What is the fear of recurrence?

Fear of recurrence is the worry that cancer will return or progress.

At some point, this fear affects most people who live through this disease. Although it is difficult to know the exact figures, some studies estimate that approximately seven out of 10 people with cancer experience fear of recurrenceto a greater or lesser extent. This shows how important it is to learn how to manage it. The key thing to remember is that this concern is not necessarily related to any actual medical risk of recurrence, but rather mainly reflects the emotional impact and the uncertainty that accompanies the pre- and post-treatment period.

While fear of recurrence can occur at any time, it arises more often after treatment. When medical follow-ups decrease and daily life resumes, people may feel more vulnerable. This is often a time when they have less medical support or monitoring and more time to experience their suppressed emotions.

What drives this anxiety

There are several reasons why the fear of recurrence may occur.

Certain factors, such as being younger or being a woman, seem to increase susceptibility. Some people also react more readily to change and may feel less comfortable with uncertainty. This can make their anxiety grow more acute with each passing day.

A person’s mental health prior to diagnosis also plays a role. People who have previously experienced anxiety, depression or significant stress may be more distressed by the fear of recurrence. However, all these factors in themselves do not determine whether or not this fear will occur. More importantly, the intensity of this fear is not necessarily proportional to the real risk.  A person with a good prognosis may sometimes be very afraid that the cancer will return. By contrast, another person, even one with a higher risk, may feel little fear. So fear of recurrence is linked more to personal experience, emotions and life events than to purely medical reality.

Can stress and negative thinking cause recurrence?

It is important to address certain common beliefs that can reinforce the fear of recurrence. Many people mistakenly believe that stress, anxiety or negative emotions can cause cancer or increase the risk of recurrence.

Although understandable, this notion is not based on solid scientific evidence. It can be tempting to believe because it suggests that remaining calm and positive can help a person better manage their risk of recurrence.

But research shows that cancer is a multifactorial disease. Although many factors remain unknown, it is untrue to believe that “poor stress management” or “not being positive enough” could cause a recurrence. The Vulnérables mais pas coupable podcast series (in French) attempts to deconstruct these preconceived ideas.

Understanding this makes it easier to be realistic and kind to yourself. Experiencing fear or anxiety does not increase the risk of recurrence. You are not obliged to be positive all the time. The new book by Josée Savard, PhD, Apprivoiser la peur de la récidive du cancer avec l’optimisme réaliste (in French),addresses precisely this issue and suggests practical strategies for fostering realistic optimism.

Is the fear of recurrence a normal phenomenon?

The fear of recurrence can be expressed in different ways. It can cause stress, anxiety, negative thinking, and more, feelings that can sometimes intensify before a medical examination. It happens when someone experiences physical discomfort, feels new symptoms, or is confronted with something that reminds them of their illness.

However, when this fear becomes overpowering and consumes your thoughts on a daily basis, it is important to pay attention to it. If it interferes with sleep, limits your activities, or causes significant distress, it becomes necessary to consult a healthcare professional. Psychologists and social workers are professionals who can support you and provide you with coping tools.

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Sources

• Lebel, S., Ozakinci, G., Humphris, G., et al. (2016). From normal response to clinical problem: definition and clinical features of fear of cancer recurrence. Supportive Care in Cancer, 24(8), 3265–3268.
• Thewas B, Brebach R, Dzidowska M, Rhodes P, Sharpe L, Butow P. Current approaches to managing fear of cancer recurrence: a descriptive survey of psychosocial and clinical health professionals. Psychooncology. 2014;23(4):390–6. https://doi.org/10.1002/pon.3423.
• Thewes B, Butow P, Bell ML, et al. Fear of cancer recurrence in young women with a history of early-stage breast cancer: a cross-sectional study of prevalence and association with health behaviors. Support Care Cancer. 2012;20(11):2651–9. https://doi.org/10.1007/s00520-011-1371-x.
• Savard, J. (2025). Groupe de psychothérapie sur la peur de la récidive de cancer – Manuel du participant. Centre de recherche du CHU de Québec – Université Laval. https://www.crchudequebec.ulaval.ca/wp-content/uploads/2025/02/SavardJ_Manuel-du-participant.pdf
• Simonelli, L. E., et al. (2017). Fear of cancer recurrence: a review of the literature. Journal of Cancer Survivorship, 11(1), 1–12.
• Singer S, Das-Munshi J, Brähler E. Prevalence of mental health conditions in cancer patients in acute care – a meta-analysis. Ann Oncol. 2010;21(5):925–30. https://doi.org/10.1093/annonc/mdp515.