No votes yet

Update on Research-Based Interventions for Anxiety in Patients With Cancer

Patsy R. Smith
Diane Cope
Tammie L. Sherner
Deborah K. Walker
CJON 2014, 18(6), 5-16 DOI: 10.1188/14.CJON.S3.5-16

Anxiety may begin at the moment a person is diagnosed with cancer and may fluctuate throughout the cancer trajectory as physical illness improves or declines. The purpose of this article is to present current evidence for nurses to implement interventions to reduce anxiety in patients who have cancer. The PubMed and CINAHL® databases were searched to identify relevant citations addressing interventions that treat or prevent anxiety symptoms in patients with cancer. Based on available evidence, the interventions addressed herein are categorized according to the Putting Evidence Into Practice (PEP®) rating schema. Interventions include pharmacologic and nonpharmacologic approaches to care, and meet criteria for three PEP categories: likely to be effective, effectiveness not established (the largest category of results), or effectiveness unlikely.


Ames, S. C., Tan, W. W., Ames, G. E., Stone, R. L., Rizzo, T. D., Jr., Crook, J. E., … Rummans, T. A. (2011). A pilot investigation of a multidisciplinary quality of life intervention for men with biochemical recurrence of prostate cancer. <i>Psycho-Oncology, 20</i>, 435-440. doi:10.1002/pon.1769

Ando, M., Morita, T., Akechi, T., Ito, S., Tanaka, M., Ifuku, Y., & Nakayama, T. (2009). The efficacy of mindfulness-based meditation therapy on anxiety, depression, and spirituality in Japanese patients with cancer. <i>Journal of Palliative Medicine, 12</i>, 1091-1094. doi:10.1089/jpm.2009.0143

Ando, M., Morita, T., Okamoto, T., & Ninosaka, Y. (2008). One-week short-term life review interview can improve spiritual well-being of terminally ill cancer patients. <i>Psycho-Oncology, 17</i>, 885-890. doi:10.1002/pon.1299

Arving, C., Sjoden, P. O., Bergh, J., Hellbom, M., Johansson, B., Glimelius, B., & Brandberg, Y. (2007). Individual psychosocial support for breast cancer patients: A randomized study of nurse versus psychologist interventions and standard care. <i>Cancer Nursing, 30</i>, E10-E19. doi:10.1097/01.NCC.0000270709.64790.05

Badger, T., Segrin, C., Dorros, S. M., Meek, P., & Lopez, A. M. (2007). Depression and anxiety in women with breast cancer and their partners. <i>Nursing Research, 56</i>, 44-53.

Banerjee, B., Vadiraj, H. S., Ram, A., Rao, R., Jayapal, M., Gopinath, K. S., … Hande, M. P. (2007). Effects of an integrated yoga program in modulating psychosocial stress and radiation-induced genotoxic stress in breast cancer patients undergoing radiotherapy. <i>Integrative Cancer Therapies, 6</i>, 242-250. doi:10.1177/1534735407306214

Bar-Sela, G., Atid, L., Danos, S., Gabay, N., & Epelbaum, R. (2007). Art therapy improved depression and influenced fatigue levels in cancer patients on chemotherapy. <i>Psycho-Oncology, 16</i>, 980-984. doi:10.1002/pon.1175

Birocco, N., Guillame, C., Storto, S., Ritorto, G., Catino, C., Gir, N., … Ciuffreda, L. (2012). The effects of Reiki therapy on pain and anxiety in patients attending a day oncology and infusion services unit. <i>American Journal of Hospice and Palliative Care, 29</i>, 290-294. doi:10.1177/1049909111420859

Boesen, E. H., Karlsen, R., Christensen, J., Paaschburg, B., Nielsen, D., Bloch, I. S., … Johansen, C. (2011). Psychosocial group intervention for patients with primary breast cancer: A randomised trial. <i>European Journal of Cancer, 47</i>, 1363-1372. doi:10.1016/j.ejca.2011.01.002

Bradt, J., Dileo, C., Grocke, D., & Magill, L. (2011). Music interventions for improving psychological and physical outcomes in cancer patients. <i>Cochrane Database of Systematic Reviews, 8</i>, CD006911. doi:10.1002/14651858.CD006911.pub2

Breitbart, W. (1995). Identifying patients at risk for, and treatment of major psychiatric complications of cancer. <i>Supportive Care in Cancer, 3</i>, 45-60.

Bulfone, T., Quattrin, R., Zanotti, R., Regattin, L., & Brusaferro, S. (2009). Effectiveness of music therapy for anxiety reduction in women with breast cancer in chemotherapy treatment. <i>Holistic Nursing Practice, 23</i>, 238-242. doi:10.1097/HNP.0b013e3181aeceee

Burnham, T. R., & Wilcox, A. (2002). Effects of exercise on physiologic and psychological variables in cancer survivors. <i>Medicine and Science in Sports and Exercise, 34</i>, 1863-1867. doi:10.1097/00005768-200212000-00001

Cameron, L. D., Booth, R. J., Schlatter, M., Ziginskas, D., & Harman, J. E. (2007). Changes in emotion regulation and psychological adjustment following use of a group psychosocial support program for women recently diagnosed with breast cancer. <i>Psycho-Oncology, 16</i>, 171-180. doi:10.1002/pon.1050

Campeau, M. P., Gaboriault, R., Drapeau, M., Van Nguyen, T., Roy, I., Fortin, B., … Nguyen-Tan, P. F. (2007). Impact of massage therapy on anxiety levels in patients undergoing radiation therapy: Randomized controlled trial. <i>Journal of the Society for Integrative Oncology, 5</i>, 133-138. doi:10.2310/7200.2007.018

