Music Therapy vs. Cognitive-Behavioral Therapy for Cancer-related Anxiety (MELODY)

Inclusion Criteria: * English- or Spanish-speaking * 18 years or older * Prior cancer diagnosis of any type or stage * Free of oncological disease, or stable disease with no evidence of progression * Score of ≥8 on the anxiety subscale of the Hospital Anxiety and Depression Scale (HADS) * Report anxiety symptoms lasting at least one month * Willing to adhere to all study-related procedures, including randomization to one of two treatment arms: MT or CBT * Access to Zoom and a quiet/private location Inclusion Criteria for Advanced Cancer Sub-Study (N=50) * English-speaking * 18 years or older * Advanced cancer diagnosis: stage III or IV lung cancer; any stage pancreatic cancer, unresectable cholangiocarcinoma, unresectable liver cancer, unresectable ampullary or peri-ampullary cancer, or other stage IV gastrointestinal cancer; stage III or IV ovarian or fallopian tube cancers or other stage IV gynecologic cancer; stage IV breast cancer; stage III testicular cancer or any stage IV genitourinary cancer; stage IV sarcoma; stage IV melanoma; stage IV endocrine cancer; lymphoma, myeloma, or leukemia * Currently receiving oncological treatment or on active surveillance * Karnofsky performance score of ≥60 * Score of ≥8 on the HADS anxiety subscale * Anxiety symptoms lasting for at least 1 month * Greater than 6-month expected survival as judged by the treating oncologist * Willing to adhere to all study procedures * Access to Zoom and a quiet/private location Inclusion Criteria for group MT sub-study (N=18) * English-speaking * 18 years or older * Prior cancer diagnosis of any type or stage * Free of oncological disease, or stable disease with no evidence of progression * Score of ≥8 on the anxiety subscale of the Hospital Anxiety and Depression Scale (HADS) * Report anxiety symptoms lasting at least one month * Willing to adhere to all study-related procedures * Access to Zoom and a quiet/private location Exclusion Criteria: * Completed active cancer treatment (e.g., surgery, radiation, chemotherapy) less than one month prior to enrollment (maintenance hormonal or targeted therapies are allowed). * Active suicidal ideation, bipolar disorder, schizophrenia, or substance abuse * Score of ≥10 indicative of cognitive impairment on the Blessed Orientation-Memory-Concentration * Received a treatment course of seven or greater MT or CBT sessions for anxiety symptoms within the last six months * Unable to provide informed consent for themselves Exclusion Criteria for Advanced Cancer Sub-Study * Active suicidal ideation; bipolar disorder, schizophrenia, or substance abuse * Score of ≥10 on Blessed Orientation-Memory-Concentration * Prior receipt of MT within the past six months * Plan to receive any form of psychotherapy in the coming 8 weeks * Initiation or change in anxiety medications within the past 4 weeks * Plan to initiate or change anxiety medications in the coming 8 weeks * Unable to provide informed consent for themselves Exclusion Criteria for group MT sub-study * Completed active cancer treatment (e.g., surgery, radiation, chemotherapy) less than one month prior to enrollment (maintenance hormonal or targeted therapies are allowed). * Active suicidal ideation; bipolar disorder, schizophrenia, or substance abuse * Score of ≥10 on Blessed Orientation-Memory-Concentration * Prior receipt of MT within the past six months * Plan to receive any form of psychotherapy in the coming 8 weeks * Initiation or change in anxiety medications within the past 4 weeks * Unable to provide informed consent for themselves