Anxiety

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 but that we haven’t yet reviewed; see guidelines ›

Conventional approaches

Various prescription drugs may help manage anxiety. Ask your doctor for recommendations, but also ask about side effects from their use.

Self-care practices

The evidence supporting the effects for each practice is listed in the full handbooks available through the image links.

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 ›

Small to moderate improvement in anxiety among people participating in exercise after cancer treatment (strong 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

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)

Complementary therapies

We present complementary therapies supported by evidence for managing anxiety. Those with the best evidence are presented first.

A therapy may show a stronger effect or have more evidence in some situations than in others. The evidence supporting the effects for each therapy is listed in the full reviews available through the image links.

Good or modest evidence of benefit

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 a relatively high degree of confidence that the therapy is linked to the outcomes as noted. 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 several smaller or at least one large study have found the effect described.

• Less anxiety after surgery among people treated with melatonin (good evidence)

Relaxation techniques, often used with guided imagery: modest to weak evidence

Lower anxiety without regard to treatment stage among people with cancer participating in relaxation training, often with other mind-body therapies (modest evidence)

Less anxiety during chemotherapy among people treated with relaxation, sometimes also with guided imagery (modest evidence)

Less anxiety during or soon after radiotherapy among people treated with relaxation, sometimes also with guided imagery (preliminary evidence)

Less anxiety soon after surgery among people with cancer treated with relaxation, sometimes with other complementary therapies (modest evidence)

Less anxiety among hospitalized children with cancer treated with relaxation and guided imagery (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))

Less anxiety among parents of hospitalized children with cancer treated with relaxation and guided imagery (preliminary evidence)

Less anxiety among people with cancer in hospice with interactive guided imagery and progressive muscle relaxation (preliminary evidence)

Lower subjective ratings of anxiety after a stressful task among people with reflux disease receiving a relaxation intervention (preliminary evidence)

Caution: occasionally, people using relaxation techniques report negative experiences such as increased anxiety, intrusive thoughts, or fear of losing control

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)

Not specific to people with 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)

Therapies with preliminary or weak evidence of benefit for anxiety

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

Therapeutic Touch™ ›

• 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, but we have not yet reviewed their effectiveness or safety. Those in bold are recommended in at least one clinical practice guideline; see guidelines ›

Resources for managing anxiety