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
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
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.