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Dealing with Recurrence

103060407_8Recurrence is the return of cancer after it has been treated and thought to have been eliminated. Head and neck cancer recurrence almost always creates an emotional crisis for patients and their caregivers.1 Adjustment to cancer: anxiety and distress. National Cancer Institute – PDQ Cancer Information Summaries, Health Professional Version. http://www.ncbi.nlm.nih.gov/pubmedhealth/PMH0032514/. Cancer recurrence can be devastating. Often the emotions you felt during the initial diagnosis return, and sometimes more strongly. You may also feel worried that you don’t have the physical or emotional strength to cope with another round of cancer and that it will be difficult to get the practical support you need.

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Fear of recurrence

Fear of cancer recurrence is nearly universal for both patients and caregivers. Caregivers continue to feel deep distress for many months after their loved one has completed treatment. Much of this anxiety is due to fear of recurrence.2 Mellon S, Northouse LL, Weiss LK. A population-based study of the quality of life of cancer survivors and their family caregivers. Cancer Nurs. 2006 Mar-Apr;29(2):120-131;quiz 132-133. Some people’s fear of recurrence becomes an anxiety disorder or leads to panic attacks or even post-traumatic stress disorder (PTSD).3 Crist JV, Grunfeld EA. Factors reported to influence fear of recurrence in cancer patients: a systematic review. Psycho-Oncology. 2012 Jun 3. doi: 10.1002/pon.3114.

Fear of follow-up tests

You may develop a fear of your loved one’s follow-up appointments, particularly the imaging scans that are often used to screen for cancer recurrence. It’s not actually fear of the tests, but rather fear of bad news that the tests might reveal that causes patients and caregivers anxiety. This is normal, but it is still difficult to handle the stress of knowing an appointment is coming up and then waiting for results.4 Feiler B. Scanxiety. Fear of a postcancer ritual. Time. 2011 Jun 13;177(24):56.

Remember that the scans do not make your loved one’s cancer return, and your loved one avoiding follow-up screenings will not keep cancer away. Scans and tests are simply the means by which you can learn if the cancer is back, and you do need to know. Just like the initial diagnosis, the earlier a new tumor is caught, the better your loved one’s chances are for survival and recovery. Think of follow-up screening appointments as early warning systems that will help your loved one continue to survive.

Dealing with a diagnosis of cancer recurrence

If you are diagnosed with cancer recurrence, try some of these strategies to help you cope.

  • Using the Same Coping Mechanisms as Your First Cancer Caregiving Experience
    Think back to your first cancer caregiving experience—the same strategies that helped you cope then are likely to help now, whether this is reaching out to your support network or using relaxation techniques.
  • Your Knowledge About Cancer
    The knowledge you’ve gained from your first cancer caregiving experience can help reduce your anxiety. You know what to expect this time around and can feel optimistic that if you did it once, you can do it again.
  • Relationships with Your Loved One’s Cancer Care Team
    Having an existing relationship with the doctor and cancer treatment center can help you feel more comfortable.
  • Renewed or Continuing Therapy, Counseling or Support Groups
    If counseling, therapy or support groups helped you during your first round of cancer treatments, continue or resume these meetings to help you cope with emotions that may be even more intense and overwhelming now. If you did not use professional help the first time but find yourself feeling more overwhelmed this time, consider seeking psychological care and assistance to help you cope with your cancer recurrence and treatment.

It’s important to use your prior cancer caregiving experiences to your advantage, as they can help you feel more in control.

When the cancer recurred, it wasn’t as bad as the first time since I knew what to expect.Tony L. (oral cancer survivor)

References

1 Adjustment to cancer: anxiety and distress. National Cancer Institute – PDQ Cancer Information Summaries, Health Professional Version. http://www.ncbi.nlm.nih.gov/pubmedhealth/PMH0032514/.

2 Mellon S, Northouse LL, Weiss LK. A population-based study of the quality of life of cancer survivors and their family caregivers. Cancer Nurs. 2006 Mar-Apr;29(2):120-131;quiz 132-133.

3 Crist JV, Grunfeld EA. Factors reported to influence fear of recurrence in cancer patients: a systematic review. Psycho-Oncology. 2012 Jun 3. doi: 10.1002/pon.3114.

4 Feiler B. Scanxiety. Fear of a postcancer ritual. Time. 2011 Jun 13;177(24):56.