This informal CPD article ‘Stress and cancer: why emotional strain can make physical symptoms feel harder to manage’ was provided by Dr Sue Clenton, Medical Director and Specialist Consultant Oncologist at Releaf, a HealthTech company dedicated to transforming access to Cannabis Based Products for Medical use (CBPMs) in the UK.
Cancer can affect every part of a person’s life, not just their physical health. One of the things professional oncologists often see is the emotional impact of cancer, and how closely connected mental wellbeing is to the more physical side of the condition.
Many cancer patients describe feeling more tired, less comfortable, less able to sleep or simply unable to cope when stress levels are high. And that makes complete sense when you think about it. Stress can have a real effect on how we all feel physically anyway. But when you add the demands of cancer and chemotherapy, that emotional and physical load only gets bigger. [1]
Why stress can feel different when living with cancer
Most people feel stressed at some point in life, but cancer can add a particularly unique kind of strain. [2] Whether it is uncertainty around diagnosis, anxiety while waiting for test results, making difficult treatment decisions or the emotional impact of not feeling like yourself, there is a lot to it.
It is no wonder then that feelings like fear, anxiety, depression and post-traumatic stress are so commonly associated with every stage of cancer care. In fact, 30% of patients are estimated to experience these forms of psychological disorders. [3]
What can make this even harder is the fact that emotional and physical strain often happen simultaneously; for instance, you might already be coping with physical factors like sleep problems, pain, poor appetite or exhaustion, while also trying to process the emotional load of what is happening inside your body. When all of these things build up, even everyday tasks can start to feel much more difficult.
Stress and cancer: before, during and after treatment
One of the most common misconceptions about stress in cancer care is that it only happens at the point of diagnosis. In reality, stress can appear at every stage of the cancer journey: before treatment, during active treatment, after treatment ends and during follow-up appointments. [4]
It is also important to distinguish this from another common misconception that around half of Britons believe: that stress causes cancer. [5] Although stress can affect wellbeing and make symptoms feel harder to manage, it is not a direct cause of cancer.
With that distinction in mind, let’s look at the types of stress someone might experience before, during and after cancer treatment.
Before: Waiting for tests and results
For some people, waiting for test results is one of the most difficult aspects of a cancer diagnosis. The uncertainty and limbo can leave your mind racing, constantly scanning for what-ifs and hypothetical scenarios that may impact your ability to sleep, eat and overall mood.
During: Coping during active treatment
Receiving treatment itself can be physically and emotionally demanding. Managing appointments, coping with side effects and having concerns over how the treatment is working can all weigh on your mind during the treatment journey, ultimately adding to your stress level.
After: The emotional comedown and fear of recurrence
Many patients are surprised to find out that stress doesn’t necessarily disappear when their treatment ends. Once the routine of treatment stops, some people feel relieved, while others feel exposed, unsettled or unsure of what comes next. [6] Even after treatment, it is common to feel anxious before follow-up appointments or scans, or to worry about symptoms appearing that may or may not mean anything serious. That kind of uncertainty can take a real toll over time.
Accessing tailored psychological support
When stress may be a sign you need more support
Stress is common, but that doesn’t mean it simply has to be put up with. It is important to recognise when additional support may be needed. Patients should consider seeking extra support if they are experiencing difficulties with: [7]
- poor sleep
- feelings of overwhelm on most days
- symptoms that are becoming harder to manage or affecting their quality of life
- persistently low mood, depression or anxious thoughts
- relationships or daily functioning
Whether it is from the hospital team, GP, counsellor, psychologist or another appropriate healthcare professional, it is important to notice the signs of stress and seek help when they appear. Talking openly, receiving social support and accessing tailored psychological support may help reduce anxiety and depression in people living with cancer. [8]
Looking at the bigger picture: managing stress in cancer care
Managing stress in cancer care works best when taking a step back and looking at the whole person. That means treating emotional wellbeing, physical symptoms and day-to-day holistically, rather than as separate issues.
When someone is living with cancer, stress rarely exists on its own. It often sits alongside other symptoms like pain, fatigue, poor sleep, nausea, reduced appetite and the emotional weight of treatment and recovery. [1–3] That is why support needs to look at the bigger picture, rather than focusing on any one symptom in isolation.
Top tips for patients: small ways to reduce stress when symptoms feel overwhelming
When people feel particularly stressed, receiving broad advice all at once can feel unhelpful. So, it is often better to start small. Here are some useful ideas to think about:
- Focus on the symptom that is bothering you most: You don’t have to solve everything at once. If sleep is the main issue, start there. If cancer-related pain is dominating your day, find ways to manage that first.
