What approaches can help you manage anxiety?
We present many approaches to reducing anxiety and summarize the evidence regarding their effectiveness. Seek professional help if needed. Diagnoses such as anxiety can require therapy from trained practitioners for management. We encourage you to explore the options available to you through your cancer team and others. Taking care of your mental health is as important as taking care of your physical health.
Top practices and therapies for managing anxiety
Therapies and practices we have reviewed
The effects of these practices and therapies are described below on this page.
Further therapies
Therapies recommended in clinical practice guidelines; see guidelines ›
Hypnosis
Meditation
Music therapy and other forms of expressive arts therapies
Psychosocial therapies:
- Cognitive-behavioral therapy
- Cognitive-behavioral stress management (CBSM)
- Mindfulness-based stress reduction (MBSR)
- Supportive/expressive therapy
Conventional approaches
Various prescription drugs may help manage anxiety. Ask your doctor for recommendations, but also ask about side effects from their use.
Caution: Among people with pancreatic cancer, the anti-anxiety drug lorazepam increased a marker of inflammation (IL-6) and was linked to poorer survival outcomes.1Cornwell AC, Tisdale AA et al. Lorazepam stimulates IL6 production and is associated with poor survival outcomes in pancreatic cancer. Clinical Cancer Research. 2023 Aug 17:OF1-OF20.
Self-care practices and complementary therapies
Strong, good, or modest evidence of benefit
Strong evidenceconsistent, significant effects in several large (or at least one very large) well designed clinical studies or at least two meta-analyses of clinical studies of moderate or better quality (or one large meta-analysis) finding similar results (this is the CancerChoices definition; other researchers and studies may define this differently) indicates confidence that the practice or therapy has an effect as noted. Good evidencesignificant effects in one large or several mid-sized and well-designed clinical studies (randomized controlled trials (RCTs) with an appropriate placebo or other strong comparison control or observational studies that control for confounds) (this is the CancerChoices definition; other researchers and studies may define this differently) indicates that the practice or therapy is linked to the outcomes described with reasonable certainty. Modest evidencesignificant effects in at least three small but well-designed randomized controlled trials (RCTs), or one or more well-designed, mid-sized clinical studies of reasonably good quality (RCTs or observational studies), or several small studies aggregated into a meta-analysis (this is the CancerChoices definition; other researchers and studies may define this differently) means the practice or therapy may be linked to the outcomes described, but with a lower degree of certainty.
A therapy may show a stronger effect or have more evidence in some situations than in others. The evidence supporting the effects for each practice is listed in the full handbooks available through the image links.
Eating Well: good evidence
Some foods may help you reduce your risk of anxiety.
Modestly lower risk of anxiety symptoms among people eating the recommended diet patterns or a vegetarian/vegan diet (good evidencesignificant effects in one large or several mid-sized and well-designed clinical studies (randomized controlled trials (RCTs) with an appropriate placebo or other strong comparison control or observational studies that control for confounds) (this is the CancerChoices definition; other researchers and studies may define this differently))
Insufficient evidence of an effect on anxiety among people participating in a diet intervention in combined analyses of studies
Recommended in a practice guideline for treating anxiety; see guidelines ›
Moving More: strong and good evidence
A small improvement in anxiety without regard to treatment phase among people participating in exercise (strong evidenceconsistent, significant effects in several large (or at least one very large) well designed clinical studies or at least two meta-analyses of clinical studies of moderate or better quality (or one large meta-analysis) finding similar results (this is the CancerChoices definition; other researchers and studies may define this differently))
Slightly less anxiety during chemotherapy, radiotherapy, adjuvant therapytherapy used before a main treatment, such as chemotherapy, radiation therapy, and hormone therapy before surgery, or hormone therapy among people participating in exercise (good evidence)significant effects in one large or several mid-sized and well-designed clinical studies (randomized controlled trials (RCTs) with an appropriate placebo or other strong comparison control or observational studies that control for confounds) (this is the CancerChoices definition; other researchers and studies may define this differently)
Small to moderate improvement in anxiety among people participating in exercise after cancer treatment (strong evidence)
Less prostate cancer-specific anxiety and fear of progression among people with prostate cancer on active surveillance participating in high-intensity interval training (preliminary evidence)
No evidence of an effect on anxiety among adults with advanced cancer participating in exercise in a combined analysis of studies
Recommended in a practice guideline for treating anxiety; see guidelines ›
Combining Eating Well and Moving More: good and modest evidence
Not specific to cancer:
- Slightly less anxiety among people participating in a combined intervention of diet and physical activity (good evidence)
- Less anxiety among overweight or obese women participating in an intervention of physical activity and/or diet (modest evidence)
Managing Stress: good evidence
Lower anxiety and distressemotional, social, spiritual, or physical pain or suffering that may cause a person to feel sad, afraid, depressed, anxious, or lonely; people in distress may also feel that they are not able to manage or cope with changes caused by normal life activities or by having a disease, such as cancer among people with better acceptance of cancer (good evidencesignificant effects in one large or several mid-sized and well-designed clinical studies (randomized controlled trials (RCTs) with an appropriate placebo or other strong comparison control or observational studies that control for confounds) (this is the CancerChoices definition; other researchers and studies may define this differently))
Recommended in a practice guideline for treating anxiety; see guidelines ›
Anxiety may be a symptom of stress. If stress is contributing to your anxiety, managing your stress will be important in reducing your anxiety.
