How to Cope When Others Die of Cancer: My 50:10:40 Rule

If you are affected by cancer (whether you have been diagnosed, treated, or a relative, friend), then you will know how painful it can be, when someone else dies of cancer. How can we honor the pain of the loss, and the fear of what may lie ahead for us, and still keep going?

Because their death can touch us in so many ways and for so many reasons, leaving an unsettling effect on our emotional and therefore also on our physical wellbeing.

After I was first diagnosed with breast cancer, I started to feel what many of us feel on a regular basis: the mix of empathy and dread when someone else dies of cancer, especially breast cancer. And since I have been diagnosed with a local recurrence, things have not changed. But I am working hard for them not to get worse.

And this is not just limited to people I knew. Often these are people I have never met in person but may have been aware of from afar or followed their personal story unfold via social media. There are too many to mention across the globe, who generously share their own cancer experiences.

1. How can that be?

Because the cancer news of another, whether known to us or not, can re-trigger and intensify our own experiences, hopes, doubts, anger and fears. Unless we isolate ourselves from the rest of the world, feeling like this is normal and we need to find ways of coping with it.

With cancer comes uncertainty because it is a complex and unpredictable disease. And as human beings, you, me and the next person, we prefer clarity. Rightly or wrongly, we have a need to control. And it can be hard to let go of that.

And so we develop this split attitude towards cancer.

Take me as an example:

• I want to know everything and I want to know nothing.

• When others die of cancer I want and I don’t want to know – how much their cancer was like mine and how much it wasn’t.

• I want to believe what I am told, but I cannot trust it.

• I think next time it’s not going to be me, but I also taunt fate – why not me?

2. And I am not alone in this. Why do we do it?

A. Because we are looking for clues:

Bottom line, will I die of it or not? How similar or not is your story to mine? What did you do that I haven’t or shouldn’t?

B. We need to belong:

We want to identify with someone’s story, which is also ours. Because identification gives a much-needed sense of belonging when the experience of illness is very lonely.

But at the same time, we don’t want to belong to any of it – the illness, the suffering and the potential death.

And therein lies one big risk. We may lose sight of the fact that cancer is complex. Over-identification with another can be unhelpful.

Take breast cancer – there is no single type. And if you have breast cancer, then yours may be different to mine – in its hormone profile, grade, stage, size, location. As much as our overall and other specific areas of health may differ. Therefore what may happen to me, may not happen to you and vice versa.

You may have the social or relational support I lack or vice versa. We both may be struggling financially because of the illness, or not.

We may be in the same boat, yet our positions are not identical.

Cancer is vague yet excruciatingly precise, and we may find the uncertainty harder to deal with than clarity, which we don’t get.

3. But I have to make sense of it, keep going and keep hope.

If not hope for a cure, then hope I continue to cope well with the difficult days and that I can continue to live in peace with the possibility of dying from it a lot sooner than I want to.

And when someone else dies of cancer, then knowingly and sometimes unknowingly a darkness full of doubt, sadness and self-pity creep up on me.

Over the years I have become better at spotting it, and that helps with riding it out and not getting stuck in it. Because what’s the point?

What good will come of this negativity? Nothing. What bad can come of it? Plenty.

The link between emotional and physical wellbeing is well established. Stress and loneliness, to mention some, have a detrimental effect on our immune system. Stress, depression, anxiety and loneliness are just some of the emotions people affected by cancer face in their lives, whether they have cancer or NED status (no evidence of cancer).

When someone else dies of cancer, the death potential of our own cancer illness can get amplified and overshadow everything.

It can make living with the disease and its potential that much harder. That very relevant and understandable pain, however, can detract from feeling grateful for the life of the one who has gone and for the life we still have.

4. The 50:10:40 rule

So when others die of cancer, I know I will be affected. And I let it. Because it is human, and I don’t want to turn into a machine, even if I could. But I try to keep to a rule. My mental, emotional and physical well-being depends on it.

50% empathy and grief for the other and myself.

I allow the sadness for them and for myself. It is like a time of mourning we deserve and need. But it must not become a permanent position to be in. That would not be fair on the other or on us.

10% self-indulging my self-pity and fear.

Both are human, should not be denied, but need to be kept in proportion.

40% gratitude for me – here – now.

I know some cringe at the mention of gratitude when cancer is in the room. I had to work hard at getting to this position. And it is the best for me to be at. Because otherwise my life and my identity will become synonymous with cancer, with what I have not had because of it, and what I will never have because of it. Neither can I live with permanent cancer anger.

Cancer (and its potential) is part of my body, and I cannot possibly be at war with my body or myself.

When someone else dies of cancer I try and avoid personal future gazing. I have to stay with the here and now — honoring that place, wherever I may find myself, and cope with it as best as I can.