YOUR HEALTH: The fear of breast cancer returning

In In The News by Barbara Jacoby

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By: Jim Mertens



It’s a huge challenge for women after breast cancer treatment: living with the fear of recurrence

They’ve either heard the words, “you are cured”, or they are still being monitored and treated for the disease.

Almost four million women in the United States are breast cancer survivors.

But for many women, there’s overwhelming fear the disease will come back.

Now, researchers are working to determine the best way to help survivors face those fears.

Women like Kristen Lyons.

She was diagnosed with breast cancer at age 39.

“I was thinking about my kids and oh my goodness, what does this mean for our future?”

Kristen had treatment and beat the cancer.

She rang the clinic bell signaling the all-clear. but that started an internal battle that got worse.

“I thought I should have a new lease on life because here we are cancer-free, you know, and instead i found myself getting more and more worried and anxious.”

That’s where psychologist Shelley Johns wants to get involved.

“The number one problem that almost every cancer survivor that I work with has dealt with is the fear that it’s going to come back.”

A Treatment that Could Work

Johns and her colleagues at the Regenstrief Institute conducted a clinical trial comparing three interventions for people struggling with fear of cancer recurrence.

The researchers found one method produced significant reduction.

It’s called Acceptance and Commitment Therapy, or ACT.

“We’re all going to have thoughts and feelings that are uncomfortable,” explained Johns, a Clinical Health Psychologist.

“They just kind of naturally come into our mind. So, it’s about accepting those thoughts and feelings without necessarily getting hooked by them.”

Johns and her team met with survivors for six weeks and used mindfulness practices, like meditation, to help them focus.

Then patients developed a personal plan to give priority to their values, activities, and people important to them.

Kristen calls ACT life changing.

“I go down the worry path, but I now have the tools to reign it back in, and that’s made all the difference.”

Acceptance and Commitment Therapy has been around for two decades, but Johns says it has never been used to help people struggling with fear of cancer recurrence until now.

Researchers tested the interventions in a sample of 90 breast cancer survivors.

Johns says she would like to conduct a similar trial involving a much larger number of survivors.

Ongoing Research for Recurrent Breast Cancer

Vanderbilt University Medical Center is investigating changes from breast cancer tissue and blood samples, before and after treatment, in people with triple-negative breast cancer (TNBC).

They hope to identify factors that predict chemotherapy resistance, recurrence, and relapse-free survival.

Dana-Farber Cancer Institute is evaluating how genetics and immune cells change in people with TNBC over time.

The results of this study could lead to new ways to identify these patients at risk for developing treatment resistance, tumor recurrence, and metastasis and Virginia Commonwealth University is studying different combinations of FDA-approved drugs for their ability to kill breast cancer cells and stop breast cancer recurrence and metastasis.

If this story has impacted your life or prompted you or someone you know to seek or change treatments, please let us know by contacting Jim Mertens at or Marjorie Bekaert Thomas at