‘Is My Cancer Coming Back?’ How to Cope with the Fear of a Recurrence

• Cancer survivors share many things, including this: a fear that their cancer will return. It’s a worry that, ironically, often surfaces at what should be an occasion for relief—the end of active treatment. But that’s exactly when cancer survivors see their doctors less frequently and may feel adrift and anxious.

  “This worry is both normal and likely to lessen considerably in time,” said Paula Finestone, PhD, a clinical psychologist at Fox Chase Cancer Center. “Still, it may never go away entirely.” Even years after treatment, certain things may make someone feel anxious—for example, the anniversary of a diagnosis, a cancer in a friend, or a new ache or pain.

  This anxiety can be especially intense before a follow-up scan. There’s even a name for it: scanxiety.

  If you’re a cancer survivor nodding your head as you read this, these suggestions from Dr. Finestone may help you worry less and feel more hopeful:

  Be in the know about symptoms. “It’s natural to be hyper-aware of aches and pains and worry that each one means your cancer is back,” Dr. Finestone said. So be sure to ask your oncologist which symptoms to watch for and report right away. And if anything worries you, always check with your oncologist for advice. Remember, too, that an ache is often just an ache.

  Take steps to minimize scanxiety. Try to schedule scans early in the day—to minimize waiting time—and line up support before you have a scan. “See if a friend or family member with a calming presence can accompany you,” Dr. Finestone said.

   While you wait for results, surround yourself with people you can count on for lots of TLC, and give yourself some too. Distract yourself with something that gives you pleasure (such as a massage or a dinner out with a close friend) or will engage you (such as an engrossing movie or book).

  Do your best to accept uncertainty. No one can promise that cancer won’t return, and that’s emotionally difficult. “Try to remind yourself that uncertainty is a part of life,” Dr. Finestone said. “Nobody knows what’s ahead.” But rather than worrying about an uncertain future, do your best to stay in the present.

  Also, find a way to feel peaceful—for example, by breathing deeply or visualizing something serene, such as a sunset—when uncertainty nags at you.

  Focus on wellness. Instead of using your energy worrying, redirect it toward staying healthy. Consider consulting with a registered dietician who specializes in healthy diets for cancer patients. Be as physically active as you can—exercise can boost your mood. And if you’re a smoker, try to quit.

  Take charge of what you can. Stick to your follow-up plan for cancer care by showing up for every visit and test your oncologist advises. And as much as possible, get back to your routine. Even something as simple as setting a daily schedule can help you feel in control.  

  Write down your worries. “Think of this almost like a data dump,” Dr. Finestone said. Make a list of your worries either on paper or in your smart phone. Then take that list to your next doctor’s visit and ask, “Are these worries realistic?” If a worry is particularly pressing, call your doctor right away.

  Create a worry time. Designating a specific time to fret every day can relieve anxiety. Choose the same place and time—just not close to bedtime. Set aside about 10 to 15 minutes and make the rest of day a worry-free zone. “If a concern crops up, tell yourself, ‘Not now, I’ll save you for later,’” Dr. Finestone said.

  Get support. Talking openly about your worries—rather than trying to bottle them up—can help you feel supported and stronger. So, seek out a trusted friend or loved one who listens well, a clergy member who might comfort you, or a mental health professional who can help you manage your worries.

  You can also turn to the Patient-to-Patient Support Network at Fox Chase. This telephone-based support program can put you in touch with other survivors who have a similar cancer or who have had similar treatments. Call 215-214-1618 for information.