Cankurtaran, E. S., Ozalp, E., Soygur, H., Akbiyik, D. I., Turhan, L., & Alkis, N. (2008). Mirtazapine improves sleep and lowers anxiety and depression in cancer patients: Superiority over imipramine. <i>Supportive Care in Cancer, 16</i>, 1291-1298. doi:10.1007/s00520-008-0425-1

Chan, C. W., Richardson, A., & Richardson, J. (2011). Managing symptoms in patients with advanced lung cancer during radiotherapy: Results of a psychoeducational randomized controlled trial. <i>Journal of Pain and Symptom Management, 41</i>, 347-357. doi:10.1016/j.jpainsymman.2010.04.024

Chan, R. J., Webster, J., & Marquart, L. (2012). Information interventions for orienting patients and their carers to cancer care facilities. <i>Cochrane Database of Systematic Reviews, 12</i>, CD008273. doi:10.1002/14651858.CD008273.pub2

Cheung, Y. L., Molassiotis, A., & Chang, A. M. (2003). The effect of progressive muscle relaxation training on anxiety and quality of life after stoma surgery in colorectal cancer patients. <i>Psycho-Oncology, 12</i>, 254-266. doi:10.1002/pon.638

Chien, C. H., Liu, K. L., Chien, H. T., & Liu, H. E. (2014). The effects of psychosocial strategies on anxiety and depression of patients diagnosed with prostate cancer. <i>International Journal of Nursing Studies, 51</i>, 28-38. doi:10.1016/j.ijnur stu.2012.12.019

Chujo, M., Mikami, I., Takashima, S., Saeki, T., Ohsumi, S., Aogi, K., & Okamura, H. (2005). A feasibility study of psychosocial group intervention for breast cancer patients with first recurrence. <i>Supportive Care in Cancer, 13</i>, 503-514. doi:10.1007/s00520-004-0733-z

Cochrane, B. B., Lewis, F. M., & Griffith, K. A. (2011). Exploring a diffusion of benefit: Does a woman with breast cancer derive benefit from an intervention delivered to her partner? <i>Oncology Nursing Forum, 38</i>, 207-214. doi:10.1188/11.ONF.207-214

Cohen, L., Warneke, C., Foulacli, R. T., Rodriguez, M. A., & Chaoul-Reich, A. (2004). Psychological adjustment and sleep quality in a randomized trial of the effects of a Tibetan yoga intervention in patients with lymphoma. <i>Cancer, 100</i>, 2253-2260. doi:10.1002cncr.20236

Courneya, K. S., Segal, R. J., Gelmon, K., Reid, R. D., Mackey, J. R., Friedenreich, C. M., … McKenzie, D. C. (2007). Six-month follow-up of patient-rated outcomes in a randomized controlled trial of exercise training during breast cancer chemotherapy. <i>Cancer Epidemiology, Biomarkers and Prevention, 16</i>, 2572-2578. doi:10.1158/1055-9965.EPI-07-0413

Deng, G., Chan, Y., Sjoberg, D., Vickers, A., Yeung, K. S., Kris, M., … Cassileth, B. (2013). Acupuncture for the treatment of post-chemotherapy chronic fatigue: A randomized, blinded, sham-controlled trial. <i>Supportive Care in Cancer, 21</i>, 1735-1741. doi:10.1007/s00520-013-1720-z

Deshler, A. M., Fee-Schroeder, K. C., Dowdy, J. L., Mettler, T. A., Novotny, P., Zhao, X., & Frost, M. H. (2006). A patient orientation program at a comprehensive cancer center. <i>Oncology Nursing Forum, 33</i>, 569-578. doi:10.1188/06.ONF.569-578

Dhruva, A., Miaskowski, C., Abrams, D., Acree, M., Cooper, B., Goodman, S., & Hecht, F. M. (2012). Yoga breathing for cancer chemotherapy-associated symptoms and quality of life: Results of a pilot randomized controlled trial. <i>Journal of Alternative and Complementary Medicine, 18</i>, 473-479. doi:10.1089/acm.2011.0555

Dolbeault, S., Cayrou, S., Bredart, A., Viala, A. L., Desclaux, B., Saltel, P., … Dickes, P. (2009). The effectiveness of a psycho-educational group after early-stage breast cancer treatment: Results of a randomized French study. <i>Psycho-Oncology, 18</i>, 647-656. doi:10.1002/pon.1440

D'Souza, V., Blouin, E., Zeitouni, A., Muller, K., & Allison, P. J. (2013). An investigation of the effect of tailored information on symptoms of anxiety and depression in head and neck cancer patients. <i>Oral Oncology, 49</i>, 431-437. doi:10.1016/j.oraloncology.2012.12.001

Eaton, L. H., & Tipton, J. M. (Eds.). (2009). <i>Putting Evidence Into Practice: Improving oncology patient outcomes.</i> Pittsburgh, PA: Oncology Nursing Society.

Fellowes, D., Barnes, K., & Wilkinson, S. S. (2008). Aromatherapy and massage for symptom relief in patients with cancer. <i>Cochrane Database of Systematic Reviews</i>, CD002287. doi:10.1002/14651858.CD002287.pub2

Ferrante, J. M., Chen, P. H., & Kim, S. (2008). The effect of patient navigation on time to diagnosis, anxiety, and satisfaction in urban minority women with abnormal mammograms: A randomized controlled trial. <i>Journal of Urban Health, 85</i>, 114-124. doi:10.1007/s11524-007-9228-9

Ferrer, A. J. (2007). The effect of live music on decreasing anxiety in patients undergoing chemotherapy treatment. <i>Journal of Music Therapy, 44</i>, 242-255. doi:10.1093/jmt/44.3.242

Fukui, S., Ogawa, K., Ohtsuka, M., & Fukui, N. (2008). A randomized study assessing the efficacy of communication skill training on patients' psychologic distress and coping: Nurses' communication with patients just after being diagnosed with cancer. <i>Cancer, 113</i>, 1462-1470. doi:10.1002/cncr.23710

