Never Fear

Treatment anxiety can be conquered [and besides, it usually turns out to be unfounded].

Before the first of five surgeries for lung cancer, Lori Monroe grappled with multiple fears: her life would end in the operating room, the incision would be exceedingly large, surgery would fail, she would wake up in severe pain.

She also envisioned a nightmare scenario in which, following surgery, she would regain consciousness and be unable to breathe adequately.

All these fears proved groundless. “When I woke up after the first surgery, I was never that terrified again,” says Monroe, 49, who was diagnosed with stage 4 cancer in 2001.

Monroe, a registered nurse from Bowling Green, Kentucky, is like many cancer patients who, in addition to the many uncertainties associated with their disease, dread the thought of treatment, including its side effects and likelihood of success. Over the course of therapy, however, many come to realize, as Monroe did, that the outcome often is less horrific than they anticipated and there are effective ways to keep fear of treatment in check.

A survey conducted by Harris Interactive on behalf of the National Coalition for Cancer Survivorship and drug company Sanofi-Aventis was released in early 2008 and offers a glimpse of just how widespread and oftentimes illusory such fears may be.

Eighty-three percent of 326 adult cancer survivors (solid tumors only) said they were at least somewhat fearful before they underwent chemotherapy, but only 38 percent said their fears had been justified. Sixty-two percent acknowledged they had many misconceptions before treatment.

Fear of the unknown—including worries that therapy will be difficult—is normal; it may even be more overpowering than the diagnosis. Symptoms of anxiety include heart palpitations, high blood pressure, shortness of breath, chest pain, lightheadedness, trembling, sweating, nausea, heartburn, diarrhea, muscle tension, irritability, and trouble focusing or solving problems.

However, unwarranted fear could be harmful because it may interfere with a patient’s understanding about the purpose and rationale of treatments or cause patients to postpone much-needed therapy.

The many different types of cancer and therapies, the extent of necessary treatment, and individual circumstances and attitudes vary widely, so it’s difficult to draw general conclusions about the impact that age, gender, culture, and other demographic factors have on treatment fears.

Clearly, though, some cancers are more life-threatening and do require more aggressive and potentially frightening treatment. Depending on individual circumstances, some patients may take comfort in the fact that the arsenal of treatments for certain cancers, such as breast and prostate, has a relatively high success rate.

Paul Brenner, MD, PhD, a surgical oncologist and psychologist in San Diego who counsels cancer patients and has had prostate cancer for 10 years, says that, in his experience, the majority of fears about treatment stem from preconceived notions that may simply be wrong. He says that staying focused on the present and being “a witness of your thoughts” has enabled him and others to be more objective about their disease and the therapy necessary to fight it.

Talk about this article with other patients, caregivers, and advocates in the General Discussions CURE discussion group.
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