Living with Uncertainty: Overcoming the Fear of Recurrence

By Gloria Top, RN, CBCN, CN-BN Feb 28, 2017

How does one learn to live with a cancer diagnosis?

Upon an initial diagnosis of cancer, one is educated about his or her specific disease and treatment, usually proceeding positively with courage and strength as the plan of care unfolds. This plan of care may include surgery, chemotherapy, radiation and/or endocrine therapy.

However, quite often a survivor will articulate feeling fearful and anxious when cancer treatments are completed. At a time when family and friends feel their loved one should be elated, why is it that instead he or she may feel unsettled, anxious and uncertain? Isn’t the tough part of the cancer diagnosis finished?

There are a couple of reasons for these feelings of ambiguity. First of all, there is a sense that cancer won’t come back as long as one is in treatment. Frequent clinical exams, blood work and drug therapy help aid this sense of reassurance.

Secondly, there is a relationship that develops between the survivor, providers, nurses and extended staff. A huge team of different disciplines are all part of a survivor’s treatment plan. Friendships and bonding happen throughout the crisis. Many positive unexpected blessings occur, but now the survivor is moving from active treatment and the comfort it brings into a time of uncertainty and potential change. Life felt stable and controlled prior to the cancer diagnosis, and now it is full of unanswered questions and change.

John Wynn, MD, wrote an article, “After Cancer Diagnosis, Moving Beyond Our Fears,” which was published in Coping with Cancer magazine.

Dr. Wynn says, “Much of our life is certain: the sun will rise in the morning, the news will come on, birds will fly, and the highways will hum with traffic. Today will be pretty much like yesterday. These truths reassure us that we live in a constant, certain, reliable world. However, there are deeper truths we easily overlook. Change is constant.”

Dr. Wynn continues, “Friends come and go. We are born, we live and we die. Our time here is limited, and even our trusted beliefs are vulnerable. … You have not built your life around certainty; you have built it around values, priorities and purpose.”

So how can we learn to live with uncertainty and fear? This is a very difficult question to answer and even more difficult to practice every day. It is important to remain vigilant in following the physician’s recommendation for monitoring and follow-up appointments. The American Cancer Society recommends adopting a healthy lifestyle including exercising 150 minutes per week, maintaining a BMI within the range of 18 to 25, decreasing stress and eating at least 2.5 cups of fruits and vegetables a day. All of these actions decrease the risk of recurrence.

Life is always about choices. As an oncology nurse navigator and cancer survivor, I feel the mental battle is the toughest. It is helpful if one can adopt a “mindful state” of being in the present, living each day and each moment in the best way possible. This means living out the values, principles and purposes one believes in and building a legacy that will affect others in a positive manner, whether diagnosed with cancer or not. None of us is guaranteed tomorrow. This brings perspective to a cancer diagnosis as well as decreasing fear and worry, freeing us up to live a rich and meaningful life.


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