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NCCN Guidelines for Patients



Distress, Version 1.2017


What help is there?


Your chances for a substance use disorder are very

low if you haven’t had a problem before. Poor control

of cancer-related symptoms may increase your

chances of developing a substance problem.

You should have a thorough evaluation if you

have had substance use disorder. Current use of

some substances may require detox. After detox,

specialized treatment programs to help you stay

clean or sober are advised. If you haven’t had a

recent problem, be aware that relapse may occur

under the stress of cancer. Joining a risk reduction

program may be a good option.

Complementary and integrative therapies

Complementary therapies are non-standard

treatments given with standard treatments. An

example is yoga given with psychotherapy. Some

people call complementary therapies by a different

name—integrative therapies. Others refer to the

practice of providing both complementary and

standard treatments as integrative therapy (or

integrative medicine).

There is proof that complementary therapies improve

mental health among people with cancer. One study

reviewed 203 clinical trials. The study found that

meditation, yoga, relaxation with imagery, massage,

and music therapy might be helpful for depression

among women with breast cancer. Music therapy,

meditation, and yoga may also reduce anxiety.


Some people know that exercise can improve health

among people with cancer. Fewer people know that

exercise may also improve quality of life and mental

health. More research is needed to learn how well

exercise treats mental health among people with





Learning more about cancer may reduce




A chaplain can meet your spiritual needs

through counseling, prayer, and other services.



Practical problems in life may be solved by

learning new information or skills, counseling,

attending support groups, and connecting with

community resources.



Psychosocial problems may be relieved by new

information, counseling and supportive groups,

and community assistance.



Mental health services for distress are based

on an evaluation. Psychoeducation may be

helpful for some people while others greatly

benefit from medication, psychotherapy, or

both. People struggling with drugs, alcohol, or

tobacco problems need substance treatment.

Complementary therapy and exercise appear to

improve mood and reduce anxiety.