Coping with anxiety and stress

It’s normal to feel anxious or stressed when you have cancer.

Anxiety is a feeling of worry or unease and being afraid that something bad is going to happen.

While feeling anxious when you have cancer is normal, sometimes anxiety can get so bad that it overwhelms you. When that happens, anxiety can be diagnosed as a medical condition that needs treatment.

Stress is a reaction to something that is dangerous or that is a challenge to us. Some stress is a good thing, because it can help us get things done or solve problems. Stress helps our bodies get ready to run away from danger or to fight it. But you can’t always run away from problems – you have to learn to face them. If we have too much stress in our life or if we avoid facing the cause of our stress, it can cause long-term health problems.

Reducing anxiety and stress

How you coped with feeling stressed or anxious in the past may not work now. But there are many things you can do to cope better. It is worth taking some time to figure out what works for you.

Your healthcare team may be able to help by teaching you ways to cope, suggesting a stress management class or referring you to a counsellor or support program. Sometimes, anxiety may have to be treated with medicine.

Lowering your stress levels can help your mood and give you emotional strength to get through the tough times.

Mind-body practices

There are several types of mind-body practices that can help calm your mind, restore your body and reduce stress, anxiety and fatigue. Many hospitals and cancer centres run classes where you can try them out. Or you can practise at home using books, CDs or websites. The idea behind these techniques is to focus on the present moment rather than sadness about the past or fears about the future.

Relaxation exercises usually involve slow breathing and loosening your muscles.

Meditation involves focusing the mind on a single thing, like your breathing. There are many forms of meditation, which can be done sitting, lying down or walking.

Guided imagery combines deep breathing and meditating as you imagine a peaceful scene or setting. Some people like to play gentle music or nature sounds while practising. Others prefer silence.

Mindfulness meditation is a more structured type of meditation that therapists and doctors sometimes teach as a way of coping with emotions. It involves bringing awareness to each moment without judgment or the need to change it.

If you are interested in trying one of these techniques, ask your healthcare team for information and referrals.

By listening to the recordings that we've prepared, you will learn deep breathing and be able to practise 6 different relaxation techniques.

Mind-body physical activities

Some gentle types of exercise connect the mind and body through movement.

Yoga is probably the most well-known. Some types of yoga are slow and meditative while others are more athletic.

Tai chi is an ancient Chinese form of “moving meditation” that involves slow, continuous movements that help relax the mind.

Be sure to talk to your doctor before starting any physical activity. It’s also important to practise with a trained practitioner at first so that you learn proper techniques. Hospitals and cancer centres sometimes offer classes for people with cancer. Once you’ve learned the basics, you can practise at home with a book, CD or online support.

Massage therapy

People often use massage therapy to help reduce muscle soreness and stiffness. Having a massage may also help you relax and reduce your anxiety and stress. Before trying massage therapy, talk to your healthcare team to make sure it is safe for you. Look for a registered massage therapist who has experience in working with people with cancer. Be sure to tell your massage therapist that you have cancer and talk about the treatments you have had or are having and any medicines that you’re taking.

Writing and other creative outlets

Many people find it helpful to keep track of feelings by writing them down. The writing process can get your emotions out and help you process your feelings. This, in turn, reduces your stress levels. Some people find it easier to write about their emotions than to talk about them.

You can write as much or as little as you want, depending on how you are feeling. Your words can be written in a private journal or diary, just for you. Or they can be shared with friends and family through letters, group emails and private social media posts. Some people share their thoughts with the world through blogs, personal websites or public social media pages.

If writing isn’t for you or if you find it’s making you tired or upset, try another creative outlet. Photography, drawing or painting, and music are also great ways to express your emotions.

Hobbies and interests

Many people living with cancer emphasize how much it helped them to spend time on hobbies and interests. Do something enjoyable and relaxing each day, or something physically challenging that you enjoy. This can help balance out the stresses of daily life or pass the time. Many people feel better when they stay busy.

You can stick with something you’ve always enjoyed and can still do. Or you can try something new.

Spending time with friends and family

Spending time with people whose company you enjoy can ease your stress levels. Sometimes you might talk about your feelings with people close to you. Other times you might share a laugh or do things you’ve always loved to do together – and try to forget about cancer for a bit.

