Anxiety is commonly experienced over fears and uncertainties about the future and therefore some degree of anxiety is common in all patients and families. Their distress may be related to any of a number of physical, psychological, social, spiritual, or practical issues, or it may be a component of many other syndromes (e.g., an underlying panic disorder that is unmasked by advanced illness).
It is important to look for reversible causes of anxiety such as insomnia, poorly controlled symptoms and pain, dehydration, electrolyte imbalance, alcohol, caffeine, or medications (e.g., increased doses of beta-agonists and methylxanthines for the management of dyspnea), or withdrawal from benzodiazepines or opioids.