Hearing, "You are in remission" after months of chemotherapy and radiation is likely one of the happiest moments of a cancer patient’s life. For some patients, however, that joy is a double-edged sword, as happiness can be clouded by the worry of recurrence.
The American Cancer Society estimates that 70 percent of cancer patients deal with the anxiety of disease recurrence. These fears can be a motivating force to encourage the patient to make changes for the good of his or her health (stopping smoking, losing weight, exercising, etc.), but, unfortunately, recurrence anxiety can also be detrimental to the patient’s physical and emotional welfare. As oncology nurses, we should be alert to patients who are struggling and help them find ways to cope with their cancer diagnosis.
Journaling is one way to reduce anxiety. Having patients put their fears down on paper can help to clarify the cause of the anxiety. In addition, it can be useful for visits with the physician or the oncology nurse. When I worked in inpatient psych, some of the patients who were dealing with severe anxiety felt it was helpful to write down their fears, then tear up the paper and throw it away; in effect, getting rid of what was troubling them.
Being with others in a support group is also a positive way of coping with the anxiety of recurrence. Group members can often point out things they’ve found helpful for them. In addition, it gives participants the reassurance that they are not alone in their experience.
As nurses, we can help patients by educating them regarding their disease, treatment, and what they can expect. As part of the patient's education, nurses can teach them about healthy lifestyles such as exercise and weight management. Stress management techniques such as relaxation therapy and breathing exercises can give the patient the tools to treat anxious episodes in a healthy manner.
There are times that a patient’s fear of recurrence becomes a problem. If a patient becomes overly preoccupied with health concerns, is unable to resume his or her life prior to cancer, and/or allows the anxiety to interfere with activities of daily living, then the patient’s oncologist may need to consider an anxiolytic to help the patient cope. Therapy, in combination with medication, may help the patient learn how to deal with the uncertainty of living with cancer.
What do your facilities offer to help patients cope with recurrence anxiety?