#64 How to Manage the Fear of a Cancer Recurrence

Resources:
Predicting Fear of Breast Cancer Recurrence and Self-Efficacy in Survivors by Age at diagnosis
10 Crucial Differences Between Worry and Anxiety
Cancer Worry Scale

Anxiety and Physical Illness

Read the full transcript:

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This is Laura Lummer, the breast cancer recovery coach. I'm a healthy lifestyle coach, a clinical or Aveda specialist, a personal trainer, and I'm also a breast cancer survivor. In this podcast, we talk about healthy thinking and mindfulness practices, eating well, moving your body for health and longevity. And we'll also hear from other breast cancer survivors who have reengaged with life, and have incredible stories to share. This podcast is your go to resource for getting back to life after breast cancer. Hello, and welcome to episode 64 of the breast cancer recovery coach. I am your host, Laura Lummer. And today, we're gonna be talking about a really important and common aspect of cancer recovery, which is managing the fear of having a cancer recurrence. So this past week, I was really fortunate to have been invited to participate with five other cancer survivors, all of us with different types of cancer on a popular YouTube show called spectrum, which I am super excited to be able to share that link with you when it comes out, which will be several weeks from now, but I'll make sure to let you know, this episode that we filmed was on how cancer survivors feel about the impact that cancer and its treatment had on our lives. So the format was one of we all kind of stood in the center of the room and we were given prompts. And depending on our responses, we move to one side of the room or the other whether he agreed or disagreed and then discussed why we had those feelings. And one of the prompts that we received was, I still have fear of a cancer recurrence. And what happened in that room reinforced what I already know about the life long impact of cancer. Because even though our ages ranged from a 23 year old to me being the oldest at 55. And the length of time out of treatment ranged from one woman who was there who is less than a year out of cancer treatment to a young man who was 12 years out of cancer treatment. But with that huge range of age and experience and time from treatment, five out of six of us agreed that we still deal with the fear of recurrence. And yes, I'm one of them. So if you resonate with this, know that you're not alone. Now time certainly takes the edge off of the rawness of the trauma of cancer and cancer treatment. But I don't feel like everything that you've been through and all the scars that it's left behind just goes away. The trauma is real, you guys, it's it's real trauma you've been through. And that's something that needs to be worked on and needs to be looked at and dealt with in order to heal from it. So even though I own it that yes, I still have thoughts of cancer occurrence, I really had to work on managing that fear, so that it doesn't paralyze me so that it doesn't turn into something bigger. And so that the decisions I make in my life aren't based on or around that fear of a recurrence. So, the day after I finished filming the show, a friend of mine sent me a podcast episode. And it was an interview with a woman who had survived breast cancer. And when they were interviewing her, they asked if she thought about having a recurrence. And she said she thought about it every day. But after having been out of treatment for five years, she's gone from thinking about it all day, every day, to maybe thinking about it once or twice a day. The point is that having those thoughts is normal. But the key is to not allow them to stop you from living your best life. The key is to keep yourself from making decisions based on the fear of having cancer again, or of dying. I mean, if everyone let the fear of death, stop them from living, no one would do anything ever, because we all have to take that ticket out of here at some point. So let's just be honest and transparent and open about that. Not in a morbid sense, but in a prospective sense, right? In bringing things into perspective and looking at where we are now, helping us to enjoy this moment in our lives. If this topic that you just want to take a moment to address this if you really really struggle with this topic of death facing dads having faced your mortality in being diagnosed and in going through treatment. When you feel finish this episode, I highly recommend that you go back and listen to episode 46, which is all about coming to terms with the impermanence of this life, impermanence in general. And it also has an audio meditation on impermanence in the show notes for that page. And you can find those at Laura lummer.com, forward slash 46. And when you're done listening to that, download that meditation use it, practice it. But for today, I want to give you a little insight into how common the fear of recurrence is, the difference between worrying about it and having anxiety over it. And then, of course, because I'm not going to leave you hanging some tips on what you can do to manage that fear, so that you can live your happiest life. Now, first, I want to make an important distinction. There is a difference between worry and anxiety. And that difference can have a huge impact on your health. In a Psychology Today article titled The 10 crucial differences between worry and anxiety written by Dr. Guy winch, he explains that worry actually tends to be less harmful to our health than anxiety. Because worry is typically