Anxiety

A cancer diagnosis almost certainly causes some anxiety. For people with cancer, anxiety may also be triggered by fears about the cancer continuing to grow or spread during treatment or coming back after treatment and the effect of the illness on all aspects of their life. The symptoms can be mild or severe, occurring in short episodes that end quickly (acute) or remaining over time (chronic). Some of the symptoms of anxiety may be similar to symptoms of depression, with differences in intensity and frequency.

Acute anxiety

The symptoms of acute anxiety last for a short time. A person may frequently experience the following symptoms:

• Heart palpitations or rapid heartbeat
  
  
• High blood pressure
  
  
• Chest pain
  
  
• Shortness of breath
  
  
• Feeling of suffocation
  
  
• Sweating
  
  
• Chills
  
  
• Dizziness, lightheadedness
  
  
• Trembling
  
  
• Nausea, diarrhea, heartburn, or a change in appetite
  
  
• Abdominal pain
  
  
• Fear

Chronic anxiety

The symptoms of chronic anxiety often continue for a much longer period. People may experience one or more of the following symptoms:

• Excessive worrying
  
  
• Restlessness
  
  
• Muscle tension
  
  
• Insomnia
  
  
• Irritability
  
  
• Fatigue
  
  
• Trouble concentrating
  
  
• Trouble making decisions

What causes anxiety?

People with anxiety related to a cancer diagnosis often say that fear of death is their main concern or worry. However, anxiety can also be caused by fear of the cancer returning or spreading or a concern over losing control over one's life and future. Individual concerns reflect each person's fears and may change over time and range from fearing pain to fearing physical disfigurement or disability. People may also develop a fear of being dependent, or a fear of being abandoned.

For more information about the fear of cancer recurrence, read Cancer.Net: Coping with Fear of Recurrence.

How is anxiety treated?

Medical and psychological treatments are available to help people manage their anxiety. Sometimes people with anxiety feel a sense of dread or fear that they cannot identify. Describing their fears as specifically as possible to the doctor or nurse can help identify the cause. This is true even if the fears have no obvious solution, as with fear of a necessary medical procedure. By identifying the cause of a patient’s anxiety, the doctor or nurse can guide the patient to the appropriate techniques or treatments to help lower the person’s anxiety.

Relaxation techniques

The following relaxation techniques can help control the symptoms of anxiety. Some of these can be done with minimal guidance, while others may require the help of an instructor.

• Focused breathing
  
  
• Muscle relaxation
  
  
• Guided imagery
  
  
• Meditation
  
  
• Hypnosis
  
  
• Biofeedback
  
  
• Yoga

Counseling and support

Many psychotherapists are trained to work with people who have anxiety, and some specialize in working with people with cancer. Some people prefer individual therapy, and others prefer group therapy where they can learn from other people with cancer and provide support. Support groups can be found through the social work department of many local hospitals and medical centers and some patient information resource groups. Ask your doctor or nurse for more information or read Support Groups for additional resources. For some, involvement in community or spiritual activities may also help relieve anxiety.

Medication

People who experience severe anxiety may need medication to treat the condition, especially if their anxiety symptoms are severe. Frequently used medications include

Benzodiazepines. Benzodiazepines such as lorazepam (Ativan, Lorazepam Intensol), alprazolam (Alprazolam Intensol, Xanax), and clonazepam (Klonopin) can quickly relieve the symptoms of anxiety. Common side effects can include drowsiness, loss of coordination, fatigue, and mental slowing or confusion. Talk to your doctor about long-term use of benzodiazepines because some people may develop a tolerance for or a dependence on the medication.

Selective serotonin reuptake inhibitors (SSRIs). SSRIs such as fluoxetine (Prozac), sertraline (Zoloft), paroxetine (Paxil), and citalopram (Celexa) allow the body to build up serotonin (a neurotransmitter) levels, and make the best use of the limited amount it has at the time. The most common side effects include nausea, insomnia, headache, and sexual dysfunction.

Learn more about medications through Cancer.Net’s Drug Information Resources, which provides links to searchable drug databases.

Last Updated: September 26, 2008

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