Emotional Distress

stacked rocks on beach

You and your family members are under a great deal of pressure to cope effectively with the treatments, side effects, and anxieties that accompany your cancer diagnosis. Every single patient, at every stage of disease, regardless of the type of treatment, deals with issues that cause some level of distress, ranging from common feelings of vulnerability, sadness, and fear of recurrence or death, to problems that are more disabling, such as clinical depression, intense anxiety, or panic.

Emotional distress can affect your ability to carry out daily activities and to participate actively in your treatment. It can also make physical symptoms more severe, or even impact the treatment outcome. It takes time to accept the diagnosis of cancer and to understand what it will mean for both patient and family. People’s reactions will differ and will probably vary over time. But please know that you are not alone.

What Are the Stages of Emotional Distress?

  • Pre-treatment: You may feel that “no one understands” what you are going through. It is important at this time to gather as much information as possible and to find someone to talk to who has been through treatment.
  • Mid-treatment: You may feel overwhelmed, even unable to manage daily responsibilities. This is a normal reaction and often reflects the strain on your physical and emotional energy as you manage treatment and cope with your situation. Many people find a support group to be very helpful at this time as you can learn from others about what helps them at this time.
  • Post-treatment: You may feel “abandoned” by your healthcare team or other supportive people that were so involved during treatment, or you may feel anxious about the cancer returning. Throughout this time, you and your caregivers may find that a support group can be beneficial in making the transition from being ill to living well after cancer.

Anger is also a normal and healthy response to having cancer. Expressing anger in a productive and thoughtful manner can prevent emotions from building up and help prevent more serious emotional problems. If you are concerned about anger for yourself or your loved one, please find someone to talk to such as a family friend, a mental health professional or pastoral counselor.

How Much Emotional Distress Is “Normal”?

If you or a family member experience five or more of the following symptoms for a period of two weeks or longer, it is advisable to seek professional help:

  • Persistent sadness or “empty” mood, not relieved by talking with others
  • Sleep disturbances, insomnia
  • Fatigue or restlessness
  • Significant changes in eating habits
  • Changes in body weight (loss or gain)
  • Difficulty concentrating or making decisions
  • Loss of interest in pleasure or ordinary activities 
  • Changes in sexual desire (unrelated to treatment)
  • Trembling or shaking
  • Verbal or physical expressions of anger that seem out of proportion to the circumstances
  • Verbal expressions of anxiety
  • Irrational fears or a sense of panic
  • Excessive stubbornness or rebelliousness

What Can You Do to Manage Emotional Distress?

  • Talk with your family, friends, doctor, nurse, and/or oncology social worker about what you are feeling.
  • Talk to other people who have been through your type of treatment.
  • Join a support group at a local or online Cancer Support Community, or in a nearby hospital.
  • Seek professional help from a therapist experienced in working with cancer patients.
  • Talk with your physician or therapist about medication that can ease depression and anxiety.
  • Try stress-relieving activities such as meditation, yoga, or Tai Chi.
  • Use humor. Try to find something to laugh about every day.
  • Consider prayer. Many people have shared that praying before and during cancer treatment is extremely helpful in reducing distress.
  • Exercise as much as possible, given your physical limitations.
  • Use the Internet wisely for chat rooms, support groups, and other information.
  • Be aware that not all information on the Internet may be accurate or particularly helpful to your situation.
  • Keep a journal to record and release your feelings.

The Challenge of the ‘Positive Attitude,’ Optimism and Hope

Successful coping, in terms of cancer, is not necessarily about having a positive outlook or striving for a cheery disposition. In essence, you should strive to develop realistic expectations about your illness so you can make good decisions about care and not be pressured to be blindly positive. A feeling of optimism during the cancer experience should not exclude sadness, anger, sorrow, grief and hurt, but rather, studies seem to underscore the importance of optimism in relation to quality of life. In research studies, patients who were more optimistic were less depressed and more likely to follow treatment.
A hopeful person can experience a wide range of negative and positive emotions; yet through all of the difficulties, will try to move forward in life. At the Cancer Support Community, we understand that hope is something that our members gain from each other. If longer survival is not possible, then it is reasonable to hope for other meaningful outcomes — like a peaceful death or the resolution of family conflicts.

Find Support—You Are Not Alone

If you would like to talk to someone in person about emotional concerns or find out more about Cancer Support Community can help you, there is a staff person available to meet with you today.


If you or your loved one has serious thoughts of suicide, help is just a phone call away. Call the National Suicide Hotline at (800) 273-8255 to be connected with a crisis center in your local area. This service is available 24 hours a day, seven days a week.