After treatment ends, one of the most common concerns survivors have is that the cancer will come back. If this does happen, it is called cancer recurrence.
Having a fear of recurrence is very normal. The main way to reduce the chance of cancer recurrence is to have a good follow-up care plan, also called a survivorship care plan, with a health care team you trust. Knowing your health is being closely monitored can help reduce your fear of recurrence. If fear of recurrence persists, there are additional things you can do to help control this fear and reduce its effect on your daily life.
How to cope with the fear of cancer recurrence
Living with uncertainty is never easy. It is important to remind yourself that fear and anxiety are normal parts of survivorship. Worrying about cancer coming back is usually most intense the first year after treatment. This worry usually gets better over time, and you should let your health care team know if it does not. Here are a few ideas to help you cope with the fear of recurrence:
Recognize your emotions. Many people try to hide or ignore “negative” feelings like fear and anxiety. Naming them will help you think about ways to cope with them.
It often helps to talk about your fears with a trusted friend, family member, or mental health professional. Talking out loud about your concerns may help you figure out the reasons behind your fears. This might include the fear of having to repeat cancer treatment, losing control over your life, or facing death. You can also try writing down your thoughts, such as keeping a journal, or expressing yourself through art or music.
Do not ignore your fears. Telling yourself not to worry or criticizing yourself for being afraid will not make these feelings go away. Accept that you are going to experience some fear, and focus on ways to manage the anxiety. Be aware that your anxiety may temporarily increase at specific times. For instance, when you need follow-up imaging scans, you may experience "scanxiety." Other times this fear often increases includes follow-up lab tests or doctor visits, the anniversary of your diagnosis, or a time when someone else gets a new cancer diagnosis.
Sometimes, you may worry about things that are unlikely to happen. Talking with your health care team about your worries can help by discussing the likelihood of your concerns together.
Join a support group. Many cancer survivors find joining a support group to be helpful. Support groups offer the chance to share feelings and fears with others who understand. They also allow you to exchange practical information and helpful suggestions. The group experience often creates a sense of belonging that helps survivors feel less alone and more understood.
Make healthy choices. Healthy habits like eating nutritious meals, exercising regularly, and getting enough sleep help people feel better both physically and emotionally. Avoiding unhealthy habits, like smoking and excessive drinking, helps people feel like they have more control over their health. Read more about healthy living after cancer.
Reduce stress. Finding ways to manage stress will help lower your overall level of anxiety. Try different ways of reducing stress to find out what works best for you. Tips to reduce stress include:
Spend time with family and friends
Focus on hobbies and other activities you enjoy
Take a walk, meditate, or enjoy a bath
Read a funny book or watch a funny show
Be well informed. There is some research about the pattern of recurrence for many types of cancer. But no one can tell you exactly what will happen in the future. Your oncologist or another health care professional who knows your medical history can tell you about the chances of the cancer returning. They can also tell you what symptoms to look for. Knowing what to expect may help you stop worrying that every ache or pain means the cancer has returned. If you do experience a symptom that does not go away or gets worse, talk with your health care team.
Stick with your follow-up care plan. A main goal of follow-up care is to check for a recurrence of cancer. Recurrence can happen in the weeks, months or even years after your original cancer was treated. Your follow-up care plan may include regular physical examinations and or tests to keep track of your recovery. Having a regular schedule of follow-up visits can provide survivors with a sense of control. Find more information on developing a survivorship care plan.
When you may need more help
You might find yourself overwhelmed by fear or anxiety even after your best efforts to cope with it. The following signs may indicate more serious anxiety or depression:
Worry or anxiety that gets in the way of your relationships and daily activities
Fear that prevents you from going to your follow-up care appointments
Hopelessness or apathy about the future
Difficulty sleeping or eating well
Not participating in activities you used to enjoy
Trouble concentrating or making decisions
Feeling that you have nothing to look forward to
Being unusually forgetful
If you are concerned about anything on this list, talk with your health care team. You may also want to consider counseling. Counseling may help you sort through unrealistic and realistic fears and give you tools to reduce anxiety. Working with a counselor can also help determine if you have ongoing symptoms of depression or chronic anxiety that could be relieved by additional support, like medication or psychotherapy.
Questions to ask the health care team
What follow-up care plan should I follow to watch for a possible recurrence?
What is the likelihood of the kind of cancer I had returning?
What symptoms of a cancer recurrence should I watch out for?
Which doctor should I talk with if I suspect a cancer recurrence?
Who can I talk to about anxiety or worry I experience about cancer recurrence?
Can you recommend any support groups or counseling services that might help?
Podcast: How to Cope with Fear of Recurrence
Telephone and E-Mail Cancer Helplines
What Comes After Finishing Treatment: An Expert Q&A
Why Cancer Survivors Should Have a Written Survivorship Care Plan
Dealing With Cancer Recurrence
National Cancer Institute: Facing Forward Series: Life After Cancer Treatment