Will My Breast Cancer Come Back?: Dealing with Fears of Recurrence

December 15, 2017 | by Robert Young

Your breast cancer treatments were successful, your latest exam showed no trace of disease, and you’ve officially joined the ranks of cancer survivors. It’s an exhilarating feeling, a rush of relief.

But that relief can quickly turn into a nagging, persistent fear of recurrence — and that’s perfectly normal.
 
Even though everything looks good right now, it’s natural to worry if the cancer will come back at some point. For most women the fear can linger like a black cloud that never dissipates. But there are a number of ways to cope, said Ruby Bañuelos Calhoun, a clinical social worker in the Department of Supportive Care Medicine at City of Hope.  


The most important step is to give voice to your fears, get them out in the open, she said. Holding back will only make it worse down the line.

It’s common and normal to be afraid of recurrence,” Calhoun said. “For most women it’s something that never goes away completely. That’s why you need to find someone safe to talk with about your fears — a friend, mentor or peer from a support group. It’s important to find a safe space to express your fear, because it’s not going to go away on its own.” 

Expressing the fear can be a challenge, though. Many women feel that if they do, people will think they’re being negative. And they don’t want to worry their families. 

“Some survivors try to deal by burying their fear, trying not to even think of it,” Calhoun said. “They feel that thinking about recurrence somehow makes it more likely to happen, so they try to avoid these thoughts completely.”  

As much as you might want the fear to simply disappear, all you’re really doing is burying it deeper.

Being proactive and aware 

Following your doctor’s guidelines and making positive lifestyle choices can help a woman feel empowered and safe, said Lesley Taylor, M.D., a breast cancer surgeon at City of Hope. And know that the longer you go cancer-free, the more likely it is to stay that way. 

“The risk of recurrence is highest within the first three years,” Taylor said. “We celebrate with our patients when there is no evidence of disease after five and 10 years.”  

Survivors can take a proactive role by sticking to their physician’s treatment plan, taking medications if indicated and following the surveillance plan for imaging and clinical exams.  “The patient should have physical exams 1-4 times per year as clinically appropriate for five years, then annually,” Taylor said.

Taylor also encourages survivors to take positive steps to increase their overall health. “Focus on proper nutrition, stress reduction, daily exercise, no smoking, and alcohol in moderation if you drink,” she said.  

Keep in mind that while early-stage cancer is generally considered less likely to return, a later diagnosis doesn’t necessarily mean you’re at great risk. Genetic factors can help determine the risk level a woman faces, giving a more accurate picture that can help guide a survivor’s regimen or perhaps ease worries. 

“The risk of recurrence is related to the biology or the phenotype of the breast cancer,” Taylor said.  “We determine whether the cancer is hormone positive or expresses a protein called Her2/neu. In certain cases we send off the cancer for genomic analysis to help us stratify risk of recurrence.”

Let’s talk

Joining a support group is a great way to find a safe space for venting, Calhoun said. Resources like WeSPARK and the American Cancer Society can provide a wealth of support and information. 

WeSPARK Cancer Support Centers offer a number of groups based on individual needs, along with workshops and classes. It's an excellent resource for connecting with other cancer survivors in your local community, Calhoun said.  

Staying up to date on the latest ACS literature, exploring coping skills, and finding ways to communicate and deal with stress are all positive ways to empower yourself. But be selective, she added.    

“It’s important to stay connected and informed, but be careful to get your information from reliable sources. Don’t just start googling random websites and focusing on negative stories.”

Finding meaning

Taking steps to find meaning in your journey can help foster a more positive outlook, Calhoun said.  “It helps to find meaning without allowing cancer to define your identity.  Many of my patients do so by volunteering at City of Hope or other hospitals, or maybe get involved in fundraising events like cancer walks.”  

Some survivors find new life priorities from their experience, maybe something as simple as reconnecting with a family member. “It might also help to know that there are new, advanced cancer treatments being developed, and many recurrences are treatable,” Calhoun said.  

“If there is a recurrence, treatments can be tailored to increase chances of surviving and living a full life. But if the stress and fear become too overwhelming, we have psychologists, psychiatrists and other resources at City of Hope. There are also mental health professionals in the community that can be very helpful. Find what works best for you.” 

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