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What Does Telling a Cancer Patient to “Just Stay Positive” Really Mean?

The topic of maintaining a positive attitude during cancer treatment (and beyond) is one that comes up time and time again in Cancer Land. In fact, it comes up everywhere. Society seems obsessed with positivity sometimes, or so it seems to me. But in Cancer Land there is this ongoing theme that no matter what, a cancer patient should always try to remain positive. Why this is, I do not know. I don’t mean to harp on this topic, but…

Recently I’ve been thinking about this again probably due to my recent cancerversary (hate that term, but what the heck do I call it?) and because it’s always one of my hot-button topics.

I do not believe always aiming to maintain a positive attitude should necessarily be the gold standard for how to “properly” do cancer. That’s a lot of pressure. And no, I am not opposed to trying to feel positive when you’re up to it, but when you’re not I say, let the tears flow. Or whatever. It’s the notion of insisting a particular emotion be felt and the presumption that positivity is always better that drive me nuts and likewise the perception that if you’re not feeling positive, well then, you’re being negative.

Why not just encourage genuineness?

And it’s pretty darn clear that having a positive attitude does not mean a person will survive cancer longer. If this were true, cancer patients would likely be some of the most determined smilers on the planet.

But what exactly does telling a cancer patient to always remain positive, mean anyway?

And how exactly should a cancer patient (or anyone for that matter) go about doing this?

It’s all rather mystifying to me.

Of course, I don’t really believe anyone actually expects a cancer patient to ALWAYS remain positive, at least I hope not. But there does seem to be a general societal expectation that well, if you’re not giving off positive vibes, maybe you should rethink how you’re “doing” cancer or maybe even your life in general.

I cannot figure out why everything, even the super shitty stuff that happens to most of us, needs to be twisted around, reshaped and turned into a positive. Shitty stuff is just that, shitty stuff. (I might have to get going on that, “Ten Shitty Things Cancer Taught Me” post!)

But again, what does, just stay positive, even mean?

I decided it might be more about suggesting that cancer patients keep quiet about how they’re really feeling/doing.

Perhaps when people say, just stay positive, they really mean…

It might be better to keep your cancer truths under raps; no one really needs to know your truths, do they?

It makes me uncomfortable to hear all those gory details.

It’s too hard to be around you if you’re not upbeat.

I can’t handle this if you’re not positive. 

You should be over this by now, shouldn’t you?

And as for the other part of this discussion, helpful suggestions offered as to how a cancer patient is supposed to go about staying positive seem to be lacking. Advice without ideas for implementation might not be that helpful here either.

Regardless, how does a cancer patient just stay positive when, in fact, she might really feel like hell and be scared to death?

So what might be a better, simpler, less burdensome and far more helpful  “gold standard” for most cancer patients to hear and to aim for?

Be real. Be you. It’s enough.

Because having cancer, and navigating survivorship, are both hard enough. No one should feel pressured to smile her/his way through either one.

Do you ever feel pressured to smile your way through everything, even cancer (and/or survivorship)?

What do you think is sometimes really meant when it’s suggested to above all else, just stay positive?

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36 thoughts on “What Does Telling a Cancer Patient to “Just Stay Positive” Really Mean?

  1. I believe that when you go thru cancer, you go thru the grief process – ALL the stages, sometimes out of order and sometimes more than once. And there is no “magic” time frame for when your grieving is done. Some losses we never really get over, but we learn to move forward. So, when our “loss” is continuous (not feeling good/like yourself, going thru treatments, etc.), then parts of grieving may be long term also. I think some people do not understand this, may have never experienced a great loss, or may not be emotionally able to go thru the emotions with you. But it’s not healthy to suppress every negative emotion. I am grateful that my husband and a couple close friends truly “get it,” and since they really understand me and listen when a tidal wave of emotions hits me, it’s easier to forgive the others that need to only see my positive side. And, having someone understand my negative emotions and my fears, somehow makes me more positive and less fearful. For me, the tidal waves of emotions come further apart now– I allow them because I know they won’t swallow me, and that they are the ‘surface’ emotions. Way down deep, I am hopeful and thankful and grateful.

  2. I can only speak for myself (I also mentor women going through breast cancer treatments) – if I didn’t “try” to remain positive during my year of treatments / surgeries, etc…part of me would have failed myself and my family. I tried to look at it more of taking it day by day, sometimes hour by hour and minute by minute. Enjoy the little things…

    Let’s face it — at one point I had one side of my nose packed with a Rhino Rocket (didn’t even know it existed) for a few days due to an unstoppable nose bleed. It was awful, was I positive about it — no, however I had to repeat over and over “this too shall pass” and found things to keep me busy like playing games on my phone to divert my thoughts.