Galway, K., Black, A., Cantwell, M., Cardwell, C. R., Mills, M., & Donnelly, M. (2012). Psychosocial interventions to improve quality of life and emotional wellbeing for recently diagnosed cancer patients. <i>Cochrane Database of Systematic Reviews, 11</i>, CD007064. doi:10.1002/14651858.CD007064.pub2

Garcia, M. K., McQuade, J., Haddad, R., Patel, S., Lee, R., Yang, P., … Cohen, L. (2013). Systematic review of acupuncture in cancer care: A synthesis of the evidence. <i>Journal of Clinical Oncology, 31</i>, 952-960. doi:10.1200/JCO.2012.43.5818

Garland, S. N., Tamagawa, R., Todd, S. C., Speca, M., & Carlson, L. E. (2013). Increased mindfulness is related to improved stress and mood following participation in a mindfulness-based stress reduction program in individuals with cancer. <i>Integrative Cancer Therapies, 12</i>, 31-40. doi:10.1177/1534735412442370

Gehring, K., Patwardhan, S. Y., Collins, R., Groves, M. D., Etzel, C. J., Meyers, C. A., & Wefel, J. S. (2012). A randomized trial on the efficacy of methylphenidate and modafinil for improving cognitive functioning and symptoms in patients with a primary brain tumor. <i>Journal of Neuro-Oncology, 107</i>, 165-174. doi:10.1007/s11060-011-0723-1

Girgis, A., Breen, S., Stacey, F., & Lecathelinais, C. (2009). Impact of two supportive care interventions on anxiety, depression, quality of life, and unmet needs in patients with nonlocalized breast and colorectal cancers. <i>Journal of Clinical Oncology, 27</i>, 6180-6190. doi:10.1200/JCO.2009.22.8718

Goerling, U., Foerg, A., Sander, S., Schramm, N., & Schlag, P. M. (2011). The impact of short-term psycho-oncological interventions on the psychological outcome of cancer patients of a surgical-oncology department—A randomised controlled study. <i>European Journal of Cancer, 47</i>, 2009-2014. doi:10.1016/j.ejca.2011.04.031

Gravis, G., Protiere, C., Eisinger, F., Boher, J. M., Tarpin, C., Coso, D., … Viens, P. (2011). Full access to medical records does not modify anxiety in cancer patients: Results of a randomized study. <i>Cancer, 117</i>, 4796-4804. doi:10.1002/cncr.26083

Greer, J. A., Solis, J. M., Temel, J. S., Lennes, I. T., Prigerson, H. G., Maciejewski, P. K., & Pirl, W. F. (2011). Anxiety disorders in long-term survivors of adult cancers. <i>Psychosomatics, 52</i>, 417-423. doi:10.1016/j.psym.2011.01.014

Greer, J. A., Traeger, L., Bemis, H., Solis, J., Hendriksen, E. S., Park, E. R., … Safren, S. A. (2012). A pilot randomized controlled trial of brief cognitive-behavioral therapy for anxiety in patients with terminal cancer. <i>Oncologist, 17</i>, 1337-1345. doi:10.1634/theoncologist.2012-0041

Grob, C. S., Danforth, A. L., Chopra, G. S., Hagerty, M., McKay, C. R., Halberstadt, A. L., & Greer, G. R. (2011). Pilot study of psilocybin treatment for anxiety in patients with advanced-stage cancer. <i>Archives of General Psychiatry, 68</i>, 71-78. doi:10.1001/archgenpsychiatry.2010.116

Hanssens, S., Luyten, R., Watthy, C., Fontaine, C., Decoster, L., Baillon, C., … De Grève, J. (2011). Evaluation of a comprehensive rehabilitation program for post-treatment patients with cancer [Online exclusive]. <i>Oncology Nursing Forum, 38</i>, E418-E424. doi:10.1188/11.ONF.E418-E424

Hayama, Y., & Inoue, T. (2012). The effects of deep breathing on ‘tension-anxiety’ and fatigue in cancer patients undergoing adjuvant chemotherapy. <i>Complementary Therapies in Clinical Practice, 18</i>, 94-98. doi:10.1016/j.ctcp.2011.10.001

Hernandez-Reif, M., Field, T., Ironson, G., Beutler, J., Vera, Y., Hurley, J., … Fraser, M. (2005). Natural killer cells and lymphocytes increase in women with breast cancer following massage therapy. <i>International Journal of Neuroscience, 115</i>, 495-510. doi:10.1080/00207450590523080

Hidderley, M., & Holt, M. (2004). A pilot randomized trial assessing the effects of autogenic training in early stage cancer patients in relation to psychological status and immune system responses. <i>European Journal of Oncology Nursing, 8</i>, 61-65. doi:10.1016/j.ejon.2003.09.003

Hirai, K., Motooka, H., Ito, N., Wada, N., Yoshizaki, A., Shiozaki, M., … Akechi, T. (2012). Problem-solving therapy for psychological distress in Japanese early-stage breast cancer patients. <i>Japanese Journal of Clinical Oncology, 42</i>, 1168-1174.

Hoff, A. C., & Haaga, D. A. (2005). Effects of an education program on radiation oncology patients and families. <i>Journal of Psychosocial Oncology, 23</i>, 61-75.

Hoffman, C. J., Ersser, S. J., Hopkinson, J. B., Nicholls, P. G., Harrington, J. E., & Thomas, P. W. (2012). Effectiveness of mindfulness-based stress reduction in mood, breast- and endocrine-related quality of life, and well-being in stage 0 to III breast cancer: A randomized, controlled trial. <i>Journal of Clinical Oncology, 30</i>, 1335-1342. doi:10.1200/JCO.2010.34.0331

Holland, J. C., Morrow, G., Schmale, A., Derogatis, L., Stefanek, M., Berenson, S., … Feldstein, M. (1991). A randomized clinical trial of alprazolam versus progressive muscle relaxation in cancer patients with anxiety and depressive symptoms. <i>Journal of Clinical Oncology, 9</i>, 1004-1011.

