it is known as the fast enemy that should be treated and destroyed very fast as well . most women do not like to hear the word cancer , and feel worried and stressed over it . it can be the beginning of learning how to fight , getting the facts , and finding hope . this is followed by lack of patient 's personal control over the current treatment method and uncertainty of its outcome . therefore , anxiety is associated with cancer ; it is the most prevalent psychological symptoms perceived by cancer patients as a response to a threat , and so many patients are anxious . in one study done by ashbury et al , 77% of 913 patients within 2 years of treatment recalled experiencing anxiety . however , anxiety after cancer diagnosis is not necessarily abnormal , may not present a problem , or may even be a constructive part of dealing with problems . the most common cancer and the number one cause of cancer death amongst women in malaysia is breast cancer . if not detected and treated promptly , breast cancer can metastasize , spreading to the lymph glands and other parts of the body including the lungs , bones , and liver . usually , cancer is named after the body part in which it originated ; thus , breast cancer refers to the erratic growth and proliferation of cells that originate in the breast tissue . the term breast cancer refers to a malignant tumor that has developed from cells in the breast . the breast is composed of two main types of tissues : glandular tissues and stromal ( supporting ) tissues . glandular tissues house the milk - producing glands ( lobules ) and the ducts ( the milk passages ) , while stromal tissues include fatty and fibrous connective tissues of the breast . the breast is also made up of lymphatic tissue - immune system tissue that removes cellular fluids and waste . breast cancer is characterized by the uncontrolled growth of abnormal cells in the milk - producing glands of the breast or in the passages ( ducts ) that deliver milk to the nipples . the early stage of breast cancer usually refers to the cancer that is confined to the fatty tissue of the breast . it may then spread to underlying tissues of the chest wall and then to other parts of the body . furthermore , worldwide , breast cancer is the leading cause of cancer death in women , and more than one million women are diagnosed each year . in addition to that , more than 500,000 women every year die from the disease worldwide . anxiety , tension , worry , stress , and strain are all common feelings and it is a part of our life today . simple worry or stress will not drive us to look for specialist , but when these feelings become a chronics and interfere with our lives we need to do something and look for ways to manage it in order to function well . anxiety can be defined as an unpleasant subjective experience associated with the perception of real threat ; therefore , it is a common symptom in connection with cancer . furthermore , it can be described as an emotional state characterized by feelings of unpleasant expectation and a sense of imminent danger . according to stark , et al . autonomic hyper - arousal with acceleration of heart rate and respiration , tremor , sweating , muscle tension , and gastrointestinal changes are common physiological experiences . apprehension , feeling powerless , and fearing loss of control are psychological aspects . according to kazdin , anxiety is an emotion that characterized by feelings of tension , worry , and stress as well as physiological changes such as increased blood pressure . furthermore , medical news today defines anxiety as  a general term for several disorders that cause nervousness , fear , apprehension , and worrying . these disorders affect how we feel and behave , and they can manifest real physical symptoms . mild anxiety is vague and unsettling , while severe anxiety can be extremely debilitating , having a serious impact on daily life  . . we may worry about things that might happen or have a restless night of sleep . but , people with an anxiety problem worry so much that it affects their lives in negative ways . as stated above , anxiety is one of the most dominant psychological challenges associated with cancer . in another word , patients anxiety increases once they discover that they suffer from breast cancer , they may also become more anxious as cancer spreads or treatment becomes more intense . consequently , the level of anxiety experienced by one person with cancer may differ from the anxiety experienced by another . many anxiety cases associated with cancer were treated from this sickness , but others were not . therefore , psychologists need to give support and hope to breast cancer 's patients ; they need to help them cope with their feeling and pain . moreover , cancer 's patients may experience anxiety at different situation as while undergoing a screening test , waiting for the results , receiving a diagnosis , undergoing treatment , or anticipating a recurrence of their cancer . the anxiety associated with cancer may increase feelings of pain , interfere their ability to sleep , causes nausea and vomiting , and interfere with their quality of life . and for most patients , cancer requires facing uncertainty , worries about cancer treatment effects , fear of cancer progression and death , guilt , and spiritual questioning . a study by ashbury et al . , indicated that 77% of patients within 2 years of treatment recalled experiencing anxiety . on the other hand , anxiety after cancer diagnosis is not necessarily to be normal , understanding the nature of the anxiety in cancer patient populations is important because abnormal anxiety is troublesome the psychological wellbeing of the patients sherbourne and sheard . interviewing some breast cancer patients reported that their anxiety is characterized by a number of typical symptoms and signs such as shivering or tremor . the level of anxiety