With the new day comes new strength and new thoughts

- Eleanor Roosevelt

Fear of recurrence and living with uncertainty

After cancer treatment, the fear of recurrence and living with the constant uncertainty about your health can be exhausting.

Dealing with the “what ifs” of cancer

Acknowledging the unknowns of cancer may make you feel anxious, angry, sad, or afraid, but it is par for the course for all those living a life beyond treatment. You may even have physical symptoms from these feelings. For instance, worry may disrupt sleep or make it harder to concentrate on things you once found important. Learning to manage the uncertainty is an important part of staying healthy. These tips may help you cope:

  • Recognize that there are situations you can control and those you can’t. As hard as it sounds, many people find it helpful to let go of those things that they can’t change and focus on their reaction to events.
  • Talk with your health care team if your feelings of uncertainty are affecting your daily life. They can help you find the resources you need to feel better.
  • Talk with a counselor or social worker at the hospital. They may recommend a support group in your area. A group may help you share with others who are going through a similar cancer experience. There are also support communities online.
  • Talk with friends and family members. Tell them how you are feeling and how they can help.
  • Learn as much as you can about the cancer and its treatment. Having the right information can help you know what to expect.


Tips for coping with the fear of 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.

Here are a few ideas to help you cope with the fear of recurrence:

  • Recognise your emotions. Many people try to hide or ignore “negative” feelings like fear and anxiety. Ignoring them only allows them to become stronger and more overwhelming. 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.
  • Don’t ignore your fears. Telling yourself not to worry or criticising 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. These may include follow-up care appointments, the anniversary of your diagnosis, or someone else’s cancer diagnosis. Sometimes, what you are worrying about may be unlikely. Talking to your health care team may help you figure out if your fears are likely.
  • Do not worry alone. 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.
  • 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. This could include spending time with family and friends, focusing on hobbies and other activities you enjoy, taking a walk, meditating, or enjoying a bath, exercising regularly reading a funny book or watching a movie you enjoy
  • Be well informed. Most cancers have a predictable pattern of recurrence. But no one can tell you exactly what will happen in the future. A health care professional who knows your medical history can tell you about the chances of the cancer returning. He or she 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.
  • Talk with your health care team about follow-up care. One goal of follow-up care is to check for a recurrence of cancer. Your follow-up care plan may include regular physical examinations and/or medical 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.
  • 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.


Acknowledge when you need help-

For some, living with the fear and uncertainty of life after cancer treatment can be managed by doing self contained excersises such as meditation or guided imagery, but for others, going it alone is not a feasible option. It is important to acknowledge when you need help, and understand that it is not a negative, or weak thing.

You can find information on counsellors and cancer support groups in your area here at Survive and Thrive.