Last month we introduced common themes that occur as we discuss survivorship issues with participants in the Connecticut Challenge Survivorship Clinic.  In this issue we'll explore perhaps the most common concern of people who have recently completed cancer treatment, fear of recurrence.  Fear of recurrence is expressed in various ways:

We asked our specialists to address this concern in a hypothetical participant.

Social Worker: Fear of recurrence is very common.  A helpful way to think of this is that fear of the cancer returning is a projection into the future...we are imagining the future in a negative way.  I suggest that, if we are going to use our imagination, then it is helpful to use it in a positive way and imagine ourselves healthy.  There are visualizations and affirmations that can be helpful in projecting into the future.  Best of all, there are techniques to assist in keeping us in the present.  Meditation or mindfulness and conscious breathing bring us into the present moment. There are numerous books, CDs, and DVDs that are presently available, as well as classes in most communities to learn these skills.  We have a survivor support group following individual sessions in our clinic, which includes a short conscious breathing/meditation practice.  Concern about health can be a motivator to adopt other healthy practices, such as nutritious eating and exercise.

 

Physical Therapist: Regular exercise has been shown to reduce the risk of several illnesses, including cancer.  Exercising 5 times a week for 30 minutes may reduce one's risk of recurrence or developing a secondary cancer.  Moderate to vigorous levels of exercise are the most effective.  If we think of exercise on a scale of 1-10-1 is sitting on the couch, at 10 you feel like you'll pass out-aim for 5-7.  Additional benefits of exercising after cancer treatment include weight reduction, improved cardiovascular endurance, increased muscular strength, and improved mood.  Exercising not only reduces one's risk of a recurrence of cancer but it also decreases one's risk for other chronic diseases such as diabetes and high blood pressure and reduces the risk of stroke and heart attack.

Nutritionist: There is no one food that will trigger a cancer recurrence or protect a person from recurrence. However, following a healthy diet plan may help prevent recurrence of some cancers.  In addition, a nutritious diet will contribute to weight management, improved cardiovascular health, and help manage blood pressure, cholesterol levels, blood glucose levels, and even mood.

APRN: Participants in our clinic have had state-of-the-art cancer treatment and have no detectable cancer.  The chances of recurrence are low, but it is difficult to assign a percentage.  We know that in some people the cancer will come back, but we can't predict with any certainty the risk of recurrence for a specific person.  It is helpful, and prudent, to look on this as an opportunity to begin a personal wellness program.  Taking preventive or maintenance medications (if applicable) significantly reduces risk.  In addition, keeping to the schedule of physical exams, lab tests, and scans (as applicable) increases the chances of early detection just in case there is a recurrence.  Taking advantage of the fitness, nutrition, and emotional health resources available in the community or a survivorship clinic will provide tools for health promotion that survivors can continue to develop with a primary care provider.