Six Tips for Managing Fear of Cancer Recurrence

Pictured: Karen Hartman

Social worker Karen Hartman

A complex and unexpected mix of emotions can accompany the end of cancer treatment. You may feel relieved and elated that it is over but vulnerable and uncertain about what the future holds. For some people, hearing that they are free of disease upon completing treatment may give rise to a significant level of worry and anxiety that the cancer will come back, or recur.

Fear of recurrence is a normal and very common emotional reaction to finishing cancer treatment,” says social worker Karen Hartman. “The reality is that no one can promise the cancer won’t return or spread to another part of the body, but we can work with people so they can gradually move away from that sharp fear.”

Ms. Hartman works with patients and their families at Memorial Sloan Kettering’s Commack location, on Long Island, helping them cope with the emotional and practical effects of cancer through individual and family counseling. Here, she shares a number of tools survivors can use to lessen fear of recurrence and the impact it can have as they adjust to life after treatment ends.

Identify your triggers.

For most people, worries about their cancer returning are often prompted or intensified by certain things. For example, the anniversary of your diagnosis or surgery or news of a celebrity being diagnosed with cancer can stir up feelings of angst and evoke difficult memories of times you may rather forget. The anxiety surrounding follow-up exams and scans can also be overwhelming.

“Physical symptoms such as pain or a lump can be a major trigger because those can be legitimate signs of recurrence,” Ms. Hartman explains. “Usually a headache is just a headache, but for someone who has been through cancer and treatment, it might feel like a brain tumor, and that can bring on anxiety.”

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Have a plan.

Ms. Hartman encourages people to make a plan for coping with the triggers they have identified. If you are nervous before a follow-up exam, for example, anticipate how you’re going to get through the day of the appointment, and possibly the days leading up to it. “Plan activities that will distract you from thinking about cancer or write out a list of the things that have helped reduce your anxiety level in the past,” she suggests. “Remember this feeling will pass.”

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Talk about it.

Family and friends can be your biggest supporters during your cancer treatment, but they may not realize you’ll still have ongoing concerns after your treatment ends. Let them know that you welcome their continued emotional support and encouragement as you adjust to life beyond active treatment.

Ms. Hartman points out that it also can be comforting and validating to talk to others who have gone through the same things you’ve experienced. Memorial Sloan Kettering offers online and in-person support groups where you can discuss your concerns, as well as a Patient-to-Patient Support Program, which can put you in touch with other cancer survivors to talk about your experiences and share concerns or anxieties you may have.

Participating in an online community such as Connections also offers cancer survivors the opportunity to discuss their fears among peers. “The interesting thing that happens in these support networks is that you not only can receive support, but also can share your own experience and help others, which can be therapeutic,” says Ms. Hartman.

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Focus on wellness.

Complementary therapies such as acupuncture, massage, music therapy, and guided meditation can help reduce your anxiety and make you feel more relaxed. Some survivors find comfort in spirituality and prayer.

A healthy diet and physical activity also enhance overall well-being. “Focusing on things like nutrition and exercise not only helps from a wellness and health perspective, but also helps you feel like you’re regaining some control over your life,” says Ms. Hartman.

Memorial Sloan Kettering’s Survivorship Center offers health education programs on topics like sexual health, nutrition, and fatigue management. There are plans to simulcast some of the programs currently offered at the Manhattan campus for those living or working near or receiving treatment at Memorial Sloan Kettering locations in Westchester, Long Island, and Basking Ridge, New Jersey.

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Consider counseling.

Social workers, psychologists, and psychiatrists work with survivors to help them accept that fear of recurrence is a normal part of the cancer experience. They can help you develop strategies to cope with your fears and move forward with your life.

If you’re continuing to struggle with worries about your cancer returning, you may find relief in cognitive behavioral therapy (CBT), a form of psychotherapy that has been shown to help reduce anxiety and depression for people with cancer. It combines cognitive therapy — a type of talk therapy that helps identify and change self-destructive thought patterns — with behavioral therapy, which helps people recognize their unhealthy beliefs and behaviors and replace them with positive ones. “CBT is a tool you can use to bring negative or disruptive thoughts back to reality before they spin out of control. It takes practice, but it really works,” Ms. Hartman explains.

