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TRANSCRIPT
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Fear of Recurrence:
LBBC Web Seminar January 29, 2015
Allison Nilsen, LCSW
Women’s Cancers Program Director
CancerCare
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Today’s Objectives
Better understand your fear of recurrence
Learn about practical tools for managing your
fears
Recognize when fears are turning into
something larger that may need a different
kind of support
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Understanding Fear of Recurrence
• Fear of recurrence is normal and valid
• Fear can be a motivator towards healthy behaviors
• Usually, fear comes and goes
• But when fear is dominating one’s life, there are
resources available
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Understanding Fear of Recurrence
• The 14.5 million cancer survivors in the US have
their own unique concerns and needs!
• Mixed emotions around treatment ending
o Happy to be done, but “waiting for the other
shoe to drop”
o Changing roles
• Finding a new normal after cancer –
vs. “going back to how things were”
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Understanding Fear of Recurrence
• Fear can be adaptive – alerting us to danger and
helping us survive
o Freeze, fight or flee
o Fear can be a response to a real danger
o Our active imaginations can also trigger fear
response
• Fear can motivate one to make healthy changes
o Diet
o Exercise
o Keeping follow up appointments
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Understanding Fear of Recurrence
Creating Open Dialogue with Medical Team
• Make a list of questions about recurrence
• Ask for a Survivorship Care Plan
o A written summary of your treatment
o What follow ups will occur, and when
o Which MDs will be seen for specific issues
• The Two-Week Rule
o Contact MD if unusual, persistent, acute,
worsening
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Understanding Fear of Recurrence
Practical Tools for Coping
• Ask if your treatment center has any survivorship
programs
• Don’t hold it all in. Talk to someone who
understands… and find ways to ask for what you
need. Reaching out may feel vulnerable at first, but
can be very rewarding
o Support group (lead by professional)
o Individual counseling
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Understanding Fear of Recurrence
Practical Tools for Coping, cont.
• Be curious about your fear. Look for the:
o Trigger
o Physical/emotional reactions
o Automatic thought
o Evidence for and against?
o Alternative view
Cognitive Behavioral Therapy: thoughts are not
good or bad, but helpful and not helpful
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Practical Tools for Coping, cont.
• What are you grateful for?
• Affirmations: another way to
restructure our thinking
• Mindfulness
o “Mindfulness means paying attention in a particular
way; on purpose, in the present moment, and
nonjudgmentally.”
~ John Kabat-Zinn
Understanding Fear of Recurrence
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Understanding Fear of Recurrence
Practical Tools for Coping, cont.
• What skills or strategies have gotten you through
difficult times?
• What is going right?
• Pursue activities that feel meaningful
• Low-information diet: limit your exposure to
cancer-related info that may be upsetting
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Understanding Fear of Recurrence
Practical Tools for Coping, cont.
• Build a “toolbox” of stress reduction techniques
to utilize when you experience fear
• Take time to experiment with a combination of
tools
• Everyone’s coping strategies
will be a bit different
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When Fears Are Larger
• Sometimes, fear becomes all-consuming and
gets worse, not better
o Fear, irritability, anger
o Trouble concentrating, eating or sleeping
o Unable to enjoy pleasurable activities
o Nightmares/flashbacks
o Intrusive, unwanted thoughts
o Feelings of hopelessness, guilt
o Self-harm
• Could signify PTSD or another serious issue
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When Fears Are Larger
• There is no shame in this or any mental health
diagnosis (a chemical imbalance)
• Support is available
o Individual counseling
o Groups
o Medication is often effective (esp. in
combination with talk therapy)
• Counseling referrals: American Psychosocial
Oncology Society (APOS) – 866-276-7443, or
www.apos-society.org
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Summary
• While fear of recurrence cannot be extinguished, it
can be managed
• You can develop healthy behaviors to nurture mind
and body
• Don’t hesitate to reach out for help
• When fear becomes overwhelming, support is
available