verbally focused, meaning we talk about the things that we're Yes, worry tends to be specific and temporary. And it's more reality based. And it tends to trigger solution oriented thoughts and speech, which is why it is more verbal, we talk about what worries us in the hopes of finding or creating a solution for this worry. Whereas anxiety on the other hand, according to which is more damaging physically and mentally, because of the thought component, meaning that we don't just talk about our anxieties, we think about them. And we actually create emotionally charged mental imagery around them. I think this is absolutely fascinating. And it's something that you can test with yourself right now. If you focus for a moment on something that gives you anxiety, you can literally feel the physical change in your body, by those thoughts. By that focus on something that gives you anxiety, you can increase your heart rate just by thinking about it, increase your blood pressure, increase your rate of breathing, and you can start to feel really awful. That is how powerful your mind is. And this is why I based my coaching and my programs in mindfulness, because when you engage and you train your mind, you can change everything. In fact, a study published in the oncology nursing forum in 2012, found that breast cancer survivors who had the highest self efficacy, which is your own belief that you can succeed in something in a situation or overcome something. And those who had the highest sense of self efficacy both during and after breast cancer treatment, had less anxiety, and an overall better quality of life after treatment. Now, the good thing about this is that there are ways you can build self efficacy, to support your peace of mind and to better manage worry and anxiety. One way is to achieve something, and by achieving or mastering something, we build confidence in ourselves that we can achieve it again, or achieve something bigger, like the example I just gave of the woman who thought and, and feared cancer all day long every day. And she was able to slowly lessen that. So if you could go from six times a day, to four times a day, that increases your own belief and confidence in yourself that maybe you could get it down to two times a day or two times every other day. You see what I'm saying. You can also build self efficacy by seeing others be successful in the thing you want to be successful in. And through verbal persuasion, which means other people verbally reinforcing your ability to be successful. And this, my ladies is the power of community. This is why revivify has a private community for the members. And it's why I started the free group on Facebook breast cancer recovery group. Because by like minded women who want to achieve something more, who don't want to feel stuck in fatigue and stuck in meds and they come together and they support each other. By doing that we grow stronger. You begin to believe in yourself more and you become confident in your ability to create the life you want to live

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now fourth way to increase self efficacy is through emotional arousal, which means to really get in touch with the emotions that motivate you to change. So people are very focused on tactical ways to improve health, which is something like exercise for 30 minutes a day, eat four cups of vegetables a day, we give you these tactics, and say, if you do these tactics, you'll change your life. But when we become focused on those tactics, it rarely ever works. And then if it does work, it works for a little bit of time, because it's not sustainable. Because it's the thoughts, it's the behaviors, it's the triggers, and the cues behind the things that we do. And the motivations for doing them that create real change. And without that piece without the why The reason the behavior, it's really hard, if not impossible, to experience real and lasting change. So that's why I talk about all of this stuff, in addition to obviously, food and nutrition, but I really focus a lot on the mindfulness aspects, instead of just giving you recipes for juices or workout programs, because it's what's in your head. And it's what's in your heart, that is going to make other things happen, or not happen, your choice. So if you're finding that you're actually suffering from anxiety, rather than just worry, you might want to ask yourself, if you're trying to find a solution for what is creating your anxiety, or if you just dwelling on the issue itself, the issue being fear of recurrence, for example, I think most of us can agree that going in for scans and bloodwork triggers some anxiety, because we're all too familiar with the fact that something can be growing inside of us without our knowledge, something that could take our life. And that's friggin scary. So when we go into a scan, and we're actually going to take a peek inside and see actually what's in there, it really does bring up some anxiousness. But here are two different scenarios. You're going in for your annual scan, and you start creating a story in your head about what you'll do when they find something, how you'll react when the doctor tells you you have cancer again, whether or not you're going to go with traditional treatments, again, how you're going to put your loved one to this crap again. And then your doctor comes in and says, You're clear, all good. And you say, awesome. And you run across the street to get a latte from Starbucks versus the same scenario. But when the doctor says you're good, you're all clear. Your mind goes to, okay, great. Well, I'm