Coping with Fear of Recurrence

Fear of recurrence is one of the most common experiences after cancer treatment ends. A recurrence is a return or relapse of your cancer in the original location or somewhere else in the body (called metastasis).

Cancer has shown you what it feels like when something is wrong in your body. This is scary. That fear doesn't just fade away with time. A scan, an appointment, a pain in a certain place, can bring feelings rushing back. These feelings are stress from the trauma of a cancer diagnosis and treatment. You have faced a threat to your health, your well-being, and maybe even your life. You have gone through painful, scary procedures and treatments. You have had side effects that limited your quality of life. Many cancer survivors have this traumatic stress without ever being diagnosed with any kind of mental health problem or post-traumatic stress disorder. This stress can shape how things feel, your relationship with your body, and your thoughts on the future. Learning to cope with these feelings is an important part of managing your fear of your cancer coming back.

Why would my cancer come back?

• The goal of cancer therapy is to remove or kill (through radiation or chemotherapy) all the cancer cells in the body.
• But, we cannot detect all the cells with today's tests, and some cells may be left behind and resurface later as a recurrence or metastasis.

What can I do to reduce the risk of recurrence?

• Be aware of your body and tell your provider about any new symptoms.
• Eat a healthy diet.
• Get enough rest.
• Exercise regularly.
• Communicate regularly with your providers and keep your follow up appointments.
• Take prescribed medications and get all scheduled labs and scans – even if you feel fine!

What should I ask my healthcare team about the possibility of recurrence?

• How likely is it for this cancer to come back?
• When is it most likely to come back?
• Where would it most likely come back?
• Is there anything I can do to keep it from coming back?
• What symptoms should I look for and report?

What can I do to cope with my feelings?

• Some worry, nervousness and anxiety are normal. If these feelings start to interfere with your daily life or coming to appointments, it's time to talk to your provider.
• Make a list of what helped you get through treatment and use those things after treatment as well. Ask for help from your support community when you need it.
• Deep breathing, guided imagery, journaling, meditation, and mindfulness can help you de-stress and reduce feeling worried and anxious.
• Movement can also help with stress. Take a walk, dance to your favorite song, or take a group fitness class with other cancer survivors. Movement releases endorphins, which can ease tension and lift your mood. 
• Seek out help and support from family, friends, clergy, support groups, and social workers.
• There are many integrative therapies that help with stress and worry. Things like reiki, acupuncture, and massage can help with stress management.
• if these feelings start to interfere with your sleep, your ability to function day to day, or your ability to keep appointments, it's time to talk to your provider.  Ask them to recommend a mental health professional with experience in working with people with cancer. If you are having thoughts of suicide or hurting yourself, call or text 988 to reach the Suicide & Crisis Lifeline.

For more information about coping with fear of recurrence:

• NCI publication, When Cancer Returns
• ACS resource, Understanding Recurrence