• A diagnosis of advanced ovarian cancer can lead to feelings of being stressed, anxious, and overwhelmed.
• Recognizing anxiety and chronic stress and learning better coping strategies can support your mental health.
• Staying on track with treatment, talking to a counselor, relaxation techniques, medication to support your mood, and getting support from friends, clergy, or family can all help lessen feelings of anxiety when you’re overwhelmed.

Living with advanced ovarian cancer can take a major toll on your mental health, and stress and anxiety are common experiences. Supporting your mental health doesn’t just improve your quality of life now — it can also support your cancer treatment journey. When people with advanced cancer have anxiety, they are more likely to experience sleeping problems and recover from treatments more slowly, and they may even have a worse outlook.

Take your mental health as seriously as you do your cancer treatment. Learning effective coping techniques can improve your feelings of well-being and help make sure you have the best outcome possible.

What Causes Anxiety and Stress?

When living with advanced cancer, your mental health may be harmed by many factors, including:

• Waiting for test results
• Not knowing how well treatments will work or what their effects will be
• Feeling stressed about having to make difficult decisions regarding a treatment plan
• Juggling many different visits to doctors’ offices, a hospital, or a clinic for treatments
• Dealing with treatment-related side effects, such as pain, nausea, or fatigue
• Noticing changes in physical appearance
• Not knowing what your cancer will look like in the future, or whether it will get worse
• Trying to explain your diagnosis or your symptoms to loved ones
• Experiencing a lack of understanding from your family, friends, caregivers, or workplace
• Worrying about the future and how it will affect your family and friends
• Feeling fear about dying or uncertainty about what happens during or after death

Many members of MyOvarianCancerTeam have reported dealing with these types of stressors. “I just got my blood work done, and now the stress of waiting for that CA-125 result begins,” said one member. “I had my first treatment today. I’m quite apprehensive about the outcome and side effects,” wrote another.

One member who is currently in remission shared that she struggled with anxiety about experiencing a relapse. “Every day I don’t feel well, I worry that the cancer is returning,” she said.

“There is so much to deal with having this cancer, but outsiders just don’t quite get it,” one member shared. “They mean well, but really just want to hear you are feeling better. Many times, I was so affected by the hope in their voices that I would say I was fine.”

Stress and Treatment

In one study, researchers found that as many as 74 percent of people with advanced ovarian cancer had symptoms of anxiety before undergoing surgery. The study also reported that the number of people with anxiety decreased while people were undergoing chemotherapy. However, other research has found that anxiety can sometimes increase over time during or after treatment for advanced ovarian cancer.

Coping With Stress and Anxiety

If you have a diagnosis of ovarian cancer, it may help to spend some time working to improve your mental health, especially if you have advanced-stage disease. There are strategies that may provide some relief while living with cancer.

Recognize the Signs

Most people probably recognize general signs of anxiety, like feeling worried or afraid. However, there are multiple types of anxiety disorders, and they can sometimes lead to unexpected symptoms. You may be experiencing anxiety if you:

• Feel restless and irritable
• Are unusually tired
• Can’t focus
• Have extra aches and pains
• Can’t sleep
• Blush, sweat, or shake when you’re around other people
• Have trouble making eye contact or talking to strangers
• Hate being in public places, standing in line, or going outside your home

Panic disorder is a form of anxiety that can cause panic attacks. During these episodes, you may feel extremely afraid or uncomfortable. Panic attacks can also cause chest pain, sweating, and a fast or pounding heartbeat, which can make some people feel like they are having a heart attack or dying.

Too much stress can also lead to problems with physical health such as pain, dizziness, jaw clenching, stomachaches, or high blood pressure. People who feel too stressed for too long may also be tempted to drink too much, overeat, gamble, smoke, or go on shopping sprees. Eventually, stress can also cause anxiety or depression.

Is It Stress, Cancer, or Side Effects From Treatment?

It’s important to note that many of these sensations can also be cancer-related symptoms or side effects. For example, many people with cancer experience fatigue, pain, and insomnia. However, if you think you are experiencing symptoms that could be related to anxiety or chronic stress, talk to your cancer care team about how to boost your mental health.

Speak Up

Research has shown that people living with advanced cancer who have anxiety have a harder time trusting their doctors, understanding all of the medical information they are given, and asking questions. This can cause even more anxiety about your condition and treatments.

Try to remind yourself that asking questions is normal throughout this process. You may want to prepare for your appointments by looking up and writing down questions in advance. At the appointment, take notes about what your doctor says, have a family member come with you to take notes, or ask your doctor if it’s OK for you to record the conversation. Then, you can better remember what was discussed and look up any relevant topics you want to know more about.

