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Anxiety with Cancer: Progressive Muscle Relaxation and Guided Imagery

Symptoms and description

It is common to feel stress or anxiety when you have cancer. Anxiety can be a vague or uneasy feeling of distress. There are many things that can bring on these feelings, such as trips to your healthcare provider's office, treatments for your cancer, waiting for test results, or fears about your cancer.

Learning needs

There are many things that you can do to help your stress. Two things that are easy to learn are called progressive muscle relaxation and guided imagery. They may also help with pain, nausea, and vomiting.

These skills take practice. The more you practice these skills, the more helpful they are. Some people find it helpful to listen to soothing music as they practice. Many libraries have relaxation CDs or quiet, soothing music.


Here is how to prepare:

  • Find a quiet, comfortable spot to practice.

  • Sit up or lie down while you practice.

  • Have a blanket or sheet handy. Often when people are relaxed, they find they are cooler and need a light blanket.

  • Take a few minutes to think about your breathing. (You can keep your eyes open or closed.) Try to do stomach breathing. Let your belly expand as you breathe in, and then let your belly relax as you breathe out. Begin to slow your breathing down. Try to focus only on your breathing.

Progressive muscle relaxation

Steps to follow for progressive muscle relaxation:

  • Take in a deep breath. Hold that breath for a count of 4, let it out, and begin to relax. Do this about 4 times. As you breathe in, think about good, soothing energy flowing in. As you breathe out, breathe out your stress and bad thoughts.

  • Allow your mind to focus on one body part at a time. You will slowly move from the top of your head all the way down to your toes.

  • Tense the muscles in one part of your body for about 5 seconds. Then relax the muscles in that part of your body. Breathe out as you relax your muscles. Notice the difference when your muscles are tense and when they are relaxed.

  • Start with your head and your scalp.

  • Move down to your eyes.

  • Focus on your mouth. Tense the muscles. Then relax your mouth. Allow it to go limp. Move down your neck, tensing then relaxing your neck muscles. Move on to your shoulders.

  • When you get to your arms, you may tense and relax them one at a time or both at the same time. You may even choose to tense and relax each finger, one at a time.

  • Move all the way down to your toes using this skill.

Extra tips

Tips that may help body areas that are tense or painful:

  • Warm often feels good. Think about any part of your body being warmed by the sun. For example, if your right arm has pain, you can focus on this arm. Think about warm rays of sun on your arm as you relax.

Guided imagery

Tips for guided imagery include:

  • It's best to do this skill after you have done the progressive muscle relaxation. Once your body is relaxed, you can allow your mind to rest.

  • Before you begin, think about a special image or place. This can be a place where you have been, or it can be a made-up place. Choose a relaxing place. Think about the whole scene. What does it look like? What do you hear? What do you taste or smell? Be as detailed as you like.

  • Some examples of pleasant places might include a warm, sunny beach, a sparkling lake, a walk in the woods, or a lovely snow-capped mountain.

  • Your image should be a place where you can be very relaxed. It's a place with no stress or worry. You can go to this place when you need a break.

Example of a guided imagery scene

I am lying alone on a beach in the late afternoon sun. It's nice and warm, but not too hot. The water is aqua blue, with small white caps close to the shore. The sky is light blue, with a few white puffy clouds. I am lying with my feet to the water, with the sun moving to the right of me. I can feel my warm beach towel under me and warm sand on my hands and feet. I feel the soothing sun on my body. I hear seagulls flying over me. I hear sea grass swaying in the breeze behind me. I hear some children playing in the sand, but I can't hear what they are saying. The water is gently lapping on the shore, over and over and over.


These skills are not to be used instead of pain medicine or any other type of treatment that you need. They should be used with your current treatment.

It's OK to fall asleep during either progressive muscle relaxation or guided imagery. It does not mean that it's not working. It may mean that you need the sleep. Allow yourself to enjoy the rest that comes with a relaxed body and mind.

Progressive muscle relaxation and guided imagery take practice to help you relax. When you feel good with these skills, they may also help with pain or nausea and vomiting.

Talk with your healthcare provider or someone you trust about your feelings of anxiety and stress. They may be able to advise other types of treatments.

Online Medical Reviewer: Jessica Gotwals RN BSN MPH
Online Medical Reviewer: Sabrina Felson MD
Online Medical Reviewer: Todd Gersten MD
Date Last Reviewed: 5/1/2023
© 2024 The StayWell Company, LLC. All rights reserved. This information is not intended as a substitute for professional medical care. Always follow your healthcare provider's instructions.
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