For people coping with a cancer diagnosis, managing treatment and its side effects is oftentimes only the beginning. Cancer inevitably weaves itself into all other facets of one’s life beyond treatment—school, career, finances, and even family planning. For people with cancer, coping with the loss of fertility can seem secondary. But for many, it is viewed as something everlasting, staying with them long after there is no longer evidence of the disease. It is a reminder that, “Yes, cancer happened to me.”

Like cancer, the loss of fertility can touch every aspect of one’s life—from one’s own self-esteem, to relationships with friends or loved ones. It can even affect future relationships that have yet to develop. Although having children may not be in everyone’s future regardless of cancer, for some, coping with the lack of choice is what’s most difficult.

As a professional oncology worker at CancerCare, I’ve often heard clients say, “I lost my ability to have children before I even knew I wanted them.” Unfortunately, this reality is not at all uncommon. The pressure to raise a family, inconspicuous or overt, can be enormous. What you once imagined your life would look like now looks quite different.

In my work with young adults coping with cancer or caregiving for a partner or spouse, I’ve found that it can be helpful to impart to clients that, as overwhelming as this new normal may seem, there are ways to cope with the feelings that may arise.

Encourage patients to let themselves feel There is no right or wrong way to feel. One thing is certain though: bottling it up will only ensure that at some point these feelings will burst free. More than likely it will happen at an unexpected moment—perhaps among friends, at work, or in a crowded train car.  Suggest patients allow themselves time to grieve the loss and feel the sadness, anger, and guilt that may come. Help them find new and unique ways to express these feelings: scream into a pillow or punch a punching bag to express anger, or keep a journal. Let them know that speaking with a professional oncology social worker, such as the ones at CancerCare (www.cancercare.org), who provide free services to help patients and caregivers manage the emotional, practical, and financial concerns of cancer, can also be tremendously helpful.

Become educated Uncertainty of the future and what it has to offer is often a catalyst for stress. Talk to your patients and caregivers about their diagnosis, treatment, and posttreatment care. Connect them with fertility specialists who can help answer questions regarding fertility options and give clarity on alternatives such as adoption. Although planning for every conceivable outcome is impossible, having this knowledge can give patients a peace of mind the uncertainty did not.