    It helped me to find stock in the fact that I am still here – treatments or not, to be able to enjoy what life has to offer and be here for my kids. I had to keep myself in my routine and worked the entire time (missing work here and there for chemo) but would then work from home. Was it fun to feel like crap, have no hair, almost lose my fingernails, etc…(list goes on) No but I was super trooping it out for my son (who was only 7 at the time) to make sure he wasn’t scared something might happen to his mama. At times being positive was the only choice I had….helped a lot!

    1. Erica, I agree, sometimes we have no choice. We all do what we have to do to get through each day. My issue is with the ongoing, outside pressure to keep the positivity flowing all the time. And not being positive doesn’t mean we are being negative. I also think it’s better for children to see our pain and vulnerability, or at least get glimpses of it. Again, each parent must do what feels right. I just feel constantly trying to maintain that “smile” is exhausting and even potentially harmful. Thank you for reading and sharing. Hope you’re doing okay now.

      1. Doing great thanks! As for outside pressure, as a mentor myself it’s hard to not try to be a cheerleader to those going through treatments. Speaking from personal experience when my own mentor through out all of the side effects she went through (when I hadn’t experienced any yet) during chemo. I stopped corresponding with her.

        It’s a tough tightrope walk, when people were negative about cancer saying they knew someone that died from it or couldn’t conduct themselves (staring at my port) I walked away. Sometimes, yes agree it is hard to remain positive – totally but staying in routine and being mostly positive for my children was the best way for ME to get through it all. The dark things were shared in my head on my own time and those days made it that much harder to get out of bed.

        When I was thankful to be here that positive attitude wasn’t exhausting as much as helping me continue to move on. Everyone deals with things differently in their own way and on their own time. Ongoing pressure? Not sure I have experienced that so maybe my thoughts are out of context for this string 🙂 Have a great 4th of July weekend all!

        1. Erica, So glad you are doing great. Your thoughts are not out of context. Though you and I might not agree on this topic, this space is for sharing thoughts and opinions of all kinds. So thank you. You have a great 4th as well.

  3. A friend who died last year from BC would get so upset by these coments to stay positive … She knew she was dying and it broke her heart to be leaving two young boys and these type of comments would make her feel she was not trying hard enough to stay alive …being positive may help but sometimes it is just not possible …

    1. Helen, I am sorry about your friend. Making someone feel guilty about not trying hard enough or staying positive enough is so horrible and so wrong. Thank you for sharing. Again, I’m sorry.

  4. I don’t know why they tell us cancer people to be positive. I might be positive but I am also sarcastic as hell.

    However, I will say that it has been shown in studies that people who maintain a positive outlook often have better outcomes with illnesses. Think of it this way, if you let yourself fall into depression and become down, you are less likely to comply with your medications, go to the doctor as often, isolate yourself, and do not interact with others (think support groups or other support mechanisms). But if you keep thinking positive you are more likely to make the effort to learn more about your disease, go to the doctor, take medications, seek emotional support, and participate in life.

    However sticking a smile on everything is not possible. I’ll settle for a sarcastic smirk as needed.

    1. Caroline, I think it’s also been shown in studies that people with positive attitudes do not have better cancer outcomes. I agree that someone who is depressed might struggle more staying on meds, going to the doctor, etc, and depression is common with cancer patients; but just because someone isn’t smiling all the time, doesn’t mean they are suffering from depression. It doesn’t have to be all one way or the other. Genuineness, that’s what everyone is entitle to IMO. Otherwise it’s all too exhausting.

  5. Nancy, everything you said! Isn’t it weird that people feel the need to incessantly fix others anyhow? How arrogant is that to think you can fix someone by reminding them to “Just be positive!” Okay, preaching to the choir here, but it’s good to know I’m not alone.

    1. Eileen, It is weird that people feel the need to fix how others feel or suggest how they should act. Cancer is hard and sometimes the societal expectations make it even harder. Thank you for reading and sharing.

  6. People thought of me as positive. And, at the onset, and even 7 years out, I remind myself ” How do I wish to die?” That sets my time for each day. Not saying the aftermath, the collateral damage, and the sacrifices, loss, and giving up life’s dreams are positive. They are the price I pay for being alive. #bittersweetexistence

    1. Kathy, You say people thought of you as positive. How do they perceive you now? Has this changed? And yes, the price you pay… But you are still allowed to be real. To be you. To be genuine.