“When fear of recurrence becomes unmanageable, an anti-anxiety medication can also be useful,” she adds. “I encourage people to talk with their doctor about whether it’s appropriate for them and when it’s warranted.”

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Be patient with yourself.

It helps to know that for most people, fear of recurrence gets better over time. “I can’t say that it goes away altogether,” Ms. Hartman explains, “but as the time between follow-up care appointments increases, it often becomes more tolerable and occurs less frequently.”

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Commenting is disabled for this blog post.

Karen: I just fimished treatment for a reoccurrance after 6 years. I believe we both serve on PWCC board together. Is there a group or seminar you can refer me to?

Dear Candace, we forwarded your inquiry to Karen Hartman, and she responded:

“Memorial Sloan Kettering has a comprehensive support program for cancer survivors. Resources for Life After Cancer offers programs for specific diagnoses as well as for general issues that come up after treatment. You will find the calendar of upcoming programs at Many of the concerns after treatment for a recurrence mirror those after initial treatment. If you experience different issues you might want to contact the oncology social worker at your treatment facility for individual counseling around those specific concerns.”

Thank you for reaching out to us.

I been a "survivor from ovarian" cancer for 3 years follow up visit came up .so.. my colonoscopy follow up t est is comi g up. My ca125 was on 24.,4 from long do i have to wait to really be called a survivor..? Is this stress going away anytime?

Dear Agnes, we forwarded your questions to Memorial Sloan Kettering social worker Karen Hartman and she responded:

“Hi, Agnes,
Congratulations on three years! You have pointed out those triggers that so many survivors (more on that later) say are troubling.

Follow-up scans and tests can bring up all that anxiety (some say “scanxiety”) that sounds as though you are able to keep at bay much of the time. We tend to think “oh my gosh, what will it show…?” with worry before the test and then after, awaiting results.

What helps? Well, awareness is the first step, knowing the reasons for feeling anxious. Then it’s important to have a plan, some preparation and a strategy for managing the anxious time. Meditation or prayer, if these are helpful to you, can alleviate some of the stress. Support groups can also offer the chance to share your concerns with others who truly understand your fears without telling you that all will be well. That assurance can be well-intentioned but is not usually what we need to hear. And distraction, some kind of activity that you enjoy and that can keep your mind occupied, can really help get through this time.

And for that word “survivor,” many organizations, including the American Cancer Society, say that people have the right to define it in their own way. There is not a generally agreed-upon time frame for calling yourself a survivor—in fact the word is generally used to refer to anyone diagnosed with cancer. You’ve identified another issue that survivors talk about: the meaning of that sometimes-loaded term.

And when will this get easier? Time helps. It really does. For most people this gradually gets easier. As long as follow-up tests are part of your life, though, having a plan for managing them should help.”

You may be interested in learning more about managing “scanxiety” here:

You may also subscribe to our newsletter for survivors, called “Bridges,” here:

Thank you for your comment.

Does MSKCC have any resources, perhaps online, for survivors in other parts of the country? I would be interested. Thanks very much.

Mike, thank you for your question. We have several resources for cancer patients in other parts of the country.

You can learn more about Connections, our online community, including how to register, here:

You can learn more about our Virtual Programs, many of which are available to people who are not MSK patients, here:…

Our web site has a library of patient and caregiver informational materials, which can be accessed here:

We also have information for cancer survivors in our Living Beyond Cancer section, accessed here:

I had kidney/pancreas surgery at MSKCC, now time for follow up appointments and tests. I am feeling anxious and quite alone; truly, family and friends think I am fine and are not interested in talking to me about my fears for metatastic spread. And MSKCC does not offer support groups for kidney cancer survivors. There's a lot out there for breast, other GYN, prostrate, etc. cancers but nothing for kidney cancers survivors. I know that kidney cancer spread to distant organs is incurable; I cannot stop worrying about it.

