Purpose <p>Many cancer survivors experience financial distress. This distress can be associated with anxiety and depressive symptoms in cancer survivors. The aim of the study was to examine how much unique variance in anxiety and depressive symptoms is accounted for by financial distress using a measure developed specifically for financial distress using item response theory.</p> Methods <p>Participants were recruited either through a cancer survivorship program or through the Prolific survey panel. Measures included patient reports of demographic and clinical variables. Financial related anxiety/worry and depression were assessed. The Generalized Anxiety Disorder-7 (GAD-7) and the Patient Health Questionnaire-8 (PHQ-8) were used for general measures of anxiety and depression, respectively. Separate hierarchical regressions were performed with the GAD-7 and PHQ-8 as outcome variables.</p> Results <p>A total of <i>N</i> = 459 cancer survivors completed the survey. The sample average age was 51.5&#xa0;years (SD = 15.0), 67.5% female, 85.6% White, 7.4% Hispanic, and 6.5% Asian race. The most common cancer diagnosis was breast (27.9%). Age, income, education, and financial anxiety were associated with anxiety, and the overall model accounted for 31% of the variance. For depression, only female sex and financial depression were significantly associated and accounted for 46% of the variance.</p> Conclusion <p>Financial distress in combination with demographic and clinical variables operated differently in models of anxiety and depression in cancer survivors. More demographic variables were associated with anxiety symptoms than with depressive symptoms. Interventions such as financial navigation could reduce overall distress.</p>