This Too? Isn’t Having Cancer Enough?

This Too? Isn’t Having Cancer Enough? Susan Hedlund

Tools for Managing the Uncertainty, Anxiety, and Distress of Coping with Cancer During a Pandemic

by Susan Hedlund, LCSW, FAOSW, OSW-C

The past year and a half has presented enormous and unprecedented challenges. For people with cancer (and their loved ones), navigating the COVID-19 pandemic while also coping with a life-altering disease has been extraordinarily difficult.

If you’ve found yourself feeling stressed or anxious, you are not alone. Researchers estimate that 41 percent of Americans have experienced an increase in symptoms of anxiety, depression, or both since the pandemic began.

Though the data is still emerging, population-based studies have recorded increased rates of anxiety, depression, and post-traumatic stress symptoms among people with cancer as well. For example, one study found that 55 percent of people with cancer surveyed experienced general distress, 44 percent experienced depression, and 58 percent experienced anxiety.

Symptoms of anxiety include feeling nervous, restless, or tense, as well as having a sense of impending danger, panic, or doom. Additional physical symptoms may include rapid breathing, sweating, trembling, and feeling weak or tired. Many people with anxiety also find they have difficulty concentrating.

How COVID-19 Has Affected Cancer Care

When the COVID-19 pandemic hit the U.S., our world changed dramatically. Hospitals postponed or deferred non-emergent treatments (including cancer treatments). Many healthcare facilities began restricting or prohibiting visitors. Cancer prevention screenings and follow-ups were delayed, by both medical providers and patients themselves. And cancer survivors reported being fearful of coming to the hospital because they didn’t want to risk exposure to the coronavirus.

As the pandemic raged on, our healthcare systems moved rapidly to reprioritize care. Many moved from crisis to creativity in real time. The National Comprehensive Cancer Network Best Practices Committee examined and laid out recommendations for post-pandemic innovations to improve cancer care. And many cancer centers began to deliver some cancer care via telemedicine, a practice which appears to be here to stay.

There are, of course, pros and cons of these services. For some, telemedicine results in reduced feelings of connection and emotional support. However, there are others who prefer the ease and safety of telemedicine visits. And once we are on the other side of this pandemic, we may find that many services can and should continue to be delivered remotely.

Researchers estimate that 41 percent of Americans have experienced an increase in symptoms of anxiety, depression, or both since the pandemic began.

Managing the Uncertainty, Anxiety, and Distress of It All

Uncertainty, anxiety, and distress are not new experiences for most people with cancer. Fear of the unknown, worry about cancer recurrence, and general feelings of unease are not uncommon. In fact, research suggests that under “normal” circumstances, about 30 percent of people with cancer will experience distress or anxiety.
One way you can manage anxiety and distress is through mindfulness, or the practice of being in the moment. When we are anxious, this is often because we are worrying about the future or ruminating about the past. Both take us out of the present moment.

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Mindfulness strategies, like deep breathing exercises, can help calm your distress and reduce anxiety. Other helpful mindfulness techniques include meditation, prayer, guided imagery, and nature walks. There are even apps you can download to aid in your mindfulness practice. For example, Insight Timer, Calm, and HeadSpace, to name just a few. And the good part is most of these techniques can be effective when practiced for just 10 minutes a day.

Other strategies for managing anxiety include practicing gratitude, art or music therapy, journaling, physical exercise, and just being in nature. If your anxiety or distress becomes disabling to the point that you are having difficulty functioning, talk with a mental health professional, as you may benefit from counseling or medication to control your anxiety.

As you navigate cancer and the pandemic, remember you are not alone. We are all in this together. And help is available for you if you need it.

Susan Hedlund has been a healthcare social worker for more than 30 years and has extensive experience working with individuals and families facing life-threatening illness and loss. She is the director of Patient and Family Services at the Knight Cancer Institute at Oregon Health & Science University in Portland, OR, and is an associate professor at the OHSU School of Medicine, as well as the Graduate School of Social Work at Portland State University.

This article was published in Coping® with Cancer magazine, September/October 2021.