Handling Fear of Cancer Recurrence

February 19, 2019

The uncertainty that cancer might return can be managed.

Patients undergoing treatment often worry about whether therapy will cure their disease. But a different kind of worry—fear of the cancer returning—often emerges at the completion of therapy when the medical team is no longer present.

Although fear of recurrence might never go away, it should diminish over time, especially if a patient has a positive experience of being a survivor and a well person. Managing fear is essential when external stimuli, known as triggers, feed anxiety. Some common triggers include a relative or friend receiving a cancer diagnosis, aches and pains previously associated with cancer, media coverage of cancer and follow-up medical appointments. Having to revisit those emotions during medical appointments can sometimes lead survivors to avoid necessary follow-up testing. For others, fear becomes part of an action plan, motivating survivors to seriously look at maintaining a proper diet and healthy lifestyle.

Helpful coping strategies include using calming self-statements, imagery and distraction; talking to family, friends, doctors or nurses about the fear; or writing in a journal, which provides a setting for a personal monologue to explore issues behind the fear and ways to overcome it. Other tips follow:

Acknowledge the fear, anger or sadness. Survivors should accept that sometimes they will worry about cancer returning, and the best thing to do is acknowledge their feelings and talk with someone who will listen and not judge.

Live life to the fullest. Around the time of a check-up, survivors should pursue activities that provide a distraction so they have something else to focus on.

Exercise. Survivors should find an exercise they enjoy that will take their mind off fear. Exercise can also help reduce stress.

Learn the actual signs of recurrence. Being informed about the potential warning signs of recurrence and the potential risk of it can help ease concerns.

Predicting Recurrence

Doctors can't precisely predict if cancer will recur, but depending on the type of cancer, stage and other factors, a strategy to monitor for recurrence can be put in place when treatment ends.

Typically, patients who had complete surgical removal of their tumor or those with early-stage, nonaggressive tumors are less likely to have a recurrence. For most cancers, the risk of recurrence declines over time, but every cancer type has a different pattern.

Adjuvant therapy usually refers to hormone therapy, chemotherapy, radiation therapy or immunotherapy after surgery to increase the chances of curing the disease or reduce the risk of recurrence. While surgery removes the tumor, undetected cancer cells can remain, so the goal of adjuvant therapy is to kill or disable them. In addition, frequent exercise and a healthy diet with plenty of fruits and vegetables could help lower recurrence risk in many cancers.

Get a check-up. If fear of recurrence is overwhelming, survivors should talk with their doctor about blood work or other tests that could alleviate their fears.

Sometimes people become so fearful that they fall into despair. Symptoms of fear that can indicate a need for mental health care include excessive anger and irritability, difficulty with concentration and problem solving, and physical symptoms, such as muscle tension, dry mouth, trembling, shaking or restlessness.

Changes in appetite or sleep can also be important symptoms that indicate a need for help. Some people find that medication is appropriate in helping them get through the most stressful periods.