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Managing the Fear of Prostate Cancer Recurrence


Prostate Cancer Image

Don’t worry alone. Joining a support group offers the chance to share your feelings and fears with others who understand.

The completion of prostate cancer treatment can bring both relief and worry. When caught early, initial treatment can lead to cure, and most men will live cancer-free for years, possibly forever. However, despite successful treatment, you may still feel worried, anxious, or fearful that your cancer may come back.

The good news is that the five-year survival rate for men with localized prostate cancer is nearly 100 percent. However, up to 40 percent of all men treated for prostate cancer will experi­ence a recurrence. Therefore, it is important to understand your risk for recurrence, but it is equally important to live your life after cancer.

The fear of recurrence is normal and reasonable for all cancer survivors. Though you cannot control whether your cancer recurs, you can control how much you let the fear of recurrence affect your life.

What is cancer recurrence?
Cancer recurrence is the return of cancer after a period when no cancer cells could be detected in the body. When a man has treatment for prostate cancer, his PSA level will drop significantly. Regular testing with PSA is one of the tools the physician will use to measure if the cancer has returned. There are two types of prostate cancer recurrence: biochemical recurrence and metastatic prostate cancer.

What is biochemical recurrence?
When PSA levels rise to a certain threshold after prostate cancer treatment, this is known as biochemical recurrence. This means that some cancer cells have survived and are producing PSA. If this happens, your doctor will order addi­tional tests and make recommendations for how to manage your disease. Just as you did at the time of diagnosis, consider a second opinion and seeking care from a multidisciplinary team.

Telling yourself not to worry or criticizing yourself for being afraid won’t make these feelings go away.

There are differing opinions in the medical community about how best to manage a biochemical recurrence, ranging from immediate treatment to delayed treatment. Many factors will need to be considered, including the characteristics of your initial cancer, the rate of your PSA doubling time, your initial treatment option, and your personal health. Talk with your health­care team to make a plan.

What is metastatic prostate cancer?
When PSA levels rise and tests and scans show prostate cancer in other parts of the body, such as the bones, this means the cancer has returned and is now metastatic prostate cancer. Fortunately, there are many treatments available today to help men with meta­static prostate cancer.

What can I do to ease my fears about my prostate cancer coming back?
♦ Accept your fears. It is common to experience some fear about your cancer recurring. Telling yourself not to worry or criticizing yourself for being afraid won’t make these feelings go away. Accept that you are going to experience some fear, and focus on finding ways to help yourself manage the anxiety.

It may also help to remember that the fear usually lessens over time, and that you won’t always feel so anxious. Be aware that your anxiety may temporarily increase at certain times, such as before follow-up care appointments, around the anniversary date of your diagnosis, or if a friend is diagnosed with cancer.

♦ Don’t worry alone. Talking about your fears and feelings, or writing down your thoughts in a journal, can help re­duce your anxiety. Talking and thinking about your concerns can help you ex­plore the issues underlying your fear. Fear of recurrence might include fear of having to repeat cancer treatment, losing control of your life, or facing death.

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, as well as to exchange practical infor­mation and helpful suggestions.

♦ Adopt a healthy lifestyle. Eating a well-balanced diet, exercising regularly, and getting enough sleep helps you feel better physically and emotionally. Doc­tors do not know why cancer recurs in some people and not in others, but avoid­ing unhealthy habits, like smoking and excessive drinking, may help reduce the risk of recurrence. Adopting a healthy lifestyle will also lower your chances of developing other health problems.

♦ Reduce stress. Finding ways to lower your stress will help lower your overall level of anxiety. Experiment with differ­ent ways of reducing stress to find out what works best for you. Despite your best efforts to stay well, you may find yourself overwhelmed by fear or recur­rent thoughts of illness. If in doubt, talk with your doctor or nurse and consider a referral for counseling.

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Reprinted with permission from ZERO – The End of Prostate Cancer,

This article was published in Coping® with Cancer magazine, September/October 2015.