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Coping with the fear of recurrence

Winning the battle against cancer or completing treatment can be a moment of relief for many survivors. But this relief is usually accompanied by another real and raw emotion that makes any survivor feel like they are not out of the woods just yet: fear of recurrence or cancer coming back.

Understanding that anxiety about the unknown is a natural response

It’s common for individuals who face the fear of recurrence to feel anxious about any pain, discomfort, or sensation they experience in their bodies. This concern is entirely understandable and something many people can relate to.

Additionally, it’s essential to acknowledge that any new pain can trigger a similar response.

Jordan Green, social work counsellor, provides an example of a fearful thought. He states, “A lot of times if a person experiences a new pain, they associate it with one of their previous cancer symptoms.” He further says, “They can begin to spiral thinking this is the return of their cancer.” (JONES, 2023)

The following are indicators that fear of cancer has become problematic:

  • Minor aches, coughs, or headaches often trigger an intense fear of cancer recurrence.
  • Due to persistent fears, there is hesitancy to rebuild and fully engage in life.
  • The fear of cancer recurrence is a constant presence.
  • Thoughts about cancer returning occupy the mind before bedtime and upon waking in the morning.
  • Long-term sleeping problems, lasting more than a few weeks, are experienced.
  • Little to no appetite persists for several days.
  • There is a lack of desire to spend time with friends.
  • There is a diminished interest in maintaining usual routines.
  • Difficulty concentrating at school or work is evident.

 (LIVESTRONG, 2011) 

Here are strategies to help cope with the fear of recurrence

Certain things may make someone experience anxiety, for example, the anniversary of a diagnosis, or even a new ache, pain, or discomfort, says Paula Finestone, PhD, a clinical psychologist at Fox Chase Cancer Center. One’s anxiety can be elevated before a follow-up scan. This is referred to as scanxiety. 

Dr Finestone has suggested a few things to focus on to help you
worry less and feel more hopeful:

  • Be in the know about symptoms. Maintaining open communication with your oncologist regarding any symptoms you should be vigilant about and report promptly is always essential. Whenever something causes concern, don’t hesitate to seek advice from your oncologist. It’s necessary to remember that sometimes an ache is simply that—an ache—and not necessarily a cause for alarm. Your healthcare provider can help provide reassurance and guidance in such situations.
  • Take steps to minimise scanxiety. To help reduce waiting time, it’s recommended to try scheduling your scans early in the day. Additionally, arranging for support before your scan, such as reliable individuals, can be beneficial.
  • Do your best to accept uncertainty. Understandably, the uncertainty of cancer recurrence can be emotionally challenging. While no one can guarantee it won’t return, focusing on the present is essential rather than worrying about an uncertain future.
  • Focus on wellness. Rather than expending your energy on worrying, it is advisable to redirect it towards maintaining your overall well-being. A valuable step is to explore the guidance of a registered dietitian specialising in creating healthy diets for cancer patients. They can provide personalised nutrition advice that can contribute to your overall health.
    • Remaining physically active to the best of your ability is also recommended, as exercise has been known to enhance mood.
    • Additionally, if you are a smoker, it may be beneficial to consider quitting.
  • Take charge of what you can. Ensuring consistent follow-up care for cancer is crucial, so it’s essential to prioritise attending all scheduled visits and undergoing the recommended tests as advised by your oncologist. By faithfully adhering to your follow-up plan, you are actively taking steps to monitor your health and address any potential concerns that may arise.
  • Write down your worries. Creating a list of your concerns can be helpful by jotting them down on paper or using your smartphone. Bringing this list to your next doctor’s visit allows you to address each concern directly with your healthcare provider.
  • Create a ‘worry time’. Setting aside dedicated time daily to address and process your worries can effectively manage anxiety. Choosing a consistent place and time for this designated period is beneficial, ensuring it’s not too close to bedtime to avoid interfering with your sleep.

(Fix Chase Cancer Center, 2018)

This blog post is for informational purposes only and should not be considered medical advice. Please consult with a healthcare professional for personalized guidance. 

References

Fix Chase Cancer Center. (2018, March 23). ‘Is My Cancer Coming Back?’ How to Cope with the Fear of a Recurrence. Retrieved from Fix Chase Cancer Center: https://www.foxchase.org/blog/2018-03-23-how-to-cope-with-the-fear-of-a-cancer-recurrence

JONES, V. (2023, March 16). How to manage the fear of cancer recurrence. Retrieved from MD Anderson Cancer Center: https://www.mdanderson.org/cancerwise/how-to-manage-the-fear-of-cancer-recurrence.h00-159617067.html

LIVESTRONG. (2011). Fear of Recurrence. Retrieved from www.livestrong.org: https://www.fredhutch.org/content/dam/www/research/patient-treatment-and-support/survivorship-program/survivorship-health-links/Fear%20of%20Recurrence.pdf

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