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Facing the Fear of Recurrence

by Richard Dickens, LCSW-R

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President Franklin D. Roosevelt said it best in his inauguration address in 1933: “The only thing we have to fear is fear itself.” In other words, the event we most fear could change our life, but the fear of that event (which might not even happen) can be more disruptive. Chronic fear is insidious.

Let’s take a moment to look at the good and bad aspects of fear – yes, some fear can be helpful. Human beings are born with the fight-or-flight response. If something in our immediate environment threatens us, our body moves quickly into an action mode, sharpening the brain and energizing the body to rapidly de­cide whether to flee or to fight off this danger. Confronted with potential for future danger, we can be trapped in a chronic state of worry, characterized by shallow breathing, sleeplessness, upset stomach, and chronic fatigue. All of which can have detrimental effects on our health.

You have come through fearful times before and can do it again.

Author of Article photo

Richard Dickens

For cancer survivors, fear of recurrence is a legitimate concern. As a survivor, you have already experienced can­cer, gone through treatment, and un­derstandably do not want to do that again. Depending on how far away from treatment you are, you are still adjusting to the “new normal” of your post-cancer life. And you may knowingly be deal­ing with a chronic cancer that will need additional treatment at some point. So as not to become trapped in worry, how can we manage fear?

When it comes to cancer, fear has a past and a future. To manage the future, it helps to review the past. As a survivor, do you remember how scared you were when you began treatment? It seemed daunting at the time, but you got through it. Make time now to identify the strengths that got you through: tenacity, prayer, family and social networks, research, resilience, an expert medical team, hope. You might be surprised by how much strength you had, and still have. Give yourself credit for that. Those strengths will continue to help you confront any potential obstacles ahead.

Fear can also empower you to make important changes. Remember the fight-or-flight response? Many survivors respond to the warning fear creates by changing their diets, exercising more, shedding excess weight, and changing negative lifestyle choices that might af­fect their health. Fear of recurrence can empower you to be an active partici­pant in your well-being.

Other techniques to manage fear in­clude meditation, guided imagery, yoga, tai chi, support groups, qigong, nature walks, and talk therapy. And in instances where fear becomes too much, some will use medication under the guidance of their doctor to manage the effects of long-term fear.

We are born with a full range of emo­tions. Joy, anxiety, love, sadness, guilt, happiness, peace, and even fear all have purpose in our lives. When any emotion, especially fear, begins to overwhelm you, remember two things:

  • As a survivor, you have come through fearful times before and can do it again.
  • Fear can actually empower you to be more active in your ongoing well-being.
Fear doesn’t need to rob you of your goals and dreams, but your goals and dreams can be the best tools you have against fear.

♦ ♦ ♦ ♦ ♦

Richard Dickens is a clinical supervisor, program coordinator, and project coordinator at CancerCare® and a lecturer in social work at Columbia University in New York, NY. Richard presents at confer­ences throughout North America and has led workshops for healthcare professionals in Hong Kong, South Africa, and Australia on mind/body/spirit techniques. He is also a two-time lymphoma survivor.

This article was published in Coping® with Cancer magazine, March/April 2012.

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