Distress

People living with cancer feel many different emotions, including distress. Distress is emotional, mental, social, or spiritual suffering. You may have a range of feelings from fear and sadness to depressionanxiety, panic, and isolation. You may have feelings of distress while being screened for a cancer, waiting for the results of tests, receiving a cancer diagnosis, being treated for cancer, or worrying that cancer will recur (come back).

Close to 70% of people affected by cancer say they have emotional distress.

Distress may affect your ability to cope with a cancer diagnosis or treatment. It may cause you to miss check-ups or delay treatment. Even mild distress can affect the quality of life for you and your caregivers, and may need to be treated.

Distress and Cancer

Some patients living with cancer have a low level of distress and others have higher levels of distress. The level of distress ranges from being able to adjust to living with cancer to having a serious mental health problem, such as major depression. However, most patients with cancer do not have signs or symptoms of any specific mental health problem. Talk to your cancer care team to better understand your feelings and learn whether treatment may help you.

Understanding Distress

Most people with cancer do not have signs or symptoms of any specific mental health problem. Follow these tips to find out whether you are experiencing a normal amount of stress or when it is becoming difficult to cope with. Recognizing signs of distress can help you deal with them.

Know the Signs

You may need help coping with distress if you are feeling:

  • Irritable
  • Angry
  • Overwhelmed by panic
  • Too sad to go through daily tasks
  • Other intense emotions

Consider Your Past

Talk to your cancer care team if there are any current or past events that could be adding to your distress, such as having:

  • A loved one who died from cancer
  • A recent sickness or death of a loved one
  • A history of depression or thoughts of killing yourself
  • Memories of painful events that come back as nightmares or panic attacks

Take a Quiz: What’s Your Stress Level?

Take this quiz to find out how much stress you have been dealing with lately.

Coping with Distress

No matter what your level of stress about cancer, there are a number of positive things you can do to cope.

 

Tips for Coping

Take advantage of the many options available to help you meet the challenges of distress. Here are some things you can do, and other things you should avoid, to deal with unpleasant feelings.

  • Use healthy coping skills that have worked in past crises. How do you usually deal with distress? The same can apply if you have cancer.
  • Focus on one thing, one day at a time. Don’t overwhelm yourself. Take small steps.
  • Find a peer group to work with.
  • Tell your cancer care team how you’re feeling. Ask your doctor for a psychotherapy or counseling referral.
  • Don’t believe that cancer means death.
  • Avoid blaming yourself for causing cancer.
  • Don’t feel guilty if you can’t stay positive all the time.

Get Support

Different types of help are available if you are feeling distress. It will depend on the kind of problems you have and how you feel. A social worker is the usually the first support person you may see. He or she may try to determine whether you could gain from patient or family counseling, psychotherapy, or pastoral counseling. It also may help to get involved in peer groups to learn and gain comfort from others who have been or are going through experiences similar to yours.

Be Active

Exercising during and after cancer treatment can improve how well you function physically and your quality of life. Most people are safe to start a walking program or other light-moderate intensity exercise program on their own. However, if you’ve never exercised before or you have balance problems or muscle weakness, you should check with your doctor to determine a safe exercise program before adding physical activity to your routine. You may need physical therapy or another medically supervised conditioning program.
Features of a good exercise plan include:

  • Start slowly. Don’t work too hard or for too long. Build up intensity and exercise for longer periods slowly over time.
  • Include a warm-up for at least two to three minutes and a cool down.
  • In your weekly routine, include three types of exercise: 1) aerobic exercise, 2) exercise that increases your flexibility and range of motion, and 3) muscle-strengthening exercise.

Practice Mindfulness and Relaxation

Mindfulness is slowing down to pay attention to what’s going on right here, right now. Practicing mindfulness involves breathing methods, guided imagery, and other practices to relax the body and mind and help reduce stress and anxiety. To help you cope with your stress, set aside about 5 to 10 minutes a day to practice one or more of the following exercises and use our guided relaxation videos.

Practice Self-Reflection

When you’re feeling stressed, pause for a moment to think about the situation.

  1. Stop and take a deep breath.
  2. Ask yourself, what’s really going on here?
  3. Remind yourself that your thoughts are “just thoughts.” Thoughts come and go. We all have thoughts, but having a thought doesn’t mean that it’s true or that it will last forever.
  4. Take another deep breath and move on with your day.
  5. Do something nice for yourself. Go for a walk, take a bath, paint your nails, call a friend, go to a movie, or play with a child or a pet. Do whatever feels good to you.

Connect with Your Body’s Relaxation Response

  1. Lie comfortably on your back or find a comfortable and quiet place to sit.
  2. Close your eyes and breathe gently and naturally through your nose.
  3. Relax all your muscles, starting at your toes and moving up to the top of your head.
  4. Focus on your breathing.
  5. Continue for 5 to 20 minutes.
  6. When you are done, sit quietly for several minutes, at first with your eyes closed and then with your eyes open. Wait a few minutes before standing up.

Practice Deep Breathing

  1. Find a comfortable and quiet place to sit or lie down.
  2. Relax your face, jaw, neck, and shoulders. Gently place one hand on your chest and the other hand on your belly button.
  3. As you breathe in, allow the breath to expand your belly, chest, and lungs. As you breathe out, gently press your hands against your chest and belly to let out more air.
  4. Focus on steady breathing.
  5. Take your time.

 

Try Progressive Muscle Relaxation

  1. Sit in a comfortable chair or lie comfortably on your back and close and relax your eyes.
  2. Feel all 10 toes. Then think about your ankles, knees, and thighs.
  3. Feel your belly and chest. Think about your breathing. Breath deeply and then relax when you let the air back out.
  4. Feel your hands. Then think about your upper arms, shoulders, and neck.
  5. Feel your mouth and jaw. Relax them.

Learn More About Distress

The National Cancer Institute and the American Cancer Society have additional resources to help you, including distress in people with cancer and adjustment to cancer.