Guilt: A Lasting Side Effect for Cancer Survivors

By Julie Grisham,

Wednesday, June 29, 2016

Lymphoblastic leukemia survivor speaking at Fabulous and Fighting event for cancer patients.

Difficulty coping with the emotional toll of a cancer diagnosis can continue long after treatments are over. Guilt is a common feeling experienced by cancer survivors, but there are ways to address it.

  • Guilt is a normal emotion after cancer, and there are many reasons survivors experience it.
  • Classic “survivor guilt” is common.
  • Many survivors find that giving back is a way to combat feelings of guilt.
  • MSK offers support services for many of the problems cancer survivors face.

“I lived my life better when I was sick,” says Leslie Gauthier, who was diagnosed with an aggressive T cell lymphoblastic leukemia in November 2011, just a few months after graduating from college. “I didn’t take anything for granted. I said what I needed to say. And I kept positive people around me. That’s a model for how I want to live now, and I feel guilty when I don’t do that.”

No matter what kind of cancer you’re diagnosed with, coping with its emotional toll can continue long after active treatments are over. The aftermath can lead to a tangle of complex feelings. For those who enter the world of cancer survivorship, guilt is often one of those emotions.

After more than two years of chemotherapy, Leslie says guilt is a part of her life that she’s working to overcome.

Guilt can be a way to protect us from those feelings, because it's something we feel we can control.
Kimarie Knowles
Kimarie Knowles social worker

Cancer survivors may experience a range of guilty feelings in addition to what is considered classic survivor guilt — surviving the same thing that someone else dies from.  Some people may feel guilty about disrupting the routines of friends and family members, especially those who had to give up extensive amounts of time to provide care. Others may feel guilty about not doing everything they can to live the best life possible after surviving cancer.

“Often when people are diagnosed with cancer, they contemplate their own mortality and vulnerability for the first time,” says Kimarie Knowles, a Memorial Sloan Kettering clinical social worker who works with cancer survivors.  “The feelings of powerlessness or helplessness that can be triggered in the face of illness are overwhelming. Guilt can be a way to protect us from those feelings, because it’s something we feel we can control.”

Leslie, who is now cancer free, participated in a support group for young cancer survivors led by Ms. Knowles last year. She developed close bonds with others in that circle. “We talk all the time about how it’s important to lead a life that’s meaningful and full of joy,” she says. “I’ve been given this time, and doing things that are meaningful — including connecting with others who are going through cancer — is the best way to combat the guilt.”

Painful Feelings Triggered by Trauma

Cancer patients may develop special attachments to others who are being treated at the same time they are. Even if they never speak to them, they often connect emotionally to other people they regularly see in treatment and in waiting rooms. One sign of survivor guilt, Ms. Knowles says, is when patients try to minimize or dismiss their own cancer experience because they believe other people are worse off than they are. “They may say, ‘I only had surgery, while he had surgery, chemotherapy, and radiation,’” she notes.

Survivors coping with these emotions often feel that they need to justify their existence or that they don’t deserve to be here, Ms. Knowles says. This often speaks to the feelings of powerlessness and grief related to their own cancer experience. “We as social workers try to look deeper and understand what people are struggling with,” she says. “Once we help them recognize their feelings connected to the guilt, they often have an aha moment, which helps them to begin moving past it.”

Social workers can help cancer survivors who are struggling with feelings of guilt.

“These feelings can come out anytime someone is looking at issues of fairness,” says MSK clinical social worker Susan Glaser. “People who have experienced trauma are comparing themselves to others. Survivors look at other people who did everything ‘right’ but died anyway and try to make sense of that.”

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Recognizing Emotions and Moving Forward

Aside from her support group, Leslie has connected through social media with a young woman who currently has leukemia, sending her encouraging messages, singing a song for her on a video, and even mailing her a care package of items that friends had given Leslie during her own treatment. “Reaching out to her makes me feel better,” she says. “The worst thing for me would be feeling like I was sitting on my hands and not doing anything to help this other person.”

Leslie has also become active in two groups that support cancer patients and survivors: Fabulous and Fighting, which helps women going through cancer treatment by providing clothes donated by designers, and True North Treks, which takes young adult cancer survivors on free outdoor adventures that help them connect with nature.

Pictured: Michael Quinlan
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I thought I was crazy. But to know that others suffer from this makes me feel better. I'm a survivor fought my fight til it was gone. With the BEST ppl in the world. Mskcc. I'm 20years cancer free. But every time someone gets it. I say why did you make me survive. Well I've been living in fear for since day one. I can't kick the feeling. I hate this n wish it would stop.

Rose Mary, thank you for sharing your story. We're glad to hear you're cancer free. If you're having these feelings, you may be interested in participating in Connections, our online support group for cancer patients and survivors. You can learn more about it here:…. You can learn about other counseling and support groups at

MSKCC saved my life! It's 17 years since my dx., and thanks to Doctor Alexandra Heerdt and Doctor Diana Lake; all the nurses and techs; and social workers Roz Kleban and Susan Glaser, I got through treatment as comfortably and easily as possible. Thank you all SOOO much!

Carol, thank you for sharing those kind words! All the best to you.

This is so familiar to me. Our daughter (Emily) was treated and cured at MSKCC 8 years ago. She made 3 close friends. Rhabdo kids they called themselves. One younger girl there from Dubai and Emily became extremely close. Emily was the only survivor. The loss of Dania was extremely hard on Emily. She is still in counseling but still has a hard time becoming close to anyone. Afraid to go through a loss again. I'm glad that Leslie has been able to work her way through this. It gives me hope.

Dear Jerry, thank you for sharing your thoughts on our blog. Your daughter's experience is not uncommon and we are glad to know that is getting the help and support she needs. We wish her all our best.

I had stage 1A lung cancer which was discovered by accident - a CAT scan after extensive spinal surgery to rule out a collapsed lung. I subsequently had a lobectomy at Sloan. I did not need chemo or radiation. Am I a survivor? Should I deal with the fact that I had lung cancer. I feel like I didn't suffer enough

Dear Leslie, we are sorry to hear about your diagnosis. The definition of a cancer survivor can vary with each individual, but most agree that a person is a cancer survivor from the moment of diagnosis. It has nothing to do with your treatment experience or whether or not a person has found the experience to be a difficult one. If you feel like you are having a hard time coping with your cancer experience it may be helpful to speak with a social worker or psychologist to sort out those feelings and get some support. We wish you well.

I get really sad whenever I hear of someone's diagnosis of cancer or passing from cancer. I'm a survivor of four years. I thank God everyday for healing me and directing me to the great professionals at Sloan Kettering. I'm learning about survivor guilt and understanding better what it really means to experience that emotion. I've recently begun meeting with a therapist on a weekly basis to help me cope and understand the emotional struggles I face as a survivor. I do experience fear but my faith helps me during those times.

AnnMarie, thank you for sharing your experience, and we are glad to hear you are doing well!

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