Stress and Cancer

Emotional and social support can help patients learn to cope with stress. Such support can reduce levels of depression, anxiety, and disease- and treatment-related symptoms among patients. NCI’s page on Emotions and Cancer has tips for coping with the many emotions that arise with cancer.

There is some evidence that successful management of stress through social support is associated with better clinical outcomes for people with breast cancer (10). Social support has also been linked to lower levels of stress-related hormones that can promote tumor progression in ovarian cancer (10, 18).

Another approach to cope with stress is by being physically active. A report of the 2018 American College of Sports Medicine International Multidisciplinary Roundtable on Physical Activity and Cancer Prevention and Control found “sufficient” evidence to conclude that moderate-intensity physical activity during and after cancer treatment can reduce anxiety and depressive symptoms among cancer survivors (19). There is also evidence suggesting that physical activity is helpful in preventing depression among survivors of childhood cancer (20).

People who are experiencing significant stress with a cancer diagnosis may also want to consult their doctors about a referral to an appropriate mental health professional. In fact, some expert organizations recommend that all cancer patients be screened with an appropriate tool, such as with a distress scale or questionnaire, soon after diagnosis as well as during and after treatment (21, 22) to gauge whether they need help managing stress or are at risk for distress (23).

Treatment of significant distress, depression, and anxiety under the care of a mental health professional might include psychotherapy (talk therapy) and/or antidepressants or other medication. The choice of treatment should be personalized, ideally as a joint decision between the patient and the health care provider.

Researchers are studying novel psychotherapeutic approaches to lessen depressive symptoms such as distress and hopelessness in people with cancer. In one randomized clinical trial of people who had recently been diagnosed with advanced cancer, three to six sessions of a tailored psychotherapy intervention reduced symptoms of depression (24). Results from the trial also suggest that the approach may help prevent the onset of depression in those with advanced disease.

Another randomized clinical trial compared two different mindfulness-based cognitive therapy interventions—one delivered in person, the other electronically—with usual treatment in reducing psychological distress in people with cancer (25). Both interventions reduced elements of distress like fear of cancer recurrence and increased mental health-related quality of life, mindfulness skills, and positive mental health.

A resurgence of academic research into the therapeutic potential of psychedelic drugs has produced preliminary evidence for the possible role of psilocybin-assisted psychotherapy in the treatment of cancer-related anxiety, depression, and existential distress (26).