Part 1: Can Medication Help Mesothelioma Survivors With Anxiety?

This is Part 1 of a two-part series looking at ways to help mesothelioma survivors manage anxiety symptoms. Part 2 explores complementary medicine approaches.

As a psychotherapist specializing in working with mesothelioma patients, I speak with many survivors who experience anxiety and seek relief. Symptoms of anxiety and depression top the list of mental health issues that mesothelioma patients, and cancer patients in general, cope with throughout treatment. 

In recent decades, there has been a significant increase in research on the mental health needs of cancer patients. Depending on how the study defines the severity and types of anxiety symptoms,  between 10%-45% of people diagnosed with cancer report symptoms of anxiety. 

Anxiety is a very common occurrence when living with a mesothelioma diagnosis. Seeking counseling and/or medication to reduce anxiety symptoms can bring relief from those uncomfortable symptoms. 

Causes of Anxiety in Mesothelioma Patients

In our mesothelioma support group via The Mesothelioma Center, we discuss stresses that can cause anxiety. Some of the most common concerns discussed are fear of disease symptoms, treatment effects, pain and the unknown progression of their disease.

Common Causes of Anxiety Symptoms

• How will I feel after HIPEC surgery for peritoneal mesothelioma?
• Will it be painful?
• How will immunotherapy make me feel?
• Will I be too tired to do anything?
• How will I know if my treatment is working?
• How do the doctors know if treatment is working?
• What happens if chemo doesn’t work?

Discussing your concerns with others with similar experiences in support groups can help. Our private Facebook group exclusively for those with mesothelioma and their caregivers can also offer a safe space to discuss anxieties. 

Talk to your doctor about your concerns and questions. Learning as much as possible about mesothelioma and treatment from your healthcare team and patient advocates can help as well.

Symptoms of Anxiety

Anxiety symptoms can be broken down into different types. You may experience physical symptoms, emotional symptoms and cognitive (thoughts) symptoms.

Symptoms of Anxiety

• Anger
• Crying
• Constant worrying
• Dizziness
• Fear
• Feeling hot or flushed
• Headaches
• Helplessness
• Increased heart rate and blood pressure
• Indigestion or gastrointestinal problems
• Jitteriness or shaking
• Muscle tension
• Poor concentration
• Racing negative thoughts
• Sense of dread
• Shortness of breath
• Sweating

Not everyone experiences anxiety the same way nor has the same symptoms. The way you feel and the way you think can all be impacted. 

Anxiety Treatment Options in Addition to Therapy

Treatment recommendations for cancer patients struggling with anxiety symptoms begin with psychotherapy – also called counseling or talk therapy. This includes teaching patients about anxiety and offering ways that patients can manage those symptoms with changing thinking or behaviors. 

However, sometimes anxiety symptoms are too severe. It may be most helpful then for counseling to be combined with medication management. Your primary care physician or psychiatrist will evaluate you and help you choose a care plan that’s best for your individual needs.

There are a variety of types of prescription anxiety medications that may benefit you. Discuss your questions, concerns and all other medications and supplements you’re taking with your doctor before starting any new medications for anxiety.

Benzodiazepines 

These medications are very effective in reducing anxiety symptoms quickly. However, these medications should only be used short-term as they can be habit forming. Benzodiazepines can be taken as needed.

Types of Benzodiazepines

• Ativan (lorazepam)
• Klonopin (clonazepam)
• Xanax (alprazolam)

Some users complain that these medications are sedating. They may affect the ability to drive or complete other necessary tasks. 

Antidepressants

Some people are surprised when they are prescribed an antidepressant for anxiety symptoms. However, several antidepressants have been shown to reduce symptoms of several anxiety disorders. 

The two classes of antidepressants used to treat anxiety are: Selective serotonin reuptake inhibitors and serotonin and norepinephrine reuptake inhibitors.

SSRIs Commonly Used for Anxiety

• Celexa (citalopram)
• Lexapro (escitalopram)
• Luvox (fluvoxamine)
• Paxil (paroxetine)
• Prozac (fluoxetine)
• Zoloft (sertraline)

SNRIs and SSRIs can take up to 4-6 weeks to reduce anxiety symptoms. They must be taken daily.

SNRIs Commonly Used for Anxiety

• Cymbalta (duloxetine)
• Effexor (venlafaxine)

These medications are considered safer than other medications such as benzodiazepines. They’re not habit forming and typically are not sedating.

Sleep Medications, Beta-Blockers and BuSpar

Some medications used to treat anxiety symptoms may surprise people. For example, the off-label use of medications used to treat heart conditions has been found to help manage anxiety symptoms in some patients. 

Beta-blockers are typically used to treat high blood pressure. Some physicians, however, will prescribe a beta-blocker off-label for anxiety if there are contraindications for using another type of anti-anxiety medication. 

As a recent study published in the journal Cardiovascular Research noted: “…captopril reduced anxiety behaviour, as did candesartan and losartan… valsartan, irbesartan, and telmisartan exerted an antidepressant effect, indicating that AT1R stimulation is involved in controlling the cognitive and behavioural responses to stress and anxiety.”

Sleep medications may also be prescribed if anxiety is preventing a person from falling or staying asleep. These medications are approved for temporary relief from sleep problems.

Off-Label Use of Sleep Medications for Anxiety

• Ambien (zolpidem)
• Lunesta (eszopiclone)

One medication approved as an anti-anxiety drug, BuSpar, is neither an SSRI nor an SNRI. BuSpar is the brand name for buspirone. 

According to the National Library of Medicine, buspirone is “used to treat anxiety disorders or in the short-term treatment of symptoms of anxiety.” The drug changes “the amounts of certain natural substances in the brain.”

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