Hopko, D. R., Armento, M. E., Robertson, S. M., Ryba, M. M., Carvalho, J. P., Colman, L. K., … Lejuez, C. W. (2011). Brief behavioral activation and problem-solving therapy for depressed breast cancer patients: Randomized trial. <i>Journal of Consulting and Clinical Psychology, 79</i>, 834-849. doi:10.1037/a0025450

Jane, S. W., Chen, S. L., Wilkie, D. J., Lin, Y. C., Foreman, S. W., Beaton, R. D., … Liao, M. N. (2011). Effects of massage on pain, mood status, relaxation, and sleep in Taiwanese patients with metastatic bone pain: A randomized clinical trial. <i>Pain, 152</i>, 2432-2442. doi:10.1016/j.pain.2011.06.021

Jensen-Johansen, M. B., Christensen, S., Valdimarsdottir, H., Zakowski, S., Jensen, A. B., Bovbjerg, D. H., & Zachariae, R. (2012). Effects of an expressive writing intervention on cancer-related distress in Danish breast cancer survivors—Results from a nationwide randomized clinical trial. <i>Psycho-Oncology, 22</i>, 1492-1500. doi:10.1002/pon.3193

Johnson, L. A. (2014). Putting evidence into practice: The process. <i>Clinical Journal of Oncology Nursing, 18</i>(3 Suppl.), 2-4. doi:10.1188/14/CJON.S3.2-4

Jones, R. B., Pearson, J., Cawset, A. J., Bental, D., Barrett, A., White, J., … Gilmour, W. H. (2006). Effect of different forms of information produced for cancer patients on their use of the information, social support, and anxiety: Randomised trial. <i>BMJ, 332</i>, 942-948. doi:10.1136/bmj.38807.571042.68

Kangas, M., Milross, C., Taylor, A., & Bryant, R. A. (2013). A pilot randomized controlled trial of a brief early intervention for reducing posttraumatic stress disorder, anxiety and depressive symptoms in newly diagnosed head and neck cancer patients. <i>Psycho-Oncology, 22</i>, 1665-1673. doi:10.1002/pon.3208

Karagozoglu, S., Tekyasar, F., & Yilmaz, F. A. (2013). Effects of music therapy and guided visual imagery on chemotherapy-induced anxiety and nausea-vomiting. <i>Journal of Clinical Nursing, 22</i>, 39-50. doi:10.1111/jocn.12030

Katz, M. R., Irish, J. C., & Devins, G. M. (2004). Development and pilot testing of a psychoeducational intervention for oral cancer patients. <i>Psycho-Oncology, 13</i>, 642-653. doi:10.1002/pon.767

Khan, F., Amatya, B., Pallant, J. F., Rajapaksa, I., & Brand, C. (2012). Multidisciplinary rehabilitation in women following breast cancer treatment: A randomized controlled trial. <i>Journal of Rehabilitation Medicine, 44</i>, 788-794. doi:10.2340/16501977-1020

Kim, H. S., Shin, S. J., Kim, S. C., An, S., Rha, S. Y., Ahn, J. B., … Lee, S. (2013). Randomized controlled trial of standardized education and telemonitoring for pain in outpatients with advanced solid tumors. <i>Supportive Care in Cancer, 21</i>, 1751-1759. doi:10.1007/s00520-013-1722-x

Kim, S., & Kim, H. (2005). Effects of a relaxation breathing exercise on anxiety, depression, and leukocyte in hemopoietic stem cell transplantation patients. <i>Cancer Nursing, 28</i>, 79-83. doi:10.1097/00002820-200501000-00012

Kolden, G. G., Strauman, T. J., Ward, A., Kuta, J., Woods, T. E., Schneider, K. L., … Mullen, B. (2002). A pilot study of group exercise training (GET) for women with primary breast cancer: Feasibility and health benefits. <i>Psycho-Oncology, 11</i>, 447-456. doi:10.1002/pon.591

Korstjens, I., Mesters, I., May, A. M., van Weert, E., van den Hout, J. H., Ros, W., … van den Borne, B. (2011). Effects of cancer rehabilitation on problem-solving, anxiety and depression: A RCT comparing physical and cognitive-behavioural training versus physical training. <i>Psychology and Health, 26</i>(Suppl. 1), 63-82. doi:10.1080/08870441003611569

Krischer, M. M., Xu, P., Meade, C. D., & Jacobsen, P. B. (2007). Self-administered stress management training in patients undergoing radiotherapy. <i>Journal of Clinical Oncology, 25</i>, 4657-4662. doi:10.1200/JCO.2006.09.0126

Kutner, J. S., Smith, M. C., Corbin, L., Hemphill, L., Benton, K., Mellis, B. K., … Fairclough, D. L. (2008). Massage therapy versus simple touch to improve pain and mood in patients with advanced cancer: A randomized trial. <i>Annals of Internal Medicine, 149</i>, 369-379. doi:10.7326/0003-4819-149-6-200809160-00003

Kwekkeboom, K. L. (2003). Music versus distraction for procedural pain and anxiety in patients with cancer. <i>Oncology Nursing Forum, 30</i>, 433-440. doi:10.1188/03.ONF.433-440

Lavigne, J. E., Heckler, C., Mathews, J. L., Palesh, O., Kirshner, J. J., Lord, R., & Mustian, K. (2012). A randomized, controlled, double-blinded clinical trial of gabapentin 300 versus 900 mg versus placebo for anxiety symptoms in breast cancer survivors. <i>Breast Cancer Research and Treatment, 136</i>, 479-486. doi:10.1007/s10549-012-2251-x

