Fear That My Cancer Will Return Goes Beyond Depression and Distress

Cancer-related anxiety and distress are not limited to diagnosis and treatment; even after recovery they can persist as fear of recurrence (the cancer returning). As the number of cancer survivors increases, fear of recurrence has become a new clinical issue attracting attention. These concerns can last a long time and adversely affect quality of life. Seeking help from psycho-oncology professionals and following their advice is recommended for coping with fear of recurrence.

- Related topic: Which cancers RECUR, and how often?

New findings show that fear of cancer returning may cause anxiety, stress disorders and depression.

Moderate to high fear of cancer recurrence occurs in between 22% and 87% of people who have completed cancer treatment. However, patients reporting depression or stress disorders do not appear to differ significantly in how intensely they fear recurrence. This suggests that fear of cancer recurrence is a clinical condition distinct from depression or stress disorders.

Fear of cancer recurrence, compared with anxiety disorder and other psychological conditions, needs to be distinguished more clearly through further research.

This study evaluated 1032 people in the United States who had received cancer treatment and recovered; none had experienced recurrence at the time of the study.

The assessment found:

• Of the patients, 34% did not fear cancer recurrence;
• 54% had a low level, and
• 11% had a high level of fear of recurrence. 
• Fear of cancer recurrence was high during the first 1 to 5 years after diagnosis, but decreased as the years passed.
• People of Hispanic origin and those with less than 12 years of education were also found to have a lower risk of fear of recurrence.

More strikingly, the groups with high and low fear of recurrence did not differ significantly in depressive symptoms or psychological distress. Fear of recurrence therefore appears to be a clinical condition different from other known and well-defined psychological conditions.

Alongside its valuable findings, this study raises further questions. One is that we do not know how much fear of recurrence affects cancer survivors’ lives. It also appears to be a new clinical psychological condition that could fall under anxiety, and there is no established criterion for grading it.

Another question is whether fear of recurrence is related to health behavior and healthcare use. Might treated patients experience fears because they have not developed positive health habits? More educated people may fear more because, although they want to and recognize its importance, they have not yet adopted healthy habits such as maintaining an ideal weight, quitting smoking or exercising. We hope further research will answer these questions and help patients more.

Related topics:

- Why does treated cancer return: Dormant cancer cells

- Eating nuts may reduce the risk of colon cancer recurrence

- When is surgery preferred in recurrent breast cancer?