After Treatment: Anxiety
Topics covered on this page:
What is cancer-related anxiety?
Anxiety is a feeling of worry, nervousness, uncertainty or stress. It is completely normal to feel anxious or stressed when you have cancer.
- How does it affect me? Even mild anxiety can affect the quality of your everyday life. It can affect how you feel about situations and people. It can also affect your ability to do your daily activities at home and work. How anxiety is experienced can be very different from person to person.
- Does it get better?Feelings of anxiety can improve or get worse at different times. Depending on the cause, anxiety may come and go. For example, when you’re waiting for test results. It may also feel like it’s always there. For example, because of the uncertainty about the future. Self-management strategies have been shown to help improve anxiety in many cases. (See What can I do to help manage my anxiety).
What causes cancer-related anxiety?
Everyone usually feels some anxiety when they find out they have cancer. A cancer diagnosis can make you feel unsure and nervous about many things. You may feel more anxious as you wait for test results. Also, when making decisions about treatment and dealing with the physical effects of cancer. Some—but not all—of the other things that may cause anxiety as you are coping with cancer include:
- Needing to depend on family and friends.
- Changes in relationships with family and friends.
- Feeling guilty about not having enough time for your family.
- Feeling stressed about having to organize medical appointments. Also balancing your personal and professional life.
- Worrying about the future.
What are the signs of anxiety?
Anxiety can have many different effects on your body and mind. Typical signs of anxiety include:
- Short temper, impatience.
- Unease, difficulty relaxing.
- Worrying more than usual.
- Loss of interest in social activities or seeing people.
- Difficulty with tasks or activities that you usually find easy.
- Difficulty concentrating or making decisions.
- Headaches.
- Loss of appetite.
- Trouble sleeping.
- Stomach discomfort.
- Fatigue.
- Dizziness.
- Diarrhea.
- Nausea.
- Choking sensation.
When should I get help for my anxiety?
It is normal to feel anxious when you have cancer. However, if your anxiety is so bad that you feel like you can’t cope, you should talk to your health care team. This can be your oncologist, psychologist, nurse, or pivot nurse at your next appointment. (For tips on talking with your healthcare team, see Talking to your healthcare professional about your symptoms or concerns). Consider if the following situations are true for you. If so, it may mean that your anxiety is too much for you to handle on your own.
- You feel “frozen”. You feel anxiety is preventing you from doing things you have to do or want to do.
- You experience any “signs of anxiety” very strongly and/or all the time. (See list above).
- You can’t sleep through the night.
- Anxiety stops you from going to your medical appointments.
- You can’t make the necessary decisions.
- Your worries and fears are hurting your relationships.
- You can’t cope with your basic daily activities.
- You can’t seem to enjoy life at all or look forward to the future.
- You frequently experience sudden shortness of breath. Also, sudden fast heartbeat or chest pains.
Talk to someone in your healthcare team immediately if:
- You have had an experience with depression or an anxiety disorder in the past.
- You have a history of physical or emotional trauma.
- You are having thoughts about harming or killing yourself. If you can’t reach someone in your healthcare team, call Suicide Action Montreal at 1-866-277-3553 or call 9-1-1 or go to https://suicide.ca/en.
What can I do to manage my anxiety?
There are many things that you can do to manage your anxiety. Things to do to keep it from getting worse. You may want to use ways to cope with stress that have worked for you in the past. If these do not work as well as before, think about trying something else. You may have to test a few things to see what works best for you. Below are some suggestions you can try.
- Keep a diary of when you feel anxiety. Write down:
- When did it start?
- What seems to make it worse?
- What makes it better?
- Track if there’s anything you do that lessens your anxiety. This can be meditation or exercise.
- For more information, see Symptom Diary.
- Knowing more about your cancer and your treatment options. Also knowing about the side effects of treatment. This can help you feel more in control and less anxious.
- In between appointments, keep a list of questions to ask your oncologist at your next visit. You may worry less if you feel more prepared.
- When you feel anxious or stressed, it can be difficult to ask your doctor questions or speak up for yourself. However, being assertive in this way can help remove some uncertainty that may be causing your anxiety. This might make you feel a bit more in control.
- Sleeping well can give you more energy. This can help to reduce anxiety.
- If you are having trouble sleeping, before going to bed, try doing an activity that you know relaxes you. This can include listening to music, reading or meditating.
- It’s recommended that you turn off computers and tablets at least one hour before you plan to go to bed. The bright screens of these devices can trick your brain into thinking it’s daytime. This makes it harder to sleep.
- A healthy, balanced diet can help boost energy. This can improve your mood.