Pets

Some people might have a pet. Research shows that spending time with a dog or other animal can ease stress and anxiety and improve your sense of well-being.

Being active

Many people find they feel better, have more energy and are less stressed when they take part in physical activities such as swimming, walking or biking. You can often continue to be active during and after cancer treatment, as long as your healthcare team says it’s OK and you feel up to it. Talk to your healthcare team before trying a new activity or if you have questions about physical activity.

Laughter

Although cancer isn’t a funny subject, some people find that laughter helps them deal with the stress and anxiety around cancer. Using laughter to relieve tension doesn’t mean you aren’t taking cancer seriously. It’s OK to laugh. When a person laughs, their brain releases chemicals that relax muscles and make them feel good. So don’t hesitate to watch your favourite funny movie or read your favourite funny book again. Or call a friend to tell them about the silly thing your pet did. You just might feel better afterwards.

Post-traumatic stress (PTS) and post-traumatic stress disorder (PTSD)

It’s normal to think that after treatment you will not be so stressed. And for many people, it does work that way. But when treatment ends, you are left to deal with how you feel about this traumatic and unexpected event that has drastically changed your life and your family’s life. This can be very hard.

You may start having feelings of anxiety about the cancer that won’t go away. This is called post-traumatic stress (PTS). You may:

  • stay away from places (such as hospitals) or people that were part of the cancer treatment
  • be nervous or irritable
  • sleep poorly, with bad dreams about the cancer or cancer treatment
  • think about your cancer experience over and over again

Most of the time, symptoms start within the first 3 months of diagnosis, but they can show up months or years later. PTS is not a disorder – symptoms will often improve or go away on their own.

But post-traumatic stress disorder (PTSD) is more serious. It’s a specific group of symptoms that some people get after painful, life-changing events, such as being diagnosed with cancer or going through natural disasters, violent crimes, bombings or war. It is a medically recognized mental health condition. PTSD symptoms are more severe than PTS and can last for a very long time.

Some cancer survivors are at a higher risk of developing PTSD. These are people who have had previous mental health problems or previous trauma, have high levels of stress in their life or have very little support from family or friends.

If you are experiencing symptoms of PTS or PTSD, it is important to talk to your healthcare team. There is treatment available. It may include counselling or medicine or a combination of both. Asking for help is not a sign of weakness. It is a sign that you are taking the first step toward dealing with and gaining control over your feelings.

Expert review and references

  • American Cancer Society. Anxiety, Fear and Depression . 2016.
  • How Can I Help Myself Cope with Cancer? .
  • American Society of Clinical Oncology. Anxiety . 2019: https://www.cancer.net/coping-with-cancer/managing-emotions/anxiety.
  • American Society of Clinical Oncology. Managing Stress . 2017: https://www.cancer.net/coping-with-cancer/managing-emotions/managing-stress.
  • Andrykowski MA & Kangas M . Posttraumatic stress disorder associated with cancer diagnosis and treatment. Holland JC, et al (eds.). Psycho-Oncology. 2nd ed. Oxford University Press; 2010: 47: pp. 348-357.
  • Kantor D. Psychological distress. Kantor D, Suzan Z (eds.). Issues of Cancer Survivorship: An Interdisciplinary Team Approach to Care . Philadelphia, PA: Wolters Kluwer; 2016: 47–63.
  • Kennedy SL, Barnett M. Anxiety and uncertainty. Lester JL, Schitt P (eds.). Cancer Rehabilitation and Survivorship: Transdisciplinary Approaches to Personalized Care . Pittsburg PA: Oncology Nursing Society; 2011: 16: 165–174.
  • National Cancer Institute. Adjustment to cancer: anxiety and distress (PDQ®) Patient Version . 2019: https://www.cancer.gov/about-cancer/coping/feelings/anxiety-distress-pdq. Wednesday, January 06, 2021.
  • National Cancer Institute. Adjustment to cancer: anxiety and distress (PDQ®) Health Professional Version . 2019: https://www.cancer.gov/about-cancer/coping/feelings/anxiety-distress-hp-pdq#section/all. Wednesday, January 06, 2021.
  • National Cancer Institute. Cancer-Related Post-traumatic Stress (PDQ®) Patient Version . 2019.
  • National Cancer Institute. Cancer-Related Post-traumatic Stress (PDQ®) Health Professional Version . 2019.

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