Anxiety and its management in advanced cancer

As patients enter the palliative phase of their illness, both physical and psychological burdens change. Anxiety commonly increases as patients become aware of both the relative ineffectiveness of medical treatments in halting the progress of their disease and, consequently, their limited life expectancy. This review will allow clinicians to be more effective in helping patients manage their psychological distress.

Anxious cancer patients facing death may often be plagued with recurrent unpleasant thoughts including fears of pain, of death and of dependency on others. In the palliative care setting it may not be easy to distinguish the somatic causes of anxiety from the psychological ones; in addition, anxiety may be a manifestation of either depression, delirium or another medical problem. The most effective management of anxiety often involves psychotherapy, behavioral therapy and pharmacological management.

It is our hope that this article will inform oncologists, oncology nurses and mental health workers about the prevalence, assessment and treatment options for anxiety in advanced cancer patients. Unfortunately, there is a scarcity of research in this field; we hope that this article will encourage the motivation for more studies to assess different treatments for anxiety in this population.