  7. I found this blog looking for info for my niece who is about to start chemo for BC, so I am not speaking at all from experience. I just think the whole “be positive” thing is cold and in some strange way, mentally unhealthy. Of course, if someone is being positive during their treatment, that’s great, and their choice. But to TELL someone to be positive is completely inappropriate. It’s almost superstitious or something. I agree with the comment above that a positive attitude could certainly make a patient more likely to be compliant and have hope, etc, but to think that being positive will actually change your outcome, I don’t think that is true.

    1. Victoria, Your comments are spot on – cold and unhealthy – bingo! It’s all about allowing for genuine feelings. Everyone deserves to deal with her/his cancer in her/his own way. The societal expectations make everything just that much harder. Thank you for sharing your insights and I’m sorry your niece has to deal with this. I wish her well as she begins chemo. Hope things go as smoothly as possible. Thanks again.

  8. This really resonated with me. During my treatment, I felt a lot of pressure to be positive. And sometimes taking the positive route really helped me. But I found that it made everyone (doctors, nurses, staff, family) nervous when I cried or got angry or had a breakdown. As if that wasn’t warranted and a good way to deal with the stress. I think it is and can be.

    Also, I felt like I had to be positive for others so that they wouldn’t be burdened or worried. That’s a lot of responsibility to take on on top of everything else.

    1. Carrie, Exactly. Constantly keeping up that brave front is a lot of responsibility and pretty darn exhausting, at least for me. Thank you for reading and sharing. Glad this one resonated.

  9. I think the emphasis on positive sets up unrealistic expectations. The HR lady denying me paperwork to file for disability smiled and said, “Just stay positive and you’ll be well and back teaching.” I’m metastatic. A friend whose husband was going through lung cancer cheerily said, “I know he will make it. He is so positive all the time.” She is now a widow.
    Nothing wrong with being positive. When your time is limited, better to enjoy life than cry the rest of your days away. But above all, be real. Positive is not a cure.

  10. I would be interest in how others handle a spouse or family member who is constantly saying “Stop obsessing over this ( i.e. My breast cancer). I was diagnosed 2 months ago. Lumpectomy 1 month ago. Genetic testing came back positive for mutations, therefore I am research next step. My husband sees me on computer Cancer sites and keeps telling me to take a break, stop thinking about it You got it out …you will be fine. I can’t get him to realize this is only the beginning.

    1. Pj, Sorry to hear about your diagnosis and your genetic test result too. It’s a lot for you and your husband, too, to absorb. Keep communicating with him. Do what you need to do. You’re right, this is only the beginning. Good luck with everything.

  11. Thank you, Nancy for bringing this up. There is much medical evidence of the physical and mental harm done to people who deny their true feelings, who stuff their feelings – and many of us realize that a lot of the “positive police” are doing that, perhaps unconsciously, when they urge others to stay positive. What they are saying, or what I am hearing, is they don’t really want to know how you are, they are afraid or don’t have time – their problem, not yours! Like you, I am realistic. I deal with facts, and truth, and science. I find that extremely positive. I am doing everything I can to stay alive and have a high quality of life. What the hell is more positive than that? This happened to me when I was caring for my parents who died within six weeks of each other. Like you and many others, Nancy, I learned about grief. I came across people who told me I should be over it. There was a magic timeline I didn’t know about, apparently. I wasn’t doing grief right, just like I’m not doing cancer right. This is why WE NEED YOU, Nancy, to bring these topics up. Be real. Be you. It’s enough. This is what I will tell women who need support.

    1. Linda, There are many parallels between cancer and grief, as you know. And expecting someone to just be over either one, well, it’s not really possible, at least not for me. And like you, I’ll take realism any day. It’s far healthier in the long run. Thank you very much for your kind words. They are extra meaningful right now as I am dealing with my dad’s serious health issues.

  12. Nancy, I just came from being with my father who has been diagnosed with acute leukemia at 86–a very poor prognosis, and he is angry right now. He doesn’t want to die. I told him that there is a tyranny of positive thinking and the socially acceptable cancer narrative of “brave warrior”–which exists because it is easier for others to be around him. The truth is so painful. He is not ready to die. Does he have to be a brave warrior right now? NO!

    No studies show that positive attitude conveys survival benefit. Read Bright Sided.

    I agree that how we all approach is is to do what is best and necessary for us at the time, and raw grief is so hard for everyone, but to stifle it just to make others feel better? Rubbish.