good now. But what happens when I come back in six months? Or how do I go another year? How are you going to know if everything's gonna be okay? By then I mean, between then and now, something could happen and suddenly can start to grow and, and how much damage can be done in that time and, and you get where I'm going with this right? One is temporary anxiousness. It's a little more than just worry, right? Because you begin to create that story with it. So you do build anxiety. And the other is the kind of anxiety that is going to impact your life, your cardiovascular health, your relationships, and it's going to undermine your happiness. Don't let cancer steal your happiness, it is the most important thing. And it's your right to choose it every day. Now, I gave you a little example about something we're all familiar with going in for a scan. But I do think it's important to note that studies have found that the worry of recurrence does seem to have specific triggers, like scans, mammograms, or even knowing someone else who gets diagnosed with a recurrence. So it is important that you notice whether or not you have a tendency to react to triggers like these, because if you know what your triggers are, you can better prepare yourself with the tips that are coming up when these triggers arrive. Now another important differentiation to make between worry and anxiety, and I'm going to quote Dr. Winch for this one is quote in certain intensities and duration, anxiety is considered a true mental disorder, one that requires psychological treatment and or medication, whereas worry is not. So be real with yourself and really know when it's time to reach out for help. Now, there's actually a tool or several versions of the tool that's called the cancer worry scale. And I'm not even joking. It's a real thing. And in the show notes for this episode, I'm going to post a link to the cancer worry scale that was published by the Seattle Cancer Alliance. This is an assessment tool, asked some really good questions and you can rate yourself I don't know if I don't recall right now if it's a one to 10, but you rate yourself on a scale of how much these different questions or these different topics impact you. And this tool can help you get an honest picture of where your mind is, in terms of dealing with the fear of cancer. And you can also take it to your doctor with you, if you feel you need additional support. Or if you think you want a referral to someone who can help you work through this anxiety, it's really nice to have that data, it's about three pages long, this one that I'll link to, and you just go through it and get that nice assessment of yourself and that tool to get professional guidance and support if you need. Now whether you feel like you worry about fear, and it's temporary and comes and goes, or you feel you have anxiety over the fear of recurrence, you want to be able to recognize and distinguish it, because regardless of the root cause of anxiety, it can have very powerful health consequences. According to Harvard health, publishing, anxiety is known to contribute to many chronic illnesses, like heart and respiratory diseases, and gastrointestinal conditions just to name a couple. But in addition to that untreated anxiety has been shown to make the diseases it contributes to more difficult to treat. And it can even worsen the symptoms, it can lead even to an earlier death as a result of some of the diseases that contributes to and that is not what we want. We have been through enough ladies. So let's talk about what you can do to get anxiety and worry over a recurrence in check, so that you don't have to go down that dark road of anxiety related illness. Now, here's the interesting thing. As I said a few minutes ago, we know that when we engage our brain, and we run with the things that we're worried about, we create those stories, we develop anxiety, and anxiety can literally make us sick, among all kinds of other things we don't want. Yet, when we flip that, and we talk about some very simple steps to reduce anxiety. By retraining our brain, we often dismiss that as either things that are too easy, or we give it an off the cuff. Yeah, yeah, I tried that. And it didn't work for me. So let's just be very clear that in this world of Amazon, and Netflix and instant everything, and Z packs that take this pill, and you'll feel better in the morning, some things actually really need your focus, your energy, and they need to be done consistently, over a period of time. We're changing behavior, or changing habits, retraining, the way your brain thinks. So if you checked out on me right there, come on back, this is really important. And it is worth the effort. You have to put in that effort to support the healing of your mind and body. You have to put in the work. And you know what you are worth it. You're worth the time and the effort, and even the money that it might take you. So don't buy into this Oh, she's high maintenance be is good things take time and attention, and often money. And we women have to get past our hang ups of investing in ourselves, whether that is time, money, energy, or anything else. If you know someone who has an incredible, amazing garden, the kind that's just right out of Martha Stewart magazine, you know, it took time and attention to grow and nurture and cultivate that garden to become the beautiful thing that it is. If you know someone who's super educated or accomplished or, and you just love listening to their insights, and you, you know, this person invested a lot of time and money and energy into becoming the person they want it to be. So I want you to make this commitment to yourself, that you are worth the time and the energy. It will take you to move past your suffering. And to become the person you want to be and live the life you want to live. Even if it is professional help. I just breaks my heart when people say oh, that's expensive. Yeah, it's expensive. But what about your life? Your mental well being your happiness? At what cost? Is that? Okay, so we're good. So you're worth this. Alright, I'm