Cindy, we’re sorry to hear that you’re experiencing anxiety and that you haven’t found the help you need. We recommend you reach out the MSK Counseling Center, who can find someone to help you deal with these feelings. You can find more information at:

You may also want to look into Connections, our online community, which offers support for people with any kind of cancer. It may be a good way for you to connect with other survivors of kidney cancer. You can find more information at:

You may also benefit from some of our support groups that are not disease-specific, such as art therapy. You can find a list of programs at:

Wishing you the best in your recovery.

I was diagnosed with thyroid cancer in 1995...was finally feeling like i beat it, only to find out last month that it came back. I'm NOT handling this well at all and my family doesn't understand why I'm so angry. I'm falling apart very quickly

We’re sorry to hear that you’re going through this. We recommend that you ask your healthcare team to refer you to a psycho-oncologist, a mental healthcare professional who specializes in treating people with cancer. You may also want to check out Connections, Memorial Sloan Kettering’s online resource for patient support, where you can find people who have had the same experiences you’re having. You can learn more at

Thank you for your comment.

I am interested in taking part in MSK's integrative aftercare program. How do I connect? I recently was treated at MSK for lymphoma.

Susan, we’re not sure if you’re referring to our Lymphoma Survivorship Clinic or our general Integrative Medicine program. You can learn more about the Lymphoma Survivorship Clinic, including the number to call for an appointment, at…. You can learn more about our Integrative Medicine services at Thank you for your comment.

I was diagnosed with prostate cancer in January 2015. I had a radical prostatectomy in May of that year. I am consumed with the fear of a recurrence of cancer. It is getting worse not better. I was somewhat hypochondriacal before this occurred; now I'm just frozen,

Dear Denis, we’re so sorry to hear that you’re having these feelings. We recommend that you ask your oncologist to refer you to a therapist who has experience in working with cancer patients. You may also find it helpful to join a support group. If you are interested in Connections, MSK’s online community for cancer patients and their caregivers, you can go to… for more information. You do not have to be a patient at MSK to join this group. Thank you for your comment, and best wishes to you.

I'm coming up on my 20-year anniversary of MSK's curing me of testicular cancer. I rarely see any sessions covering this type of illness...any being planned?

Dear Steve, we’re so happy to hear about your upcoming anniversary. We don’t currently have any support sessions planned for testicular cancer in particular, but we do have a number of support services that are available to all of our patients. To learn more, you can go to… Thank you for your comment, and best wishes to you.

Although I did Ct chemo, radiation, and armidex for my breast cancer. I feel doomed with the high score.

Dear Camille, we’re sorry to hear that you’re having these feelings. We recommend you discuss your concerns with your doctor. In addition, if you would like to come to MSK for a second opinion, you can call 800-525-2225 or go to for more information on making an appointment. Thank you for your comment, and best wishes to you.

I was diagnosed with Nodular Melanoma stage 3b. I am currently on an immunetherapy cancer trial.
Although currently NED, the fear of it still being in my body or that it will return, haunts me daily.

Dear Wendy, we’re very sorry to hear you’re going through this, but glad to hear you have no evidence of disease. We recommend that find a professional who can work with you to help you manage your fears. Thank you for your comment, and best wishes to you.

I have fallopian tube/ovarian cancer dx at stage 3 after surgery
One lymph node involved. Treated with taxol and carbo weekly. Scans are normal and CA 125 is 11 the lowest it has been. This is 3 months after treatment. I am 67 yo look well and feel well
What are the chances of remaining cancer free.

Dear Mary Ellen, we’re sorry to hear about your diagnosis, but glad to hear your scans are clear after treatment. Because there are so many factors involved, it’s hard to provide statistics for recurrence that apply to an individual. However, you may want to discuss this with your medical team. Thank you for your comment, and best wishes to you.