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Monday, November 7, 2011

Dealing With the Fear of Recurrence

By Richard Frank, MD

One of the most difficult challenges in coping with cancer is dealing with the fears of recurrence.

In the jargon of cancer, we talk of “remission,” which can be partial (cancer goes partly away) or complete (no evidence of cancer can be found). Examples of partial remission include stage IV cancers (metastatic to different regions of the body) that reduce in size, as detected by tests such as CAT, PET or bone scans; complete remission may be obtained at surgery (for early stages of breast, colon, prostate, lung, etc.) which is often followed by some type of chemotherapy or hormonal therapy to prevent a cancer relapse or recurrence.

So whether a person is living with an active cancer or has been told they are “cancer- free,” the possibility of the cancer returning or reactivating is very real.

Needless to say, every day in my oncology office, I see patient after patient dealing with the fear or apprehension of a cancer recurrence. They love me to say, “You’re cured” or, “Still clear, the scans are perfect!” They leave reassured and happy but I know their fears will creep in and heighten in the days before they are due to see me again for another checkup.

Beyond my practice, I have close friends and loved ones in my family who are cancer survivors. They confide in my their fears and I try my best to alleviate these and reassure them that things are well, that they are well and that hopefully they will continue to be well. But I can never make that guarantee, because I cannot possibly know the future and cancer can be unpredictable.

It takes work to deal with the fears of recurrence. The first step in doing so is to acknowledge the reality of the situation — not to bury it mentally and ignore it. But it is not helpful to focus on it again and again; it is important to “live for today,” as I have recently blogged about. There are many other helpful coping strategies and helpful individuals experienced in this field.

One of my most trusted resources is Wendy Harpham, MD, a physician who has personally had to deal with cancer over the past 20 years. She is a wonderful patient advocate who blogs, authors books, lectures and inspires patients and physicians on how to cope with cancer and its aftermath. I would encourage everyone to follow her blog on Healthy Survivorship. Dr. Harpham alerted her followers to a helpful video on this topic.

Finally, I would encourage all cancer patients and their loved ones to attend a support group, led by an experienced professional, such as an oncology social worker or family therapist. Rather than inciting more fear, bonding with other survivors can be a great comfort. Individual counseling should also be sought out, especially for those who have private concerns that they would not like to share with others. Most cancer centers have counselors available free of charge; there are also other organizations that have support groups and counseling, such as CancerCare or Gilda’s Club.

Posted by: Richard C. Frank, MD at 9:44 am


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