In this issue of ISNCC Academic Express, we highlight research led by Prof. Kailei Yan from the College of Nursing, University of Central Florida, USA. The study examines anxiety trajectories among cancer patients receiving active treatment and identifies factors associated with persistent anxiety.

This research underscores that anxiety during cancer treatment is not one-size-fits-all. By assessing emotional distress over time and supporting patients’ coping self-efficacy, oncology nurses can identify high-risk patients earlier, address anxiety alongside physical symptoms, and promote patient-centred, evidence-based cancer care.

Why we chose this research topic?

Anxiety remains a common and clinical important concern in cancer care. It is especially relevant during active treatment, when many patients experience clinically significant anxiety that may persist, worsen co-existing symptoms, reduce quality of life, and contribute to poorer adjustment and health outcomes. For many patients, it is part of the treatment experience itself. However, anxiety does not look the same for everyone. For cancer nurses, this means anxiety care cannot be “one-size-fits-all.”

What we discovered?

Our study confirmed that cancer patients on active treatments showed different anxiety trajectories over time. Some patients had consistently low anxiety, some had moderate and relatively stable anxiety, and many experienced high anxiety throughout treatment. Younger patients were more likely to be in the high-anxiety group. Patients with stronger cancer coping self-efficacy were more likely to have lower anxiety over time.

We also found that anxiety was closely connected with the broader symptom experience. Patients in the high-anxiety group more likely to report including depression, nausea, and difficulty concentrating. High anxiety group had higher number of symptoms, more symptom communication barrier. Importantly, high anxiety was also linked with poorer quality of life, more emergency department visits, more hospitalizations, and greater use of hospital resources.

Implication for cancer care

Anxiety can change over time, thus, nurses should assess emotional distress not only at diagnosis but throughout the treatment journey. Regular screening can help identify patients who are at risk for persistent or worsening anxiety and connect them with support earlier.

Our findings also suggest that cancer nurses should pay close attention to patients who may be more vulnerable, including younger adults and those with lower confidence in their ability to cope with cancer-related challenges. Nursing care can help strengthen coping self-efficacy through education, symptom-management guidance, emotional support, and practical strategies for managing uncertainty during treatment.

Because anxiety is closely tied to physical symptoms, it should be addressed as part of whole-person symptom management. Nurses can help patients manage symptom clusters by assessing anxiety alongside pain, fatigue, nausea, sleep disturbance, depression, and cognitive concerns. They can also reduce communication barriers by encouraging patients to report symptoms early and by creating timely opportunities to discuss emotional distress.

Overall, anxiety management should be viewed as an essential component of high-quality cancer care. By identifying high-risk patients early, supporting coping skills, improving symptom communication, and coordinating timely referrals, nurses can help improve patients’ quality of life and may also reduce avoidable emergency department visits, hospitalizations, and healthcare resource use.

Source：

 Yan, K., Kim, E., Small, B., Wang, H. L., Elliott, A., & Loerzel, V. (2026). Anxiety trajectories in cancer patients during active treatments: Clusters, influencing factors, and impact on quality of life and health service utilization. Journal of affective disorders, 408, 121900. Advance online publication. https://doi.org/10.1016/j.jad.2026.121900.