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Juggling Worry, Stress, and Anxiety.

May 1, 2023

By Anne Dabbs, 
NCAN TN Support Group Leader, NET Patient

However your neuroendocrine cancer life began, whether by a long diagnostic journey, or via a seemingly unrelated health concern, you’ve probably experienced at least one of these angst provoking emotions on a reoccurring basis. Once a cancer diagnosis is confirmed, it is possible that all three of these paralyzing emotions can become a routine part of your average day.

A 2017 study by the Anxiety and Depression Association of America reported that three out of four citizens experienced feeling stressed in any given month. Constant stress is a burden on our mental and physical well being. Worry and anxiety are prime culprits for inducing stress. As neuroendocrine cancer patients, we owe it to ourselves to understand the differences of these emotions and how to best manage them.

Journalist Emma Pattee’s article about the differences of these three emotions was published in the New York Times in February 2020. The article shares a universal application of these challenges and offers basic strategies for dealing with them. I have found the suggestions most applicable for those of us with an incurable cancer diagnosis.

Worry is a constant, repetitive, obsession which becomes the cognitive component of anxiety. The effects of worry stay in your mind. Worry is actually an important stimulator of our brains. Worry, should cause us to problem solve or to take action to resolve a situation. Once we have solved the problem and taken action to resolve it, that worry should leave our mind. Appropriate worry helps to keep us safe. It is only when an individual gets stuck on a problem that worry stops being an asset and becomes a liability. In order for worry to be helpful, it must lead to change.

2 tips from Emma Pattee to help manage your worries:
1) Give yourself a “Worry Budget”.
If a short allotted amount of time to worry about a particular situation does not offer a solution or action, redirect your thoughts.

2) Write them down.
Seeing your concerns written out instead of churning in your mind can lead to action toward a solution.

Stress is provoked by external circumstances. It is the physiological response to that event, and occurs when your emotional resources have been exceeded by an external, environmental change or force. Stress is a natural and appropriate response to a threat. “Fight or flight” is a behavioral response to stress. Stress can be beneficial. As cortisol and adrenaline rush through your body you may receive that burst of energy to catch an item before it falls or to quickly to finish a task within its final hour. This stress is “Acute Stress” and it wears off once the situation is resolved.

Chronic Stress, however, is when your concerns/worries do not leave your body. The external stressors such as health conditions, financial issues, can’t be easily or quickly resolved. Chronic Stress is directly linked to numerous health concerns, and can truly make us sick.

3 Tips To Help Manage Stress:
1) Get Exercise.
This can help recover from the increase of cortisol and adrenaline in your body.

2) Understand what you can and cannot control.
Control the situations you can and learn to accept those you can’t. “Redefine” that which you cannot control so that it becomes acceptable to you.

3) Don’t compare your stress to anyone else’s stress.
No one has the exact same stimulants or resolutions. We all react differently.

Anxiety occurs when you experience both worry (the cognitive element) and stress (the physiological element) at the same time dealing with any given situation.
Worry + Stress = Anxiety. If stress is considered to be a natural response to a threat, anxiety is the same thing, but there is no threat. Anxiety is an overreaction to stress and worry. Your body begins to over respond to normal everyday life. Anxiety is not a beneficial emotion.

3 Tips To help Manage Anxiety:
1) Limit external stimulants such as caffeine and sugar.
Anxiety is physiological, and these items can impact your emotional responses.

2) Refocus.
A popular and effective tool for managing anxiety is the 54321 Technique. When you sense that your anxiety is about to boil over, count 5 things you can see, 4 things you can touch, 3 things can can hear, 2 things can smell, and 1 thing you can taste. This simple exercise can redirect your over-racing mind and allow you to take a deep breath.

3) Break the anxiety cycle.
Talking about it or thinking about it does not help as your brain churns out of control. Utilize your senses to distract yourself. Trying to think your way out of an anxiety episode will not be helpful. Anxiety occurs in both your mind and your body. Both need redirection.

Worries and Stressors are an everyday occurrence for all of us. Cancer patients can understandably have an over abundance. When you find your worry and stress becoming anxiety building, please utilize these tips to help you juggle your emotions into a manageable state. Correctly and promptly identifying which of these three emotions is causing you angst at any given time will assist you in using these strategies to reduce or even eliminate the distractions. Always seek professional advice from your doctors or mental health therapists if your anxiety includes harmful thoughts. And please remember that NCAN is with you along this journey and are ready to offer help and encouragement whenever you need it. Just give us a CALL. A patient or caregiver is here to help.

Find out more about how YOU can help the NET Community.


Disclaimer: NCAN blog posts are the opinions of its writers and are not intended as a replacement for medical advice. Please consult your Health Care Providers for individual concerns.


  1. REPLY
    TIna says

    Totally needed this one. Thank you Anne.

  2. REPLY
    Nancy says

    One of Anne’s best blogs!

  3. REPLY
    Alysia Christensen says

    Thanks for posting this Anne! Before I was diagnosed, I don’t think that I had ever had anxiety issues a day in my life. Now I do for sure! I will try to follow some of these suggestions as it’s happening more and more!

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