It’s normal to feel scared, anxious, or depressed when you get a cancer diagnosis. About a third of people recently told they have advanced non-small-cell lung cancer (NSCLC) report feeling depressed. Therapy can help you process and manage your emotions.
“It’s normal to go into a state of shock when you learn you have NSCLC. Your life gets upended in an instant,” says Emaan Lehardy, PhD, a psychologist at the Dan L Duncan Comprehensive Cancer Center at the Baylor College of Medicine in Houston, Texas.
“It’s helpful to have the space to talk through some of your feelings and concerns with a therapist. You can be open with them in a way you may not feel comfortable doing with your family and close friends,” he says.
Here’s how therapy can help you after a new NSCLC diagnosis and how to find the best therapist for you.
The Benefit of Therapy for NSCLC
While you may first focus on ways to treat your lung cancer, it’s important to care for your emotional health, too. Research shows talk therapy can help improve your mental health and quality of life when you have cancer.
Therapy can help you:
Manage anxiety. “People with NSCLC often have a lot of anticipatory anxiety. They worry about getting test results back or about treatment side effects,” says Patricia Pedreira, PhD, a psychologist at the Duke Cancer Center in Durham, North Carolina.
Reframe thoughts. If you have NSCLC, you may worry that you’re a burden to others or that you’ll die, says Pedreira. A therapist can show you ways to replace these negative thoughts with more positive ones.
Get support. “Many lung cancer patients don’t want to talk about their condition because they may feel uncomfortable to open up to family or friends,” says Valentina Ogaryan, PhD, a psychologist and clinical director of the Simms/Mann UCLA Center for Integrative Oncology in Los Angeles, California. “Therapy can serve as a safe space.”
Therapy may also help you better manage the physical toll of lung cancer. A therapist can help you manage symptoms such as shortness of breath and fatigue. One 2025 study found that patients with lung cancer who had five one-hour therapy sessions per week saw a big improvement in breathlessness as well as reduced anxiety.
What to Expect in Therapy
Your first session to talk about your NSCLC diagnosis may be different from what you expect. You may not be asked to discuss your childhood or lie on a couch.
“It actually may feel almost like a job interview. Your therapist will ask you a lot of questions about your current mental health and if you have ever experienced depression or anxiety before your lung cancer diagnosis,” says Claire Conley, PhD, an assistant professor of oncology at the Lombardi Comprehensive Cancer Center at Georgetown University Medical Center in Washington, D.C. They may also ask you about your physical symptoms.
You should feel like you and your therapist have clear goals in mind. These may include ways to help you:
- Deal with physical symptoms such as pain, fatigue, and trouble breathing
- Stick with treatment, even through side effects
- Address fears that your cancer will come back or won’t respond to treatment
- Find solutions to practical problems, such as work or financial stress
- Talk to your family and friends about your cancer
- Continue to lead a healthy lifestyle that includes a nutritious diet, regular exercise, and stress management
Be prepared to do some “homework” on your own, too. “You’ll see better results faster if you do some work on your own between therapist visits,” says Conley. “It’s like exercising just once a week with a trainer. You’ll get stronger, but you’ll progress faster if you do workouts on your own, too.”
Psycho-oncology and NSCLC
After your NSCLC diagnosis, you may often hear the term “psycho-oncology.” It’s a cancer specialty that addresses the emotional issues many patients experience. “It recognizes that lung cancer can cause significant distress for patients and their loved ones,” says Lehardy.
Psycho-oncology was developed in the 1980s by Jimmie Holland, MD, a psychiatrist at Memorial Sloan Kettering Cancer Center in New York City.
“It’s a targeted field that addresses all the psychological and social concerns that crop up for cancer patients,” says Lehardy. “There’s a lot of anxiety, stigma, and even self-blame around NSCLC. Psychosocial support helps all cancer patients, but it’s especially so for lung cancer, where the emotional burden can be very high.”
Most major cancer centers have at least one provider who specializes in psycho-oncology. They may be a psychiatrist, psychologist, mental health counselor, social worker, or psychiatric nurse. They can:
- Screen you for anxiety and depression
- Conduct therapy to help ease distress and improve your quality of life and ability to stick to treatment
- Offer support and training to caregivers
Older Adults and Therapy
The average age of those diagnosed with NSCLC is 70. If you’re in that age range, you may feel uncomfortable with the idea of therapy.
“Many older patients were raised during a time when there was a lot of stigma around therapy,” says Lehardy. “They may assume therapy is reserved for people with full-blown clinical depression or anxiety. But any patient with an NSCLC diagnosis can benefit.”
