Hester Hill Schnipper Photo courtesy of Beth Israel Deaconess Medical Center

ANXIETY INEVITABLY accompanies cancer. Predictably, it can be especially intense at certain times: right after diagnosis; when preparing for surgery, chemotherapy or radiation; when treatment ends; and if cancer recurs or progresses. Anxiety is a normal response to these difficult circumstances.

Anxiety can often be managed without medical intervention, though there are times when medications will help. You should talk with your doctor if you’re unable to sustain your normal routines or obligations because of anxiety, you’re unable to sleep through the night and awaken in the dark to find your mind and heart racing, you frequently can’t control the worry, or you’re having panic attacks.

Keep in mind that feeling worried or frightened is an appropriate response to a serious illness. Most people describe the first weeks after being diagnosed or learning about a recurrence as the most difficult. As a little time passes, you almost certainly will feel better.

Here are some strategies to help during the hard times:

1) Stop for a moment and take a deep breath. Even better, take several and pay attention to your breaths. Feel your body relax.

2) Starting with your toes, mentally name your body parts and move upward. At each step, consciously relax.

3) If you can’t concentrate, move your body. Get up and do something—anything. A short walk outside is best, but even moving around your living room, kitchen or office will help.

4) Identify anxiety-provoking events, such as scans, doctors’ appointments or the start of a new treatment, and consider asking someone to accompany you. Give that person specific directions: Do you want her to bring snacks? Sit quietly? Rub your feet during chemo? Talk with you? Admitting that you are scared and asking for help are therapeutic steps in and of themselves, and your family and friends want to be useful.

5) Try to pinpoint your fears. For example, if you are beginning chemotherapy, are you frightened about the needle stick, the possible side effects or the drugs themselves? Once you know your trigger, work toward easing it. Try not to let a worry grow large and vague.

6) Make a plan. If you are scared about getting the results of a scan, talk with your doctor about how and when you will receive the results, and be clear about your needs. Decide if you want a phone call no matter the results, or if you want to wait for your next appointment. Do not leave this to chance; you do not want to wonder whether not receiving a phone call means good or bad news.

7) Make sure to take good care of yourself. This means trying to maintain a balanced diet, get enough sleep, keep up a mild to moderate exercise routine, and stay hydrated. Your mood will be better if you are physically feeling as well as possible, and it can be reassuring to take control of the things that you can control.

8) Finally, be gentle with yourself. If it’s a bad day, have a treat or take a nap or just reassure yourself that tomorrow will be better.

Hester Hill Schnipper, a licensed independent clinical social worker, is a breast cancer survivor who served as the manager of oncology social work at Beth Israel Deaconess Medical Center in Boston.