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gonna give you three tips, then I'm going to keep them very simple because they're simple practices. Remembering simple doesn't always mean easy. It takes effort. Here are three things you can do to reduce your anxiety and your fear of cancer recurrence. Number one, commit to a stress relieving practice and do it at least three times a week daily. It's even better. These practices can include exercise, any kind of exercise, dancing, martial arts, biking, spinning strength training, pick something you love, and have fun with it, do it because you're worth it. And that the strenuous physical activity will create competence in your ability to achieve something, it will build self efficacy, it will cause this beautiful cascade of hormonal reactions in your body, that will actually make you feel happier. And it will distract your mind and relieve the feeling of stress, meditation, yoga, pilates, any of these things, find a stress reducing practice and do it. That's one option to talk about your fear. Seriously, find a community, I cannot tell you. Literally, I felt like there was this electrical, magical connection between the other five people who did that show with me this past week, we walked into the room, we never met each other in our lives, we had a huge gap in age range, we had all different kinds of cancers. But we got each other. Every single one of us had had multiple surgeries, the challenges of dealing with the medical system, we'd been through chemotherapy, we'd been through the emotional mental crap you go through, we went through the struggles of how our families had to deal with our cancer and how how we felt about our families dealing with that how our families don't have with us, we got each other. And within minutes of us being in that room and sharing our experiences together. We live there you guys, we all have each other's phone numbers. And we're setting up a date to get back together to have dinner together. Because we connected so quickly and so deeply. And we just got it there was nothing we couldn't share with each other that someone else didn't get. And let me tell you, in those few hours, we were together, there were tears or a lot of tears. But there was understanding and there were breakthroughs. And there were hugs. And it is so important to find your community. Turn to your dearest friend, or a close family member, or common find the community that I created online or that anyone else created online, or find an in person group at a local hospital anything, find your community and get those scary thoughts out of your head and through your mouth. Turn your thoughts into words and share them out loud, so that you can put them into perspective. And you could stop feeling alone. And you can trust that someone else can help you find solutions. That's so important. I just want to say that one again. Because it's so important. I won't say it again. But understand it's really, really meaningful. I know it sounds simple. And I know a lot of people think oh not the group kind of tie up. I'm not a joiner. It's not about joining. It's about connecting. And connecting and joining are two very different things. Try it out. Okay. Number three, inform yourself, really and truly understand the things that could increase your risk of recurrence, and the things that can reduce your risk of ever recurrence, including medication, lifestyle choices, and then make intentional healthy choices, to reduce your stress around those things and support your goal of having that peace of mind. So I am and have been for I don't even know how many years decades, just fascinated by the human body nutrition exercise, the way we move, the way we heal. I think the human body is just as absolute magical thing. And oftentimes, we just don't even connect to our own body. We don't understand how it works. I cannot even tell you of how many conversations over the years I've had with people who don't even connect their food to their health. So really understanding how your body works, what you respond to how your body responds to it. And if it's medications, I know that oftentimes we have an aversion or I don't want to be on Medicaid. I have that aversion. I've had to deal with it. And from time to time I've had to ask myself, you know why? Why are you fighting this? You know, when I went through cancer treatment, I literally had to overcome this battle in my mind and give myself permission. And I was really helped by a friend of mine who said Laura, in this next few months, give yourself permission to ask for help. through medication, take what you need to be as comfortable as you can and get through this experience. And so, you know, I think that on some levels, we connect, being on medication with being ill will, for obvious reasons. Maybe we connect it with being old. And we don't want to be old, because we want to stay young, or whatever our hang ups are, examine that for yourself and figure it out. But if being on some kind of a medication, that doesn't have horrible side effects for