You may view therapy as a sign of weakness. But experts say it’s actually a sign of strength. “You need all the tools possible to face this challenge head-on,” stresses Lehardy. “You may feel like you need to keep a stiff upper lip and stay strong for your family. You need one safe space where you don’t feel pressure to keep it all together.”
Older adults diagnosed with NSCLC face a cancer journey when they may have been ready to kick back and enjoy retirement. “I hear over and over, ‘everything I thought I’d do in my (later years) has gone out the window,” says Lehardy. A therapist can coach you on how to navigate this stage of your life and enjoy your golden years despite your new diagnosis.
What Type of Therapy Is Best?
There are several different types of talk therapy your mental health provider may suggest to help you manage your NSCLC.
Cognitive behavior therapy (CBT). It helps you reframe negative thoughts into positive ones. It also teaches you ways to relax and better manage emotions and behavior. “Its focus is to give you coping skills to get you through your cancer journey,” says Conley.
Acceptance and commitment therapy (ACT). This is a form of CBT that uses mindfulness techniques as a way to identify and address your negative thoughts and feelings. “It’s particularly helpful for patients who have a lot of self-blame because it encourages them to learn how to be compassionate with themselves,” says Pedreira. “We focus on ways to silence your inner critic, so you can give yourself grace and love.”
Dialectical behavior therapy (DBT). It’s a type of talk therapy geared to people who feel intense emotions. It may be especially helpful for you if you’re diagnosed with late-stage or very aggressive NSCLC, notes Pedreira. One small pilot study at Duke found that DBT helped patients with stage IV NSCLC manage emotions better and improved their quality of life.
Meaning-centered therapy (MCP). This form of therapy helps you find meaning and purpose while living with NSCLC. “We use it a lot in patients with terminal disease, to help them reflect on what they want to leave as their legacy, and how they can connect with others in the time they have left,” says Pedreira.
How to Find Accessible Therapy
There are some challenges when it comes to therapy with NSCLC. These include:
Physical limitations. If you have side effects from treatment, such as nausea or fatigue, it’s harder to get to in-person appointments. Telehealth is one good option, says Pedreira. You can do counseling at home and avoid the need to travel to and from a therapist’s office
Time. Patients with NSCLC spend a lot of time at medical appointments and at treatment. It can be hard to carve out additional time for therapy.
Cost. Therapy can be expensive. People with cancer already pay almost $600 more each month in health care costs than those without cancer. Although your health insurance may cover therapy sessions, your coverage may be limited or require a high copay. Here are some ways to help make it more affordable:
- Ask your therapist about a sliding scale. Some will adjust their hourly fee based on your income and assets.
- Look into your cancer center’s programs. Some have social workers on staff who provide counseling at no extra cost, says Pedreira.
- Consider a support group. Many are led by a trained therapist, allowing you to get professional advice at low or no cost.
How to get started
If you're interested in therapy, talk to your cancer care team. They may have mental health professionals on staff who can work with you. Or they may suggest another mental health provider and help book your first appointment.
When you reach out to therapists, ask:
- Do you have experience with other patients with lung cancer?
- How have you helped other patients with lung cancer in the past?
- How long have you been working with patients with cancer?
- What type of therapy will you use?
- How often will you meet with me?
- How will you make sure therapy is helping?
- Can you prescribe medications or refer me to another specialist if you think I need them?
Finding a mental health specialist
Several types of professionals can provide therapy when you have cancer:
Psychologists and licensed mental health counselors or social workers. They’re trained and certified to treat mental health problems. Look for one who works with people with cancer. The American Psychological Association (APA) has a psychologist locator. Type in your zip code, then highlight chronic illness in the practice area.
Psychiatrists. These medical doctors specialize in mental health. They can conduct talk therapy and prescribe medication to help manage your depression and anxiety.
Faith, pastoral, and spiritual counselors. They integrate religious or spiritual beliefs with traditional counseling techniques. This may help you deal with worries such as fear of death, and help you find meaning on your cancer journey. You can find one of these counselors rooted in your specific faith or denomination.
Culturally matched therapists. You may want a therapist who looks like you, comes from a similar background, or has a shared identity. Helpful resources for finding them include Clinicians of Color, Latinx Therapy, Asian Mental Health Collective, and Inclusive Therapists.
Your health insurance company may also have a list of therapists who specialize in cancer care.
Don’t be discouraged if you don’t find a therapist that you “click” with right away. “It can take several tries before you find a therapist that seems to ‘get’ you, as well as the realities of living with NSCLC,” reassures Lehardy.
“But when you do find someone you connect with, it’s worth it.”
