Fear of relapse after breast cancer

To gain insight into the extent of the problem, questionnaires are used that score these fears. There are some validated ones in circulation: the "CancerWorry Scale" and the "Fearof Progression Questionnaire. They are used in scientific research. For example, research using the Cancer Worry Scale shows that on average 73 percent of all cancer survivors feel anxious occasionally, 49 percent feel anxious regularly and 7 percent suffer greatly from intense anxiety. Anxiety is generally more severe in younger people, in women, in the first year after diagnosis and in cases of poorer prognosis. Fear of relapse may manifest as brooding behavior, nervousness, poor sleep or inability to let go. The risk of stress and depression increases. Anxiety interferes with finding pleasure in things one used to enjoy, and it sometimes causes impaired functioning at work.

Dealing with fear of relapse

Fear of relapse, however severe, has no impact on survival, but it does impact quality of life. Four in ten cancer patients would like more psychosocial support or coaching to deal with fear. Coen Völker, GZ psychologist at the Helen Dowling Institute and a specialist in psychological care after cancer, has developed several pieces of advice for dealing with the fear of cancer return. Together with psychologist Jan Verhulst, who was himself confronted with cancer, he wrote the book "Fear After Cancer. In it they discuss how fear arises and offer practical tools to make it manageable, so that you dare to look to the future again.

Völker developed a five-step program, based on the acronym HOPPA, that helps deal with fear of relapse:

1. Recognizefear: Recognize that fear is a normal reaction to a threatening situation that has a major impact on your life.

2. Examineyour anxiety: Try to understand exactly what you are afraid of and what thoughts and feelings are involved.

3. Talkabout it: Share your feelings and fears with others, such as friends, family or peers. This can help reduce your anxiety.

4. Trynew strategies: Find ways to deal with your anxiety, such as relaxation techniques, mindfulness, yoga, playing music or other methods that work for you.

5. Acceptwhat you cannot change: Learn to deal with the uncertainties that come with life after cancer and focus on what you can influence.

Our book tip. 'Fear after cancer. What if you're afraid of getting sick again?" by Jan Verhulst and Coen Völker (Lannoo 2024).