you, but reduces your risk of getting the recurrence and makes you feel safer, and makes you feel good, and you can function and be happy, give yourself permission to do that, there's nothing wrong with it, it's perfectly fine. So you can pick one of those steps, you can do all three of those steps. But start with one, start with one I know they sound simple, but trust me, they are powerful practices. So just pick one, one that really resonates with you, and do it and be consistent at it for three months, holy cow, three months, that's a big commitment, right. But I see women who come into the groups and they introduce themselves and just by reading what they're going through, I can feel their pain, I can feel their struggle, but then they don't engage and continue conversations, right, they're just kind of stay on the periphery. So engage, invest in yourself, if it's community that you choose, and don't limit yourself to just 28 days or 40 days, or whatever amount of time you've heard or believe it takes to form a new habit. Because this isn't just about forming the habit. It's about changing the way that you think. And that takes time. And it may gradually improve. And then you may have a setback. So for instance, you may figure out a solution by talking through your fear with your best friend. And then something happens, life gets in the way something comes up and you get off track for a period of time. And then you start to notice that these thoughts start to come back, the fear starts to resurface. And you'll realize that you need to get back to being consistent at that practice that helped you in the first place. But the good thing is, you may find that when you go back to the practice that works for you, your thoughts get healthier faster than they did the first time around. And that's neuroscience girl, and I love neuroscience. So you can think about even now, something that you may have had success with in your past, maybe you can think of something that when you were in a dark place, or you were struggling through different thoughts, or emotional struggles, something that helped you to feel more positive, go back to that, and you may get results even faster. So when you start this practice, actually make a note or make a mark in your calendar, something simple, it doesn't have to be extravagant, but some type of an acknowledgement that you did the practice that you committed to. And here's why. Because we're all so busy, it is so easy for time to get away from you. And then you think you've been practicing regularly. And you're not getting the results that you wanted. But in reality, you have much lower compliance than you think you do with practicing your healthy habit. I'll give you an example. I have a budgeting app that I use. And I love this app, super easy to use. And I thought, Oh, this is super convenient. And it'll help me be more consistent and stay on track daily. But then I get busy. And I may forget a day I think I forgot a day. Maybe I think I forgot two days. So I go to open up my app to stay on top of my budget. And I'm embarrassed to say that the time tracker tells me it's been way longer than I thought since I checked it. You know, I think it's been two days. And it says last time opened eight days ago. What how can I days have gone by time goes by fast. So set up a system to help keep yourself accountable for creating positive change. And then

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trust the process. Be patient with yourself. Just keep doing it. Give yourself credit for just working towards creating positive change in your life. Don't be hard on yourself, don't judge yourself. Don't beat yourself up. Just say I'm gonna make this commitment. And I'm gonna do it for three months, as consistently as I can, whatever you commit to, and make it a little tiny mark, open the Notes app on your smartphone or whatever it takes, I don't know a little cross off a day with a pink marker on your on your calendar. Just a note that lets you know when you practice it so it'll help keep yourself accountable. Those tools can be really helpful. All right. Well, I hope that those tips helped you. And you know, you can always find me on Facebook as Laura Lummer on Instagram as the breast cancer recovery coach. You can message and email me I get contacts from women all the time with questions about things I hear on the podcast and I love it. So if you have questions then reach out to me, I'd love to hear from you. If you have insights or something that works for you, post it, come and join us in the breast cancer recovery group where you can share with other like minded women and find a community. Now, one more thing, before I go, if you are a listener and you enjoy hearing the breast cancer recovery coach podcast, please take the time to go to the iTunes Store and leave a review for the show. It really really means the world to me. And it's so so so helpful and letting other people find the show and getting the information that might help them as well. So get out there and make it a great day and make your commitments turn off this podcast then decide make a decision on the thing you're going to do. To help manage this fear of reoccurrence reduce anxiety in your life and live your best and happiest life. And I'll talk to you again next week. Until then, be good to yourself.

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Use courage to the test laid all your doubts your mind is clearer than before your heart is full and wanting more your futures Give it all you know has you been waiting on yours this is your