Symptom Specific Services

Anxiety
• Is it normal to experience feelings of worry or anxiety when diagnosed with cancer?
• What help is available?

Is it normal to experience feelings of worry or anxiety when diagnosed with cancer?
Worry or anxiety is a normal reaction to cancer. These feelings may intensify if the disease progresses or if treatment becomes more aggressive. Your feelings of anxiety may:

• Increase feelings of pain.

• Interfere with sleep.

• Cause you to lose your appetite and, in extreme instances, cause nausea and vomiting.

• Interfere with your and your family's quality of life.

• Cause or heighten your concern about being a burden on others.

People are different, with varied life experiences and individual strengths and weaknesses. These differences mean that each person will confront anxiety in his or her own way.

If you are normally a “worrier,” you may find that these feelings intensify with a cancer diagnosis. An individual's experience with cancer may cause reactive associations and memories of previous illness. Cancer can also cause feelings of vulnerability and a lack of control.

Nearly everyone diagnosed with cancer has fears that they will suffer or die because of the disease. For some people, these feelings are private. Other people find it easier to discuss their feelings with family, friends, clergy, or with other patients who have been affected by cancer. Patients who have problems communicating with their families, friends, and physicians usually have more difficulty coping with anxiety.

Anxiety may interfere with your life and that of your family. It can hinder your ability to function socially and emotionally and can affect your ability to cope with your cancer diagnosis and treatment. You may experience extreme fear, and you may have difficulty absorbing information given to you by caregivers, or be anxious about following through with treatment. You may find that your feelings of anxiety increases or decreases at different times.

It is common to become more anxious if:

• The cancer spreads or if treatment becomes more intense.

• You are experiencing pain. Anxiety, in turn, may cause additional pain.

• You are experiencing shortness of breath.

• You have other medical conditions.

• You are waiting for the results of diagnostic procedures or cancer treatment.

• Your cancer is not responding to treatment.

• You have only a few friends or family members to help care for you.

• You are taking medications or are involved in treatments that list anxiety as one of the side effects.

Anxiety can be managed and you should not hesitate to discuss your concerns with your family, your significant other, and your team of professionals, so they can help you.

These questions might help you determine the severity of your anxiety:

• Do you feel shaky, jittery or nervous?

• Have you felt tense, fearful or apprehensive?

• Have you avoided certain places or activities because of fear?

• Have you felt your heart pounding or racing?

• Have you had trouble catching your breath when nervous?

• Have you felt a lump in your throat?

• Do you find yourself pacing?

• Are you afraid to close your eyes at night for fear that you may die in your sleep?

• Have you suddenly had a fear of dying?

• Do you worry about whether you will be able to get your next dose of pain medication on time?

• Do you spend more time in bed than necessary because you are afraid that your pain will intensify if you stand up or move around?

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What help is available?
Treatment for anxiety begins by sharing your concerns with those around you. One strategy to consider is to view your cancer as a problem to be solved. If you obtain information in order to understand your disease and treatment options, and use available resources and support systems, you can help relieve your anxiety.
You may benefit from a variety of treatment options for anxiety. Some of these are:

• Psychotherapy

• Group therapy

• Family therapy

• Self-help groups

• Hypnosis

• Relaxation techniques, such as guided imagery (a form of focused concentration on mental images to assist in stress management)

• Biofeedback (a method of early detection of the symptoms of anxiety so you can take preventive action)

You may also find it beneficial to treat the underlying causes of such pain or side effects due to medication.

Our wellness programs (yoga, meditation, Reiki, water aerobics) provide an emotional and physical release of stress. Participating in these programs with other people who have experienced cancer can help you feel less alone. For more information, go to http://www.wehealny.org/calendar/karpas.html.

Our support groups, run by professionals or trained peers, can help you reduce your fears by learning from others and sharing your experiences. In partnership with SHARE, a self-help organization in the New York area, veteran patients run support groups for patients with breast or ovarian cancer. For more information on SHARE and SHARE programs, visit their Web site at http://www.sharecancersupport.org.

Medications may be used alone or in combination with these techniques. You should not avoid anxiety-relieving medications for fear of becoming addicted. Your doctor will give you the right dose of medication to alleviate the symptoms and reduce your dose as your anxiety improves.

Many anti-anxiety medications are non-addicting. One of the basic types of anti-nausea (anti-emetic) medications is Lorazepam (Ativan). This drug is prescribed during chemotherapy treatment as an anti-anxiety medication. Lorazepam is given orally or intravenously during treatments. Extra doses of the same medications, sometimes available in long-acting forms, provide extra relief without adding new medications to those you may already be taking.

It is important for you to understand anxiety management techniques, so you can help control and reduce your own anxiety. Your physician can discuss with you the thoughts and feelings that are causing you distress, so make sure you feel comfortable discussing all of your concerns with him or her.

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