Anxiety Treatment Options During Cancer


Anxiety is a feeling of fear or anticipation. While anxiety is a natural response to some situations, it can develop into a debilitating disorder in some people. There are several types of anxiety disorders, but they all have the common symptoms of excessive, irrational fear and dread. Anxiety is treatable. Usually a combination of medications and psychotherapy is prescribed.

What is anxiety?

Anxiety is a feeling of fear or anticipation. All human beings experience anxiety at some time, but the cause and severity is very different for each person. Most people experience relatively mild and brief anxiety before a stressful event, such as an exam, business presentation or a first date. For others, anxiety becomes chronic, relentless, developing into an anxiety disorder. If left untreated, anxiety disorders can grow progressively worse, making it difficult to function in everyday life.

There are many different types of anxiety disorders. Some examples include:

  • Panic disorder

  • Obsessive-compulsive disorder

  • Post-traumatic stress disorder

  • Phobias

  • Generalized anxiety disorder

While each of these have their own distinct set of symptoms and features, they are all bound together by the characteristic symptoms of excessive, irrational fear and dread. Post-traumatic stress disorder and generalized anxiety disorder may be associated with being diagnosed with or treated for cancer. For more information, go to Post-traumatic stress disorder.

What causes anxiety?

Anxiety disorders develop from a complex combination of factors, including:

  • Genetics

  • Brain chemistry

  • Personality

  • Stressful life events

Being diagnosed with or treated for cancer may cause symptoms of an anxiety disorder in some people.

What are the symptoms of anxiety?

Generalized anxiety disorder is characterized by excessive, unrealistic worry that lasts six months or more. In adults, the anxiety may focus on issues such as health, money or career.[1] In addition to chronic worry, symptoms of generalized anxiety include:

  • Trembling

  • Muscular aches

  • Insomnia

  • Abdominal upsets

  • Dizziness

  • Irritability

What is the treatment for anxiety?

Anxiety is most often treated with a combination of medication and psychotherapy. Medication is often used to ease symptoms so that other therapy can continue. Your doctor may prescribe medication for a short-term therapy, or it may be required for a lengthy period of time, depending on your circumstances.

Drug treatment: A number of medications that were originally approved for treating depression are also effective for anxiety disorders. Most of these medications take 3 to 6 weeks to begin working and may be associated with some side effects. Your doctor may try several different drugs to find the best treatment for you.

Some of the newest of these antidepressants are called selective serotonin reuptake inhibitors (SSRIs). SSRIs increase the level of the neurotransmitter serotonin, a chemical in the brain thought to be linked to anxiety disorders. While SSRIs have gained popularity because they have fewer side effects than other medications, they still do have some side effects (see table 1).

Table 1 Examples of SSRIs and common side effects associated with these medications

Examples of SSRIs Common side effects
  • Fluoxetine (Prozac®)
  • Agitation, nervousness
  • Sertraline (Zoloft®)
  • Decreased sex drive
  • Paroxetine (Paxil®)
  • Nausea
  • Insomnia
  • Headache

Another type of antidepressant drug called a tricyclic antidepressant (TCA) may be prescribed for anxiety. TCAs are associated with more side effects than the SSRIs. TCAs also work by regulating serotonin levels.

Table 2 Examples of TCAs and common side effects

Examples of TCAs Common side effects
  • Amitriptyline (Elavil®)
  • Increased heart rate
  • Imipramine (Tofranil®)
  • Blurred vision
  • Nortriptyline (Pamelor®)
  • Drowsiness
  • Sexual problems
  • Dizziness
  • Difficulty urinating
  • Dry mouth
  • Constipation
  • Moderate weight gain

Another type of medication commonly used for anxiety is a class of drugs called benzodiazepines; an example is diazepam (Valium®, Valrelease®).

Psychotherapy (talk-therapy): There are many different kinds of psychotherapy, also known as talk therapy. The approaches that are commonly used to treat anxiety are Behavior Therapy and Cognitive Therapy. Behavior therapy seeks to modify unwanted behavior and find ways to cope with difficult situations. This provides a sense of having control over your life. Cognitive therapy aims to change harmful or unproductive thoughts that cause anxiety. A combination of these two approaches may also be utilized.

What else can I do?

Make sure you are getting enough sleep and try to exercise daily. Being well rested will help you cope with difficult situations, thoughts, or other triggers of your anxiety. Exercise increases the release of natural chemicals in your body called endorphins, which promote a feeling of well-being. A daily exercise program can be as simple as 20-30 minutes of walking.

Also, cancer support groups may help you deal with your anxiety. Support groups have been shown to improve mood, encourage the development of coping skills, improve quality of life and improve immune response. Support groups can be found through the American Cancer Society, or ask your doctor.

To help you manage your anxiety, you may wish to try relaxation techniques, such as:

  • Meditation

  • Yoga

  • Deep breathing


[1] Anxiety Disorder Association of America. Brief Overview of Anxiety Disorders accessed 1/14/04.