Managing Fear of Recurrence
“It turns out that the lack of tools to address fear of recurrence is one of the most common unmet needs noted by caregivers. Here are some strategies that you can try.” - Ranak Trivedi, PhD
Fear of cancer recurrence, also called fear of recurrence, is the “fear, worry, or concern relating to the possibility that cancer will come back, or progress.” In our family, my mom’s disease did not have any symptoms and the initial detection of cancer was incidental. For people like her and their families, the lack of symptoms in the After Cancer phase is not reassuring and may increase the fear of recurrence.
Caregivers can also experience fear of recurrence, especially as they evaluate their role in the After Cancer phase. Should they continue monitoring patients? Are they still the patient’s caregiver? Such uncertainty may intensify a caregiver’s fear of recurrence. It turns out that the lack of tools to address fear of recurrence is one of the most common unmet needs noted by caregivers. Fortunately, there are a lot of evidence-based strategies that can help you manage mild, moderate or even severe fear. Here are some strategies that you can try.
First, recognize what triggers your fears. Fear of recurrence can increase around anniversaries; around follow-up visits or tests; or hearing about someone else’s recurrence. Next time you note fear of recurrence bubbling up, see if you can figure out what may have caused it. Are you close to an anniversary of diagnosis, procedures, and treatment? Did you hear something from a friend or on TV? I remember that one of my triggers was watching movies that showed someone suffering cancer. Understanding your triggers can help you catch your fear earlier when it is easier to manage.
Second, build an arsenal of helpful coping strategies. Helpful coping strategies are activating, like talking to family and friends, attending support groups, engaging in hobbies, taking a walk, and vigorous exercise. Weeding or watering your plants gets you outside--and knocks a chore off your list! You may also find comfort in your spiritual or religious faith. I also teach my patients guided relaxation, progressive muscle relaxation, and deep breathing, all available on the internet, or through mobile apps like Calm, Headspace, and Buddhify 2. On the flip side, unhelpful coping strategies are disengaging like zoning out with TV, overeating, or using alcohol or other substances to cope. These may seem to help in the short-term, but can make your fears worse over time.
Try to set a small goal first. Can you walk around the house for a few minutes? A recent study found that even 15 minutes of sitting in nature improved positive emotions and reduced negative emotions, compared to people who spend 15 minutes in a closed, windowless room. So, could you sit outside for 15 minutes?
Third, get help from experts. Fear of recurrence reflects the difficulty with adjusting to the uncertainty of cancer, rather than a generalized fear of the future. In my experience, often there are no other psychological symptoms and the treatment is short-term. You don’t need to feel distressed to seek professional help. Mental health professionals are happy to help everyone! However, you definitely want to seek help when things feel out of hand and the above strategies are not working. Ask yourself, is my fear getting in the way of carrying out my daily tasks? Am I withdrawing from social contact, avoiding work, drinking too much alcohol, or in other ways not living the life I deserve? Am I losing sleep, or do I find my waking thoughts filled with cancer? You can look for psychologists in your area at https://locator.apa.org or ask your doctors or nurses for recommendations.
I hope that these tips can help you manage your fear of recurrence, so that you can go back to living the kind of life that you deserve.
Wishing you all the very best,