Sleeping Well: modest evidence
More anxiety among people with breast or lung cancer with poorer sleep quality (modest evidencesignificant effects in at least three small but well-designed randomized controlled trials (RCTs), or one or more well-designed, mid-sized clinical studies of reasonably good quality (RCTs or observational studies), or several small studies aggregated into a meta-analysis (this is the CancerChoices definition; other researchers and studies may define this differently)); improving sleep quality may lead to less anxiety
Stop smoking: modest evidence
Short-term increases in anxiety but then long-term improvement in symptoms among people stopping smoking (modest evidence)
We are still researching tobacco use; these assessments are from our work so far.
Acupuncture: mixed evidence
Less anxiety before surgery among people treated with acupuncture (modest evidence)
Less anxiety or worry, irritation, and tenseness during or after chemotherapy among people treated with acupuncture (preliminary evidencesignificant effects in small or poorly designed clinical studies OR conflicting results in adequate studies but a preponderance of evidence of an effect (this is the CancerChoices definition; other researchers and studies may define this differently))
No evidenceoverall, one or more studies did not demonstrate that a treatment or intervention led to an expected outcome; this does not always mean that there is no effect in clinical practice, but that the studies may have been underpowered (too few participants) or poorly designed. Larger, well-designed studies provide more confidence in making assessments. of additional benefit from massage therapy for anxiety during autologous tissue breast reconstruction among people treated with acupuncture
Cannabis: mixed evidence
Insufficient evidencepreclinical evidence only OR clinical studies with such poor or unclear methodology that no conclusion can be drawn OR conflicting findings across clinical studies with no preponderance of evidence in one direction; conflicting evidence occurs when studies find conflicting effects (positive effect vs no effect or negative effect) with the same treatment and the same general study population (same cancer type, for example) (this is the CancerChoices definition; other researchers and studies may define this differently) of fewer anxiety symptoms among people with cancer using cannabis or cannabinoids
Not specific to cancer:
- Fewer anxiety symptoms among people with medical conditions other than cancer treated with pharmaceutical THC either with or without CBD (modest evidence)
Melatonin: good evidence
Not specific to cancer:
- Less anxiety while preparing for surgery among adults treated with melatonin, comparable to results with benzodiazepines (good evidence); note cautions about the effects of melatonin on anesthesia in Safety and precautions›
- Less anxiety after surgery among people treated with melatonin (good evidence)
Relaxation combined with guided imagery: modest and preliminary evidence
Less anxiety among people with cancer treated with relaxation techniques and guided imagery (modest evidence)
Less anxiety among parents of children hospitalized with a malignancy treated with progressive muscle relaxation and guided imagery (preliminary evidence)
Not specific to cancer:
- Less state anxiety among people undergoing gallbladder removal (cholecystectomy) treated with relaxation with guided imagery (preliminary evidence)
Caution: occasionally, people using relaxation techniques report negative experiences such as increased anxiety, intrusive thoughts, or fear of losing control
Both relaxation and guided imagery are recommended in a practice guideline for treating anxiety; see guidelines ›
Support groups and interventions: mixed evidence
In-person support groups are linked to less anxiety, but other support interventions are not.
