Fear Influences Screening Behavior

CURE, Special Issue 2006, Volume 5, Issue 3

For most survivors, the fear of recurrence never goes away, but evolves as patients go through treatment and move into survivorship.

For most survivors, the fear of recurrence never goes away, but evolves as patients go through treatment and move into survivorship.

Research shows fear can often be useful as a tool that encourages survivors to get regular checkups and screening procedures, but the fear and anxiety can sometimes be so great that it overtakes their lives and serves as a barrier to good follow-up care.

A healthy degree of concern can motivate survivors to keep follow-up appointments and adopt healthier lifestyles. Because the risk of cancer is higher in survivors than in people without a history of cancer, screening and follow-up exams are crucial. Feelings of anxiety may increase around the time of these exams, which experts say is normal. Many survivors also begin eating healthier, exercising more and quit smoking to lower their risk of recurrence.

However, that fear may wane enough that some survivors forego checkups. A recent study found that while 80 percent of breast cancer survivors had a screening mammogram the year following treatment, only 63 percent had received a mammogram at the fifth year of follow-up. Researchers believe one reason nearly a third of breast cancer survivors skipped their annual mammogram five years out was a lessened fear of recurrence.

For other survivors, fear can become so great that they skip annual screenings or don’t report new pains or symptoms to their doctor. While most aches and pains after cancer are not from life-threatening causes, these symptoms can be signs of recurrence or late effects of cancer treatment. Oncologists recommend patients report symptoms that last longer than two weeks.