    Cancer is not a gift.

    1. Kira, I am sorry to hear about your father’s diagnosis. He is entitled to feel angry, or any other way for that matter. (So are you). And no, he does not have to be a brave warrior right now. You’re right about that too. I wish you both the best. Hope things go as well as possible for him. And cancer is definitely not a gift. It sucks. Totally. Thank you for sharing.

  13. Hi Nancy. I am in agreement with you when you say people don’t want to hear about our reality. They also want to believe that there’s always a way out of the situation – if not through science, then through positivism. But truth hurts and not everyone is ready/willing to face it, especially if it means part of their ‘innocence’ would be compromised. People like to hold on to denial as long as they can. I am convinced that shitty things are just that, shitty things; and they’re also out of my control. BTW, I love the idea of coming up with a “Ten Shitty Things Cancer Taught Me” post. Wondering if perhaps you should challenge us all to write about them based on our experience (like the “Random Facts” about ourselves post). I would def. participate and I think others would too.

    Thank you for another excellent post. xx

    1. Rebecca, You’re so right about truth sometimes being hard to face. I like your challenge idea. I have a post like the one from last year ready to go soon where we share about ourselves. But challenging people to share something shitty they’ve learned from cancer is an interesting idea. Of course, it would likely be perceived by many as being negative. But then, who cares, right? I’ll give it some thought. Thank you for reading and sharing your insights on this.

  14. Nancy,

    This positive-thinking crapola is one of those hot-button topics for me, too. I’ve been told to think positively when I was going through treatments. It was pretty difficult — no, actually impossible — not to feel like physical and emotional shit during and even after treatments. I think some people really want cancer patients to be OK, so they delude themselves that if cancer patients are positive, perhaps they will be OK. I think that some of this positive-thinking mantra is well-intentioned, while other such comments are to shut us up from sharing our reality. I believe that we must never allow others to define our own reality. If others want to be positive about their own cancer — and there are quite a number who feel that way, I think — then that’s fine. I just say don’t impose your belief system on me. I have experienced sadness, unprecedented fear, anguish, sorrow, and so on. This was realistic for me as a cancer patient. I get really angry when people tell me to think positively, thereby denying my feelings.

  15. You are singing my song! Two surgeries and a course of radiation are now four months behind me. But despite my oncotype score of 0 and an excellent prognosis I am just starting to reach the deep sadness my breast cancer diagnosis has brought me. While I have many caring people in my life, with numerous offers of help, the emphasis on being positive had what I believe was an unintentional effect. I became more and more isolated. My reality of pain, fear, sadness did not match what others wanted for me, or even want for me now. So I am largely alone with the tangle of emotions I am experiencing. I am so grateful to have found you, and to hear other voices that resonate with my own experience. Bless you.

  16. I get comfort from and hence I love this thread and wish to revisit later. Just wanted to say I got the book today “Cancer was not a gift..” and I am really looked forward to starting it after work. I feel like I have a companion, who understands, at least in this moment, some of the things I have been thinking and have been going through. (I am basically alone on this so-called “journey” but what with peoples “let me get away from you quickly” dashed off comments, perhaps I am generally just better to be so right now. Thanks for the “company” Nancy, Ellie

    1. Ellie, Thank you so much for sharing. I hope you like my book. One of the main reasons I wrote it was so others would have “company”. My best to you.

  17. My wife has a bad cancer, we are two months from diagnosis.

    People tell her to stay positive as if that will make her live. Everyone who dies was not negative about their diagnosis and the randomness of getting this deadly disease. My wife has always eaten well and ran fove or six marathons after she was fifty years old. Now she carries inside what will probably kill her.

    Just stay positive. It is like they believe that staying positive is more important than debilitating chemo and aggressive surgery. Just stay positive and you will live. I hope that I never said this to people with cancer before.

    1. bubbasixpack, I am sorry you and your wife are dealing with cancer. Telling a person to just stay positive is helpful, hurtful and even potentially harmful. Thank you for reading and sharing. Wishing you both my best.

  18. This totally hit home with me! There are so many emotions I’ve experienced going through cancer treatment. I have stage IV ovarian cancer so my disease is incurable. I take it one day at a time hoping someday there will be a cure. I can’t count how many times people say just stay positive! It actually irritates me! I want to say really? You walk in my shoes and see how easy it is to walk around with a smile plastered on my face. It’s definitely to make them feel more comfortable. I’m not saying I don’t have times of positivity but the pressure is there and if positivity cured cancer we’d all be cured.

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