Making it through cancer treatment can be a grueling process. And when it’s done, people want to “get back to their lives” as much as possible. But the fear of cancer coming back — or recurring — can make that process difficult.
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It’s natural for people who’ve lived (or are currently living) with cancer to be afraid of a recurrence. And it’s equally natural to want to get rid of that fear, especially when it interferes with quality of life. But well-meaning advice to “stay positive” may fall short.
We spoke with psychologist Karen Hurley, PhD, about cancer anxiety: How to recognize it, tips for addressing it and what to do if it’s gotten bigger than you can handle.
According to Dr. Hurley, the process of getting back on track after cancer treatment isn’t always easy. “There may be ways which you can re-engage with your goals, and there may be some goals that need to be changed or dropped altogether, which is a painful process, and one that requires time to sort through.
“Making plans or cultivating hopes again feels vulnerable,” she continues. “If those dreams have been knocked over to the side once, what’s to stop that from happening again? It may have always been there, but there’s a new sensitivity to how vulnerable our plans for the future really are.”
Dr. Hurley elaborates, “You may feel lost because no one can promise you that it won’t come back, even if you follow all the recommendations you get. You may feel demoralized that you got knocked off track with something that was important in your life — whether it’s school, building a family, work, or other obligations.”
There are often a lot of other feelings mixed in with cancer recurrence anxiety. “For example, some people will be very angry about their cancer diagnosis because they ‘did everything right’ and got cancer anyway,” she says. “So now, what are they supposed to do in order to protect themselves?”
Common anxiety triggers
Understanding the feelings contributing to your cancer anxiety is one of the first steps in addressing it. But it’s also important to know what outside factors provoke it.
Below are some common anxiety triggers people living with (or in remission from) cancer experience:
- Awareness months. Consciousness-raising campaigns around cancer are a double-edged sword. They bring in millions of dollars for fundraisers and encourage people to get screened, but they also place messaging about the disease everywhere, making the reminder constant and sometimes overwhelming. This is especially true in October: Breast Cancer Awareness Month. Wading through a sea of pink ribbons is empowering for some. To others, those bits of fabric are reminders of a painful past and an uncertain future.
- Television. Whether it’s a public service announcement about the importance of HPV vaccines, a news story about the newest scientific breakthrough or an episode of your favorite medical drama, it’s hard to avoid cancer on TV.
- Diagnosis, recurrence or progression news. When other people share our misfortunes — whether we know them personally or not — most of us feel empathy of some kind. That’s a good thing, but it can also lead us to relive our own traumatic experiences.
- Over-googling. Knowledge is power, and it’s normal to try and counter uncertainty with information. That said, spending too much time researching symptoms and statistics can overexpose you to anxiety-provoking information.
Dr. Hurley recommends practicing a three-step process she calls “information hygiene.” First, form a specific question. Second, limit your search to trusted sources to answer that question. Third, back away from the computer or phone to process what you’ve learned.
- Physical symptoms. People who’ve been living with cancer tend to be hyper-aware of their bodies, and people with anxiety often experience physical symptoms of stress. Learning to distinguish between fleeting physical sensations and signs that need medical follow-up can be especially challenging for people who had few or no symptoms before their diagnosis.
Being unable to make the anxiety go away, unsurprisingly, can make you more anxious. Without proper coping mechanisms in place, that fear or recurrence and progression can spiral.
Coping with fear of cancer recurrence or progression
We’ve already discussed how reframing your anxiety can help you better understand it. Now, let’s learn how it can actually help us cope.
Dr. Hurley teaches people dealing with cancer anxiety mind-body techniques for stress relief. Here are three of the exercises she recommends:
- The “Breath Brush.” Take a normal breath, and imagine that breath can travel inside you, find anxious sensations and brush over them lightly — like a feather, or the way you’d touch a baby’s forehead. Dr. Hurley explains: “That soft stroking sensation will help you cultivate a gentle relationship to your anxiety, tending to it rather than staying fearful of it.”
- Color naming. To distract from rising anxiety, look at your immediate surroundings, and name three things that are blue. Then look again, and name three things that are NOT red. This exercise activates verbal and organizational areas of the brain, directing attention away from mid-brain areas associated with anxiety.
- Coping statements. Focus on things that are real and true that you can say about your situation. It’s not unusual when dealing with the fear of cancer recurrence to hear attempts at reassurance like, “You’re going to be OK” or “Stay positive.”
But if you’ve been diagnosed with cancer, you’ve already experienced that things don’t always turn out the way you hope. Instead, Dr. Hurley suggests realistic statements like, “I’m doing what I can do with what I have” or “I’m in good hands with my healthcare team.”
Reach out for support
If you’re reading this article trying to figure out if you’re anxious enough to justify a call to your oncologist, call them. Cancer isn’t a one-size-fits-all experience. Communicating your thoughts and feelings to your medical team will help them help you.
Cancer is scary, and it’s normal and natural for you to worry that it may come back or spread to other parts of your body. Learning to live with that anxiety might not be easy or fun, but it’s a struggle worth having, and one you don’t need to go through alone. Organizations like CancerCare have a lot of resources to offer and can connect you to peers who share your complicated relationship with the future.