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    Adjustment to Cancer: Anxiety and Distress (PDQ®): Supportive care - Patient Information [NCI] - Normal Adjustment


    The way each patient copes with cancer depends on many physical and emotional factors.

    The following factors affect how a patient copes with the stress of cancer:

    • The type of cancer, cancer stage, and chance of recovery.
    • Whether the patient is newly diagnosed, being treated, in remission, or having a recurrence.
    • The patient's age.
    • Whether the patient is able to get treatment.
    • How well the patient usually copes with stress.
    • The number of stressful life events the patient has had in the last year, such as starting a new job or moving.
    • Whether the patient gets support from friends and family.
    • Social pressures caused by other people's beliefs and fears about cancer.

    Cancer patients need different coping skills at different points in time.

    The coping skills needed will change at important points in time. These include the following:

    Learning the diagnosis

    The process of adjusting to cancer begins before learning the diagnosis. Patients may feel worried and afraid when they have unexplained symptoms or are having tests done to find out if they have cancer.

    A diagnosis of cancer can cause expected and normal emotional distress. Some patients may not believe it and ask, "Are you sure you have the right test results?" They may feel numb or in shock, or as if "This can't be happening to me". Many patients wonder, "Could I die from this?"

    Many patients feel they are not able to think clearly and may not understand or remember important information that the doctor gives them about the diagnosis and treatment options. Patients should have a way to go over this information later. It helps to have someone with them at appointments, bring a tape recorder, or make a second appointment to ask the doctor questions and go over the treatment plan. See Talking with the Health Care Team in the PDQ summary on Communication in Cancer Care for more information.

    As patients accept the diagnosis, they begin to feel symptoms of distress, including:

    • Depression.
    • Anxiety.
    • Loss of appetite.
    • Trouble sleeping.
    • Not being able to focus.
    • Trouble with the activities of daily life.
    • Not being able to stop thinking about cancer or death.
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