Scanxiety: Dealing with the Fear of Cancer Recurrence

Living with uncertainty is never easy. From a personal perspective, my fear of recurrence intensifies as the date approaches for my annual CT scan to evaluate my “sleeping follicular lymphoma”. I refer to this as my “scanxiety” and remind myself that fear and anxiety are normal parts of survivorship.

Studying the fear of recurrence

It has been reported that half of cancer survivors overall report a moderate to high fear of their cancer returning, known as relapse or recurrence.¹ A psychological intervention called "Conquer Fear" was tested in a study to see how it impacted fear of recurrence. It was found to significantly reduce fear of recurrence immediately after therapy, as well as at several points in the months following the conclusion of the study. General anxiety, cancer-specific distress and quality of life were more improved in the psychological intervention group immediately after the intervention. The results of this study were presented at the 2017 American Society of Clinical Oncology (ASCO) annual meeting.¹

According to the lead study author, Dr. Jane Beith, "the reduction in the fear of recurrence in the psychological intervention group was large enough to improve the survivors’ psychological and emotional well-being."¹ It is important to note that this intervention was not currently being used in clinical practice at the time of the study or presentation at ASCO.

The sample included over 200 survivors of stage I-III breast cancer, colorectal cancer, or melanoma who experienced a high fear of cancer recurrence but were cancer-free at the time of the study. Each participant was assigned to either the "Conquer Fear" group or a control group that utilized relaxation techniques. Both groups participated for 10 weeks.¹

Exploring different interventions

The participants assigned to the Conquer Fear group received five, 60-90 minute long individual sessions with a trained therapist.

The following aspects were included:

• Accepting the unknown of whether cancer would return or not
• Providing strategies to reduce worry
• Assisting survivors in finding more control regarding where they focus their attention
• Focusing on what the participant wants to get out of life
• Choosing and following a reasonable cancer screening program¹

The control group received five, 60 minute, individual, face-to-face relaxation sessions that included techniques like muscle relaxation and visualization. A questionnaire was used to measure any changes to the participant's level of fear of recurrence.¹

The benefit of the Conquer Fear technique

The findings demonstrated that the total fear of cancer recurrence score was reduced significantly more in the group that utilized the Conquer Fear technique. The study also found that the Conquer Fear intervention had a greater positive impact on other patient outcomes, including anxiety, depression, and aspects of quality of life.

The study leaders noted that the face-to-face format can be time and resource intensive. Other formats, such as virtual or group formats, may be effective and should be studied.

This study emphasizes the need to address the fear of recurrence.

Recognizing and accepting the worry

A strategy that I have found successful includes recognizing your emotions. I do not hide or ignore these negative feelings, which can become overwhelming if not addressed. Talking with friends and family, and writing down/journaling your thoughts may help. Spending time with family, focusing on activities that you enjoy, exercise, music therapy, and meditation are also helpful. I have found the practice of yoga to help lessen my anxiety and promote well-being.

Keep well informed. Your physician, who knows your medical history, can tell you about the chance of cancer returning. The physician will also indicate what symptoms to look for. Knowing what to expect can help you to stop worrying that every ache and pain means that cancer has returned. Maintaining a regular schedule of physical exams and medical tests can provide you with some level of control.