- Eat foods that contribute to physical and mental well-being. These include fruits and vegetables, foods rich in omega 3 fatty acids (e.g., salmon, mackerel, sardines, flaxseeds, soybeans) and B vitamins (e.g., eggs, dairy products, whole grains, broccoli, spinach).
- Limit foods that are high in fat, sugar or salt. These include processed foods and desserts. Also sugary drinks and fast food. Also, limit caffeine and alcohol. Both can make anxiety worse.
- Check with your healthcare team to learn about foods to avoid. Sometimes, there may be foods or drinks that you should not have because of your cancer or treatment.
- For more information see Looking After Yourself.
- Regular exercise can help improve your sleep. This may help you relax and reduce anxiety. It may also help you manage pain and fatigue better. It can improve your appetite.
- It is generally fine to exercise during treatment. Always check with your healthcare team before starting any exercise.
- Choose an activity or exercise that you enjoy doing or would like to try. See if you can fit it into your schedule without too much difficulty.
- Pay attention to what your body tells you. Only increase the amount and difficulty of your activity when you feel comfortable.
- For more information, see Get Moving.
Relaxation strategies are a useful way to help relax your mind and body. This can help to reduce anxiety. The good thing about these techniques is that they can be done almost anywhere.
- Breathing exercises. This technique focuses on slow, deep breathing. Even a few minutes of deep breathing can help you relax.
- Progressive muscle relaxation. This involves tensing and relaxing a muscle. It can also be for a group of muscles, one at a time.
- Guided imagery or visualization. It can help you to imagine being in a place that makes you feel calm in real life. Guided means someone talks you through the process in person or through a recording.
- Meditation is a practice of quieting the mind. This is usually done by focusing attention on the breath. You can meditate sitting, lying down and even walking.
- Massage therapy. Use a certified massage therapist. They should have experience working with cancer patients.
- Relaxation activities. Some types of yoga and tai chi involve slow, meditative movements. These help relax the mind and body. Look for classes with trained instructors. This can help you learn the proper techniques.
- For more information, see Relaxation Strategies.
Take a break from thinking and talking about cancer. Try to make some time to do something you enjoy every day. It could be as simple as listening to music or reading a book. It can be watching a funny movie or spending time with people who make you laugh.
- Make time for your hobbies. Think of creative outlets that have always brought you joy in the past. You might want to try something new that you’ve always wanted to do. This can be creative writing, art or music lessons.
Anxiety can cause you to avoid people or situations that make you tense. However, sometimes, the more you avoid what makes you anxious, the more anxious you become.
- You may be avoiding going out with a group of friends because you’re afraid they might ask you about your cancer. To help, consider going and having an answer ready that you’re comfortable with. This could be something like: “Thank you for asking, but I’d really just like to enjoy the evening and not think about cancer.”
- Don’t try to deal with your problems all on your own. It can be difficult to ask for help, particularly from family and friends. However, it is important to let the people in your life know when you need help. This can prevent you from getting overwhelmed. Lean on family and friends. They can help with cooking, housework or babysitting. Also consider when you’d like someone to come with you to appointments.
- Talk about your feelings and fears. You can talk with a family member or friend who is a good listener. You might otherwise like to share your worries with people in a support group who have had experiences like you.
- You might prefer to talk to a professional counsellor, such as a psychologist. A psychologist can help you think about your worries differently. They may give you ideas to help you manage your anxiety.
⚠ Important information about cannabis
Some patients do use cannabis to reduce pain, help with relaxation or as a sleeping aid. However, the research is still unclear about the use of cannabis to manage cancer-related symptoms, including anxiety. It is important to talk to your doctor before trying cannabis. For more information on what cancer patients should know about cannabis, go to: http://www.bccancer.ca/health-info/coping-with-cancer/medical-cannabis.
Available services
The Quebec Cancer Foundation supports people with cancer and their loved ones throughout Quebec, through services suited to their needs and daily concerns.
Services offered
Several services and activities offered by the Quebec Cancer Foundation can be useful to help you manage your anxiety including psychological support such as guided meditation, art therapy, and telephone peer-matching. Other services such as wellness workshops, yoga and massage therapy are also featured.
The Quebec Cancer Foundation also has many documentary resources on the subject. Via the Info-cancer library, our documentalists specialized in oncology can guide you in your search for information and give you suggested readings.
Contact
1 (800) 363-0063
The mission of the Quebec Breast Cancer Foundation is to promote the well-being of cancer patients and their families through research, innovation, support and awareness.
It is committed to offering a range of services, including a hotline for information and resources adapted to the needs of people living with cancer.