Lawson, L. M., Williams, P., Glennon, C., Carithers, K., Schnabel, E., Andrejack, A., & Wright, N. (2012). Effect of art making on cancer-related symptoms of blood and marrow transplantation recipients [Online exclusive]. <i>Oncology Nursing Forum, 39</i>, E353-E360. doi:10.1188/12.ONF.E353-E360

Lengacher, C. A., Reich, R. R., Post-White, J., Moscoso, M., Shelton, M. M., Barta, M., … Budhrani, P. (2012). Mindfulness based stress reduction in post-treatment breast cancer patients: An examination of symptoms and symptom clusters. <i>Journal of Behavioral Medicine, 35</i>, 86-94. doi:10.1007/s10865-011-9346-4

Li, W. H., Chung, J. O., & Ho, E. K. (2011). The effectiveness of therapeutic play, using virtual reality computer games, in promoting the psychological well-being of children hospitalised with cancer. <i>Journal of Clinical Nursing, 20</i>, 2135-2143. doi:10.1111/j.1365-2702.2011.03733.x

Li, X. M., Zhou, K. N., Yan, H., Wang, D. L., & Zhang, Y. P. (2012). Effects of music therapy on anxiety of patients with breast cancer after radical mastectomy: A randomized clinical trial. <i>Journal of Advanced Nursing, 68</i>, 1145-1155. doi:10.1111/j.1365-2648.2011.05824.x

Liao, M. N., Chen, P. L., Chen, M. F., & Chen, S. C. (2010). Effect of supportive care on the anxiety of women with suspected breast cancer. <i>Journal of Advanced Nursing, 66</i>, 49-59.

Lin, M. F., Hsieh, Y. J., Hsu, Y. Y., Fetzer, S., & Hsu, M. C. (2011). A randomized controlled trial of the effect of music therapy and verbal relaxation on chemotherapy-induced anxiety. <i>Journal of Clinical Nursing, 20</i>, 988-999. doi:10.1111/j.1365-2702.2010.03525.x

Liu, C. J., Hsiung, P. C., Chang, K. J., Liu, Y. F., Wang, K. C., Hsiao, F. H., … Chan, C. L. (2008). A study on the efficacy of body-mind-spirit group therapy for patients with breast cancer. <i>Journal of Clinical Nursing, 17</i>, 2539-2549. doi:10.1111/j.1365-2702.2008.02296.x

Mañas, A., Ciria, J. P., Fernández, M. C., Gonzálvez, M. L., Morillo, V., Pérez, M., … López-Gómez, V. (2011). Post hoc analysis of pregabalin vs. non-pregabalin treatment in patients with cancer-related neuropathic pain: Better pain relief, sleep and physical health. <i>Clinical and Translational Oncology, 13</i>, 656-663. doi:10.1007/s12094-011-0711-0

Manne, S. L., Ostroff, J. S., Winkel, G., Fox, K., Grana, G., Miller, E., … Frazier, T. (2005). Couple-focused group intervention for women with early stage breast cancer. <i>Journal of Consulting and Clinical Psychology, 73</i>, 634-646.

Mehnert, A., Veers, S., Howaldt, D., Braumann, K. M., Koch, U., & Schulz, K. H. (2011). Effects of a physical exercise rehabilitation group program on anxiety, depression, body image, and health-related quality of life among breast cancer patients. <i>Onkologie, 34</i>, 248-253. doi:10.1159/000327813

Mentes, S. D., Unsal, D., Baran, O., Argun, G., & Ertunc, F. N. (2005). Effect of sedation with midazolam or propofol on patient's comfort during cancer chemotherapy: A prospective, randomized, double-blind study in breast cancer patients. <i>Journal of Chemotherapy, 17</i>, 327-333. doi:10.1179/joc.2005.17.3.327

Midtgaard, J., Rørth, M., Stelter, R., Tveterås, A., Andersen, C., Quist, M., … Adamsen, L. (2005). The impact of a multidimensional exercise program on self-reported anxiety and depression in cancer patients undergoing chemotherapy: A phase II study. <i>Palliative and Supportive Care, 3</i>, 197-208. doi:10.1017/S1478951505050327

Midtgaard, J., Stage, M., Møller, T., Andersen, C., Quist, M., Rörth, M., … Adamsen, L. (2011). Exercise may reduce depression but not anxiety in self-referred cancer patients undergoing chemotherapy. Post-hoc analysis of data from the ‘Body and Cancer’ trial. <i>Acta Oncologica, 50</i>, 660-669. doi:10.3109/0284186X.2010.543145

Miller, D. K., Chibnall, J. T., Videen, S. D., & Duckro, P. N. (2005). Supportive-affective group experience for persons with life-threatening illness: Reducing spiritual, psychological, and death-related distress in dying patients. <i>Journal of Palliative Medicine, 8</i>, 333-343. doi:10.1089/jpm.2005.8.333

Mishra, S. I., Scherer, R. W., Geigle, P. M., Berlanstein, D. R., Topaloglu, O., Gotay, C. C., & Snyder, C. (2012). Exercise interventions on health-related quality of life for cancer survivors. <i>Cochrane Database of Systematic Reviews, 8</i>, CD007566. doi:10.1002/14651858.CD007566.pub2

Molassiotis, A., Bardy, J., Finnegan-John, J., Mackereth, P., Ryder, W. D., Filshie, J., … Richardson, A. (2013). A randomized, controlled trial of acupuncture self-needling as maintenance therapy for cancer-related fatigue after therapist-delivered acupuncture. <i>Annals of Oncology, 24</i>, 1645-1652. doi:10.1093/annonc/mdt034

Monti, D. A., Kash, K. M., Kunkel, E. J., Brainard, G., Wintering, N., Moss, A. S., … Newberg, A. B. (2012). Changes in cerebral blood flow and anxiety associated with an 8-week mindfulness programme in women with breast cancer. <i>Stress and Health, 28</i>, 397-407. doi:10.1002/smi.2470

