Practical Strategies for Managing Cancer-Related Anxiety
by Sermsak Lolak, MD
Feeling stressed? You’re not alone.
Many cancer survivors experience anxiety – sometimes, significant anxiety. And it can persist long after active cancer treatment ends. Fear of cancer recurrence, uncertainty about the future, distressful current events, and upsetting personal or family issues can all trigger anxiety. This can be incredibly uncomfortable and often debilitating for cancer survivors.
If you’re feeling anxious, these practical, evidence-based strategies can help you manage your anxiety and boost your emotional well-being.
1. Acknowledge the anxiety. Many cancer survivors find it helpful to name or “label” their anxious thoughts or feelings. However, instead of making your anxiety part of your identity (i.e., “I am anxious”), reframe these feelings as something you notice happening to you (i.e., “I am noticing anxiety” or “I am sensing a lot of tension in my neck”). Reframing your anxious thoughts in this way can help you see that they are not a permanent part of you and will eventually pass.
2. Give it some space. This can be done through deep breathing, body scan meditation, or another mind-body technique that involves paying attention to your bodily sensations. Anxiety often “lives” in your body. Acknowledging the anxiety in your body and giving it space to move through you will help it to dissipate.
3. Write it down. Most anxious thoughts are scarier when they are bouncing around in your head. Try putting your thoughts into words and writing them down on a sheet of paper. Ask yourself, What am I anxious about? Then just start free writing. Once you get your thoughts down where you can see them, you may realize that most of the things you are anxious about are beyond your control, and you should work toward letting those go. However, you now also have a clear picture of what you can control. Try to focus only on those things and begin taking action steps to deal with them.
4. Move. Amid anxiety, it can be challenging, if not downright impossible, to “calm down.” When your anxiety is overwhelming, it helps to refocus your attention on something else, especially if that “something else” involves moving your body. Some effective ways to give your mind a break from anxious thoughts are practicing yoga, going for a walk, putting a puzzle together, painting by numbers, and knitting.
When your anxiety is overwhelming, it helps to refocus your attention on something else, especially if that “something else” involves moving your body.
5. Reflect. When your anxiety is not too intense, find ways to reflect on your experience. Reflection is an important and necessary task that can help you process the feelings of grief and loss associated with cancer. You can reflect through journaling, art, meditation, reading cancer memoirs that speak to you, or talking with a counselor who can help you work through the trauma of coping with cancer.
6. Create routines. Routines can help you regain a sense of control because they are predictable. Even simple routines, like brewing a cup of coffee or tea every morning, can help. Adding daily and weekly routines, like exercise, afternoon walks, meeting friends for lunch, or taking a warm bath before bedtime, can provide structure and a sense of safety during times of uncertainty.
7. Choose what you give your attention to. Your attention, like your energy, is a precious commodity. Decide what matters to you, and what doesn’t. Then, be selective and purposeful with how and where you spend your attention. This is where mindfulness skills can help. Practicing mindfulness can train your brain to be more effective at paying attention to the present moment. In addition, choosing to focus on the good things that happen each day, also known as a gratitude practice, can be a powerful antidote to anxious thoughts.
8. Focus on the present. Remind yourself that it is not helpful, and usually not accurate, to try to predict the future. This is especially true when you are viewing the future through your current lens of anxiety. Remember, how you feel today is not how you will feel forever.
9. Practice self-compassion. Make friends with yourself. Know that what you are feeling right now – whether that’s pain, anxiety, fear, or uncertainty – is also being felt by countless other people in this world. This is called “shared common humanity.” Realizing this can help make it easier for you to be kind to yourself, just like you would your loved ones when they go through hardship. Give yourself a break. Take care of yourself by eating right, exercising, socializing, resting, playing, and praying (whatever that means for you). But, remember, self-compassion doesn’t mean self-indulgence. Rather, it’s the act of giving yourself grace as you face this adversity.
Dr. Sermsak Lolak is a staff oncology psychiatrist at Inova Life with Cancer (LifeWithCancer.org) and director of the Psychiatry program at the Inova Schar Cancer Institute in Northern Virginia. He is a fellow of the Academy of Consultation-Liaison Psychiatry (FACLP) and serves as clinical associate professor of Psychiatry at George Washington University in Washington, DC. Dr. Lolak specializes in the management of mental health issues, such as depression, stress, and anxiety, in cancer survivors, with a special interest in mind-body and contemplative practices.