Fear of Cancer Coming Back

It is normal after active cancer treatment finishes to experience fears about cancer coming back and for some people this can affect mood, relationships, work and self-esteem.

Clinical Psychologist, Dr Christine Bonathan gives an insight into how the Fear of Recurrence programme is helping breast cancer patients to overcome some of their fears and anxieties and to move on to live more fulfilling lives.

For more information, please talk to your health professional, call us direct on 0141 301 7263 or email Fiona who runs the programme here: Fiona.Sinclair5@ggc.scot.nhs.uk

Read more about out Fear or Recurrence programme here.

What is fear of recurrence?

Most people who have completed active treatment for cancer worry about it coming back. This is perfectly understandable and normal, and often the worry will lessen over time.

For others however, the fear and anxiety can be overwhelming and get in the way of reconnecting with what makes life meaningful. Perhaps leading them to become socially isolated, avoid planning for the future or not returning to a job or hobby that they previously enjoyed.

When does it affect people?

The end of active treatment can be a complicated time. There might be relief about getting to the end of a difficult treatment regime and family and friends may want to celebrate, thinking that everything is better again.

But the end of treatment also brings less contact with healthcare professionals which can feel frightening. Where life may have been taken a day at a time to get through gruelling treatments and there was a task to focus on, now there is suddenly more time to fill and lots of thinking space. This is where fears and worries about the future can begin to grow.

Further down the line someone you know having cancer recurrence, coming across stories in the news or even a setback in your personal life can re-trigger fears and worries about cancer. Fear of recurrence can affect people at any time.

What support is available?

The Beatson Cancer Charity has funded a project for breast cancer patients who have completed active treatment. A therapeutic radiographer and clinical psychologist run a 6 week group that helps people learn skills to manage fear and anxiety so that they can get back to living the life that they want for themselves.

The group content is underpinned by a therapeutic model called Acceptance and Commitment Therapy (ACT). It teaches skills in stepping back from unhelpful thoughts and provides an introduction to mindfulness. Work is done to identify values and get in touch with what a better quality of life would look like with a view to using new skills to make positive changes to the way they are living their life.

There are also patient education components which cover dealing with new symptoms including when to seek help as well as information on the latest research and treatments. These sessions often bust myths about the impact of lifestyle on breast cancer recurrence and people generally leave realising that it’s more than ok to enjoy the odd treat.

Finally many patients say that the peer support aspect of being in a group is invaluable. It can be reassuring to know others have similar fears and worries and inspiring to witness others start to overcome their struggles.

What difference does the group make?

Throughout the 3 years that the fear of recurrence project has been running data has been collected from patients and the statistics clearly show that after participating in a group people have less fear of recurrence, are less anxious and depressed and report a better quality of life.

By the end of the group patients often speak about being less preoccupied by worry, being more physically active, re-connecting with friends and family and getting back to doing things they enjoyed in the past. Many also find that they re-evaluate what is important to them in life and some make significant changes to things like their work-life balance.

What about other types of cancer?

The fear of recurrence group is currently only open to breast cancer patients. However there are other support groups as well as individual counselling and clinical psychology sessions available for all cancers. Speak to a member of your medical team if you are struggling with fear of recurrence and they will be able to direct you to an appropriate source of support.