How many people who have been treated for cancer live with the fear that the cancer will recur?
Everybody. It's kind of the elephant in the room. It's always there. And I would say the major factor that makes this fear of recurrence recede is time. The longer you get away from it, the less you think about it. But a lot of people experience great anxiety at the completion of treatment. Treatment makes you feel like you're doing something-you're getting treatment, you're seeing doctors, people are watching you-and then you're done with treatment and you're on your own with your body, which can be frightening. Your body betrayed you once, so it could betray you again.
There are major cancer centers in this country that on the last day of a patient's treatment will say, "See you in three months." That's it. And that approach is not my recommendation. I think that staying in touch with the medical team after treatment is very important.
Is there a level of fear of recurrence that you think is healthy?
Fear of recurrence that makes you vigilant is good. So on one end of the spectrum there are those who deny that anything bad can ever happen to them, and on the other there are those who let worry and pessimism dominate their lives. Someplace in the middle is what we would want to aim for. You want people to do the follow-up care that they need and to be aware of their bodies. And if you've been treated for cancer, it's perfectly normal to get worried about normal, everyday symptoms, like a stomachache. Hopefully you have a relationship with a physician that you can call and discuss any symptoms that you're worried about.
Also, we often see that people lose touch with their cancer physicians after treatment. I know a woman who had breast cancer, who, eighteen years after her treatment started having back pain. She was treated for a year by chiropractors. Nobody ever considered that she could have metastatic breast cancer. Had she been seeing her cancer physician on a yearly basis, the cancer might have been found sooner.
