Cancer: remission and the fear of recurrence | Life

12 Aug 2009

The end of cancer treatment can bring both relief and worry. You may be relieved that your treatment is finally over and pleased that your cancer is in remission. However, you may also feel worried, anxious, or fearful that your cancer may recur.

Cancer recurrence is the return of cancer after a period when no cancer cells could be detected in the body. But some cancers can recur, and fear of recurrence is both normal and reasonable. This is a common fear experienced by cancer survivors, especially during the first few years after treatment. It is important to remember that while you cannot control whether or not your cancer recurs, you can control how much you let the fear of recurrence impact your life.

Tips for coping
Accept your fears. It is normal to experience some fear about your cancer recurring. Telling yourself not to worry, or criticizing yourself for being afraid won't make these feelings go away. Accept that you are going to experience some fear, and focus on finding ways to help yourself manage the anxiety.

It may also help to remember that the fear usually lessens over time, and that you won't always feel so anxious. Be aware that your anxiety may temporarily increase at certain times, such as before follow-up care appointments, around the anniversary date of your diagnosis, or when a friend is diagnosed with cancer.

Don't worry alone. Talking about your fears and feelings or writing about your thoughts in a journal can help reduce your anxiety. Talking and thinking about your concerns can help you explore the issues underlying your fear. Fear of recurrence might include fear of having to repeat cancer treatment, losing control of your life, or facing death.

Many cancer survivors find joining a support groups to be helpful. Support groups offer the chance to share feelings and fears with others who understand, as well as to exchange practical information and helpful suggestions. The group experience can also create a sense of belonging that helps you feel less alone and more understood.

Be well informed. Most cancers have a predictable pattern of recurrence. While a doctor cannot tell you exactly what will happen to you, an oncologist familiar with your history will be able to give you specific information about whether, when, and where your cancer might recur - as well as symptoms to look for. Knowing what to expect can help you stop worrying that every ache or pain means your cancer is back.

Get regular follow-up care. Every cancer survivor should receive regular follow-up care including doctor visits and appropriate testing. Good follow-up care can help ensure that a cancer recurrence is caught early. Thinking of yourself and your doctor as partners in charge of your health-care decisions can help you feel more in control.

Adopt a healthy lifestyle. Eating a well-balanced diet, exercising regularly, getting enough sleep, and reducing stress can help you feel better physically and emotionally. Doctors do not yet know why cancer recurs in some people but not in others, but avoiding unhealthy habits like smoking and excessive drinking may help reduce the risk of recurrence. Adopting a healthy lifestyle will also lower your chances of developing other health problems.

Set up your own cancer rehab plan. By setting goals in all areas of your life you are working towards regaining and taking you live back after a cancer experience .

Look at adjusting your nutritional needs
Find emotional support for adjusting to life after cancer. It is often only when treatments stops that the true impact of the cancer hits home emotionally and that the emotional journey starts; as much of the energy during the treatment phase was centred on getting through the treatment and side effects of treatment
Deal with unfinished business .
Consciously make memories with the people you love and provide meaning in your life
Plan to have more fun
Live more mindfully
Plan for more exercise and movement to assist the physical healing
Focus on plans to re-engage with wellness on multiple levels

Reduce stress. Finding ways to reduce stress will help lower your overall level of anxiety. Experiment with different ways of reducing stress to find out what works best for you.

Spend time with family and friends
Spend time on hobbies and other activities you enjoy
Take a walk, meditate, or enjoy a bath
Exercise regularly
Find time for humor—read a funny book or watch a funny movie
Join a support group
Avoid unnecessary stress—don't take on unnecessary responsibilities or commit yourself to tasks you don't have time for
Simplify your life

When you need more help
Despite your best efforts to stay well, you may find yourself overwhelmed by fear or recurrent thoughts of illness. If in doubt, talk to your doctor or nurse and consider a referral for counseling.

The following are some common features that may point to a diagnosis of anxiety or depression:

You are worried or anxious most of the time
You feel hopeless about your future
You are having trouble sleeping or eating well
You aren't participating in activities you used to enjoy
You are having trouble concentrating or making decisions
Your worry is interfering with work or relationships
Your anxiety prevents you from attending follow-up care appointments
You are forgetful

Read what survivors had to say on the Cancer survivor guest forum, and join other cancer survivors and their families to celebrate the 10th annual Cancer Survivors’ Day in Cape Town at the His People Centre on August 15 2009 – see the press release for details.

(Linda Greeff, People Living With Cancer forum)
www.plwc.org.za