Mosher, C. E., Duhamel, K. N., Lam, J., Dickler, M., Li, Y., Massie, M. J., & Norton, L. (2012). Randomised trial of expressive writing for distressed metastatic breast cancer patients. <i>Psychology and Health, 27</i>, 88-100. doi:10.1080/08870446.2010.551212

Naaman, S. C., Radwan, K., Fergusson, D., & Johnson, S. (2009). Status of psychological trials in breast cancer patients: A report of three meta-analyses. <i>Psychiatry, 72</i>, 50-69. doi:10.1521/psyc.2009.72.1.50

Nainis, N., Paice, J. A., Ratner, J., Wirth, J. H., Lai, J., & Shott, S. (2005). Relieving symptoms in cancer: Innovative use of art therapy. <i>Journal of Pain and Symptom Management, 31</i>, 162-169. doi:10.1016/j.jpainsymman.2005.07.006

National Cancer Institute. (n.d.). Adjustment to cancer: Anxiety and distress (PDQ®). Retrieved from <a target="_blank" href='http://www.cancer.gov/cancertopics/pdq/supportivecare/adjustment/Patient...

Nguyen, T. N., Nilsson, S., Hellstrom, A. L., & Bengtson, A. (2010). Music therapy to reduce pain and anxiety in children with cancer undergoing lumbar puncture: A randomized clinical trial. <i>Journal of Pediatric Oncology Nursing, 27</i>, 146-155. doi:10.1177/1043454209355983

Nightingale, C. L., Rodriguez, C., & Carnaby, G. (2013). The impact of music interventions on anxiety for adult cancer patients: A meta-analysis and systematic review. <i>Integrative Cancer Therapies, 12</i>, 393-403. doi:10.1177/1534735413485817

Nunes, D. F., Rodriquez, A. L., DaSilva Hoffman, F., Luz, C., Braga Filho, A. P., Muller, M. C., & Bauer, M. E. (2007). Relaxation and guided imagery program in patients with breast cancer undergoing radiotherapy is not associated with neuroimmunomodulatory effects. <i>Journal of Psychosomatic Research, 63</i>, 647-655. doi:10.1016/j.jpsychores.2007.07.004

Oh, P. J., & Kim, S. H. (2010). Effects of a brief psychosocial intervention in patients with cancer receiving adjuvant therapy [Online exclusive]. <i>Oncology Nursing Forum, 37</i>, E98-E104. doi:10.1188/10.ONF.E98-E104

Osborn, R. L., Demoncada, A. C., & Feuerstein, M. (2006). Psychosocial interventions for depression, anxiety and quality of life in cancer survivors: Meta-analysis. <i>International Journal of Psychiatry in Medicine, 36</i>, 13-34. doi:10.2190/EUFN-RV1K-Y3TR-FK0L

Piet, J., Würtzen, H., & Zachariae, R. (2012). The effect of mindfulness-based therapy on symptoms of anxiety and depression in adult cancer patients and survivors: A systematic review and meta-analysis. <i>Journal of Consulting and Clinical Psychology, 80</i>, 1007-1020. doi:10.1037/a0028329

Pilkington, K., Kirkwood, G., Rampes, H., Fisher, P., & Richardson, J. (2006). Homeopathy for anxiety and anxiety disorders: A systematic review of the research. <i>Homeopathy, 95</i>, 151-162. doi:10.1016/j.homp.2006.05.005

Pitceathly, C., Maguire, P., Fletcher, I., Parle, M., Tomenson, B., & Creed, F. (2009). Can a brief psychological intervention prevent anxiety or depressive disorders in cancer patients? A randomised controlled trial. <i>Annals of Oncology, 20</i>, 928-934. doi:10.1093/annonc/mdn708

Post-White, J., Kinney, M. E., Savik, K., Gau, J. B., Wilcox, C., & Lerner, I. (2003). Therapeutic massage and healing touch improve symptoms in cancer. <i>Integrative Cancer Therapies, 2</i>, 332-344. doi:10.1177/1534735403259064

Potter, P. J. (2007). Breast biopsy and distress: Feasibility of testing a Reiki intervention. <i>Journal of Holistic Nursing, 25</i>, 238-248. doi:10.1177/0898010107301618

Quattrin, R., Zanini, A., Buchini, S., Turello, D., Annunziata, M. A., Vidotti, C., … Brusaferro, S. (2006). Use of reflexology foot massage to reduce anxiety in hospitalized cancer patients in chemotherapy treatment: Methodology and outcomes. <i>Journal of Nursing Management, 14</i>, 96-105. doi:10.1111/j.1365-2934.2006.00557.x

Ramachandra, P., Booth, S., Pieters, T., Vrotsou, K., & Huppert, F. A. (2009). A brief self-administered psychological intervention to improve well-being in patients with cancer: Results from a feasibility study. <i>Psycho-Oncology, 18</i>, 1323-1326. doi:10.1002/pon.1516

Rao, M. R., Raghuram, N., Nagendra, H. R., Gopinath, K. S., Srinath, B. S., Diwakar, R. B., … Varambally, S. (2009). Anxiolytic effects of a yoga program in early breast cancer patients undergoing conventional treatment: A randomized controlled trial. <i>Complementary Therapies in Medicine, 17</i>, 1-8. doi:10.1016/j.ctim.2008.05.005

Rasavi, D., Allilaire, J. F., Smith, M., Salimpour, A., Verra, M., Desclaux, B., … Blin, P. (1996). The effect of fluoxetine on anxiety and depression symptoms in cancer patients. <i>Acta Psychiatria Scandinavica, 94</i>, 205-210. doi:10.1111/j.1600-0447.1996.tb09850.x

Rawl, S. M., Given, B. A., Champion, V. L., Kozachik, S. L., Barton, D., Emsley, C. L., & Williams, S. D. (2002). Intervention to improve psychological functioning for newly diagnosed patients with cancer. <i>Oncology Nursing Forum, 29</i>, 967-975. doi:10.1188/02.ONF.967-975

Rottmann, N., Dalton, S. O., Bidstrup, P. E., Würtzen, H., Høybye, M. T., Ross, L., … Johansen, C. (2012). No improvement in distress and quality of life following psychosocial cancer rehabilitation. A randomised trial. <i>Psycho-Oncology, 21</i>, 505-514. doi:10.1002/pon.1924

Schag, C., & Heinrich, R. (1989). Anxiety in medical situations: Adult cancer patients. <i>Journal of Clinical Psychology, 45</i>, 20-27.