Ask for Help

Your health care team may ask how you are dealing with your relationships, finances, emotions, and other aspects of your life. Try to answer these questions honestly. If you are struggling, your doctor can put you in touch with professionals who may be able to help, such as:

• Social workers, who can provide emotional support, help with practical needs, and connect you with resources in your community
• Mental health professionals such as therapists, counselors, psychologists, or psychiatrists
• Palliative care specialists, who can help you better manage your symptoms and treatment side effects
• Religious counselors such as ministers, priests, rabbis, or imams

You may also need to ask for help from your family and friends to relieve stress or anxiety. You may not be able to take on the same roles around the house that you once did. A family counselor may be able to help you and your family members adjust to these changes. Requesting support from friends, support groups, or people within your spiritual community may also help you meet some of your needs as you go through cancer treatments.

“You definitely need to support yourself with positive people,” said one MyOvarianCancerTeam member. “It isn’t easy at all,” commented another. “Friends and family support me, and prayers keep my spirits up.”

Take Time To Relax

In the midst of all of your appointments, consultations, and treatments, try to set aside some time to relax and recharge. One study found that when people with advanced cancer took foot baths using aromatic oils, their physical and mental stress levels decreased. This type of strategy may not make an impact on your cancer, but small comforts and relaxing moments can help you have a better quality of life.

You may want to try:

• Breathing exercises
• Guided imagery or meditation
• A warm bath
• Aromatherapy
• Calming music

“We have to try to live in the moment and not dwell on the what-ifs,” suggested one member of MyOvarianCancerTeam. “It helps to talk to a therapist and do guided meditations for stress. Go to YouTube and do a search for guided meditation. You’ll find a gazillion of them for stress, anxiety, you name it.”

Practice a Hobby

Many members have shared that participating in hobbies or other fun activities helps take their minds off their health.

“Doing any kind of creative project is great for coping with the stress and anxiety that come with having cancer,” wrote one member. “Even if you think you don’t have any talent, there are plenty of things you can try. A friend of mine does paint-by-number kits, and it doesn’t matter what the results look like. I have zero musical talent (believe me), but I took a ukulele class before the pandemic, and it was SO much fun.”

“I like to cook, and if I feel strong enough to stand up more than usual, I find this takes my mind away from nervousness, fear, and worry,” said one member.

Another member wrote about taking a fun day trip. “My husband knows I was stressing over an upcoming couple of weeks, so he told me to grab my bag and a warm coat and he took me up to one of our favorite places in the local hills,” they wrote. “It was a beautiful afternoon. Great way to distract me from the scary thoughts that are trying to get in my head.”

Treating Anxiety With Advanced Cancer

Cognitive behavioral therapy (CBT) is a type of talk therapy that is usually very effective at treating anxiety. However, it may not always be a good fit for people with advanced cancer. For example, CBT may not always target the specific concerns often seen by people with this type of condition.

However, researchers in one study altered traditional CBT methods to address more cancer-related concerns and adapt to the person’s needs as a person’s cancer diagnosis evolves. When they tried this adapted CBT method, people with advanced cancer had improved anxiety symptoms.

Additional research from the journal Palliative Medicine has also found that psychological treatments that help people find meaning in their life or improve their spiritual well-being also helped treat death-related anxiety in people with advanced cancer.

Find an Experienced Counselor

It may be helpful to talk to a mental health professional such as a therapist who has experience treating people with cancer or other advanced conditions. These providers may better understand your needs and worries.

“I am seeing my therapist on Zoom free of charge through the Cancer Support Community website,” said one member. “Everyone with cancer needs therapy to help them deal with the stress and anxiety of this disease.”

Connecting with others through a local support group or a website like MyOvarianCancerTeam may also help — you can share your worries with others and receive support.

Consider Medication

If you’re on treatment for ovarian cancer, you may feel reluctant to take additional drugs. However, medications such as antidepressants, beta-blockers, or benzodiazepines can ease anxiety and help you experience better mental well-being.

Some MyOvarianCancerTeam members have said that anti-anxiety medications have helped them. “My doctor prescribed me an antidepressant. It works if I take it like I’m supposed to,” wrote a member.

Make sure all of the doctors on your health care team know about all of the medications you’re taking to avoid interactions or other problems.

Talk With Others Who Understand

MyOvarianCancerTeam is an online social network for people with ovarian cancer and their loved ones. On MyOvarianCancerTeam, more than 4,000 members come together to ask questions, give advice, and share their stories with others who understand life with ovarian cancer.

How have stress and anxiety affected you while trying to manage your ovarian cancer? Have you found any effective ways to support your mental health? Share your experiences in the comments below, or start a conversation by posting on your Activities page.