Services offered
My Active Health: Reducing stress can help relieve anxiety. The services offered by the My Active Health program help you to take part in regular physical activity and relax, in particular through oncology yoga sessions.
Psychosocial support: The Quebec Breast Cancer foundation offers psychosocial support. The social workers from the Quebec Breast Cancer foundation’s support service can also help form strategies with you to manage stress and anxiety.
Free virtual clinic: a primary-care service is offered to people affected by breast cancer and their family. Through this service you can communicate online with healthcare professionals dedicated to caring for people with cancer. The clinic is free, easy to use and accessible 24/7.
- Better monitoring and screening
- Symptom management
- Promotion in health and healthy life habits
- Coordination of care between specialists and generalists
Contact
1-855-561-ROSE
General information
The Canadian Cancer Society offers support for people with cancer and their family, friends and caregivers.
Their information specialists are there to answer your questions and offer up-to-date, reliable information on topics that include:
- cancer treatment and side effects
- clinical trials
- coping with cancer
- emotional support services
- prevention
- help in the community
- complementary therapies
Services Offered
Helpline: The information specialists at the Cancer Information helpline are available Monday to Friday in English and French from 8am to 6pm. For other languages, they can access an interpreter service.
Online community: CancerConnection.ca is the Canadian Cancer Society’s online community. This service helps people with cancer and their families share experiences and create supportive relationships.
Contact
General information: https://cancer.ca/en/
Cancer Information helpline: (Toll free) number: 1-888-939-3333
To access their website and live chat: https://cancer.ca/en/living-with-cancer/how-we-can-help/talk-to-an-information-specialist
Online community: https://cancer.ca/en/living-with-cancer/how-we-can-help/connect-with-our-online-community
Service locators
Below is a list of organizations that can help identify local support services for you and those that support you. The quality of the services has not been verified by e-IMPAQc. Before using these services, verify with your healthcare practitioner.
The Canadian Cancer Society offers a service locator resource where you can find services and programs in your city or nearest your postal code.
Contact
1-888-939-3333 (Monday-Friday)
The Regroupement des Organisations Communautaires en Oncologie (ROCO) offers a service locator resource specific to the province of Quebec. It lists support resources available by region.
Contact
514-506-3503
The Quebec Cancer Foundation offers a resources directory of community, association and public resources by region or postal code.
The foundation also has a document lending service. Their materials (books, web resources, online articles, webcasts) cover a wide range of topics related to cancer. It is free to borrow and materials are sent by mail or email anywhere in Quebec.
Contact
1-800-363-0063 (Monday to Friday, 9 AM to 5 PM EST)
Resources
For more information on cancer-related anxiety, self-management strategies and support organizations, check out the resources below.
Canadian Cancer Society – Anxiety
Canadian Cancer Society – Coping When You Have Cancer
Cancer Care Ontario – How to Manage Your Anxiety (download patient guide)
Quebec Cancer Foundation – Anxiety and Depression
Anxiety Canada – Anxiety in Adults
Cancer.Net – Coping With Uncertainty
Canadian Psychological Association – “Psychology Works” Fact Sheet: Cancer in Adults
Info-aidant – Support for Caregivers (info-aidant@lappui.org or call 1 855 852-7784)
Acknowledgement of sources
The content of this document has been adapted from the following sources:
- BC Cancer. Anxiety. 2018.
- Canadian Cancer Society. Coping With Anxiety and Stress. 2019.
- Canadian Cancer Society. Coping When You Have Cancer. 2017.
- Cancer Care Ontario. How to Manage Your Anxiety. 2016.
- Coping-Together. Dealing With Stress and Worry.
- 2016.
- Quebec Cancer Foundation. Anxiety and Depression. 2020.
- University Healthcare Network. Managing Anxiety After Cancer Treatment. 2017.
Healthcare professional endorsement
The content of this document has been reviewed and approved by a team of healthcare professionals and clinical experts.
Disclaimer
Please note that this fact sheet is not intended as a substitute for consultation with a healthcare professional. Rather, it was designed to complement interventions by your treating team. If you have questions about your health, or any medical issue, you should contact a healthcare professional right away. You should not delay seeking medical advice, or disregard professional medical advice, because of information in this fact sheet. Before beginning any health treatment, always consult your doctor. All care has been taken to ensure that the information contained in this document is accurate at the time of publication. e-IMPAQc is not responsible for any injury or damage to persons or property arising out of, or related to, any use of the fact sheet, or because of any errors or omissions.
Reproduction and copyright
Any reproduction or distribution, in whole or in part, of this webpage is prohibited without obtaining prior written consent of the e-IMPAQc project lead. Permission can be obtained by writing to e-impaqc@mcgill.ca.
