Objective: Advanced non-small cell lung cancer (NSCLC) is common, deadly, and associated with impairing anxiety for patients and caregivers who often co-experience similar symptoms that can vary together over time. We aimed to discover themes as to how NSCLC patients and caregivers express and cope with anxiety.

Design: Semi-structured interviews of patient-caregiver dyads (N = 21), coded using NVivo Software.

Main Outcome Measures: Open-ended questions on anxiety mutuality, giving or receiving care, communication, and the most difficult aspects of having or caring for someone with Stage IV NSCLC.

Results: Analyses revealed that patients and caregivers were linked psychologically, co-experiencing symptoms of distress or coping, rising and falling together. Shared patient and caregiver themes emerged of cognitive, behavioural and physiological manifestations of anxiety and coping mechanisms.

Conclusions: Patient and caregiver expressions of anxiety and coping methods mapped onto the cognitive-behavioural model, implying potential use of cognitive behavioural therapy (CBT) to address these issues. This expands understanding of symptoms and coping strategies in NSCLC, explores patient-caregiver interaction, and confirms the need for future clinical intervention. Future research should focus on development and dissemination of CBT-based dyadic interventions addressing anxiety in NSCLC patients and caregivers.