What is Fear of Cancer Recurrence? Addressing this Challenge Through Research

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Jul 18, 2022

Why am I so afraid of my cancer coming back now that my treatment is complete?

Many people who have undergone treatment for cancer report being afraid once treatment is done, including having many fears about the future, which can feel very overwhelming.  What you are experiencing is common and it is called fear of cancer recurrence (or fear of cancer progression). In addition to feeling distressed due to receiving a cancer diagnosis, it is also common to experience fear that your cancer may come back once your treatments are completed. For most people the possibility of having to go through the process all over again is very distressing.  It is also common to worry or be afraid that if cancer does come back (or if it gets worse) you may not have a positive outcome this time.

 

What is the relationship between ongoing screening and fear of cancer recurrence?

There is a delicate balance between ongoing screening and fear of cancer recurrence.  On one hand, it is critically important to maintain all screenings recommended by your healthcare team. This ensures that you remain cancer free, and if a recurrence is identified early, it will often lead to a better outcome. However, when an overwhelming sense of fear, worry, or rumination takes over your mind, it can negatively impact your quality of life.  While ongoing follow-up is important, it is unhealthy to continuously check your body. Being afraid that your cancer will return is common, and you are not alone. If these feelings do occur, it is important to reach out to your healthcare team and let them know. Your healthcare team can find ways to help you cope with these feelings and ensure that you live your best life as a cancer survivor. 

 

What is the role of research in addressing fear of cancer recurrence?

Studies show that approximately 31% - 52% of cancer patients experience fear of cancer recurrence1. Therefore, we need to address this substantial problem, and one way to do this is through research.  My research has mainly been focussed on breast cancer patients and fear of cancer recurrence2; however, we know that patients with all types of cancer fear its return or progression. I was also involved with a group that did a Delphi study on this issue3. Currently, I am working  with a group of collaborators across Ontario, exploring how to better diagnose and then treat people with clinical levels of fear of cancer recurrence. In collaboration with Cancer Care Ontario, we are writing clinical guidelines on how to diagnose fear of cancer recurrence, and what treatment options are best. Moving forward, I would like to do more on this topic, to examine if we can identify what triggers fear of cancer recurrence during treatment and find new mechanisms to  ‘short-circuit’ it during cancer care.

 

Further reading:

 

About the author:

Dr. Laurie Freeman is an Associate Professor in the Faculty of Nursing at the University of Windsor. She earned her BScN from the University of Windsor, her Master’s in Nursing from Wayne State University, and her PhD in Nursing from the University of Michigan. Dr. Freeman studies cancer survivorship, and she is particularly focused on fear of cancer recurrence in breast cancer patients, researching ways to mitigate the fear response in patients and improve their quality of life in the survivorship phase of cancer. She is also evaluating the use of technology in cancer patient care and treatment, looking specifically at what can ease the patient’s journey and help them cope during this phase. Another interest of Dr. Freeman’s is the use of applications as a tool during the coping process as well as a communication channel to update health-care providers regarding patient’s symptoms. Research into cancer recurrence and technology can reveal the effect of interventions during treatment and the impact on outcomes of survivorship.

 

References:

  1. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6498985/
  2. Freeman-Gibb, L.A., Janz, N.J., Katapodi, M.C., Zikmund-Fisher, B.J. & Northouse, L. (2016). The relationship between illness representations , risk perception and fear of cancer recurrence in breast cancer survivors. Psycho-Oncology 26(9) https://doi.org/10.1002/pon.4143
  3. Shaw, J., Kamphuis, H., Sharpe, L., Label, S., Smith, A.B., Hulbert-Williams, N., Dhillon, H.M., Butow, P. (2021). Setting an international research agenda for fear of cancer recurrence: An online Delphi consensus study. Frontiers in Psychology 22(12):596682.doi: 10.3389/fpsyg.2021.596682
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