Fear of Recurrence: LBBC Web Seminar Fear of Recurrence Nilsen.pdfFear of Recurrence: LBBC Web...
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Fear of Recurrence: LBBC Web Seminar January 29, 2015 Allison Nilsen, LCSW Women’s Cancers Program Director CancerCare
Transcript of Fear of Recurrence: LBBC Web Seminar Fear of Recurrence Nilsen.pdfFear of Recurrence: LBBC Web...
Fear of Recurrence:
LBBC Web Seminar January 29, 2015
Allison Nilsen, LCSW
Women’s Cancers Program Director
CancerCare
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
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
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”
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
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
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
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
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
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
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
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
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
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