Schneider, S. M., & Hood, L. E. (2007). Virtual reality: A distraction intervention for chemotherapy. <i>Oncology Nursing Forum, 34</i>, 39-46. doi:10.1188/07.ONF.39-46

Schnur, J. B., Bovbjerg, D. H., David, D., Tatrow, K., Goldfarb, A. B., Silverstein, J. H., … Montgomery, G. H. (2008). Hypnosis decreases presurgical distress in excisional breast biopsy patients. <i>Anesthesia and Analgesia, 106</i>, 440-444. doi:10.1213/ane.0b013e31815edb13

Schofield, P., Jefford, M., Carey, M., Thomson, K., Evans, M., Baravelli, C., & Aranda, S. (2008). Preparing patients for threatening medical treatments: Effects of a chemotherapy educational DVD on anxiety, unmet needs, and self-efficacy. <i>Supportive Care in Cancer, 16</i>, 37-45. doi:10.1007/s00520-007-0273-4

Serfaty, M., Wilkinson, S., Freeman, C., Mannix, K., & King, M. (2012). The ToT study: Helping with Touch or Talk (ToT): A pilot randomised controlled trial to examine the clinical effectiveness of aromatherapy massage versus cognitive behaviour therapy for emotional distress in patients in cancer/palliative care. <i>Psycho-Oncology, 21</i>, 563-569. doi:10.1002/pon.1921

Serra, D., Parris, C. R., Carper, E., Homel, P., Fleishman, S. B., Harrison, L. B., & Chadha, M. (2012). Outcomes of guided imagery in patients receiving radiation therapy for breast cancer. <i>Clinical Journal of Oncology Nursing, 16</i>, 617-623. doi:10.1188/12.CJON.617-623

Sharp, D. M., Walker, M. B., Chaturvedi, A., Upadhyay, S., Hamid, A., Walker, A. A., … Walker, L. G. (2010). A randomized, controlled trial of the psychological effects of reflexology in early breast cancer. <i>European Journal of Cancer, 46</i>, 312-322. doi:10.1016/j.ejca.2009.10.006

Sheldon, L., Harris, D., & Arcieri, C. (2012). Psychosocial concerns in cancer care: The role of the oncology nurse. <i>Clinical Journal of Oncology Nursing, 16</i>, 316-319. doi:10.1188/12.CJON.316-319

Sheldon, L. K., Swanson, S., Dolce, A., Marsh, K., & Summers, J. (2008). Putting Evidence Into Practice: Evidence-based interventions for anxiety. <i>Clinical Journal of Oncology Nursing, 12</i>, 789-797. doi:10.1188/08.CJON.789-797.

Shepherd, L., Goldstein, D., Whitford, H., Thewes, B., Brummell, V., & Hicks, M. (2006). The utility of videoconferencing to provide innovative delivery of psychological treatment for rural cancer patients: Results of a pilot study. <i>Journal of Pain and Symptom Management, 32</i>, 453-461. doi:10.1016/j.jpainsymman.2006.05.018

Shields, C. G., Ziner, K. W., Bourff, S. A., Schilling, K., Zhao, Q., Monahan, P., … Champion, V. (2010). An intervention to improve communication between breast cancer survivors and their physicians. <i>Journal of Psychosocial Oncology, 28</i>, 610-629. doi:10.1080/07347332.2010.516811

Skrutkowski, M., Saucier, A., Eades, M., Swidzinski, M., Ritchie, J., Marchionni, C., & Ladouceur, M. (2008). Impact of a pivot nurse in oncology on patients with lung or breast cancer: Symptom distress, fatigue, quality of life, and use of healthcare resources. <i>Oncology Nursing Forum, 35</i>, 948-954. doi:10.1188/08.ONF.948-954

Sloman, R. (2002). Relaxation and imagery for anxiety and depression control in community patients with advanced cancer. <i>Cancer Nursing, 25</i>, 432-435. doi:10.1097/00002820-200212000-00005

Snow, A., Dorfman, D., Warbet, R., Cammarata, M., Eisenman, S., Zilberfein, F., … Navada, S. (2012). A randomized trial of hypnosis for relief of pain and anxiety in adult cancer patients undergoing bone marrow procedures. <i>Journal of Psychosocial Oncology, 30</i>, 281-293. doi:10.1080/07347332.2012.664261

Stark, D., Kiely, M., Smith, A., Velikova, G., House, A., & Selby, P. (2002). Anxiety disorders in cancer patients: Their nature, associations, and relation to quality of life. <i>Journal of Clinical Oncology, 20</i>, 3137-3148.

