Understand · Feelings
The short answer on gratitude journaling after breast cancer
A few small studies suggest that writing down what you are grateful for, for a few minutes a day over two or three weeks, can lift how women with or after breast cancer rate their self-esteem and quality of life. The studies are small and short, and none shows any effect on the cancer itself. It is a low-cost thing to try if it appeals to you. You do not owe anyone gratitude for having cancer.
What to know about gratitude journaling
- The evidence is promising but thin. The three studies here involved between 42 and 60 women each.
- The routines were short. About 15 minutes, most days, for two or three weeks.
- Writing why seems to matter. The journals asked women to name a reason, not just a thing.
- It does not replace care for anxiety or depression. If low mood is lasting, tell your care team.
Why is gratitude a tricky subject after breast cancer?
Because women with breast cancer are told to be grateful constantly, often by people who mean well. Grateful it was caught early, grateful to be here. That pressure can make fear or grief feel like a failure.
Babette's position is simple: nobody has to feel thankful for cancer. The studies below are about something narrower, the small practice of noticing what went right in an ordinary day. Some women find that steadying. Others find it grating, and that is fine too.
What did the gratitude journaling studies find?
A two-week diary in Poland. In a 2019 study in Frontiers in Psychology, 42 women with breast cancer, some still in treatment, kept an evening diary for two weeks. Half were randomly assigned to start each entry by listing up to six things they were grateful for that day. Compared with women who kept the same diary without that list, they reported higher daily self-esteem, more optimism and more acceptance of their illness. They also felt more supported by their partners and by other people, and they leaned less on denial as a way of coping. Their day-to-day moods, however, were no different.
A three-week journal in South Korea. In a 2025 randomized trial in Current Oncology, 60 women who had finished surgery or chemotherapy within the past five years were split into two groups. One group wrote gratitude entries of about 15 minutes at least 10 times over three weeks, with a different focus on different days: themselves, family, nature and everyday objects, and the people around them. After three weeks their resilience scores had risen, and so had their quality of life. The comparison group, which did no writing, saw no improvement.
Gratitude after relaxation in Indonesia. A 2026 study in the Indian Journal of Palliative Care followed 46 women having chemotherapy. Each did a 15-minute relaxation session of slow breathing and guided imagery, then expressed gratitude in whatever way came naturally. Anxiety scores fell in both groups. They fell further in the 26 women who directed their thanks to God than in the 20 whose gratitude was not religious.
How much should you trust these results?
Less than the headlines that tend to follow them. Each study was small and relied on women rating their own feelings. None followed participants for more than a few weeks. The Korean trial had no comparison activity, so some of the benefit may simply come from attention and structure. The paper also contains several reporting errors, which its authors would need to correct. The Indonesian study did not randomize anyone. Women sorted themselves by how they chose to give thanks, so their faith and the support around it may explain more than the gratitude does.
The wider research is mixed as well. The authors of the Polish study point to a 2016 analysis of many gratitude studies that found only weak evidence they work in general. They also cite earlier work suggesting gratitude exercises may help most when people start out with fewer positive feelings, which could include women going through cancer.
One of the papers also links gratitude to lower inflammation. That idea comes from small studies in healthy volunteers, and there is no evidence that a gratitude journal changes how breast cancer behaves.
How do you try gratitude journaling?
If you want to try it, the studies offer a template:
- Keep it short. Ten to 15 minutes, in the evening or the next morning.
- Write the reason. "My sister drove me to my scan and didn't make me talk" says more than "my sister."
- Rotate where you look. One day yourself, another day the people close to you, another day small things like a good chair.
- Give it two or three weeks, then decide whether it is helping you.
If you pray, the Indonesian study suggests giving thanks in that form may suit you. If you do not, nothing in these studies says plain gratitude doesn't count.
And if a day is simply bad, write that down instead. A journal that only allows good news is one more place to perform being fine.
When to tell your care team about how you are feeling
- Low mood, worry or loss of interest that lasts more than two weeks
- Anxiety that makes it hard to sleep or get through the day
- Feeling hopeless, or thoughts of harming yourself
Many cancer centers have counselors and psycho-oncology teams who work only with people who have cancer. If you are in crisis in the U.S., call or text 988.
Questions to ask your clinician about emotional support
- Is there a counselor or psycho-oncology service at this center?
- Are there support groups for women at my stage of treatment?
- Could any of my medicines be affecting my mood or sleep?
- Who should I call if my anxiety gets worse between appointments?
Sources: Joanna Sztachańska, Izabela Krejtz and John B. Nezlek, Using a Gratitude Intervention to Improve the Lives of Women With Breast Cancer: A Daily Diary Study, Frontiers in Psychology (2019); M. You and E. Kim, Effects of Gratitude Journaling on Patients with Breast Cancer: A Randomized Controlled Trial, Current Oncology (2025); Ni Ketut Putri Ariani and colleagues, The Impact of Gratitude Combined with Relaxation Therapy on Anxiety Reduction in Breast Cancer Patients Undergoing Chemotherapy, Indian Journal of Palliative Care (2026). This article is general information, written in Babette's own words, and is not a substitute for advice from your care team.
