Fear of Recurrence

A woman sitting on the sofa hugging a pillow looking nervous

Dealing with the ‘black cloud’: learn how to reduce your fear of cancer recurrence

Fear of cancer recurrence (FCR) is ‘fear, concern or worry that cancer could return or progress’. It impacts around 75% of the cancer population – so it’s likely that you’ve experienced FCR at some point.

In most cases the initial fear lessens over time. But for up to 15% of people, the anxiety interferes with daily life – and persists if untreated. Severe FCR is like a black cloud that constantly looms overhead: it impacts your ability to concentrate, to work, to sleep, to sustain relationships.

But now there’s hope. New research proves that intervention therapy really does reduce your levels of FCR and improve your quality of life.

What’s more, FCR continues to decrease over time, even after therapy sessions have finished. Once the techniques are learned, they can be used on a daily basis without the help of a trained therapist.

Psychiatrist Jane Turner was one of the project’s key researchers. Jane has more than 25 years of experience in psycho-oncology; she has a special interest in melanoma and joined the MPA Medical Advisory Committee early in 2017.  According to Jane, younger people are more likely to suffer from FCR.  Understandably, FCR is also more common in people who have others who depend on them.

Typically, FCR manifests in two extreme ways: either you become ultra-vigilant, requesting more tests and scans; or, you avoid follow-up altogether because you’re afraid of learning the results. Sound familiar? Don’t despair, there’s a way forward.

Remember, the actual FCR thoughts aren’t the problem – it’s the way you deal with them that’s important. You need to make sure those thoughts don’t take over.

Using the analogy of the black cloud, Jane continues: “There are techniques you can use to help you to get on with life and move away from the cloud rather than being stuck in the rain.”

So, what helps to manage your fear? This was the aim of the study, and the results provide some helpful insights.

Participants were assigned randomly to a group – either a control group, to learn relaxation techniques such as guided meditation; or an FCR intervention group, to learn ‘Conquer Fear’ psychosocial techniques from trained therapists. For example:

  • Detached mindfulness – you observe the thought, but you choose not to dwell on it. To use another analogy: you’re waiting for a bus – you see one coming, but you choose not to get on because it’s heading in the wrong direction. Instead, you wait for the next one.
  • Worry postponement – “I know this is an issue, but I’ll put it in my inbox and set aside time to process it later”. It’s like spam email – you don’t keep going back to dwell on it.
  • Values-based intervention – understand your values and priorities. Focus on the things that matter and let go of the ones that aren’t so.

Encouragingly, both groups reduced their FCR following treatment, but the impact was greater for the Conquer Fear group. Plus, they reported lower stress levels and a higher quality of life.

Finally, talking about your fear with trusted people also reduces stress. If you need someone to talk to, or you’d like to learn more about managing FCR, contact the MPA counsellor on 1300 88 44 50.