Thanks to earlier identification and better treatment of breast cancer, millions of women are surviving the disease. But even when they are cured, too many find they are living with a ghost that continues to haunt them.
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“Half to all of breast cancer survivors experience fear of recurrence. This fear can be significant and profoundly affect their lives,” says psychologist Kathleen Ashton, PhD.
Very real fears
Fear of recurrence is not related to true risk. Nor does it diminish over time. Rather, it tends to remain stable or grow.
Typically, these fears start as treatment ends, and the patient realizes she will no longer be doing something every day to beat her cancer. Nor will she have regular contact with her medical team, who were her allies and support.
“Suddenly, she has more time to worry and begins wondering if the cancer will come back and she will die,” Dr. Ashton says.
Some women start worrying about recurrence the day they are diagnosed. Not surprisingly, women with a history of anxiety or depression are at greater risk of experiencing these fears.
Pressure to get back to ‘normal’
Women who fear recurrence may be unable to feel happy when they get the all-clear signal. They may not understand these negative emotions, and neither will their family and friends. This intensifies feelings of loneliness. “There is pressure to feel like you are back to normal,” says Dr. Ashton.
Over time, anxiety over “waiting for the other shoe to fall” may become overwhelming. The patient may become consumed with fear about the potential problems associated with a cancer recurrence and wonder how her illness will affect her family. She may find herself seeking emergency medical care for minor issues, like headaches or flu, thinking her cancer has come back.
Reach for help
If worry about recurrence is interfering with your ability to enjoy a cancer-free life, don’t ignore these feelings. Make an appointment with your oncologist for a heart-to-heart talk, and ask for:
- The likelihood of recurrence for you as an individual.
- A list of every treatment you received and how much it lowered your risk. Be sure any agents you continue to take are on this list.
- A survivorship plan that includes a timetable for surveillance and follow-up appointments.
- A list of lifestyle changes you should make to reduce your risk.
These steps should help dispel your fear. If they do not, ask your doctor for a referral to a mental health professional.
“Sometimes logic and facts are not enough to eliminate a clinically significant fear. The next step is to see a psychologist for cognitive behavioral therapy or other evidence-based treatment,” Dr. Ashton says.