Coping with cancer: Acceptance and commitment therapy

September 16, 2021 Swedish Cancer Team

people sitting in a circle talking at a cancer support group


In this article:

  • Coping with cancer includes caring for your mental health.

  • Acceptance and commitment therapy (ACT) can help patients and survivors deal with fears about uncertainty and recurrence.

  • A Swedish oncology social worker explains how ACT helps patients take action based on their personal values.

Learning that you have been diagnosed with cancer can be a traumatic experience. Going through treatment can be a long and difficult process, and when you finish treatment it can be difficult to fully accept that it is finally over. Others around you may feel relief and they might want to celebrate, but for someone who has actually endured the treatments, those reactions can differ greatly.

Fear, anxiety and uncertainty are common feelings to experience after treatment has ended. Then there is the fear of cancer recurrence that can be easily triggered by follow-up appointments, hearing about others’ diagnoses and feeling the physical effects of post-treatment consequences. What can be done about these feelings? Is it possible to rid yourself of these feelings?

These feelings are normal, but that does not mean you have to accept that you will feel worried or anxious for the rest of your life. You can seize the opportunity to reduce these anxieties and improve your mental state of mind. Acceptance and Commitment Therapy (ACT) is a type of therapy that is used to help patients with cancer cope with anxiety and depression that accompany their diagnosis, treatment or recurrence. ACT uses strategies to help mitigate fear of cancer recurrence through mindful behavior, attention to personal values and commitment to action. These strategies can help you accept that, while your concerns are real and valid, you are still able to lead a meaningful life despite these concerns.

I sat down with Rachel Cox, an oncology social worker who has worked at Swedish for over 13 years, to get insight on frequently asked questions about ACT. Here’s what she had to say:

What are the goals of ACT?

The goal is to take action in a way that reflects your values and to focus on what is important to you. It aims to maximize the quality of your life while at the same time handling the pain that goes with it. ACT helps to stop fighting your past and emotions and, instead, start practicing more confident and optimistic behavior based on your values and goals by accepting all thoughts, emotions and feelings — good or bad.

How can ACT help patients with cancer cope with fear of recurrence?

ACT can help patients with cancer come to terms with their thoughts and feelings. Although they may always have fears of recurrence, ACT helps them live their best lives despite these worries. Fighting these thoughts will not make them disappear, it just results in lost time that could have been dedicated to doing something more meaningful — something that can improve their lives.

How exactly does ACT work?

The practices involved in ACT are not linear, they are flexible — they help patients take actions that are guided by their own personal values rather than avoidance out of fear. ACT aims to help patients clarify their values so that they are able to take action to make their lives more meaningful, which increases their psychological flexibility. In other terms, this means holding our thoughts and emotions more lightly and acting on long-term values and goals rather than short-term thoughts and feelings. Studies that have analyzed the effect of ACT on patients with cancer found that the changes in psychological flexibility often predicted changes in the quality of life, level of distress and mood.

What is cognitive behavioral therapy (CBT)? What are the similarities and differences between ACT and CBT?

Cognitive behavioral therapy (CBT) is a commonly used therapy that focuses on changing negative thought patterns and eliminating unpleasant feelings and emotions by recognizing your emotions, targeting how you feel by acknowledging your fears and grounding yourself in the present. ACT and CBT are both behavior-based therapies and can help treat depression and anxiety.

ACT focuses on accepting and noticing your thoughts and feelings and then acting in a way that supports your longer-term values and goals.

Find a doctor

If you have questions about how ACT can help you cope with cancer, contact Counseling & Support at the Swedish Cancer Institute. We can accommodate both in-person and virtual visits.

Whether you require an in-person visit or want to consult a doctor virtually, you have options. Swedish Virtual Care connects you face-to-face with a nurse practitioner who can review your symptoms, provide instruction and follow up as needed. If you need to find a doctor, you can use our provider directory.

Join our Patient and Family Advisory Council.

Additional resources 

Helping cancer survivors cope with cancer-related anxiety and Distress — National Cancer Institute

Fear of cancer recurrence: Mind-body tools offer hope — Harvard Health Publishing

Coping with the fear of recurrence — CancerCare

This information is not intended as a substitute for professional medical care. Always follow your health care professional's instructions.

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About the Author

The Swedish Cancer Team is committed to bringing you the most up-to-date insights about treatments, prevention, care and support available. We know cancer diagnoses strain you both mentally and physically, and we hope to provide a small piece of hope to you or your loved ones who are fighting the cancer battle with useful and clinically-backed advice.

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