Managing Fear of Recurrence After Cancer Treatments End
What is fear of cancer recurrence?
Fear of cancer recurrence (FCR) is the fear, worry, or concern that your cancer will come back or progress.
FCR does not show the same in all people. You may have a very different experience than another person even though you both have FCR.
The following are some signs that you may need support to manage your FCR:
- You feel very anxious and you cannot control your worry most of the time.
- You think your cancer has returned every time you have aches or pains.
- You examine or monitor your body and symptoms more than your health care team recommends OR you do the opposite and avoid medical appointments and do not monitor your body as recommended.
- You spend a lot of time researching and thinking about cancer OR you refuse to think about cancer at all.
If your FCR is mild, the strategies in this resource may help you keep it in control. If your FCR makes daily life difficult, you may need more support.
Talk to your health care team to get support if FCR becomes a big problem for you.
What leads to FCR when you have cancer?
Most people with cancer and their loved ones have some level of FCR at some point.
Most people can identify triggers, which are specific things that cause FCR. Some triggers cannot be avoided, and others are things that can be planned for, like the anniversary of your diagnosis.
Some examples of common triggers are:
- seeing news or social media posts about cancer
- hearing that someone you know has been diagnosed with or has died from cancer
- the anniversary of your diagnosis
- going to the cancer centre for tests, scans or appointments and waiting for results
People who are more likely to experience FCR
Anyone can have or develop FCR, however it is more common in people who:
- identify as women
- are young adults and their care partners
- have more late effects from cancer or its treatment
How your health care team can help with FCR
Explaining your risk of recurrence
Your oncologist, family doctor or nurse can explain your personal risk of cancer coming back. Your personal risk depends on the type and stage of your cancer, your overall health, age and many other factors.
It may help to discuss with your doctor:
- how likely it is that your cancer will come back
- signs of recurrence that you should watch for
- what you should do if you notice these signs
- what you can do to reduce the possibility of your cancer coming back, such as quitting smoking, limiting alcohol intake and exercising regularly
For care partners: Ask how you can best support your family member or friend in managing FCR or leading a healthy lifestyle.
Explaining next steps in your care
Knowing what to expect after treatment can help to manage stress about next steps. Ask your health care team for details about:
- how your cancer will be managed and fter treatment as part of a survivorship care plan
- what emotions you may expect to feel after cancer
- which symptoms are expected to last after treatment and how to manage them
How to manage FCR
Use the following recommendations and coping skills to help manage your FCR. Always speak to your health care team if you need support.
Cognitive Behavioral Therapy
Cognitive Behavioural Therapy (CBT) teaches you how to use your thoughts and behaviours to manage strong feelings related to FCR. CBT is one of the best therapies available to help with FCR and other anxiety-related issues. You can learn CBT with a therapist or there are programs online to teach you the basics.
Mind-Body Interventions
Mind-body interventions are therapies that combine the use of body sensations, mindfulness and relaxation to reduce stress. Some examples of mind-body interventions are meditation, yoga, tai chi and hypnosis.
Self Care and Relaxation Strategies
Self care is any activity that allows you to feel better about yourself or improve your health. Many self-care and relaxation activities are things you can easily do at home. Self care can include:
- regular exercise
- a healthy diet
- getting enough sleep
- relaxation strategies, for example, listening to music or deep breathing
- enjoyable hobbies and meaningful activities
- getting out into nature
- praying, meditating and going to your place of worship
- being patient with and kind to yourself
Express Your Feelings
Acknowledging and talking about your FCR can help you cope and feel supported.
- Talk to supportive friends or family members.
- Write about your feelings in a journal, make art or whatever outlet works for you.
- Join a professionally led support group to express your feelings and concerns with people who have also had cancer.
- Speak to a mental health professional such as a social worker, psychologist or psychiatrist. Talk to your primary care provider or your cancer care team for a referral, if necessary.
Relaxation Techniques
Relaxation is a great way to reduce daily stress on your mind and body. Some relaxation techniques to try are:
- progressive muscle relaxation (gently tensing and then releasing parts of your body)
- guided imagery (imagining yourself in a safe and relaxing environment such as taking a walk along the beach)
- calming self-talk, such as, “I am calm, relaxed and focused. I can deal with this” and “this feeling is temporary. I am in control.”
You can find online videos or apps that explain these strategies.
Where to get more information
Your health care team is the best source of information.
You may also find information through other trusted sources, such as:
- Groups or classes through your cancer centre or hospital.
- Self-led, online educational modules or sessions through cancer .
- Books, pamphlets and websites from trusted sources.
- Princess Margaret Cancer Classes e-learning course on Fear of Recurrence. The course is for anyone, not just patients of Princess Margaret Cancer Centre.
The Canadian Cancer Society is a trusted source of information.
Visit them at cancer.ca or phone 1-888-939-3333.
For Ontario Health guides to help manage other symptoms, please see