What Happens Mentally When You're Told You May Be Dying
I was a guest on Darrell’s podcast, Breaking Mental Health. Here’s what I couldn’t stop thinking about after.
There’s a question Darrell asked me early in our conversation that I’ve been sitting with ever since.
“At any point during the whole cancer thing, did reality actually set in for you?”
It’s a deceptively simple question. And the honest answer is complicated, because yes, reality set in. I knew I had a terminal disease. I knew the five-year survival rate for Stage IV colorectal cancer was 13%. I knew I might not be here for too long.
But here’s the part that’s harder to explain: knowing all of that, and still choosing to live in the moment anyway, isn’t denial. It’s a decision.
I was a guest recently on Breaking Mental Health, a podcast hosted by Darrell, who is one of those rare interviewers who actually listens. Not just to what you say, but to what you're trying to say underneath it. He's also someone who speaks openly about his own struggles with depression and anxiety, and that kind of honesty creates a space where you can be equally honest back.We talked for a while, and I want to share a few moments from that conversation, not because I said anything new, but because sometimes hearing your own story reflected back to you reveals something you hadn’t fully named yet.
On the diagnosis itself
When the urgent care doctor told me I had cancer, I was so calm that he asked if he should call my wife to come get me. I wasn’t in shock. I wasn’t numb. I had spent nearly a decade practicing mindfulness and meditation, and in that moment, all of it kicked in.
My first honest thought was: What do we do next?
My second thought was: How am I going to tell my wife when I get home?
That second one was harder.
On the only statistic that mattered
I threw out almost every number they gave me. Except one.
13%. That’s the five-year survival rate for Stage IV colorectal cancer patients.
Most people hear 13% and think: small. I heard 13% and thought: I am going to be one of those people. I knew other men had made it. They were the reason I believed I could. And so I latched onto that number not as a ceiling, but as a club I was going to join.
On the dark thoughts — and where they went
There’s something I shared on the podcast that I don’t always say out loud: there were moments during chemo where the cumulative fatigue — physical, mental, emotional, all of it stacked on top of itself — got to a place where I wondered if it was worth it.
I never got to the point of saying no. But those thoughts existed. And I think it’s important to say that, because pretending they didn’t doesn’t help anyone who’s having them right now.
What helped me was having Man Up To Cancer, a men’s cancer group, where I could let those thoughts out the moment they arrived. Not hold them, not analyze them, not carry them — just release them into a space where someone else would say I know exactly what you feel. And then they’d be gone. I’d be back.
That outlet wasn’t optional for me. It was survival.
On being the 13% for someone else
It took me almost two years after reaching No Evidence of Disease before I could walk back into a support community without feeling like a fraud. I thought: What do I have to offer someone who’s in active treatment right now?
It took a therapist. It took other survivors. And eventually, it took someone going through chemo looking me in the eye and saying, Tim, you are giving me hope.
I had been so inside my own head, worrying about how others would judge me for being there, that I had forgotten the only reason I believed in that 13% was because someone else had already made it there before me. They showed up for me without knowing it. I owed that to the next person coming in.
I could keep going, but that’s exactly why you should listen to the full episode.
Darrell asks questions that go places most interviewers don’t — vulnerability, mortality, how men process fear differently, what cancer taught me about who actually belongs in your life. We talked about traveling during treatment, meditation that doesn’t look like meditation, and what it means to be open to receiving help in whatever language someone offers it.
🎙️ You can find Breaking Mental Health Podcast wherever you listen to podcasts. The episode is called “What Happens Mentally When You’re Told You May Be Dying.” Give it a listen, and if it moves you, share it with someone who needs it.
And if any of this resonates with your own story, as a patient, a caregiver, or someone quietly wondering if they’re going to be okay, my inbox is always open.
The wound becomes the wisdom, and the wisdom becomes the work.
— Tim
Tim McDonald is a colorectal cancer survivor, patient advocate, and author of From Patient to Advocate: Turning Survivorship Into Impact. Find him on Substack at advocacyatwork.com and on LinkedIn.