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A normal reaction to hearing you have cancer is anxiety. You may also feel this while undergoing screening tests, waiting for your test results, receiving the diagnosis, undergoing treatment or even anticipating the recurrence of cancer. Anxiety may cause the feeling of pain, as well as interference with one’s ability to sleep, nausea and vomiting and interfere with the quality of life. If the anxiety becomes so severe that it becomes incapacitating or involves excessive worry or fear, it may warrant its own treatment. Untreated it may be associated with lower survival rates from cancer.
Feelings of anxiety increase and decrease at different times with those dealing with cancer. As it spreads or treatment becomes more intense, the patient may become more anxious. This differs from person to person and most are able to reduce their anxiety by learning more about their cancer and the treatments for it.
Cancer treatments are likely to cause intense anxiety in patients with a history of anxiety disorder or depression. If a patient is in severe pain or disabled with few friends or family to care for them, anxiety may also be felt. It may be hard to distinguish between normal fears that are associated with their cancer and abnormally severe fears that can be classified as an anxiety disorder.
Most people do not expect that patients with advanced cancer experience anxiety from fear of uncontrolled pain, being left alone or dependent upon others more than the fear of death itself. These can often be alleviated with treatment. Some patients already have intense anxiety because of unrelated cancer situations in their lives.
Often a patient may experience extreme fear, be unable to understand the information given to them by caregivers or unable to follow through with the treatments. In this instance, a doctor may ask additional questions like do they feel shaky, have they felt tense or fear, does their heart pound or race, any trouble catching their breath, unjustified sweating or trembling, felt a knot in the stomach, felt like they have a lump in their throat, afraid to close their eyes at night for fear of dying, and so on.
Often in treatment, it is difficult to distinguish between normal fears associated with their cancer and abnormal severe fears that can be classified as an anxiety disorder. It depends upon how anxiety is affecting the patient’s daily life.
Giving the patient adequate information and support is the beginning treatment. They need to be taught to develop coping strategies as viewing cancer from the perspective of a problem to be solved, obtaining enough information to understand the disease and treatment options, utilizing resources and support systems, all that can help the patient to lessen their anxiety.
There may be new anxieties after the patient has survived cancer. They may experience fear when asked about their cancer when confronted with insurance-related problems when attending a follow-up exam and tests or even fear of a recurrence of cancer. There are resources available to help people readjust to life after cancer to help alleviate these concerns and fears.
Dr Fredda Branyon