Hester Hill Schnipper Photo courtesy of Beth Israel Deaconess Medical Center

SURVIVOR GUILT, defined as the feeling of having done something wrong in surviving a situation that others have not, can manifest itself in many ways, including depression, shame or anger. This kind of remorse is all too common among cancer survivors.

Though most of us don’t really think we did something wrong to have survived cancer, we too often worry that we haven’t earned our good luck. If you have been successfully treated for early-stage breast cancer, for example, you may not feel entitled to worry about your own health when others are living with a recurrence or have later-stage disease. If you have been treated for early-stage prostate cancer, you may not feel justified complaining about the very difficult side effects of surgery or radiation. If you have endured a bone marrow transplant for leukemia and are doing well, you may not want to acknowledge your exhaustion, fear and changed sense of self when others have not been so fortunate in their response to aggressive treatment.

Of course, you are more than entitled to all of your feelings, whatever they may be, but the following strategies can help you deal with survivor guilt so you can embrace your life—and your good fortune.

1) Yes, your cancer situation could have been worse. However, remind yourself that whatever the specifics were, your experience has been bad enough.

2) You have gotten through a disease that most people are terrified of. Pat yourself on the back for your strength and accomplishment.

3) Make a list of the changes that cancer has brought to your life, including the good and the bad. Emphasize the positives while acknowledging the negatives. The point here is that you have paid your dues.

4) When you were initially diagnosed, you may have wondered “Why me?” or “Did I do something to bring this on?” As time passes, a new version of those questions may haunt you: “Why have I survived?” Just as there were no answers in the beginning, there are no answers now.

5) Talk about your feelings. The most empathetic listeners are likely to be other cancer survivors or an oncology-savvy therapist. Your friends and family may find it more difficult to appreciate and understand your complicated feelings.

6) Not all cancer survivors will be the best listeners. In spite of your common experience, you may have very different perspectives and coping strategies. Avoid anyone whose comments make you feel worse.

7) Remember and honor your friends who have died of cancer. Running from your sadness and fear will not help.

8) Above all, cherish your life. As a cancer survivor, it is important to live with appreciation, awareness and gratitude.

Hester Hill Schnipper, a licensed independent clinical social worker, is a breast cancer survivor who served as the manager of oncology social work at Beth Israel Deaconess Medical Center in Boston.