experienced by one person may differ from the level of anxiety experienced by another . anxiety in breast cancer patients is associated with death anxiety , fear of death as a result of their symptoms . according to pollak this type of anxiety is lower for people who have a positive sense of well - being and sense of meaning in life . in addition , evidence indicates that religious beliefs influence their level of anxiety [ figure 1 ] . many researchers have investigated the differences in anxiety level among women receiving different breast cancer treatments . recent study done by lim , indicated that anxiety presents in all treatment types for breast cancer . moreover , the anxiety level in women who underwent chemotherapy was highest before the first chemotherapy infusion , mediated by age and trait anxiety . this result confirms the needs for more research and studies on anxiety among breast cancer patients . in addition , the villadeguadarrama free article reported that the cancer - related anxiety may manifest as physical symptoms , such as rapid heartbeat , tightness in the chest or shortness of breath . the patient may also experience digestive symptoms , such as nausea , vomiting , or diarrhea . thinking about anxiety that can lead to physical symptoms , the overall symptoms of anxiety among cancer patients include : excessive , ongoing worry and tension , an unrealistic view of problems , restlessness or a feeling of being  edgy  , irritability , muscle tension , headaches , sweating , difficulty concentrating , nausea , the need to go to the bathroom frequently , tiredness , trouble falling or staying asleep , trembling , and being easily startled . symptoms of anxiety and depression have been found to be common in patients with cancer , frequently occurring around the time of diagnosis and during the period of chemotherapy . high - depression burden has been found at the time when patients experience adverse effects of chemotherapy . significant difference in psychological distress has been found depending on age , gender , and living situation , with those living alone experiencing higher levels of distress in a sample of icelandic cancer patients during the treatment period . a study of women at high risk for breast cancer showed significantly higher levels of depressive symptoms and feelings of emotional alienation than did a standardized test group , with 27% of this population defined as having a level of psychological distress justifying psychological counseling . a second study also documented an increase in distress among first - degree relatives of breast cancer patients . an israeli study found that first - degree relatives who have physical symptoms of breast pathology respond with more emotional distress than do women of normal risk in the same situation . patients with cancer face most of the stressors associated with diagnosis , illness , and treatment . cancer diagnosis and treatment brings changes in patients personal paths of life , in their daily activities , work , relationships , and family roles , and it is associated with a high level of patient psychological stress . if you are really caring for someone who is having the symptoms of anxiety , encourage him or her to get help . people are differing in the way they perceive their sickness and they are also differ in the way they cope with their anxiety . some are easily disturbed by their feeling of being anxious and other may take it as a challenge and they try to look for ways to overcome their feeling . there are many treatments for clinical depression including medicines , counseling , or a combination of both . therefore , the diagnosis of anxiety in cancer is usually complicated by the overlap of anxiety and sickness symptoms such as cancer - related fatigue and pain . many common symptoms of major depression were observed in cancer patients who do not endorse full depression symptoms . different studies showed that various kinds of coping strategies are used to overcome the anxiety in different types and stages of cancer . for instance , reuter et al . , stated that patients using ineffective coping strategies have higher levels of anxiety and depression and that benefiting from social support results in a marked reduction in the levels of anxiety and depression . moreover , the importance of social support to good mental health outcomes is well established . as well as the positive effect of good social support , the detrimental effect of negative interactions with significant others in the social environment has also become apparent in psychiatric and other conditions . eventually , people are unique in the way they perceive and cope with the anxiety , also the way one patient uses is different from the way other uses . undoubtedly , it is related to the personality , strength , faith , and hope patients is having toward their sickness . worry , tension , fear , and stress are interrelated to the anxiety and depression among them . patients are differing in the way they perceive their problem as well as the way they cope with the anxiety associate with it . the huge literatures on anxiety , its effects , coping , counseling , and mental health are evidence of the extensive belief that the way people cope is somehow linked to their belief and faith . in conclusion , anxiety has a great effect on the feeling of breast cancer patients and it leads to high level of coping mechanisms .
cancer is a disease wherein abnormal cells divide without control and are able to attack other tissues . 
 most of the patients and their families face some degree of depression , anxiety , and fear when cancer becomes a part of their lives . they feel helpless and eager to find ways on how to get rid of it . 
 the study focuses on anxiety among breast cancer patients . 
 it aims at investigating cancer , its symptoms , and effects the disease has on the anxiety level of patients .