contributed to her having a nervous breakdown and being admitted to a mental hospital during that time. When later told she was lucky because her cancer had been caught early she didn't feel lucky.

 

Reacted calmly to her diagnosis and decided she just had to deal with it.

Reacted calmly to her diagnosis and decided she just had to deal with it.

Age at interview: 53
Sex: Female
Age at diagnosis: 52
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As soon as I was diagnosed I was able to say 'I have ovarian cancer' and I think you've got to be able to admit it to yourself and not be afraid of it because, you know, it's just part of life. And I think because I was able to talk about it and, you know, not feel this, I don't know, shame or embarrassment or anything, I never really fell into like a depression or anything like that because it was just kind of assimilated into my life and you just get on with it, it's just part of the journey.

 

Was calm at the time of diagnosis but reacted emotionally later.

Was calm at the time of diagnosis but reacted emotionally later.

Age at interview: 65
Sex: Female
Age at diagnosis: 59
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Well, the consultant showed me the scan of this little cauliflower thing and he told me what it was and I felt quite calm, actually. Just sat there, I suppose because it really didn't sink in and he told me what would happen with me; I'd go in, have the operation, have both ovaries out and some lymph glands. And I drove home quite calm and it wasn't until I came in the street door that it suddenly hit me, and I just burst into tears. And I didn't ring my husband, I rang my sister because we're very, very close. And I told her and I felt that as soon as I'd told her, I felt sort of relief.  

The diagnosis can be particularly frightening when it is unclear what will happen. Women may not know anyone else with ovarian cancer and can feel isolated. Some assumed they would not live much longer and began to prepare wills and plan funerals.

 

Updated her will and planned her funeral after getting the diagnosis.

Updated her will and planned her funeral after getting the diagnosis.

Age at interview: 57
Sex: Female
Age at diagnosis: 56
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And what I decided, that I had to get a few things in order. I had to make sure my will was up, in order, and I went to see the vicar, the local reverend because I wanted my daughter not to have to worry about all the funeral arrangements, if it was going to happen. I knew I had to have an operation fairly quickly, and I mean you can have your wisdom tooth out and not come out of it, you know, I wasn't being over dramatic at that point I didn't think. So I went to see him and I think he thought I was being a bit dramatic given that I, you know, but he probably sees that all the time. I didn't know him, by the way, I mean I just rang him up and said, you know, I don't go to church or anything, but I wanted to do it right, I wanted to make sure that, anyway. 

A woman whose cancer had been diagnosed at an early stage and who only required removal of her ovaries, found it difficult to adjust to normal life after her operation despite the excellent outlook. Another said she needed time after her treatment was finished to come to terms with what had happened.

 

Could not adjust to normal life after having her ovaries removed as treatment for early cancer.

Could not adjust to normal life after having her ovaries removed as treatment for early cancer.

Age at interview: 38
Sex: Female
Age at diagnosis: 32
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It must have been odd for the people around me because of course they were all really pleased because it looked like that had gone very well and what a horrible shock but everything's going to be fine, and I think that the recovery from that for me took such a long time. The emotionally, you know, I, even a year afterwards was still reeling from it. And I think that's probably quite difficult to understand when, if you're someone looking on, because you think 'oh come on everything's great' and you're being told the good stuff, and, and you're fine. I didn't feel fine.

I think I left hospital and I really was aware that despite being told that everything looks like it's going to be fine, they can't say a hundred percent but it looked really good and the prognosis was great. I felt absolutely terrified and I knew that there was a huge kind of conflict between what I was being told and what I felt.

I think, some of it you just need to talk, you need to say how you feel, you don't want anyone to say 'ah but you shouldn't because everything's going to be all right,' or 'but the doctor said this.' You just want to say 'look I feel like this, it's got nothing logical about it, it's nothing to do with the prognosis or the treatment or anything, I just feel scared'. 

In addition to dealing with their own emotional reactions to their illness, some women had difficulties in dealing with the reactions of family and friends. One decided to end her already strained marriage because her husband was an alcoholic and could not look after her or their children. A woman who was used to helping other people with problems felt guilty at needing help when she was ill. She was glad that she had no immediate family to be affected by her illness.

 

Found it hard to deal with other people's emotional reactions to her illness.

Found it hard to deal with other people's emotional reactions to her illness.

