Anxiety and Cancer Patients
Anxiety is a normal reaction to cancer.
One may experience anxiety while undergoing a cancer screening test, waiting
for test results, receiving a diagnosis of cancer, undergoing cancer treatment,
or anticipating a recurrence of cancer. Anxiety associated with cancer may
increase feelings of pain, interfere with one's ability to sleep,
cause nausea and vomiting, and interfere with the patient's (and his or her
family's) quality of life. If left untreated, severe anxiety may even shorten a
Persons with cancer will find that their feelings of anxiety increase or
decrease at different times. A patient may become more anxious as cancer
spreads or treatment becomes more intense. The level of anxiety experienced by
one person with cancer may differ from the anxiety experienced by another
person. Most patients are able to reduce their anxiety by learning more about
their cancer and the treatment they can expect to receive. For some patients,
particularly those who have experienced episodes of intense anxiety before
their cancer diagnosis, feelings of anxiety may become overwhelming and
interfere with cancer treatment. Most patients who have not had an anxiety
condition before their cancer diagnosis will not develop an anxiety disorder
associated with cancer.
Intense anxiety associated with cancer treatment is more likely to occur in
patients with a history of anxiety disorders and patients who are experiencing
anxiety at the time of diagnosis. Anxiety may also be experienced by patients
who are in severe pain, are disabled, have few friends or family members to
care for them, have cancer that is not responding to treatment, or have a
history of severe physical or emotional trauma. Central nervous system
metastases and tumors in the lungs may create physical problems that cause
anxiety. Many cancer medications and treatments can aggravate feelings of
Contrary to what one might expect, patients with advanced cancer experience
anxiety due not to fear of death, but more often from fear of uncontrolled
pain, being left alone, or dependency on others. Many of these factors can be
alleviated with treatment.
Description and Cause
Some persons may have already experienced intense anxiety in their life
because of situations unrelated to their cancer. These anxiety conditions may
recur or become aggravated by the stress of a cancer diagnosis. Patients may
experience extreme fear, be unable to absorb information given to them by
caregivers, or be unable to follow through with treatment. In order to plan
treatment for a patient's anxiety, a doctor may ask the following questions
about the patient's symptoms:
- Have you had any of the following symptoms since your cancer diagnosis or
treatment? When do these symptoms occur (i.e., how many days prior to
treatment, at night, or at no specific time) and how long do they last?
- Do you feel shaky, jittery, or nervous?
- Have you felt tense, fearful, or apprehensive?
- Have you had to avoid certain places or activities because of fear?
- Have you felt your heart pounding or racing?
- Have you had trouble catching your breath when nervous?
- Have you had any unjustified sweating or trembling?
- Have you felt a knot in your stomach?
- Have you felt like you have a lump in your throat?
- Do you find yourself pacing?
- Are you afraid to close your eyes at night for fear that you may die in
- Do you worry about the next diagnostic test, or the results of it, weeks in
- Have you suddenly had a fear of losing control or going crazy?
- Have you suddenly had a fear of dying?
- Do you often worry about when your pain will return and how bad it will
- Do you worry about whether you will be able to get your next dose of pain
medication on time?
- Do you spend more time in bed than you should because you are afraid that
the pain will intensify if you stand up or move about?
- Have you been confused or disoriented lately?
Anxiety disorders includes adjustment disorder, panic disorder, phobias,
obsessive-compulsive disorder, post-traumatic stress disorder, generalized
anxiety disorder, and anxiety disorder caused by other general medical