Managing Your Patients’ Fear of Cancer Recurrence
A downside to your patients becoming cancer survivors is that they will live the rest of their lives with the constant and legitimate fear of cancer recurrence. As their PCP, will you be able to help them manage their fear (which itself can manifest into illness)? Are you aware of the signs to look for or the protocols to follow to prevent or quickly address recurrence?
Let’s take a closer look at how, together, we can help prevent or quickly address cancer recurrence in your patients.
What are the first things you need to know?
- The fear and anxiety your patient now has, and always will, is that his or her cancer will return. They can become hyper-anxious over common ailments like a headache. Or be withdrawn. Both are normal and should decrease over time.
- Talk openly and realistically about their risks of recurrence (how likely, when likely, and where likely to recur). If they’re overly anxious, listen intently. If they’re overly withdrawn, dig deeper.
- Don’t be over-confident with their ‘common’ colds or headaches. Stay vigilant. If you find anything unusual, it’s their fears that may have been their saving grace.
What are some common “fear” triggers to be aware of?
- The transition period when visits with their oncologist begins to decrease
- When a friend or family member has recently been diagnosed with cancer
- The time leading up to a follow-up appointment (with their oncologist)
- The periods before, during, or after emotional events like going back to work
What are the potential warning signs of a cancer recurrence?
- Return of the same signs as before (ie; a new lump where the cancer first began)
- New or unusual pain that’s unrelated to injury but doesn’t go away
- Weight loss without trying
- Bleeding or unexplained bruising
- Rash or allergic reaction such as swelling, severe itching, or wheezing
- Chills or fevers
- Shortness of breath
- Bloody stools or blood in urine
- Lumps, bumps, or swelling
- Nausea, vomiting, diarrhea, loss of appetite, or trouble swallowing
- Persistent cough
- Any unexplainable or unusual symptoms
What does high-quality cancer survivorship include?
- Surveillance for recurrence
- Monitoring for and managing psychosocial and medical late effects
- Providing screening recommendations for second cancers
- Providing health education to survivors regarding their diagnoses, treatment exposures, and potential late- and long-term effects
- Providing referrals to specialists and resources as indicated
- Familial genetic risk assessment (as appropriate)
- Guidance about diet, exercise, and health promotion activities
- Providing resources to assist with financial and insurance issues
- Empowering survivors to advocate for their own healthcare needs
How can your office help survivors be prepared for a recurrence?
- Make sure their health insurance is up-to-date
- Make sure they are keeping their appointments
- Make sure they are getting the tests you prescribe
- Make sure they are keeping a copy of their medical records close at hand
What is an OHC Treatment Summary Visit?
- OHC has instituted a new program for patients near the end of their cancer treatment. OHC will schedule a patient-treatment summary visit between the patient and his or her care team. The visit serves as a patient-focused summary review of all treatments, drugs, and effects; a review of national guidelines for follow-up protocols; and a discussion of the possible what, where, and when of recurrence. The patient also receives a print-out of the treatment summary that will be shared with their PCP.
Where can I send my patients for support?
- The local Cancer Support Community for group programs
- The local Cancer Family Care for one-on-one programs
Irfan Firdaus, D.O., is a medical oncologist with OHC. He practices at OHC Blue Ash, Clifton, and West locations. Sara Slaughter, MSN, APRN, is an advanced practice provider with OHC. She practices at the OHC Fairfield location.