Stephenson, N. L., Swanson, M., Dalton, J., Keefe, F. J., & Engelke, M. (2007). Partner-delivered reflexology: Effects on cancer pain and anxiety. <i>Oncology Nursing Forum, 34</i>, 127-132. doi:10.1188/07.ONF.127-132

Sturgeon, M., Wetta-Hall, R., Hart, T., Good, M., & Dakhil, S. (2009). Effects of therapeutic massage on the quality of life among patients with breast cancer during treatment. <i>Journal of Alternative and Complementary Medicine, 15</i>, 373-380. doi:10.1089/acm.2008.0399

Suzuki, N., Ninomiya, M., Maruta, T., Hosonuma, S., Yoshioka, N., Ohara, T., … Ishizuka, B. (2011). Clinical study on the efficacy of fluvoxamine for psychological distress in gynecologic cancer patients. <i>International Journal of Gynecological Cancer, 21</i>, 1143-1149. doi:10.1097/IGC.0b013e3181ffbeb9

Targ, E. F., & Levine, E. G. (2002). The efficacy of a mind-body-spirit group for women with breast cancer: A randomized controlled trial. <i>General Hospital Psychiatry, 24</i>, 238-248. doi:10.1016/S0163-8343(02)00191-3

Thorsen, L., Skovlund, E., Stromme, S. B., Hornslien, K., Dahl, A. A., & Fossa, S. D. (2005). Effectiveness of physical activity on cardiorespiratory fitness and health-related quality of life in young and middle-aged cancer patients shortly after chemotherapy. <i>Journal of Clinical Oncology, 23</i>, 2378-2388. doi:10.1200/JCO.2005.04.106

Thyme, K. E., Sundin, E. C., Wiberg, B., Öster, I., Åström, S., & Lindh, J. (2009). Individual brief art therapy can be helpful for women with breast cancer: A randomized controlled clinical study. <i>Palliative and Supportive Care, 7</i>, 87-95. doi:10.1017/S147895150900011X

Torta, R., Leombruni, P., Borio, R., & Castelli, L. (2011). Duloxetine for the treatment of mood disorder in cancer patients: A 12-week case-control clinical trial. <i>Human Psychopharmacology, 26</i>, 291-299. doi:10.1002/hup.1202

Torta, R., Siri, I., & Caldera, P. (2008). Sertraline effectiveness and safety in depressed oncological patients. <i>Supportive Care in Cancer, 16</i>, 83-91. doi:10.1007/s00520-007-0269-0

Tsang, K. L., Carlson, L. E., & Olson, K. (2007). Pilot crossover trial of Reiki versus rest for treating cancer-related fatigue. <i>Integrative Cancer Therapies, 6</i>, 25-35. doi:10.1177/1534735406298986

Ulger, O., & Yagli, N. V. (2010). Effects of yoga on the quality of life in cancer patients. <i>Complementary Therapies in Clinical Practice, 16</i>, 60-63. doi:10.1016/j.ctcp.2009.10.007

Vadiraja, H. S., Raghavendra, R. M., Nagarathna, R., Nagendra, H. R., Rekha, M., Vanitha, N., … Kumar, V. (2009). Effects of a yoga program on cortisol rhythm and mood states in early breast cancer patients undergoing adjuvant radiotherapy: A randomized controlled trial. <i>Integrative Cancer Therapies, 8</i>, 37-46. doi:10.1177/1534735409331456

Wald, T. G., Kathol, R. G., Noyes, R., Jr., Carroll, B. T., & Clamon, G. H. (1993). Rapid relief of anxiety in cancer patients with both alprazolam and placebo. <i>Psychosomatics, 34</i>, 324-332. doi:10.1016/S0033-3182(93)71866-6

Weller, M., Cosmos, E., DeBruyn, J., & Brader, K. (2008). The use of energy healing for ovarian cancer patients. <i>Society of Gynecologic Nurse Oncologists, 18</i>, 29-33.

White, V. M., Macvean, M. L., Grogan, S., D'Este, C., Akkerman, D., Ieropoli, S., … Sanson-Fisher, R. (2012). Can a tailored telephone intervention delivered by volunteers reduce the supportive care needs, anxiety and depression of people with colorectal cancer? A randomised controlled trial. <i>Psycho-Oncology, 21</i>, 1053-1062. doi:10.1002/pon.2019

Wilkinson, S., Barnes, K., & Storey, L. (2008). Massage for symptom relief in patients with cancer: Systematic review. <i>Journal of Advanced Nursing, 63</i>, 430-439. doi:10.1111/j.1365-2648.2008.04712.x

Wilkinson, S. M., Love, S. B., Westcombe, A. M., Gambles, M. A., Burgess, C. C., Cargill, A., … Ramirez, A. J. (2007). Effectiveness of aromatherapy massage in the management of anxiety and depression in patients with cancer: A multicenter randomized controlled trial. <i>Journal of Clinical Oncology, 25</i>, 532-539. doi:10.1200/JCO.2006.08.9987

Williams, S. A., & Schreier, A. M. (2004). The effect of education in managing side effects in women receiving chemotherapy for treatment of breast cancer [Online exclusive]. <i>Oncology Nursing Forum, 31</i>, E16-E23. doi:10.1188/04.ONF.E16-E23

Würtzen, H., Dalton, S. O., Elsass, P., Sumbundu, A. D., Steding-Jensen, M., Karlsen, R. V., … Johansen, C. (2013). Mindfulness significantly reduces self-reported levels of anxiety and depression: Results of a randomised controlled trial among 336 Danish women treated for stage I-III breast cancer. <i>European Journal of Cancer, 49</i>, 1365-1373. doi:10.1016/j.ejca.2012.10.030

Wyatt, G., Sikorskii, A., Rahbar, M. H., Victorson, D., & You, M. (2012). Health-related quality-of-life outcomes: A reflexology trial with patients with advanced-stage breast cancer. <i>Oncology Nursing Forum, 39</i>, 568-577. doi:10.1188/12.ONF.568-577

Wysocki, W. M., Mitus, J., Komorowski, A. L., & Karolewski, K. (2012). Impact of preoperative information on anxiety and disease-related knowledge in women undergoing mastectomy for breast cancer. <i>Acta Chirurgica Belgica, 112</i>, 111-115.