Anticipate and Address Anxiety in Survivorship Care

April 19, 2022 by Deborah Christensen MSN, APRN, AOCNS®

Some people may be overjoyed at the prospect of completing their cancer treatment and returning to normal life, but for many others, fear and anxiety can overshadow feelings of elation. The survivorship phase of a cancer journey can be confusing and uncertain. Comments like, “I don’t know what is next” and “The responsibility for care is now up to me” can alert oncology nurses that patients need additional communication and strategies to transition into healthy survivorship.

Even 10 years after the Institute of Medicine brought awareness to survivorship issues in its seminal 2006 report, From Cancer Patient to Cancer Survivor, people completing cancer treatment continued to report ( not receiving optimal communication from their healthcare providers about managing uncertainty and responding to emotions. Fear of recurrence, body image and sexuality changes, family and financial adjustments, and long-term health management are some of the anxiety-generating survivorship realities that can be addressed using skillful communication strategies.

Skillful Communication Strategies

Cancer survivors overwhelmingly agree ( that information on moving beyond cancer treatment is most helpful when it is explained in person. As people approach cancer survivorship, oncology professionals can acknowledge and normalize their potential feelings of anxiety. Additional communication strategies include confronting uncertainty, empowering survivors to self-manage, and ensuring information is dually exchanged. 

Apply It to Your Practice

Review the two scenarios in the sidebar. In scenario I, the nurse recognizes that Marisol is contemplative and asks if anything is wrong (a closed-ended question) but misses the conflict in Marisol’s response (“I really shouldn’t be. . .”). Although he attempts to normalize the situation, he does not explore Marisol’s concerns. In scenario II, the nurse uses open-ended questions to elicit thoughtful responses. He normalizes and validates Marisol’s emotions and listens for what has been helpful for her in the past, seizing on the opportunity to offer support and, importantly, accountability with a follow-up conversation.


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