The unknowns, and the sometimes arduous nature of lung cancer treatment, raise the risk for anxiety. The research bears this out. In a study published in April 2020 BMJ Supportive and Palliative Care, for example, researchers found that about 49 percent of participants with advanced lung cancer suffered from anxiety. Caregivers of people with lung cancer also experienced distress, with about 33 percent of reporting that they suffered from anxiety. Both groups also reported suffering from depression and poor sleep quality. RELATED: Lung Cancer’s Newest Face: Women Who Have Never Smoked
Lung Cancer and Anxiety: A Special Case
While anxiety is common with many forms of cancer, there are some issues unique to lung cancer that make patients particularly vulnerable. Shortness of breath, for instance, also known as dyspnea, is a common symptom of NSCLC. It is known to cause significant psychological distress and even lead to panic attacks. Another widespread source of anxiety for people with NSCLC is a sense that other people blame them for their condition. “The very first thing many people say upon learning that [someone] has lung cancer is not ‘I’m sorry’ but ‘Did you smoke?’” says Ellen Ormond, PhD, a psychologist in the biobehavioral oncology program at UPMC Hillman Cancer Center in Pittsburgh. Other common sources of anxiety for those with metastatic NSCLC include fear of death and fear of the unknown, according to Lanie K. Francis, MD, the director of the wellness and integrative oncology program at UPMC Hillman. “Many people are also anxious about the particulars of treatment — whether they will have nausea or pain or lose their hair,” says Dr. Francis. “Concerns about finances are enormous, as is a sense that they will need to depend on others during treatment and beyond.” RELATED: Being Diagnosed With Lung Cancer Taught Me to Fight for Myself and Others A study published in June 2017 in the Journal of Pain and Symptom Management, for example, found that among people with NSCLC, anxiety was associated with a slightly increased risk of an earlier death, whether from lung cancer itself or some other cause. That’s because unmanaged anxiety can cause people to miss or delay cancer treatments, Francis notes. In addition, she says, “anxiety may obscure listening skills, so people may not hear important discussions about what side effects to report, and when to call the medical team.” Anxiety can also impair sleep and other aspects of self-care, Francis says, which can reduce the effectiveness of cancer treatments by limiting your body’s ability to recovery. RELATED: Tracking Lung Cancer’s Path
What Are the Signs of Anxiety, And What Can You Do About It?
What, exactly, does anxiety look like? Here are some signs and symptoms to watch out for:
Frequent worrying that’s difficult to controlAgitation or restlessnessPoor sleep, or difficulty falling or staying asleepFeelings of sadness or hopelessnessDifficulty concentratingFatigueMuscle tension
If you have metastatic NSCLC and experience symptoms like these, here are some steps you can take to relieve your anxiety.
Get help. If you report symptoms of anxiety to your oncologist or primary-care doctor, they should be able to offer referral to a psychologist or therapist, Francis says. If your anxiety is severe or complicated, or if you think you might need medication, you should be referred to a psychiatrist, she says, “particularly someone with experience in treating people with cancer.” When she sees people with NSCLC for anxiety, Dr. Ormond says she also employs a range of discussion techniques, “from [addressing] existential concerns to [suggesting] behavioral ways to stop worrying and relax.”Work out. Exercise has been shown to have benefits in treating both anxiety and lung cancer. In a study published in February 2015 in the British Journal of Cancer, researchers found that an exercise program that included 40 minutes of walking a day for three days a week along with weekly exercise counseling significantly improved symptoms of anxiety and depression in people with lung cancer.Try yoga. “Yoga, with movement and breath awareness, can help people with lung cancer engage in the present moment and reduce their sense of being out of control,” says Francis. In a study presented at the 2017 Palliative and Supportive Care in Oncology Symposium in San Diego, researchers found that yoga improved physical function and mental health in patients with advanced lung. Caregivers who received yoga instruction also reported improvements in fatigue and stamina.Practice mindfulness. Mindfulness, aka the practice of focusing your mind on something in the present moment, can help manage anxiety, says Francis. According to the American Thoracic Society, some mindfulness programs have resulted in improved communication and less pain and distress among lung cancer patients and their caregivers. One way to try using mindfulness is through apps like Calm, a mindfulness app that provides guided meditations as well as soothing sounds, and Headspace, which offers meditations and sleep exercises.Consider acupuncture. In a small pilot study published in August 2017 in the Iranian Journal of Public Health, people with lung cancer who underwent anxiety-oriented acupuncture for seven days saw improvements in anxiety levels, physical comfort, and overall quality of life three weeks after the treatment ended.Get an oncology massage. According to guidelines published in the CHEST Journal, massage therapy is effective at reducing anxiety, depression, and pain in patients with lung cancer. Ask your doctor to recommend a massage therapist who specializes in working with people with cancer.Try a support group. Joining a lung cancer support group can provide a social experience while helping you realize you’re not alone in what you’re going through. Ask your doctor for recommendations for both local groups and online communities, or check out the local and remote support options offered by the American Lung Association and the Lung Cancer Alliance.
RELATED: Can You Exercise if You Have Metastatic Non-Small-Cell Lung Cancer? With Additional Reporting by Julie Marks.
