[Narrator]

It is very important for survivors and people close to them to recognize how difficult it is to resume a positive, life-oriented, and future-focused outlook after experiencing the fear of death brought about by a cancer diagnosis. Getting to a place where you can "honor our life and honor our death," as described by Arthur Frank, is a process that may begin with a diagnosis of cancer. For some people, that may take years. The secret is not how long it takes, but learning that healing can begin when we talk about it with others—a friend or loved one, another survivor, a healthcare professional, a spiritual leader—someone who can listen with an open heart to our fear of death and help us put it into perspective in our life. There are many wonderful resources available to people with cancer and their caregivers to help with this process. Those resources for additional reading are listed in the Resource Booklet that accompanies this program.

[Linda]

The second fear that healthcare professionals hear about is the fear of cancer recurrence. It may be the most common and consistently felt emotion that people with cancer experience. This fear is felt with a mixture of anxiety and depression that may come and go over time. A woman I work with who is a breast cancer survivor described her fear of recurrence this way: "Every time I go for a checkup, I get afraid that they might find something. I don't feel that way between checkups. But the fear of the cancer coming back must be somewhere in the back of my mind, and it bubbles up to the surface right before and during my checkups. My fear is probably less now than it used to be, but I keep expecting I'm not going to feel afraid, because I don't feel that way on a day-to-day basis. It always surprises me that I do feel afraid."

This sense of uncertainty can give rise to a range of reactions from mild worry and anger, to panic, and even thoughts of suicide. Many survivors find it somewhat comforting to know that the intensity of worrying about recurrence tends to fade the longer you go without symptoms that remind you of the initial diagnosis. The uncertainty that many survivors have about every little ache or pain goes away as their routine checkups show that these aches and pains are not related to the cancer. Some survivors adjust so well over time that they describe their feelings regarding a fear of recurrence as being like background music at a restaurant or on an elevator. They get used to living with it to the point where they hardly even notice it. If something happens to draw their attention to it, though, they may find that they become aware of the fear again, and it can become rather annoying and even worrisome. Being aware of when your anxious or worrisome thoughts are becoming overbearing is a key to making the adjustment to living with, but not being overwhelmed by, these nagging fears.

If you feel that you would be uncomfortable discussing your fears about recurrence openly in a support group, or if you find that the passage of time and reassuring checkups are not enough to relieve your anxiety, you may want to arrange a few sessions with a social worker or other health professional who can assist you in resolving these feelings. If you don't feel comfortable doing that, it's good to know that there are many other options for getting support. You can find a list of organizations that offer direct services for how to deal with these emotions more privately, through teleconferences, and over the Internet in the Resource Booklet that accompanies this program.

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