Fear and cancer: What’s next after treatment ends?

March 10, 2020 Swedish Cancer Team

[3 MIN Read]


You may feel relieved and fortunate when cancer therapy is over. However, this transition can also leave patients feeling vulnerable, worried and undeniably anxious. Many people are struggling with lingering symptoms from the cancer treatment, in addition to worry or anxiety that the cancer might come back. This leads to constantly fighting unseen dangers which can leave one physically and emotionally exhausted, less able to focus or access creativity.


Fear and anxiety are normal human emotions that are not only related to cancer. Neuroscience has shown us that we are hard-wired to escape or resist things that are fearful. This basic physiologic reaction to fearful events is called the “fight or flight” response. Activations of this fear center are often unconscious or can be triggered just by a reminder of a previous difficult or traumatic event. When activated, a cascade of stress hormones and nerve impulses can increase the blood pressure, heart rate and oxygen intake. Over time, persistent or uncontrolled fear and anxiety can cause irreversible physiological changes.


In a ground-breaking book called The Body Keeps Score, psychiatrist Bessel VanDeKolk, describes in layman’s language using vivid diagrams, how grief, trauma, and loss are remembered and stored in the body. Based on past experiences, people are triggered or reminded in different ways leading to different reactions and levels of anxiety or depression. The key is to discover ongoing sustainable practices that can help re-wire this sense of fear or anxiety often provoked in deeper regions in the brain beyond our conscious control.



The more obvious signs of fear or anxiety that might be interfering with day to day living may include:


• An inability to focus

• Insomnia—waking up in the middle of the night worried about the cancer

• Crying easily

• Feeling depressed

• Getting easily irritated with yourself and others

• Addictions/substance abuse

• Social isolation


Coping Strategies

Karen Hartman, a social worker at Memorial Sloan Kettering, has identified helpful tips for managing and lessening this fear of recurrence. She recommends the following strategies:


• Identify triggers and have a plan for how to cope with them. For example, anticipate how you’re going to get through the day of a follow up appointment and possibly the days leading up to it.

• Plan distracting activities and remember how you’ve dealt with stress in the past

• Talk about your fear with others who can validate how you feel

• Focus on wellness (learn new activity or exercise routine)

• Consider counseling, group therapy or mindfulness classes

• Cultivate a sense of self-compassion and patience with yourself

• Journaling


Swedish resources


• Survivorship Clinic. Call to schedule an appointment at 206-320-8266 or 425-313-4200

• Swedish Cancer Institute Patient Support Resources (Classes and Support Groups): 

• Naturopathic Medicine. For more information, call 206-386-3015

• To register for mindfulness classes, call 206 320-2404 or contact Carolyn.McManus@swedish.org.

• Dr. Shamim Nejad, Oncology Psychiatrist - Ask for a referral.


Other resources


• Team Survivor Northwest: Provides fitness and health programs, enabling women cancer survivors to take
an active role in ongoing healing. For more info, call 206-732-8350.

• Cancer Lifeline: Provides free classes and support groups for cancer patients, survivors and caregivers. For more info, call 206-397-2100.

• Harmony Hill: Provides three-day cancer retreats. For more info, call 360-898-2363.

• Susan G. Komen Foundation: Provides breast cancer resources. For more info, visit ww5.komen.org




Napolitano, E. (2014, March 24). Six Tips for managing fear of cancer recurrence. Retrieved May 27, 27, from https://www.mskcc.org/blog/six-tips-managing-fear-recurrence

Lerner, H. (2004). The Dance of Fear. New York, NY: Harper Collins.

Herring, L. (2007). Writing begins with the breath: Embodying your authentic voice. Boston: Shambhala.

DeSalvo, L. A. (1999). Writing as a way of healing: How telling our stories transforms our lives. San Francisco: HarperSanFrancisco.

The Body Keeps the Score. Bessel Van Der Kolk. (2014).


About the Author

The Swedish Cancer Team is committed to bringing you the most up-to-date insights about treatments, prevention, care and support available. We know cancer diagnoses strain you both mentally and physically, and we hope to provide a small piece of hope to you or your loved ones who are fighting the cancer battle with useful and clinically-backed advice.

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