Fear of Recurrence

A complex and unexpected mix of emotions can accompany the end of cancer treatment. You may feel relieved and elated that it is over but vulnerable and uncertain about what the future holds. For some people, hearing that they are free of disease upon completing treatment may give rise to a significant level of worry and anxiety that the cancer will come back, or recur.

These are some common concerns you might have about the cancer coming back:

  • You may worry that cancer will come back in your affected breast, your other breast or in other parts of your body.
  • You may have concerns about having to go through treatment again. You may also have fears of experiencing pain or discomfort from more surgery, chemotherapy, radiation or other treatments.
  • You may feel stressed about the impact of another diagnosis on your appearance, relationships, social life, family or career.
  • No matter what stage of cancer you had, you may be afraid of dying from cancer.

Fear of recurrence is a normal and very common emotional reaction to finishing cancer treatment. The reality is that no one can promise the cancer won’t return or spread to another part of the body. Use the following tip to gradually move away from that fear.

Identify your triggers

For most people, worries about their cancer returning are often prompted or intensified by certain things. For example, the anniversary of your diagnosis or surgery or news of a celebrity being diagnosed with cancer can stir up feelings of angst and evoke difficult memories of times you may rather forget. The anxiety surrounding follow-up exams and scans can also be overwhelming.

Physical symptoms such as pain or a lump can be a major trigger because those can be legitimate signs of recurrence. Usually a headache is just a headache, but for someone who has been through cancer and treatment, it might feel like a brain tumor, and that can bring on anxiety.

Have a plan

Make a plan for coping with the triggers you have identified. If you are nervous before a follow-up exam, for example, anticipate how you’re going to get through the day of the appointment, and possibly the days leading up to it. Plan activities that will distract you from thinking about cancer or write out a list of the things that have helped reduce your anxiety level in the past. Remember this feeling will pass.

Talk about it

Family and friends can be your biggest supporters during your cancer treatment, but they may not realize you’ll still have ongoing concerns after your treatment ends. Let them know that you welcome their continued emotional support and encouragement as you adjust to life beyond active treatment.

It also can be comforting and validating to talk to others who have gone through the same things you’ve experienced. Talk with other cancer survivors about your experiences and share concerns or anxieties you may have.

The interesting thing that happens in these support networks is that you not only can receive support, but also can share your own experience and help others, which can be therapeutic.

Focus on wellness

Activities such as acupuncture, massage, music therapy, and guided meditation can help reduce your anxiety and make you feel more relaxed. Some survivors find comfort in spirituality and prayer.

A healthy diet and physical activity also enhance overall well-being. Focusing on things like nutrition and exercise not only helps from a wellness and health perspective, but also helps you feel like you’re regaining some control over your life.

Consider counseling

Social workers, psychologists, and psychiatrists work with survivors to help them accept that fear of recurrence is a normal part of the cancer experience. They can help you develop strategies to cope with your fears and move forward with your life.

If you’re continuing to struggle with worries about your cancer returning, you may find relief in cognitive behavioral therapy (CBT), a form of psychotherapy that has been shown to help reduce anxiety and depression for people with cancer. It combines cognitive therapy — a type of talk therapy that helps identify and change self-destructive thought patterns — with behavioral therapy, which helps people recognize their unhealthy beliefs and behaviors and replace them with positive ones.

Be patient with yourself

It helps to know that for most people, fear of recurrence gets better over time.