How to cope with a cancer recurrence

A cancer recurrence brings back many of the same emotions you felt when you were first diagnosed with cancer. Common emotions include:

• When you ended treatment for your initial cancer, you slowly started to move on with your life, thinking the cancer was gone. In the weeks, months or years that passed, cancer became less and less a part of your daily life. The shock of having cancer come back after you assumed it was gone can cause distress — sometimes more so than your first diagnosis did.
• Self-doubt. You may doubt the wisdom of your past treatment decisions or the lifestyle choices you made since your last cancer experience. Try not to look backward. Instead, focus on your current situation and what you need to do now to move forward.
• It’s very common and reasonable to be angry that your cancer has returned. You might even be angry with your doctor for not stopping your cancer the first time. Or you might wonder why you put up with the side effects of your original treatment, just to have the cancer recur anyway. But you and your doctor made treatment choices based on the information available at that time. Seeking a second opinion may help you to better understand your choices.
• It’s normal to feel that you can’t deal with cancer again. Whether it’s the side effects of treatment you’re dreading or having to tell your friends and family that you have cancer, you’ve done it before.
Take heart in the fact that you were able to do it the first time, even though you might have doubted yourself back then.

All of these feelings are normal, and the same coping mechanisms you used during your first cancer diagnosis are likely to work now. Whether it was a best friend, a family member or a support group you turned to, you know that person or group provides good emotional support.

You have other advantages this time around. Rely on these to help you cope. For example:

• You know more now. Knowing more about cancer and your treatment options can help reduce your anxiety. Think about how much you knew about cancer at your first diagnosis. Compare this to what you know now, such as what treatment involves and what side effects to expect.
• You’ve built relationships. You’ve worked closely with your doctor, and you know your way around the hospital or clinic. This can make you feel more comfortable.
• You’ve done this before. Based on your first experience with cancer, you know what’s best for you during this time. Whether you needed some time alone or preferred having someone nearby, you can draw on your experience to plan ahead.

Use these experiences to your advantage. They can help you feel more in control when making decisions about your treatment.

Express your feelings to your doctor or nurse. The conversation that results can give you a better understanding of your situation, and it can help you make treatment decisions.

What should I look for if I am worried about a recurrence?

 It’s easy to obsess over every ache and pain if you’re worried about cancer returning. Check with your cancer care team for a list of common signs of recurrence of your type of cancer.

There are only a few major symptoms that could mean serious problems. If you have any of the problems listed below, tell your doctor or practice nurse at once.

• Return of the cancer symptoms you had before (for example, a lump or new growth where your cancer first started)
• New or unusual pain that’s unrelated to an injury and doesn’t go away
• Weight loss without trying
• Easy bleeding or unexplained bruising
• A rash or allergic reaction, such as swelling, severe itching, or wheezing
• Chills or fevers
• Frequent headaches
• Shortness of breath
• Bloody stools or blood in your urine
• New lumps, bumps, or swelling with no known cause
• Nausea, vomiting, diarrhoea, loss of appetite, or trouble swallowing
• A cough that doesn’t go away
• Any other signs your cancer care team has talked to you about or any unusual symptoms that you just can’t explain

Whenever you have a symptom, your first thought might be that your cancer has come back. Remember that there are illnesses and medical problems that have nothing to do with your previous cancer. You can still get colds, infections, arthritis, heart problems, and so on – just like anyone else. As with any illness, your primary care provider is the best person to find the cause of your symptoms.

If you’re seeing a new provider, be sure he or she knows about your history of cancer and its treatment.