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

Anxiety disorders are very strong fears that may be caused by physical or psychological stress.

Studies show that almost half of all patients with cancer say they feel some anxiety and about one-fourth of all patients with cancer say they feel a great deal of anxiety. Patients living with cancer find that they feel more or less anxiety at different times. A patient may become more anxious as cancer spreads or treatment becomes more intense.

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For some patients feelings of anxiety may become overwhelming and affect cancer treatment. This is especially true for patients who had periods of intense anxiety before their cancer diagnosis. Most patients who did not have an anxiety condition before their cancer diagnosis will not have an anxiety disorder related to the cancer.

Patients are more likely to have anxiety disorders during cancer treatment if they have any of the following:

  • A history of an anxiety disorder.
  • A history of physical or emotional trauma.
  • Anxiety at the time of diagnosis.
  • Few family members or friends to give them emotional support.
  • Pain that is not controlled well.
  • Cancer that is not getting better with treatment.
  • Trouble taking care of their personal needs such as bathing or eating.

Anxiety disorders may be hard to diagnose.

It may be hard to tell the difference between normal fears related to cancer and abnormally severe fears that can be described as an anxiety disorder. The diagnosis is based on how symptoms of anxiety affect the patient's quality of life, what kinds of symptoms began since the cancer diagnosis or treatment, when the symptoms occur, and how long they last.

Anxiety disorders cause serious symptoms that affect day-to-day life, including:

  • Feeling worried all the time.
  • Not being able to focus.
  • Not being able to "turn off thoughts" most of the time.
  • Trouble sleeping most nights.
  • Frequent crying spells.
  • Feeling afraid most of the time.
  • Having symptoms such as fast heart beat, dry mouth, shaky hands, restlessness, or feeling on edge.
  • Anxiety that is not relieved by the usual ways to lessen anxiety such as distraction by staying busy.

There are different causes of anxiety disorders in cancer patients.

In addition to anxiety caused by a cancer diagnosis, the following may cause anxiety in patients with cancer:

  • Pain: Patients whose pain is not well controlled with medicine feel anxious, and anxiety can increase pain.
  • Other medical problems: Anxiety may be a warning sign of a change in metabolism (such as low blood sugar), a heart attack, severe infection, pneumonia, or a blood clot in the lung. Sepsis and electrolyte imbalances can also cause anxiety.
  • Certain types of tumors: Certain hormone -releasing tumors can cause symptoms of anxiety and panic attacks. Tumors that have spread to the brain and spinal cord and tumors in the lungs can cause other health problems with symptoms of anxiety.
  • Taking certain drugs: Certain types of drugs, including corticosteroids, thyroxine, bronchodilators, and antihistamines, can cause restlessness, agitation, or anxiety.
  • Withdrawing from habit-forming drugs: Withdrawal from alcohol, nicotine, opioids, or antidepressant medicine can cause agitation or anxiety.
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WebMD Public Information from the National Cancer Institute

Last Updated: February 25, 2014
This information is not intended to replace the advice of a doctor. Healthwise disclaims any liability for the decisions you make based on this information.
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