For every patient, there is always an emotional toll they must go through during their cancer fight.

There are ups and downs and everything else in between before and after surgery and before, during and after treatment.

Like grief, there are different stages cancer patients go through. The stages of grief are denial, anger, bargaining, depression and, finally, acceptance. Those stages are also prevalent in many cancer patients.

Depression is a common emotion that I see with patients, and it can happen at any time. Before surgery, during treatment and even months or years after treatment is over, it is not uncommon to see patients struggling with what is happening to their body.

But that is normally a temporary emotion. I’ll see patients hear that they have cancer and refuse to accept the diagnosis for some time — which can range from a few minutes to days —but ultimately they will go into fight mode. They will accept the news and get ready for the next step.

The factor that most helps patients go from denial to acceptance? Support.

That support can come from family, friends, faith or strangers in a support group. It doesn’t matter where it comes from, just so long as it is present for the patient.

A time or two, I’ve encountered women who will be in the middle of cancer treatment and they ask me why they aren’t sad or depressed. In those cases, it’s because they have such a strong support system around them.

For them, the emotional impact of breast cancer doesn’t seem as detrimental for them as I found for patients who don’t really have a strong support, faith or belief system. Those patients seem to have a more difficult time dealing with the diagnosis.

Cancer is not just a physical journey, but an emotional one as well, and there is no right or wrong way to feel going through the process.

Tracy Johnson is a social worker and breast cancer patient navigator with Woman’s Hospital.