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Survivorship Issues: Managing Fear of Cancer Recurrence

Network - Winter 2010

By Laura Prus

For many cancer survivors, the fear of recurrence is oppressive. It hinders them from enjoying everyday activities and profoundly affects their quality of life.

However, by learning to manage their anxieties, patients can become more confident about their survivorship.

The fear of recurrence is quite normal. Mary Hughes, advanced practice nurse in the Department of Psychiatry, says about half the patients she meets suffer from it. “I think it has more to do with a patient’s personality. People who are worriers now really have something to worry about,” Hughes says. “The challenge is to focus on right now. The treatment is over, and you don’t have cancer.”

Patients most often feel anxiety when changes arise in their treatment. Fears run particularly high during the transition from treatment to survivorship. “No one is looking at them,” Hughes says. “They ask themselves, ‘Who’s watching me now?’”

Wading back into life

Returning to a normal routine is an important step in managing the fear of recurrence. “It’s a challenge to get back to living,” Hughes says. “Cancer is a part of your life, but it’s not controlling it.”

Hughes suggests that survivors participate in school, work, church or civic activities that distract them from their worries. Becoming a volunteer or supporting someone else in a difficult situation may also prove helpful.

“Some people may want to give back because the help and encouragement they had during treatment was important,” Hughes says. Of course, she also emphasizes the importance of maintaining one’s own strong support system.

Even after treatment, it is imperative that patients remain knowledgeable about their particular cancer. Patients who educate themselves on where their cancer might recur and the associated symptoms will know when they need to see a physician. This also eliminates anxieties caused by pains that are not associated with a recurrence.

Hughes says that meditation, visual imagery, yoga and tai chi are very beneficial. She recommends the programs offered at M. D. Anderson’s Place … of wellness to soothe anxieties.

‘The new normal’ sinks in

Caregivers also play an integral role in eliminating survivors’ fears. “They help keep the person focused on the fact that they’ve been treated,” Hughes says.

During treatment, caregivers and patients can look to the future by setting short-term and long-term goals. Later, the caregiver can help fulfill the plans.

Dividing the household chores may help a patient return to a routine. “Maybe the caregiver took over chores and wants to give some, but not all, back,” Hughes says. “The partner can help. If the survivor cooks, the caregiver can clean up.” This allows survivors to feel more involved in everyday life.

As they ease into the next phase of their lives, it is important for survivors to remind themselves that their cancer has been treated. “They have to move out of the cancer world,” Hughes says. “Cancer was the center of their lives, but it’s not anymore.”

© 2015 The University of Texas MD Anderson Cancer Center