After treatment, patients are confronted with a number of issues related to cancer survivorship. Typical issues involve fears about repeated medical follow-up and diagnostic tests. Fear of recurrence is also an ongoing concern that waxes and wanes over time. A number of specific issues can be a source of anxiety. Fears related to returning to work, such as discussing one’s treatment with employees, insurance-related problems, and concerns about discrimination, can cause distress. Fear of screening, follow-up, and risk of second malignancies are ongoing physical threats that are accompanied by anxiety for certain subgroups of patients. Body-image changes, sexual dysfunction, and reproductive issues can also cause anxiety. Posttraumatic stress disorder has been diagnosed in about 3% to 5% of patients who survive cancer and its effects, depending on site and intensity of treatment. In a study of women who were taking tamoxifen for breast cancer, trait anxiety was associated with a higher dropout rate from tamoxifen therapy due to a higher incidence of adverse physiological side effects.[1] (Refer to the PDQ summary on Post-Traumatic Stress Disorder for more information.) Survivorship programs and resources, including group and individual counseling, can help facilitate adjustment and can address specific concerns. (Refer to the PDQ summary on Transitional Care Planning for more information.)

References

1. Cameron LD, Leventhal H, Love RR, et al.: Trait anxiety and tamoxifen effects on bone mineral density and sex hormone- binding globulin. Psychosom Med 64 (4): 612-20, 2002 Jul-Aug.  [PUBMED Abstract]
   
   

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