Anxiety in Patients with Cancer

 Written by: Jaime Anderson, RN, BSN, OCN

Many cancer patients report high levels of psychological distress. Anxiety is one of the more common reasons for experiencing distress. Anxiety symptoms can be triggered by a stressful event or situation, like a cancer diagnosis, or can arise without any obvious cause. The estimated prevalence of anxiety in patients with cancer is as high as 44%, according to a study published in The Journal of Clinical Psychology.

Anxiety is an emotion characterized by stress and fear, which a variety of factors can trigger. It is often accompanied by physical symptoms such as chest pain, racing heart, sweating, dry mouth, and difficulty breathing. Cancer, along with cancer treatments, can cause physical and emotional stress, which can lead to feelings of extreme fear, worry, and helplessness, exacerbating feelings of anxiety. In addition to newly diagnosed patients or those currently in treatment, anxiety can also arise due to fear of recurrence once a patient is in remission. 

Unfortunately, anxiety can interfere with treatment decisions, tolerance of treatment, and the ability to cope with the disease. Addressing and controlling anxiety early on is vital to reducing the adverse effects of cancer treatment and improving decision-making abilities. 

Taking the time to identify what triggers your anxiety can help you better understand how to manage it in the future. With the right tools and support systems in place, you can learn how to effectively manage your stress levels and anxiety so that it doesn't interfere with your daily life.

When to seek medical advice from your healthcare team

Anxiety can mimic cardiac issues in patients with cancer due to the physical similarities between the two conditions. Patients may experience chest pain, shortness of breath, fatigue, nausea, and dizziness—all common symptoms of anxiety and cardiac problems. Additionally, some people with anxiety may also have an increased heart rate or palpitations, which can further cloud diagnosis. So, it is important to seek medical attention if you believe you are suffering from anxiety to first rule out any cardiac issues.

If you are experiencing any of the following symptoms, seeking medical advice from your healthcare team is important.

  • Chest pain or tightness
  • Dizziness or lightheadedness
  • Shortness of breath
  • Extreme fear or panic attacks
  • Difficulty concentrating or sleeping

How to Cope with Anxiety

Relaxation techniques 

Deep Breathing or Breathing Exercises

  • Reduces the physical anxiety symptoms, such as increased heart rate and sweating. It can also help to calm your mind. To practice deep breathing, sit or lie in a comfortable position and take slow, deep breaths. Focus on each breath as it enters and leaves your body. Practice this controlled breathing several times a day. Each session should last 2-5 minutes.


  • Mindfulness is a technique that involves focusing on the present moment without judgment or expectation. This can help reduce stress and anxiety's emotional impact by allowing you to observe your thoughts and feelings without getting caught up in them.  To practice mindfulness, find a quiet place where you can sit comfortably for a few minutes. Close your eyes and focus on your breath entering and leaving your body. Notice any thoughts or feelings that arise without judging or trying to change them.
15 Minute Deep Breathing Exercise | City of Hope


10 Minute Guided Imagery Mindfulness Meditation | City of Hope



  • Regular physical activity can help to release endorphins which can improve mood and reduce tension and muscle tightness in the body. Exercise has been shown to be an effective way to reduce stress and anxiety levels. Aim for at least 30 minutes of moderate-intensity daily exercise, such as walking, jogging, swimming, or cycling.
  • San Antonio Regional Hospital has a free weekly Pilates class for cancer patients in our community. 

Talking to someone about your worries

  • Talking to a trusted friend or family member, social worker, or even a mental health professional can help you express your feelings and gain perspective on your situation.
  • San Antonio Regional Hospital offers free support groups for cancer patients in our community.
  • San Antonio Regional Hospital has an Oncology Nurse Navigator available to talk with you about your cancer.

Seek professional help if needed.

  • Anxiety can be a normal reaction to a cancer diagnosis and the treatment process. However, if you develop severe anxiety or experience constant anxiety that becomes overwhelming or interferes with your quality of life, it may be time to seek help from a mental healthcare professional.
  • Talk with your Oncologist about a referral or call your insurance company for covered providers in your area.


Maintain good hygiene during cancer

  • Good hygiene is an important part of staying healthy and managing anxiety in patients with cancer. It is essential for those undergoing chemotherapy or radiation therapy, as these treatments can weaken the immune system and make it more difficult to fight off infections. Link to support groups.

Eating well during cancer treatment

  • Eating well during cancer is an important part of managing the physical and emotional effects of the disease. Eating a balanced diet can help to reduce anxiety, improve energy levels, and boost overall health.
  • SARH has a low-cost nutritional counselor you can speak to one-on-one about your nutritional needs during cancer. Link to support groups.

Good Sleep 

Sleep disturbances are a common symptom of anxiety in patients with cancer and can affect your quality of life. Anxiety can cause difficulty falling asleep, frequent awakenings during the night, and early morning awakenings. It can also lead to insomnia, which is defined as difficulty falling asleep or staying asleep for at least three nights per week for more than one month.

Sleep is an essential part of managing anxiety. Research has shown that getting enough sleep can help reduce stress and improve overall mental health. It can also help to reduce the physical symptoms associated with anxiety, such as fatigue, headaches, and muscle tension.

Good quality sleep helps to regulate hormones and neurotransmitters in the body, which are responsible for controlling emotions and moods.

How Do I Get a Good Night's Sleep? | City of Hope


Maintain Adequate Symptom Management 

A common cause of anxiety in people with cancer is uncontrolled physical symptoms related to cancer or the effects of cancer treatment. If you have uncontrolled symptoms, for example, nausea, fatigue, or pain, ask your physician about a consult for  Palliative Care. The Palliative Care team includes physicians, nurses, and social workers focusing solely on your comfort. 

Educate Yourself "Knowledge is Power"

A cancer diagnosis can be incredibly overwhelming, and feeling anxious about your diagnosis and treatment plan is expected. However, understanding your diagnosis and treatment plan can help reduce some of the anxiety you may be feeling. Education helps to remove some of the unknowns and gives you the power to make informed decisions.

San Antonio Regional Hospital has an Oncology Nurse Navigator ready to assist you and your caregivers with one-on-one cancer patient education.

To talk with an Oncology Nurse Navigator, call (909) 920-6265.

To learn more about anxiety in cancer patients and coping strategies, visit the National Cancer Institute. 
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