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Leaving Fear and Uncertainty Behind

A Plan for Embracing New Choices and Opportunities

by Merle H. Mishel, PhD, RN, FAAN, and Barbara B. Germino, PhD, RN, FAAN

Wellness image

Everyone experiences feelings of uncertainty now and then. But as a cancer survivor, you may find yourself wrestling with a unique type of uncertainty – the possibility of cancer recurrence. This fear of your cancer returning can linger long after treat­ment ends.

Though your concerns may subside over time, certain things can cause your fears to resurface, such as pain or unusual physical symptoms, particu­lar sights and smells, looming doctor’s appointments, and stories of others’ experiences with cancer or recurrence. What’s more, feelings that often ac­company fear, such as worry, sadness, and anger, only add fuel to the fire. The good news is there are a number of techniques you can use to manage your fear and uncertainty so you can take full advantage of your life after cancer.

Practicing basic relax­ation exercises can help you manage your body’s reaction to stress by reduc­ing muscle tension, pain, and soreness. Relaxation exercises also come in handy when you’re feeling anxious or fearful. For instance, if you feel anxious before a follow-up appointment with your oncologist, you can use a relaxation exercise such as this one to regain a sense of calm:

Take a long, deep breath. Say the word relax, and slowly exhale. Pay attention to your breathing, and slowly begin to let go of any tension or tightness in your body, starting from your head and gradually mov­ing all the way down to your feet. Repeat as necessary.

While uncertainty may leave room for a less-than-desirable outcome, a positive outcome is also possible.

Author of Article photo

Dr. Merle Mishel

Staying active and keeping busy can help take your attention away from your fears and reduce your anxiety. When you notice yourself feeling anxious, try shifting your focus elsewhere to distract your­self from the anxiety-provoking thought or situation. Here’s how:

Imagine a big, red stop sign. Then, simply stop what you’re doing and do something else. You can distract yourself by doing something you en­joy, like reading a book or going for a walk around the block, or by doing something that requires your concen­tration, like tackling a project at work or completing chores around the house. The important thing is to choose activities you can fully im­merse yourself in to help take your mind off your fears and calm your nerves. When you’re feeling more in control, you can go back and face the cause of your fear, if necessary.

Calming Self-Talk
The process of calming self-talk involves thinking to yourself or speaking aloud comforting words and phrases to counter your anxious or fearful feelings. When practicing calming self-talk, you should be positive but realistic; think of what you would say to comfort a close friend during a difficult time.

Author of Article photo

Dr. Barbara Germino

It’s helpful to have some substitute phrases prepared to replace any troublesome thoughts you may encounter. Take this for example:

Replace the troublesome thought “I’m afraid my cancer will come back” with the substitute phrase “This feeling of uncertainty is only temporary. I am in control.” Likewise, you might replace “I worry that I might not see my children grow up” with “I need to be positive and strong for my children. I will do everything I can to be there for them and make every day count.”

Embracing Positive Change
Another way to manage fear of recurrence is to look at uncertainty from a different perspective. When you’re certain about a situation, you expect a specific outcome. However, when you’re uncertain, many possibilities exist. This means that while uncertainty may leave room for a less-than-desirable outcome, a positive outcome is also possible.

Cancer offers an opportunity for you to experience growth and positive life changes, appreciate the fragility of life, and rediscover what’s important to you. By practicing the coping strategies mentioned here, and by learning to anticipate the fear-provoking situations that might necessitate using them, you’ll be better equipped to manage your fear and uncertainty so you can focus on enjoying your best life after cancer.

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Dr. Merle Mishel is a Kenan Distinguished Professor of Nursing, and Dr. Barbara Germino is a research professor, both in the School of Nursing at the University of North Carolina at Chapel Hill.

For audio files with step-by-step guidance through the coping strategies mentioned in this article, visit

This article was published in Coping® with Cancer magazine, September/October 2014.