Fear, anxiety, panic and cancer

It is normal to feel frightened, anxious and panicky at times when you're diagnosed with cancer. There are ways you can help yourself when you feel like this. 

Anxiety

A diagnosis of cancer is difficult to cope with. It is normal to feel anxious, frightened or panicky at times. How you cope with these feelings depends on:

• the kind of person you are
• how advanced your cancer is
• the treatment you have
• how much support you have around you

Fear and panic

You might feel frightened and worry about what will happen to you. The side effects of treatment or whether your treatment will work may also be on your mind. Or you may feel that you are coping well and you just get on with it. You deal with any anxiety as it arises.

You might have much more extreme feelings such as panic attacks, which are very different to just feeling worried.

These strong feelings can be frightening and you may feel that you are not coping well. But there is no right or wrong way to feel about having cancer. We all deal with things in our own way and a lot depends on other circumstances in our lives. 

Symptoms

At first

If you feel frightened, panicky or anxious, you may have problems with:

• sleeping
• a lack of appetite
• going out and seeing others socially
• your temper (being short tempered)
• concentration

After some time

If your anxiety becomes a long term problem, you may constantly feel that something bad is about to happen. You may also:

• keep asking people close to you about your illness and what they think you should do

• feel very negative

• feel very upset

• feel unable to cope with changes to your routine

Physical symptoms

These can be similar to feeling very nervous about an exam, job interview or giving a speech.

There are many different physical symptoms you might have. These include:

• shortness of breath, an urge to over breathe (to hyperventilate) or a dry cough
• a thumping heart (palpitations) or sweating
• a lump in your throat, a dry mouth or difficulty swallowing
• shaking hands, overall body shakes or a fluttering feeling in your stomach (like butterflies)
• chest or abdominal pain
• sickness and diarrhoea
• tense and aching muscles especially in the neck and shoulder area
• dizziness, or light or heavy headedness or ringing in your ears
• tiredness
• an urgent need to pass urine
• pins and needles
• going red in the face or looking very pale

Being constantly anxious can also affect your relationships and sex life. You may lose interest in sex and have very low self esteem.

Panic attacks

Sometimes fear or anxiety gets so overwhelming that you may have a panic attack.

You may have the physical symptoms of anxiety described above, but they may be far more intense. Some people even feel as if they are going to die or go mad.

If you have frequent panic attacks, they can seriously affect your quality of life. Seek medical help and let your doctor or nurses know how you feel.

The experience of panic attacks can be extremely upsetting or terrifying for some people.

What causes fear, anxiety and panic

All these symptoms are very real, and you may worry that your cancer is causing them. That is possible with some of the symptoms. But stress and anxiety are also likely causes.

The fight or flight response

When your body is faced with something stressful or frightening, it releases adrenalin (also called epinephrine), which prepares your body to either run or fight the stress. This is known as the fight or flight response. It’s what makes you leap out of the way to avoid being hit by a car that appears from nowhere.

The adrenalin makes your body functions speed up, your heart beat faster and your muscles contract. It also makes your gut movements shut down.

But the natural response that is supposed to protect you can become the problem. The more you worry, the more likely it is that your fight and flight response starts up, and so your symptoms increase. It can become a vicious circle, and you may feel like you have no control over your situation.

Worries about your treatment, pain and being cured

Treatment

You may worry about whether your treatment will work or whether it may be very unpleasant.

There is ongoing research into improving cancer treatments. Treatments have improved a lot, and are continuing to improve.

There is research about how to reduce treatment side effects and how to control them. This makes treatment today easier to cope with than it used to be.

Take a close friend or relative with you when you visit the doctor or nurse. They can help you ask questions about your treatment.

Questions and second opinions

Some people like to have a second opinion. Your doctor will not mind, and might be able to help you arrange this. 

You might have lots of questions. It is important to ask, even if you think you have asked them more than once. Your doctor won't mind. 

Pain

People often worry that they will be in pain if they have cancer. Or that the pain will be more than they can bear.

Many people with cancer have no pain. For people who do, many modern drugs and other types of treatment can successfully relieve or control it.

Being cured

The first thing most people ask about having cancer is whether they are going to die.

Many people with cancer are cured and others live for many years. Even when the cancer is not curable, treatment might help manage pain or discomfort, or to slow down the growth of the cancer.

It is not usually possible for doctors to say for certain that your cancer has been cured. They can’t definitely say that it will never come back. Living with this uncertainty is one of the most difficult things about having cancer.

This uncertainty can be helped by:

• talking to your specialist or nurses or a counsellor
• finding out as much about your illness as you can
• talking with your family and friends about how you feel

More information

Maudsley Learning, part of the South London and Maudsley NHS Foundation Trust, has a set of cancer and mental wellbeing videos for people affected by cancer.

The videos have information and advice on what to do if a cancer diagnosis affects your mental health. They cover several topics, including breaking bad news, managing anxiety, common reactions to a diagnosis, and relationships.