Managing The Fear of Recurrence
Founder of Above + Beyond Cancer and Medical Director of MercyOne Richard Deming Cancer Center, Dr. Dick Deming, and oncology counselor Dr. Julie Larsen discuss managing the fear of cancer recurrence. Dr. Larsen got her undergraduate degree from Miami of Ohio, a graduate degree from Columbia, NYC, and a Master’s in Social Work. She has done years of work counseling and supporting cancer survivors, caregivers, and patients.
Throughout the session, Dr. Deming and Larsen discuss ways to overcome grief, stress, and the all-encompassing fear of cancer recurrence. To begin the conversation, they acknowledged how doctors and counselors themselves have trouble knowing how to mark the end of treatment for cancer patients and survivors -- should it be a celebration? They note that too much celebration can be a false sense of hope for many people as they are unsure whether they should ‘celebrate’ yet or not.
Grief and anxiety in the cancer journey start from the beginning when someone is told they have cancer and lasts with them throughout the journey. The National Library of Medicine states that “31–52% of cancer patients experienced fear of cancer recurrence (FCR), and 24–40% of them reported moderate to high levels of need for help in coping with it.” Julie discusses that from the beginning of the cancer journey, people experience information overload, uncertainty about commitments to work, financial fear, emotional conversations with friends and family, fear of the future, and questions about the long-term impact of treatment.
Similarly, many patients go through the 5 stages of grief during their experience including denial, anger, bargaining, sadness, and acceptance. It is important to seek emotional, spiritual, and physical support throughout this process. Dr. Deming relates the grief of a cancer journey to “training all year for a marathon, you run the marathon, and then don't know what to do tomorrow."
Cancer becomes the new normal for many survivors, and Julie Larsen discusses that everyone changes with a cancer diagnosis and it's not exactly easy to tell how one has changed. Therefore it is a struggle attempting to return to ‘normal’, when in fact, the cancer journey is the new normal. During this transition, Deming and Larsen discuss the importance of self-compassion and awareness. They advocate for the coping strategy of a ‘reality check’ meaning, to work towards acceptance of the struggle and the cancer journey. Julie discusses the importance of lowering expectations to aid in accepting reality as it is, promoting self-acceptance. Ultimately, self-compassion and awareness mean putting the truth on the table while recognizing the things we cannot control and cannot change.
Dr. Larsen discusses the physical symptoms caused by anxiety such as gut pain, paranoia, lack of sleep, tight shoulders, etc impacted by an individual's parasympathetic and sympathetic nervous system. The National Library of Medicine similarly asserts that emotional difficulties are common among cancer populations and compromise patients’ quality of life, negatively affect treatment adherence and lead to a higher risk of mortality. To overcome this, Julie discusses focusing on thinking verses feeling in order to take control of your own narration. She recognizes that when someone is triggered, an individual's sympathetic fight-or-flight response can be triggered, taking away logical thinking. Julie lists the following ways to help counteract panic and anxiety as it occurs by activating the parasympathetic nervous system to help calm down:
Practice gratitude because it cannot coexist with anxiety
Prioritize your favorite self, take back control over your own narrative
Use your five senses: what you see, hear, taste, touch, and smell.
Sort thoughts into past, present, and future
Square breathing
Schedule a time to worry
Break time into manageable chunks
Give yourself permission to delegate future-oriented thoughts to your future self
Counter ‘what if’ thoughts into ‘what is, what else, what then, and what's left’
Write down your truths to counteract the false what-ifs and only focus on what's actually possible
All of these methods help the body return to equilibrium before someone attempts to find a solution to what may seem like an impossible task.
Finally, Dr. Deming leaves us with the quote that, “the two thieves of happiness are regrets of yesterday and worries of tomorrow." He urges us to practice being in the present.
For more, check out this conversation in detail on Above + Beyond Cancer's Youtube page.
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BA Ethics & Public Policy, BBA Management, minor Social Justice
annavanheukelom@gmail.com