Adjustment to Cancer: Anxiety and Distress (PDQ®): Supportive care - Patient Information [NCI] - Normal Adjustment
During remission, patients may become stressed before follow-up medical appointments because they worry that the cancer has come back. Waiting for test results can be very stressful.
Patients who are able to express both positive and negative emotions are more likely to adjust well. Patients are more able to cope with the emotional stress of finishing treatment and being in remission when they:
- Are honest about their emotions.
- Are aware of their own feelings and are able to share them with others.
- Are able to accept their feelings without thinking of them as right or wrong or good or bad and are willing to work through their emotions.
- Have support from others who are willing to listen and accept their feelings.
Learning that the cancer has come back
Sometimes cancer comes back and does not get better with treatment. The treatment plan then changes from one that is meant to cure the cancer to one that gives comfort and relieves symptoms. This may cause great anxiety for the patient. The patient may feel shock and be unable to believe it at first. This may be followed by a period of distress such as depression, trouble focusing, and being unable to stop thinking about death. Signs of normal adjustment include:
- Times of sadness and crying.
- Feelings of anger at God or other higher power.
- Times of pulling away from others and wanting to be alone.
- Thoughts of giving up.
Patients slowly adjust to the return of cancer. They stop expecting to be cured of cancer and begin a different kind of healing. This healing is a process of becoming whole again by changing one's life in many ways when faced with the possibility of death. It is very important that patients keep up hope while they adjust to the return of cancer. Some patients keep up hope through their spirituality or religious beliefs. (See the PDQ summary on Spirituality in Cancer Care for more information.)
Becoming a cancer survivor
Patients adjust to finishing cancer treatment and being long-term cancer survivors over many years. As treatments for cancer have gotten better, cancer has become a chronic disease for some patients. Some common problems reported by cancer survivors as they face the future include:
- Feeling anxious that the cancer will come back.
- Feeling a loss of control.
- Reminders of chemotherapy (such as smells or sights) that cause anxiety and nausea.
- Symptoms of post-traumatic stress, such as being unable to stop thinking about cancer or its treatment or feeling separate from others and alone.
- Concerns about body image and sexuality.
Most patients adjust well and some even say that surviving cancer has given them a greater appreciation of life, helped them understand what is most important in their life, and stronger spiritual or religious beliefs.
Some patients may have more trouble adjusting because of medical problems, fewer friends and family members to give support, money problems, or mental health problems not related to the cancer.