- Keep a simple note of stress triggers and symptom flare-ups: Sometimes patterns become clearer when you write them down. It can also help you explain what is happening to your team more clearly by keeping a detailed track record.
- Prioritise your sleep as much as possible: Try to keep evenings calm and consistent where you can. Sleep disturbance is common in people with cancer and can affect fatigue, mood and pain. [9] Even small improvements in sleep can make coping feel more manageable.
- Accept help with practical tasks: If you’re finding day-to-day activities like shopping, cooking or life admin tiring, let someone help. Going at a more sensible pace allows you to conserve energy for the things that matter most.
- Build in short moments of recovery during the day: Whether it is a short walk, practising mindfulness, or simply stepping away from stressful environments for a while, creating supportive routines like these has been shown through research to make a big difference. [7, 10]
- Speak to your team about your symptoms: Saying “I’m struggling” is a good start, but being specific can help even more. Give your support team details of what you’re dealing with, whether that’s consistently waking up during the night or struggling with your appetite. [7]
- Ask for support early on: Don’t wait until things reach crisis point. Seeking early support is often much more effective and allows techniques to be put in place that help manage your stress throughout your treatment journey. [11]
Give stress the attention it deserves
Stress is not separate from the rest of cancer care. It is not a side issue, and it is certainly not “all in your head”. Emotional strain can make physical symptoms feel heavier, and that is something which deserves proper recognition and support.
If someone is living with cancer and finding it harder to cope than usual, it is worth speaking up. Support with stress, sleep, fatigue, pain and emotional wellbeing is part of good care, and no one should feel they have to struggle alone.
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References
- D'Andre SD, Ellsworth LL, Kirsch JL, et al. Cancer and Stress: Understanding the Connections and Interventions. Am J Lifestyle Med. 2024;19(8):1193-1215. https://pmc.ncbi.nlm.nih.gov/articles/PMC11624519/
- National Cancer Institute. (2022). Stress and Cancer. [Internet]. Available at: https://www.cancer.gov/about-cancer/coping/feelings/stress-fact-sheet
- Fereidouni Z, Dehghan Abnavi S, Ghanbari Z, et al. The Impact of Cancer on Mental Health and the Importance of Supportive Services. Galen Med J. 2024;13:e3327. https://pmc.ncbi.nlm.nih.gov/articles/PMC11368479/
- Cancer Research UK. (2024). Does stress cause cancer? [Internet]. Available at: https://www.cancerresearchuk.org/about-cancer/causes-of-cancer/cancer-myths-questions/can-stress-cause-cancer
- YouGov. (2018). Half of Britons mistakenly think that stress is a cause of cancer. [Internet]. Available at: https://yougov.com/en-gb/articles/20418-half-britons-mistakenly-think-stress-cause-cancer
- Livestrong. (2024). Emotions after cancer treatment. [Internet]. Available at: https://livestrong.org/resources/emotions-after-cancer-treatment/
- NHS. (2026). Stress. [Internet]. Available at: https://www.nhs.uk/mental-health/feelings-symptoms-behaviours/feelings-and-symptoms/stress/
- Grassi L, Caruso R, Riba MB, et al. Anxiety and depression in adult cancer patients: ESMO Clinical Practice Guideline. ESMO Open. 2023;8(2):101155. https://www.esmoopen.com/article/S2059-7029(23)00375-7/fulltext
- Howell D, Oliver TK, Keller-Olaman S, et al. Sleep disturbance in adults with cancer: a systematic review of evidence for best practices in assessment and management for clinical practice. Ann Oncol. 2014;25(4):791-800. https://www.annalsofoncology.org/article/S0923-7534(19)36494-4/fulltext
- Galway K, Black A, Cantwell M, et al. Psychosocial interventions to improve quality of life and emotional wellbeing for recently diagnosed cancer patients. Cochrane Database Syst Rev. 2012;11(11):CD007064. https://pmc.ncbi.nlm.nih.gov/articles/pmid/23152241/
- Negash BT, Alelign Y. Stress and coping strategies of cancer among adult cancer patients in Hawassa University comprehensive specialized hospital cancer centre in 2024: patient, family and health professional perspective. BMC Cancer. 2025;25(1):621. https://link.springer.com/article/10.1186/s12885-025-14023-0
