Coping With Fear

"For some people it becomes excessive ... they spiral down, become progressively sad or anxious. People feel paralyzed, they feel like they've got one foot in the grave, one foot here and they don't know how to move forward."
"They get really obsessed. They feel like they're always on guard, because they can be reminded of their cancer any time."
"People talk about dying and leaving young children behind. These can be very sad things to hear. We just have to remind ourselves to not try to jump in and say something positive, which is what everybody does around them, but just stay with them and help them explore."
Dr. Sophie Lebel, psychology professor, University of Ottawa

Nadia Masot / Facebook

A 32-year-old mother-of-four says she has been de-friended by more than 100 people after she posted pictures of her cancer surgery scars on the website.

"It's always in the back of your mind: 'Is it going to come back, how much longer do I have?' There's sort of this niggling worry all the time. Every time you have an ache or a pain, you say, 'Oh, my God, is this the cancer spreading somewhere else?' It's kind of irrational, but you think it just the same."
Jane Rinard, 59, breast-cancer survivor

A group of Canadian psychologists and nurses has developed a program they devised for the specific purpose of targeted counselling, in an effort to bridge the gap between cancer treatment and recovery, and allowing former patients to live a normal life, not one consumed with fear and apprehension. Their goal is to successfully teach patients to recognize which of the symptoms that concern them that they can safely ignore and how to handle their fear.

The reason is to promote to these vulnerable people the universal reality that uncertainty plays a role in everyone's daily life. And to help them to face their own insecurities head on, aiding them in minimizing "excessive body checking". Promising results came out of a pilot study whose results saw publication a month ago describing their technique, published in the Journal of Cancer Survivorship.

A group of forty-four women who had been treated for breast or ovarian cancer completed the six-week course with over 70% of the group expressing confidence in their newfound ability to handle their fears. No one came out of the course any the worse for participation. A nurse is used to educate patients  to identify those symptoms that should legitimately given them concern, and which are to be ignored.

The purpose: to avoid "catastrophic" interpretations of symptoms through "cognitive restructuring".

The compulsive checking of their bodies for the dreaded presence of new tumours is replaced with the use of relaxation techniques, of the repetitive expression of a comforting phrase such as "I'm doing the best I can". Excessive worrying is outlined as ineffective in helping the women achieve optimum psychological health. The women were encouraged to introspection in confronting their worse fears. If they had expressed those fears to family, what they received in return was always reassurances, a kind of support that seemed unhelpful when avoidance of their fears only served to highlight them.

The fears are anything but irrational, particularly for those who have undergone the trajectory of the disease and its treatment and the numbing fear accompanying it all. For a large enough portion of survivors anxiety becomes so oppressively overwhelming it takes over their lives completely. Unneeded trips to the doctor and hospital emergency departments often result, exacerbating the issue, not relieving it when relief is fleeting and the unreasoning fear returns.

Early diagnosis and improved treatment leaves those impacted with cancer a longer life to live than formerly. Roughly 60% of cancer patients now survive at least five years post-diagnosis and treatment, compared with about 25% in the 1950s, noted Dr. Sian Bevan, director of research for the Canadian Cancer Society which is set to fund a larger clinical trial on the template developed by Professor Lebel, McGill University nursing professor Christine Maheu and colleagues in Ottawa, Montreal and Toronto.

Ms. Rinard, as an example, diagnosed in 2010, found her participation in the initial six-week program to be hugely useful. She learned through her exposure to the program to relieve herself of constant trepidation about her future and to advance with her life. The group therapy program, she is convinced, gave her that self-assurance. "I found it so helpful. It was an amazing experience", she stated gratefully.