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NCCN Guidelines for Patients



Distress, Version 1.2017


What is distress?

Distress defined

Part 1 explains the basics about distress.

You can learn what distress is and how it

may affect your life. Part 1 also describes

who may have higher levels of distress.

Likewise, the time points at which distress

is more likely are listed.

Distress defined

Distress is an unpleasant experience of a mental,

physical, social, or spiritual nature. It can affect the

way you think, feel, or act. Distress may make it

harder to cope with having cancer, its symptoms, or

its treatment.

Distress occurs across a range of experience. It

can be mild and consist of common feelings like

sadness, fear, and helplessness. On the other hand,

it can be more severe. Higher levels of distress can

cause problems in one or more areas of life. You may

struggle with taking care of yourself, your social life,

emotions, faith, and so forth.

Everyone with cancer has some distress at some

point in time. It is normal to feel sad, fearful, and

helpless. You are not “crazy” if you are distressed.

Distress is expected.

There are many symptoms of distress. See

Guide 1

. The type and number of symptoms differ

between people. Certain symptoms can be caused

by things other than distress. Thus, it is important

to tell your treatment team if you have any of these

symptoms. Tips for talking with your cancer care

team are given in Part 4.

Guide 1. Symptoms of distress

Some symptoms of distress are:

• Sadness, fear, and helplessness

• Anger, feeling out of control

• Questioning your faith, your purpose, the meaning

of life

• Pulling away from too many people

• Concerns about illness

• Concerns about your social role (ie, as mother,

father, caregiver)

• Poor sleep, appetite, or concentration

• Depression, anxiety, panic

• Frequent thoughts of illness and death