In-person support groups: less anxiety among people with breast cancer participating in in-person support groups (modest evidence)
Recommended in a practice guideline for treating anxiety; see guidelines ›
Group emotional and educational intervention: no evidence of an effectoverall, one or more studies did not demonstrate that a treatment or intervention led to an expected outcome; this does not always mean that there is no effect in clinical practice, but that the studies may have been underpowered (too few participants) or poorly designed. Larger, well-designed studies provide more confidence in making assessments. on anxiety among people participating in a group emotional and educational intervention in a preliminary study
One-on-one peer support: no evidence of an effect on anxiety after recent surgery among people with newly diagnosed breast cancer participating in one-on-one peer support interventions in a preliminary study
Caution: Online or phone-based support interventions: More anxiety among people participating online or phone-based support interventions (preliminary, conflicting evidence)
Tai chi or qigong: modest evidence
Less anxiety among people with breast cancer practicing either tai chi or qigong (modest evidence)
Recommended in a practice guideline for treating anxiety; see guidelines ›
Time in nature or forest bathing: modest and preliminary evidence
Less anxiety among people with cancer in an educational facility with outlooks on natural scenery (preliminary evidence)
Not specific to cancer:
- Lower anxiety among people participating in forest bathing or spending time in a forest (modest evidence)
- Less anxiety and agitation among people without cancer in critical care listening to recordings of nature-based sounds (modest evidence)
- Less use of psychotropic drugs for anxiety or depression among people in urban areas visiting natural spaces, although no evidence of an effect of living near or having views of green and blue (terrestrial and water) spaces (preliminary evidence)
Vitamin C supplements: modest evidence
Not specific to cancer:
- Less anxiety related to stress among people treated with oral vitamin C (not specific to cancer) (modest evidence)
Yoga: good evidence
Less anxiety, usually only for a short time after practice, among people with cancer practicing yoga (good evidence)
Recommended in clinical practice guidelines for treating anxiety; see guidelines ›
Preliminary or weak evidence of benefit
Preliminary evidencesignificant effects in small or poorly designed clinical studies OR conflicting results in adequate studies but a preponderance of evidence of an effect (this is the CancerChoices definition; other researchers and studies may define this differently) typically indicates that not much research has been published so far, although the outcomes may be meaningful. Weak evidenceone or more case studies, supported by animal evidence OR small treatment effects of limited clinical significance OR studies with no controls OR weak trends of effects (this is the CancerChoices definition; other researchers and studies may define this differently) may mean that the effects are small or that only very preliminary research has been published.
Therapies with no evidence or insufficient evidence of benefit
Non-aspirin non-steroidal anti-inflammatory drugs (NSAIDs) ›
- No evidence of an effectoverall, one or more studies did not demonstrate that a treatment or intervention led to an expected outcome; this does not always mean that there is no effect in clinical practice, but that the studies may have been underpowered (too few participants) or poorly designed. Larger, well-designed studies provide more confidence in making assessments. on anxiety during chemotherapy among people with stomach cancer treated with celecoxib in a preliminary study
- Insufficient (conflicting) evidence of an effect on anxiety among people treated with probiotics (not specific to cancer)
- Insufficient (conflicting) evidencepreclinical evidence only OR clinical studies with such poor or unclear methodology that no conclusion can be drawn OR conflicting findings across clinical studies with no preponderance of evidence in one direction; conflicting evidence occurs when studies find conflicting effects (positive effect vs no effect or negative effect) with the same treatment and the same general study population (same cancer type, for example) (this is the CancerChoices definition; other researchers and studies may define this differently) of less anxiety among people with cancer treated with TT
Further therapies used to manage anxiety
These therapies are used to manage anxiety. Those in bold are recommended in at least one clinical practice guideline; see guidelines ›
Ashwagandha
Breathing therapies
Electromagnetics
Hypnosis
L-theanine
Laughter therapy
Lavender
Massage therapy
Meditation
Music and other arts therapies
Omega-3 fatty acids (EPA and DHA) ›
Psilocybin and other psychedelics
Rhodiola rosea
Vitamin B6 supplements, sometimes combined with magnesium
Vitamin C supplements › (high-dose sustained-release)
Weighted blanket
Psychosocial therapies:
- Acceptance and commitment therapy (ACT)
- Cognitive-behavioral stress management (CBSM)
- Cognitive-behavioral therapy (CBT)
- Mindfulness-based stress reduction (MBSR)
- Supportive/expressive therapy
Helpful links for managing anxiety
Learn more
References