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Breast Cancer

Post-Cancer Fears

02/03/1999

Question:

Hello,

I wrote a couple of months ago when I was not even 1/2 way through radiation therapy and asked how I could keep my spirits up. I want to thank you for your suggestions, many were very helpful! Now I'm done with the radiation treatments and I guess I just pretty much have to wait and see what happens next (hoping that will be Nothing). I have another question now. I feel like i'm turning into a hypochondriac! Every little twinge scares me into thinking the cancer is coming back. I was never like this before. I seem to be particularly susceptible to coughs and colds since I had my cancer surgery, and what bothers me is every time I get a little swollen lymph node with a respiratory infection I start to panic that it is the cancer coming back (or spreading). Does this worry ever go away? I don't want to be always fretting about my health or complaining over things that are really minor and nothing to get excited about. Is there any good way to tell when something is minor and not life threatening besides running to the doctor or getting in a panic over every little thing? I feel very embarrassed when I do this. Thank you again for your help!

Answer:

Thank you for writing again. Women who have completed treatment and are survivors of breast cancer do live with an ongoing fear of recurrence. It is one of the most common concerns of survivors. This fear does subside with increased survival time. For coping with the fear of recurrence, therapists suggest you confront the fear and examine your feelings and attitudes about it. You have done this by expressing yourself and identifying your behaviors and fears. This is the first step in resolving your fears and building positive attitudes. The therapists recommend a program of exercise, relaxation, reading and mental imagery. Exercise programs that involve aerobic exercise and regular walking play a positive role in physical and psychological health. You may start your exercise program with a self paced program of walking 4-5 times per week for 20-45 minutes in your neighborhood. This will improve your physical performance and lessen fatigue. You don't mention fatigue but physical well-being contributes to mental well-being. There are studies that show that cancer survivors with close family ties and support networks reduce the difficulties of adjustment and fears of cancer recurrence that you are experiencing. Joining a support group designed specifically for women with breast cancer will be a great boost for your adaptation to post treatment. The survivors in support groups will be helpful in providing support and offering suggestions for effective coping behaviors for your fear of recurrence. You will find other women have had the same feelings and behaviors that you are experiencing. You will identify with some suggestions and adopt some of the behaviors that will help you cope with or overcome your fears. Research has shown that support groups may be the most powerful influence on adaptation in any phase of breast cancer from diagnosis through post treatment. The results show increased self-concept, and an increased sense of self power as a result of increased coping skills. The wisdom that survivors have to share is invaluable. Call your local American Cancer Society for the names of support groups that are available in your community. The support groups that I am familiar with are: I Can Cope, Y-ME National Breast Cancer Organization (800 222-2141), Wellness Community Support Group, Encore Program offered by the YWCA, and the National Cancer Institute(800 4-Cancer). I want to emphasize that the feelings and fears you have described are experiences the great majority of cancer survivors have. If you have not shared these fears with your physician and oncology nurse, please do so. They can review the symptoms that need to be reported. The oncology nurse is well educated about physical and emotional changes that women experience. The nurse can be a major source of support. Let your doctor and nurse know what your needs are. Ask them for information on support groups and names of other patients with similar problems you can talk to. Monthly self examination is an important method of detecting a recurrence. The doctor will outline the frequency of physical examinations and mammograms to detect any recurrence. This medical follow-up is necessary for the rest of your life. You are facing a difficult challenge but you can overcome your fears with more knowledge and help from others. The public library is also a good source of books on breast cancer that deal with your specific problem. I would like to hear from you again. Please let me know what has been helpful to you. Thank you for writing.

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Response by:

Janet   Trigg, RN, MSN, EdD Janet Trigg, RN, MSN, EdD
Formerly:
College of Nursing
University of Cincinnati