Cancer, Shame, and Stigma: The Silent Burden No One Talks About

When someone receives a cancer diagnosis, the world often narrows to medical terms: test results, treatment plans, survival rates. But cancer is never just physical. It reaches into the deepest parts of a person's identity, emotions, and social world.

One of the most painful — and often hidden — aspects of the cancer experience is shame.

Shame is not usually part of the public conversation about cancer, but for many people, it’s there: silent, isolating, and heavy. And when shame is left unspoken, it can grow — affecting mental health, relationships, and even the willingness to seek care.

It’s time we bring this part of the experience into the light.

It’s not found in medical records.

It doesn’t show up on a scan.

But for many, it’s just as real.

That hidden burden is shame.

The Hidden Emotion Behind the Diagnosis

Shame is often misunderstood. Unlike guilt, which is linked to actions (“I did something bad”), shame strikes at the core of who we are (“I am bad”) (Tangney, 2002). It’s a deeply self-conscious emotion — one that makes people feel exposed, judged, or flawed.

In Western cultures, shame is closely tied to vulnerability and mortality. Philosophers like Sartre (1943) and researchers like Dolezal (2017) describe shame as rooted in the feeling of being seen as weak, ill, or dependent — all of which cancer can make painfully visible.

Stigma: When Society Reinforces the Shame

Shame often begins internally, but it’s fueled by stigma — the social process of labelling, stereotyping, and marginalising people because of something they cannot control (Link & Phelan, 2006).

In the context of cancer, stigma can take different forms:

• Social stigma — for example, the idea that someone "brought it on themselves" through lifestyle.

• Structural stigma — such as reduced funding for cancer seen as self-inflicted (Else-Quest & Jackson, 2014).

• Internalised stigma — when people begin to believe the negative messages, leading to shame, self-blame, and social withdrawal.

This internalised stigma has real consequences. It’s been linked to higher levels of depression and anxiety, concealment of diagnosis, and even avoidance of treatment (Phelan et al., 2013; Wertheim et al., 2018; Williams et al., 2020).

Where Does Shame Come From?

Shame doesn't begin with illness. It often has deep psychological roots, going back to early childhood development.

• Erikson’s psychosocial theory suggests shame arises when a child isn’t supported in developing autonomy (Erikson, 1950).

• Attachment theories describe shame as emerging when emotional bonds with caregivers are disrupted (Bowlby, 1973; Winnicott, 1986).

• Cognitive theories argue that shame develops through repeated negative feedback, leading to self-schemas like “I am bad” (Tangney et al., 2007; Stipek, 1995).

These early patterns can become part of someone’s personality — making them more prone to self-criticism and shame, especially during stressful life events like cancer.

Mental Health Matters: The Cost of Unspoken Shame

Shame isn’t just unpleasant. It’s been linked with a wide range of psychological struggles, including:

• Depression and anxiety (Gilbert, 2000)

• Social withdrawal and low self-esteem

• Eating disorders and addictions (Gee & Troop, 2003; Wiechelt, 2007)

• PTSD and trauma responses (Saraiya & Lopez-Castro, 2016)

Cancer itself can be traumatic — especially when it’s life-threatening or involves invasive treatment. Researchers have even identified a form of cancer-related PTSD (Leano et al., 2019), where shame plays a central role.

Shame also affects the body. It activates the autonomic nervous system, leading to fight, flight, or freeze responses — consistent with the polyvagal theory (Porges in Lucas et al., 2018). This can lead to emotional shutdown or chronic stress.

Who Am I Now? Reclaiming Identity After Cancer

One of the most painful effects of shame is how it can swallow up a person’s identity. Cancer doesn’t just affect the body — it often changes how people see themselves.

They may no longer feel like the person they were before. They may begin to define themselves by their diagnosis, by the loss of control, or by how others now treat them.

But cancer is something you have, not something you are. Reclaiming a sense of identity — beyond the illness — is a key part of emotional recovery and resilience.

Living with cancer is more than dealing with symptoms or treatments. It shakes your sense of identity, change your body, impact your relationships, and bring up fears about mortality.

When shame is added to the mix, it can look like:

• Hiding your diagnosis from others

• Avoiding treatment or support groups

• Feeling like a burden

• Blaming yourself for getting sick

• Feeling disconnected from who you were before

And while cancer is never a punishment or a moral failure, shame can make it feel that way.

What Can Help: Gentle Ways to Face Shame

If shame is part of your cancer experience (or someone you care about), here are some things that may help:

1. Name the Feeling

Shame thrives in silence. Simply recognising and naming it can loosen its grip.

2. Challenge Negative Beliefs

Statements like “I brought this on myself” or “I’m a burden” are not truths — they are internalised messages that can be questioned and reframed.

3. Seek Connection

Support groups (in person or online), trusted friends, or counselling can provide the connection that shame tries to take away.

4. Practice Self-Compassion

You are dealing with something incredibly difficult. Try to respond to yourself with the same care you’d give a loved one.

5. Talk to a Professional

Psychological therapies are designed to address shame and self-criticism. You don’t have to navigate this alone.

Where to Find Support (UK-based)

• Macmillan Cancer Support – Practical, emotional, and financial support helpwww.macmillan.org.uk

• Maggie’s Centres – Drop-in cancer support in a welcoming environment www.maggies.org