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Anxiety

Having cancer is not easy to cope with. Besides the illness itself, things like investigations and treatments can also cause you to feel stressed, worried and nervous.

Having anxiety at times is normal, and for some people they are able to cope and live their daily lives. For others however, the emotion becomes intense and long-term, and interferes with their relationships and daily life. Having anxiety may make it more difficult to make decisions about your care, or cope with your illness. It is therefore important to identify and manage anxiety, as part of your entire cancer treatment.



Causes of anxiety

This differs from person to person and may vary in intensity at different times during the cancer journey. Some of the more common causes are discussed below:


  • Treatments and investigations

You may be worried about whether your cancer treatment will work, or heard about unpleasant side effects that makes you nervous about undergoing the treatment. Some people may also worry about treatment expenses or loss of income if they stop work due to treatment.

Cancer treatments in this day and age have improved tremendously, due to ongoing cancer research. Treatments have generally become more effective as compared to before, and will continue to improve. Research has also found better ways to reduce and better control treatment side effects. If you have financial concerns, our medical social workers will be able to provide financial counselling and provide assistance where needed.


  • Cancer symptoms

Many people worry about developing uncontrolled symptoms, particularly pain after they are diagnosed with cancer. However, the truth is that many people with cancer do not have any pain. For those who do develop symptoms, whether from cancer or treatment side effects, there are many medications and treatments that are available now to help relieve them successfully.


  • Uncertainties about cure and recurrence

“Can I be cured?”, “Am I going to die?” and “Is the cancer going to come back?” are questions that people with cancer often ask. The uncertainties associated with having cancer is one of the most stressful things that many of our patients face. Although it is difficult for your doctor or nurse to say for sure that your cancer will be cured or that it will not recur, advances in medicine have allowed many people with cancer to be cured, or to live longer. Even when the cancer is incurable , treatment can help to slow down cancer growth, or relieve pain and other discomfort.

  

What you need to look out for

Typically, the feeling of anxiety, worry or fear is connected to a specific issue and should only last for a short period of time. For some, the feeling may fluctuate from time to time. This may (or may not) be accompanied by the following problems:

  • Disturbances with sleeping and eating
  • Restlessness and difficulty concentrating
  • Increased irritability or impatience
  • Withdrawal from social activities
  • Feeling tired
  • Muscle tension and body pains or aches
  • Decreased sex drive
  • Bodily signs like sweating, palpitations, trembling, nausea or difficulty in breathing

If you find that the worrying is becoming excessive and affecting your quality of life, hindering you in making decisions or aggravating your pain, it is best to inform your doctor or nurse about it.

  

How it can be treated

Your doctor or nurse may ask you more questions about your feelings, physical symptoms and how your daily life is affected. Your treatment plan may include:

  • Referral to see a social worker, or psychologist who may help you by: - Connecting you to a support group
    - Individual counselling sessions
    - Group based therapy sessions
    - Art or music therapy sessions
    - Connecting you to relaxing physical sessions e.g. yoga, tai chi, qi gong
    - Connecting you with community or financial services especially if the source of anxiety is due to social or financial difficulties
  • Anti-anxiety medications prescribed by your doctor or a psychiatrist

Do not be worried about seeing social workers, psychologists or psychiatrists. Psychological problems are very common amongst cancer patients; you are not alone. Seeing them does not mean that you are mentally ill or that you are emotionally not strong enough. Many people see these professionals to help them with day by day psychological difficulties (e.g. phobias, eating and sleeping disorders, depression). They will be able to conduct therapy sessions to help you improve your coping skills and reshape negative thoughts. They will also advise you on relaxation techniques that can be used to help you cope and feel better.

  

What you can do

Although it may not be easy, try to talk about your feelings openly with your doctor or nurse. This can allow appropriate treatment to take place earlier and minimise negative effects on your daily life. In addition, all of us have our own ways to deal with anxieties and stress. It is useful to explore and find a way that suits you best. Some ways that may help:

  • Sharing your feelings and fears with someone you are close to. Some patients find speaking to a social worker/ clinical psychologist, or joining support groups helpful.
  • Getting a close friend or relative to accompany you during appointments and treatment
  • Using relaxation techniques like deep breathing or visualization before or during a difficult situation
  • Doing light exercises that you enjoy e.g. brisk walking
  • Keeping yourself occupied with relaxing activities (e.g. reading a book, listening to music)
  • Meditating, praying or engaging in other forms of spiritual support activities


When to call your cancer care team

Please inform your doctor or nurse if you feel that your anxiety is getting worse, or if you experience any unexpected or intolerable side effects from the anti-anxiety medication that you have been prescribed.

If you are a patient with NCCS, you may also call +65 6436 8417 or +65 6436 8088 to book an appointment to speak to an NCCS medical social worker if you need to talk to someone about your emotions.


If you have any questions regarding the above, please call Cancer Helpline at +65 6225 5655 or approach your doctor or nurse for further details.

  

Useful resources

You may consider visiting the following websites for more information and assistance.


The above contents have been approved by the Cancer Education Information Service, National Cancer Centre Singapore (NCCS), for people with cancer and their families and caregivers.