Managing fear after cancer
Claudia Hernandez, breast cancer survivor, Toronto
Dr Sophie Lebel, psychology researcher, Ottawa
Dr Christine Maheu, nursing researcher, Montreal and Toronto
A new group therapy is being tested for its effectiveness in reducing fear of cancer recurrence and associated anxiety in women with breast or gynecological cancer.
Since fear of cancer recurrence has been reported in about half of patients, an evidence-based therapy could be used widely to reduce anxiety and improve quality of life for survivors of many types of cancer.
Claudia Hernandez, a 51-year-old physiotherapist in Toronto, was surprised when she found a tumour in her breast in 2010. Claudia led an active, healthy lifestyle and had no family history of cancer. After being successfully treated, she had a crippling fear the cancer would return.
“I tried to be calm, but living with the uncertainty was hard. I was afraid the cancer would come back, and I would have to go through it all again. I was anxious, slept poorly, and my life was on hold,” says Claudia. She was afraid to travel with her husband in case of a recurrence while away, and she worried about how her parents in Colombia would cope if the cancer returned and she died.
About half of cancer patients report fear of recurrence. Some survivors are so overcome with fear that they constantly check for symptoms of recurrence and rush to the hospital whenever they feel an unusual ache or pain.
In 2012, Claudia joined a pilot study led by Dr Sophie Lebel from the University of Ottawa and Dr Christine Maheu from McGill University, testing the effectiveness of a new group therapy to address fear of recurrence in women with breast or gynecological cancer. The study showed encouraging results in reducing fear and anxiety, and improving coping skills and quality of life. “The women had more tools to deal with their fear. They were able to resume projects they had put aside, and fear took less space in their lives,” says Dr Lebel.
Developed by Drs Maheu and Lebel, the therapy consists of six weekly sessions, where women are taught coping strategies, such as living with uncertainty, identifying their own fear triggers, and learning symptoms of recurrence. With Canadian Cancer Society funding, they are doing a larger clinical trial, with 144 cancer survivors from four hospitals, which could result in the therapy being recommended as part of standard survivorship care.
“If our study shows the therapy is effective, it could be offered at cancer centres across Canada,” explains Dr Maheu, also an affiliate scientist with the Princess Margaret Cancer Centre. “We would modify and expand this therapy to other cancer types as well.”
Claudia felt the program helped her deal with uncertainty and anxiety, separate facts from thoughts, and make plans for the future. “The help and support from the program is incredible. Talking about your fears isn’t easy. But once you do, it’s like taking a piano off your back,” says Claudia.
Learn more about the fear of cancer recurrence in our upcoming live webcast on Tuesday October 20, Living with uncertainty: Discussing the fear of cancer recurrence