Communicate Your Distress
A cancer diagnosis often causes distress, as can cancer treatments. Typically, doctors don’t ask about distress, and patients don't say anything unless they're asked.
Your quality of life during and after cancer treatment, and even the success of your treatment, can be impaired by high distress.
Common symptoms of distress include these:2
- Sadness, fear, and helplessness
- Anger, feeling out of control
- Questioning your faith, your purpose, the meaning of life
- Pulling away from people, including those close to you
- Concerns about illness
- Concerns about your social role (as a mother, father, caregiver, and so on)
- Poor sleep, appetite, or concentration
- Depression, anxiety, panic
- Frequent thoughts of illness and death
Distress is often eased with the health-supportive measures described on this site.
Good distress screening tools:
- The National Comprehensive Cancer Network: Distress Thermometer on pages 16 and 17 of their Distress Supportive Care Booklet or stand-alone as a tool for printing.
- American Cancer Society: Tools to help measure distress
- National Health Service, United Kingdom: The Distress Thermometer
Usually, an oncology social worker conducts the psychosocial assessment, but so may nurses, doctors, or psychologists. Distress screening is not typically done right at diagnosis and the beginning of treatment when nearly everyone’s distress is usually fairly high. Instead, a screening may occur a few weeks after treatment starts, when acute distress is expected to ease. A higher level of distress at this time is a signal that you might need a referral for help.
Distress screening is not typically done right at diagnosis and the beginning of treatment when nearly everyone’s distress is usually fairly high. Instead, a screening may occur a few weeks after treatment starts.
After your cancer diagnosis, you might ask your doctor if and when someone will be asking about your emotional, social, and financial concerns and challenges (psychosocial assessment). Ask if and when someone will be doing a distress screening with you. If your cancer treatment team is not providing these assessments, you can ask for a referral to an oncology social worker, oncology nurse navigator, or psychotherapist who can provide assessment and referral for psychosocial concerns as well as distress.
If you have not been screened for distress, and you have concerns about your level of distress, you might consider completing the NCCN Distress Screening and Problem List Tool. If you feel your distress level is too high, take a copy of the completed tool to your oncology doctor, social worker and/or treatment nurse to review and refer you to resources for help.
Cancer programs that are accredited by the American College of Surgeons Commission on Cancer (ACOS COC) are required to conduct a psychosocial assessment and routine distress screening of all their patients.
In summary, the cancer experience can be distressing. Higher levels of ongoing distress can impair your quality of life and treatment success. Let your cancer treatment team know if you are experiencing distress and ask for help.
If you are experiencing distress, even if it isn’t severe, getting help may be useful. Some suggestions from the Cancer.Net article titled How to Recognize Cancer Distress and Cope with It include:
- Talk to your cancer care team.
- Connect with other cancer survivors.
- Get counseling.
The Related Pages section below includes resources for managing distressing cancer symptoms and stress that are located on this site .
Written by Laura Pole, RN, MSN, OCNS, and Nancy Hepp, MS; most recent update on July 5, 2018.
- National Comprehensive Cancer Network:
- American Cancer Society: Tools to help measure distress
- ASCO Cancer.Net Patient information: How to Recognize Cancer Distress and Cope with It
- Anticancer Lifestyle Program:
- Triage Cancer
- Nancy Novack and Barbara K. Richardson (editors): I Am with You: Love Letters to Cancer Patients
- Jackie Ogg, Herman Barangan and Andrea Betts: My Friend Has Cancer?!
- Keith I. Block, MD: Life over Cancer: The Block Center Program for Integrative Cancer Treatment
- NCCN Distress Thermometer and Problem List for Patients
- National Comprehensive Cancer Network Patient and Caregiver Resources
- Hillingdon Oncology & Palliative Care Team : Coping with Stress: The Distress Thermometer
Enter your comments or questions below.
First, take a few deep breaths. Clear your mind and calm your nerves. Trying to find and understand new information while you're panicked doesn't work well.
Then, take a look at these places, but take them one at a time. Don't feel like you have to get through this all at once. Take a "bite" of a manageable amount of information. Read what you find thoughtfully. Consider it carefully. Read it 2 or 3 times until you feel you understand what's there. You might want to look into the studies located in the footnotes, or you might leave that for a later time. When you feel ready for a new piece, come back and read some more.
Start with our Cervical Cancer page, https://bcct.ngo/cancers-and-symptoms/cancers/cervical-cancer. We don't have much there yet, but you will find information about conventional treatments, a good review article about integrative approaches, and some published protocols to investigate.
Another time, look through our therapy summaries, https://bcct.ngo/search-therapies/search-therapy-summaries/. You can search for therapies found effective in cervical cancer by selecting it from the Cancer Types: Benefit list in the search box on the left. See if any of those therapies interest you. Again, take this in small doses.
Take information that you find helpful to your medical team to see what your best options might be. If you need to find a medical professional with an integrative approach to add to your team, you might review our Centers, Clinics and Clinicians page, https://bcct.ngo/integrative-cancer-care/centers-clinics-and-clinicians. If you're outside the United States, look especially at the Other Guidance section toward the bottom of that page.
Best wishes in finding guidance on addressing your needs and moving forward with your health and wellness.
I diagnosed of cervical cancer,I'm very stressful,can you help m