Age at interview: 55
Sex: Female
Age at diagnosis: 50
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And the hardest, one of the hardest parts was, was seeing pain on other people's faces. I found that really, really difficult, and I got to the point where, I mean people would stop me in the street and say, 'How are you?' and 'I've heard about it', and there would be such a look of pity on their faces for me. That was one of the really hard things I had to cope with. And I got very, I know I got very blas' with it, because I wouldn't say, like 'I've got cancer', or 'the cancer's come back', I would say 'I'm having chemo', because it was a kind of lighter way of describing the problem. 

Women also talked about later psychological effects of their illness. Some felt guilty that they had so far survived when others had died, but others talked about the positive effects of having a serious illness. They sometimes found that having cancer made them re-evaluate their lives and put things into perspective. It taught them to value what was important in life and to be more understanding of other people's problems. Some felt stronger, more confident and able to deal with other problems more easily. Several said they lived for today and took opportunities to do things now that they might otherwise have put off until later.

 

Having cancer taught her to value the important things in life.

Having cancer taught her to value the important things in life.

Age at interview: 55
Sex: Female
Age at diagnosis: 50
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Up until then, basically, I'd had a very good job, I had a successful business, a career, I had money in the bank, I could change my car every year if I wanted. I had all the material things that I thought life was about, basically. And physically up until then I had always been very fit and very well. So to a certain extent I suppose what I'd done is taken life very much for granted. And because I was forced to rest, because I didn't through certain times have the energy to do very much more than just rest, it started me to think a whole lot more deeply about, I suppose, the meaning of life. 

And I think one of the hardest things that I had to get my head round was the fact that, you know, one of the things that is guaranteed for all of us is that we will die. And the other thing was, realising that, you know, so many people are living, they're alive, but it seemed to me they weren't really living. And so the whole of that, for me, was turned completely upside down, and I recognised that every moment I had was of great value. 

I know if you ask my mum, if you ask my friends, that I'm a more compassionate and loving person as a result of that experience. The whole of that experience, has given me a greater sense of what really has a value in life. And for that I am grateful. As mad as that sounds, had I not gone through that experience, I probably wouldn't have come out feeling, you know, when I see a sunset or when I see new flowers coming, I'm like, 'Wow'. You know, that's what's important to me now.  

 

Having cancer made her feel stronger and better able to tackle other problems.

Having cancer made her feel stronger and better able to tackle other problems.

Age at interview: 38
Sex: Female
Age at diagnosis: 32
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I think it's made me slightly more resilient than I was, when difficult things have happened, which they have in the years that came next, I didn't think it was the end of the world. It was difficult and, but I'd already had difficult things to deal with and, and you realise that you can actually survive difficult things. 

Some said they now made time for themselves, only doing what they wanted to do, when they wanted to do it, and not allowing themselves to be pressured into doing things they didn't want to do. Illness can sometimes make people seem self-centred - one reflected that she had enjoyed the attention she received from health professionals and friends, and craved it when it ceased during her remission. Another thought she had gone through a selfish period at first, but that it had balanced out in time.

 

Having cancer has taught her to only do what she wants to do.

Having cancer has taught her to only do what she wants to do.

Age at interview: 43
Sex: Female
Age at diagnosis: 41
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And since then I have lived life to the full, I have done each day as I wanted to do something. I don't, I don't go to plans, somebody says 'come out and do something', I go if I want to. If I don't want to go, I don't go, I please myself, I do what I want to do. Makes you appreciate life is not, you know, this is not a trial, this is life, you've got to go for what you have.

I don't stick to routines, I'm not washing day Monday, baking day Tuesday, I'm not that type of person. I now decide when I get up in the morning, if I want to go and do something, I do it. If I don't want to do it, I don't do it. And that's exactly how I look at life, and I just live each day as it comes and enjoy myself.

The commonest long-term psychological problem was knowing that the cancer could return. Some feel that they become hypochondriacs for a while, imagining that anything could be a sign of the cancer coming back, or alternate between optimism and worry. However, others had managed to put it behind them and found it hard to believe that it had happened to them because they now felt so well (see 'Facing the future').

 

During periods of remission she could never forget that the cancer could return.

During periods of remission she could never forget that the cancer could return.

Age at interview: 63
Sex: Female
Age at diagnosis: 52
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Well in one sense I feel that it's been quite a strain over the 10 years, because although I had quite long remissions, the cancer's always there in the background, and if people don't know until quite a late, late stage, they haven't got so much time to worry about it. Not that, you know, I've had it in my mind all the time, but you can't completely forget it. It's always there in your life.  

See ‘Coping strategies’ and ‘Other sources of support’ for information about dealing with the emotional impacts of ovarian cancer.


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Last reviewed June 2016.

Last updated June 2016.

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