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Dealing with Fears of Recurrence

Some fears can fairly quickly be dealt with by a bit of rational thought and investigation. Worried that you might die in the aftermath of a meteorite striking the earth? Well, your chances of death are pretty high if you are within meters of the strike point, but the last fatal meteorite strike was, well, never actually. There are no recorded instances of such an event.

Let’s talk about recurrence rates

Prostate cancer on the other hand, well, if you are reading this article then you or someone you love has it, and recurrence is a very real possibility. An article on the Harvard Medical School blog reveals that recurrence rates can be as high as 85% for some, and as little as 33% for a luckier group, depending on Gleason scoring, PSA and disease staging.1 I’ll declare an interest here — I’m in the top group as the unfortunate recipient of a G4+3, T2C diagnosis, albeit with a PSA that was not recorded higher than 5.95.

So my rational thought and investigation could (or should) have the result of making me very fearful. And to an extent I am worried. Next week I have my annual PSA test to check on possible recurrence. I can tell you now that I’m already developing a bit of scanxiety (the worry caused by any scan, blood test or examination) and that will peak about four days after the blood test when I have to call for the results.

Coping with fears of recurrence

How do I deal with it? I start by reminding myself that it’s by now probably more of a meteorite than anything else. By that, I mean that because I have had eight consecutive negative tests the chances of a ninth are really very small. That article I referenced earlier does not cover that aspect.

Beyond that, I know that if this next result returns a cancer-positive result then it’s been found early, again. All the evidence is that early detection and treatment of cancer deliver by far the best outcomes, and because I was treated for the first time in a world-class center I’ll be able to access the same quality of treatment again, while in the meantime the understanding of my disease has moved on remarkably.

Scanxiety persists for other cancers

As it happens I’ve actually had greater fears of contracting other cancers, even recently. A little knowledge is often said to be a dangerous thing, so when my bowels became noticeably irregular and my stools quite variable in consistency I started thinking about the possibility of bowel cancer. I’m right in the zone for it, being a 60 year old man, after all. I remember being out on a long run and becoming almost convinced I had the disease, to the point that I was reconciled to it.

Fortunately here in the UK, we have a national screening program for bowel cancer starting at age 60. A few weeks after my birthday a small package arrived by post containing the sampling kit. I sent back my sample. I wasn’t so sure I had it by then, but still, I had scanxiety. Ten days passed and in the mail came the statistically expected letter telling me no sign of bowel cancer could be detected.

Staying optimistic

Next week’s PSA test will be the same, I’m sure, but can I deal easily with that now? No, I can’t. I don’t blame you if you can’t either. I hate it.

This article represents the opinions, thoughts, and experiences of the author; none of this content has been paid for by any advertiser. The team does not recommend or endorse any products or treatments discussed herein. Learn more about how we maintain editorial integrity here.

  1. How to handle a relapse after treatment for prostate cancer. Havard Health Publishing. Accessed on December 29 2019. From