Anxiety  

It is natural to feel a range of emotions after a cancer diagnosis, throughout the stages of treatment and when living beyond cancer. Some people may notice that they feel low, others may feel angry or frustrated, or anxious.

This page focuses on the experience of anxiety but for more general information on the psychological impact of cancer you can go to psychological wellbeing, or specific pages on low mood, loneliness or body image and cancer.  

Anxiety is a feeling of worry, unease or nervousness about something. It is very common, and most people will experience anxiety at some time in their lives. It is often fleeting as a reaction to something happening, but for some it can last longer.   

You may have experienced anxiety before or may usually struggle with it and find that cancer has made your anxiety worse, or it might be the first time you are experiencing it. 

Cancer often comes with a lot of uncertainty about the future and what will happen, such as wondering if treatment will work, how will my life be impacted, will cancer recur or will I die, which naturally creates anxiety. Often there may be other concerns around work, finances, caring needs and the impact on relationships which can also cause anxiety.  

Common mental symptoms of anxiety include:  

• feeling tense or nervous 

• being unable to relax 

• worrying about the past or future 

• feeling tearful 

• not being able to sleep 

• difficulty concentrating 

• fear of the worst happening 

• intrusive traumatic memories 

• obsessive thoughts 

If you are anxious, you may also notice physical symptoms such as: 

• faster, irregular or more noticeable heartbeat 

• feeling lightheaded and dizzy 

• headaches 

• chest pains 

• loss of appetite 

• sweating 

• breathlessness 

• feeling hot 

• shaking 

Sometimes people may experience panic attacks, which involves a sudden and intense fear and physical symptoms of anxiety for usually around 5-30 minutes. People can often feel out of control. Although scary they are not dangerous.  

You may also notice changes in your behaviour, such as: 

• not being able to enjoy your leisure time 

• difficulty looking after yourself 

• struggling to form or maintain relationships 

• worried about trying new things 

• avoiding places and situations that create anxiety 

• compulsive behaviour, such as constantly checking things 

When you are living with cancer or going through treatment, it can sometimes feel hard to separate out what are the side effects from treatment and what are symptoms of anxiety.  

People often describe that others tell them “don’t worry” or “it will be ok”, and that although this is usually out of love and from a caring place it can feel unhelpful and make anxiety worse.  

In addition to the general tips about managing your emotional wellbeing at psychological wellbeing, it may be helpful to consider the following specific tips for managing anxiety:  

• Allow yourself time to adjust to news of a diagnosis, a change to treatment plans or prognosis. It is normal to feel anxious at this time, and it is likely with time that this will settle  

• Make room for your emotions. We do not always have to remain positive, and allowing oneself the space and time to feel anxious can sometimes help  

• Talk to others about your worries and concerns. That may include family and friends, peer support groups, your cancer team or a psychological professional  

• Tap into existing coping strategies for things that have helped when you have felt anxious or stressed before  

• Make room for uncertainty. Cancer is full of uncertainty, sometimes there is not an answer to your question. It can be helpful to try to focus on what you can control, and for things you cannot to try to let it pass and re-focus on the present moment by grounding yourself in your breathing or what you see around you.  

• Engaging in relaxation, mindfulness and breathing exercises can help with feelings of anxiety and stress. For information on mindfulness: Mindfulness – NHS. For relaxation and breathing exercises: Relaxation and breathing exercises | Maggie’s  

• Try writing your worries or thoughts down, or journaling to help process them. This can also be helpful at bed if you are having trouble sleeping.  

• If anxiety or worry is taking over your day, you could try setting a daily “worry time” to see if this helps. The idea is to postpone your worries or concerns to a specific time each day where you then go through them, to allow more time in your day to focus on other things. NHS Mind matters have a helpful video on tackling your worries. Some people find this strategy helpful, but others find this it difficult – so see if it works for you  

• Try to face your fears or what you are avoiding but do so slowly. For example, if you are worried about going out, can you try going somewhere locally and build on this over time. Often what we imagine will happen is worse than what happens when we try something.    

 Resources  

 Support with cancer and anxiety | Macmillan Cancer Support  

Fear, anxiety, panic and cancer | Cancer Research UK | Cancer Research UK 

 NHS mental wellbeing audio guides: Mental wellbeing audio guides – NHS 

Further support 

It is natural to feel anxious when living with and beyond cancer, and often this will improve over time. However, if you are struggling and the tips on this page do not help then please do reach out for help.   

Peer support

Peer support can often be helpful, especially when people feel alone in their experience. There are a range of support groups available, you can speak to your cancer team about this for advice or look online  

Cancer self-help and support groups | Macmillan Cancer Support 

Psychological therapy

Psychological therapy can be useful, and usually involves meeting with someone one to one or in a group. Therapists may use a variety of techniques to support you including (but not limited to) ideas from cognitive behavioural therapy, acceptance and commitment therapy and compassion focused therapy. 

You can ask your cancer team for a referral to the Macmillan Cancer Psychological Support Team (CaPS) at St George’s Hospital if you are a patient under their care. Alternatively, you can speak to your GP about psychological therapy available, including your local Talking Therapies service.   

You can find information about the CaPS team at: Macmillan Cancer Psychological Support (CaPS) Team – St George’s University Hospitals NHS Foundation Trust 

You can find your local talking therapies service at: 

Find NHS talking therapies for anxiety and depression – NHS 

 Support from cancer charities

Maggie’s Centres offer a range of psychological support including support groups, drop-in services, workshops and courses, and one to one psychological therapy: Our centres | Maggie’s. You can either drop in, email or call them.  

Macmillan offer a free support line on 0808 808 00 00, or you can email them for support: Emotional, financial and physical help for people with cancer | Macmillan Cancer Support 

Community Mental Health Teams

If you are already receiving support for your mental health, tell your team or therapist about your cancer diagnosis and how this is impacting you and your body image or confidence. For more information on this you can go to MH teams webpage 

GP 

You can speak to your GP about your anxiety. They may be able to support you in thinking about onward referrals or medication.  

Thoughts of harming yourself or ending your life 

For some people when they are facing a difficult time, they can have thoughts of harming themselves or ending their life.

If you ever experience this, please seek immediate support via the Samaritans (116 123) for someone to talk with, ask for an emergency GP appointment, call 111 who can connect you with your local 24-hour mental health crisis team, or visit A&E.  You are not alone.