Fear of cancer recurrence – anxiety or concerns around cancer returning – is common among individuals coping with cancer, especially in the post-treatment or survivorship phase. Given that most cancer if left untreated is life-threatening, some level of fear of recurrence is a human reaction and completely understandable.

Is fear the only emotion you feel when you are experiencing fear of recurrence? Fear of recurrence runs the gamut of emotions depending on the individual. For some the fear of cancer returning can be an understandable but controlled concern. For others, the fear may be severe, disruptive, and debilitating and can even lead to depression. For some cancer survivors, the thought of a recurrence can bring more distress than an initial diagnosis as people worry about experiencing the burden of cancer treatment again, or about fewer options to treat their cancer. Anxiety and thoughts surrounding re-engaging in treatment can feel overwhelming.

Regardless of your level of fear and anxiety, there are practical and emotional strategies that can help when dealing with the fear of cancer recurrence.   

• Know what to expect. Your medical team can talk with you about your clinical risk of recurrence as well as what symptoms to look out for. It is also important to know the kind of follow-up care to expect and to control that care by scheduling and attending these visits.  

• Prepare yourself for the ups and downs. It is common for anxiety about recurrence to be heightened at certain times. You may notice an increase in your fear around follow-up scans and appointments, the anniversary of your initial diagnosis, or when another relative or acquaintance is diagnosed with cancer. 

• Consider social support. Some cancer survivors find that participating in a support group allows for connection with others who understand and can empathize with their concerns. It can help to feel less alone while coping with the fear of recurrence.  

Emotional strategies for dealing with fear

Remember fear is normal: Fear is an adaptive human response to threat, and it is a normal response to thinking about your cancer returning. While animals can turn off their fear system quickly after the threat passes, humans have the gift of language and the thoughts we create in language in our minds. These thoughts can put us in a constant state of arousal or worry, even when the threat of the cancer returning is minimized by oncology treatment. 

Allow and welcome all emotions: Allowing does not mean liking the normal emotions you are feeling, but it can help to name and identify the range of emotions you are experiencing. Realize that you are not your emotion. Understand that you can notice it, and then decide what action you want to take. Emotion passes –coming and going in waves so embrace them as they wash over you.  

Consider talking with a trusted family member, friend, or counselor: Talking about your fear may help you understand the reasons behind it. Perhaps you are worrying about the loss of control, the prospect of dealing with more treatment, or even, dying. “Better out than in,” is one way of thinking about releasing some of the burden of carrying your worries alone.  

Reflect on your values and what brings meaning to your life: Connecting to your core values can help ground you with the present moment. This can be helpful while living with fears of the future.   

Employ relaxation and stress management to help manage your emotions: Changing or adding a healthy behavior can help provide a feeling of control. Know that you can do something different. You can control your behaviors even when you are coping with the unwelcome fears that cancer brings. Some ways that may help lower anxiety include:  

• Meditation 

• Breathing and mindfulness practice

• Journaling  

• Scheduling neutral or joyful activities  

• Exercise  

• A healthy sleep routine  

• Healthy eating  

• Activating your relaxation response — check out our Iris Mini exercise for help practicing this

• Practicing Progressive Muscle Relaxation

When to seek help

It is important to recognize when you might need more support to manage the fear or anxiety around your cancer returning. Consider talking with your medical and Iris teams for help if you are experiencing the following:  

• Worry or anxiety that is getting in the way of daily activities, impacting relationships, or going to follow-up care appointments 

• Difficulty sleeping for more than a few nights 

• Feeling hopeless about the future  

• Not engaging in activities you previously enjoyed  

• Changes in appetite or trouble eating well 

• Difficulty concentrating and making decisions  

• Being unusually forgetful 

 While concerns about a cancer recurrence are expected, for some survivors, the fear of recurrence can feel overwhelming. If this is you, it’s important to address these fears and develop strategies to cope more effectively with uncertainty to improve your quality of life and overall well-being.

Getting support

If your anxiety about recurrence is taking over your day-to-day life or getting in the way of follow-up medical care or adversely impacting your relationships, consider meeting with an Iris mental health clinician for added support. It’s crucial that you realize that you don’t have to deal with the fear of recurrence on your own. For individualized help facing those fears, schedule an appointment with an Iris mental health therapist now.