People often say that one of the hardest parts of cancer is the waiting. Waiting for results, waiting for the next scan, waiting to feel like yourself again. And then, when treatment ends and everyone expects relief, many people discover a new kind of fear: what if it comes back?
This article is about living with that uncertainty. I want to describe what many people experience, what research tells us, and some ways of finding your footing when the future feels unclear.
The many faces of uncertainty
Uncertainty shows up in different moments:
- Around diagnosis, when everything is new and decisions have to be made quickly.
- During treatment, when your body changes, your energy drops and your daily life revolves around appointments.
- Before check-ups, when the fear rises again. Some people call this “scanxiety”.
- After treatment, when the intensive care ends, contact with the medical team becomes less frequent, and you are expected to return to “normal”.
- With advanced cancer, when living with the illness becomes long-term and the question of time is always present.
Each of these phases has its own emotional weight. It is common to feel relieved and frightened at the same time, grateful and angry, hopeful and exhausted.
Fear of recurrence
Fear that the cancer will come back is one of the most common concerns of people who have had cancer. In a large international analysis of more than 9,000 people, almost six out of ten reported some fear of recurrence, and about one in five reported severe fear. The fear appeared across all types of cancer and at every point after diagnosis (Luigjes-Huizer et al., 2022).
A review of 87 qualitative studies described fear of recurrence as an intense, many-sided experience: it lives in thoughts, in the body, in emotions and in behaviour, for example checking the body again and again or avoiding anything that reminds you of the illness (Almeida et al., 2019).
Some fear is understandable and even protective: it reminds you to go to check-ups and take care of yourself. It becomes a problem when it takes over your days, keeps you from sleeping or stops you from making plans.
A thought to hold on to
Fear tends to speak in absolutes: “It will come back.” “I’ll never be safe.” Your actual situation is usually more open than the fear suggests. Your medical team can help you understand your individual risk.
What research says helps
Psychological support for fear of recurrence has been studied in many randomised trials. A meta-analysis of 23 controlled trials found that psychological interventions reduced fear of recurrence, with small effects that remained at follow-up (Tauber et al., 2019). Another meta-analysis focused on mind-body approaches such as cognitive behavioural skills and meditation, and found small to medium reductions in fear after the interventions (Hall et al., 2018).
Resilience, the ability to adapt and recover, also seems to matter. A review found that biological, personal and especially social factors contribute to resilience in people with cancer (Seiler & Jenewein, 2019). Resilience can grow through relationships, routines and experiences of coping.
Ways to find your footing
Name what you fear
Fear grows in the dark. Writing it down, or saying it to someone you trust, often makes it smaller and more concrete. Try: “What exactly am I afraid of right now?”
Separate worry time from living time
Some people find it helpful to set aside a short “worry time” each day, maybe 15 minutes, to write down fears and questions. Outside that time, when the fear appears, you can gently remind yourself: “I’ll think about this at six.”
Prepare for check-ups
Plan the days before and after a scan: who comes with you, what you will do afterwards, how you will get the results. Write your questions down beforehand. Ask your team when and how you will hear the results.
Notice your body with kindness
After cancer, every ache can feel like a warning. It helps to know which symptoms your team wants you to report, and to agree on a plan: “If this lasts longer than two weeks, I will call.” That way you can take your body seriously without living in constant alarm.
Return to what matters, step by step
Uncertainty can make it hard to plan. Small steps help: a weekend trip, a course, meeting a friend, a project at work. You do not need to know the whole future to live today fully.
Mark the end of treatment
The last day of treatment can feel strangely empty. Some people find it helpful to mark it in a small way, with a meal, a walk, or a letter to themselves. It can also help to plan the first weeks afterwards gently, knowing that energy, mood and confidence often need time to return.
Let others help
Partners, family and friends often want to help but do not know how. Telling them concretely what you need, whether that is company at an appointment or a normal evening without talking about cancer, is a gift to them as well.
Making room for the good days
Uncertainty can take up a lot of space, and it is easy to feel that every good moment must be earned or might be taken away. Some people find it helpful to plan small things to look forward to, such as a visit, a favourite meal, a short trip or an evening with music. These plans can stay flexible and be adapted to treatment and energy. Enjoying a good day fully is allowed, even while the illness is part of your life, and those days can give you strength for the harder ones.
When to look for more support
It can help to speak with a psycho-oncologist or therapist if fear or sadness takes up most of your day, if you avoid check-ups out of fear, if you cannot sleep, or if you feel that nobody around you understands. You can read more about support in Psycho-oncology: emotional support when cancer enters your life.
If you feel overwhelmed or have thoughts of ending your life, please call your local emergency number (for example 112 in Europe or 911 in North America and Mexico), or find a free, confidential helpline in your country at findahelpline.com. For questions about cancer itself, your treatment team or your national cancer society are good places to start.
I am a certified psycho-oncologist (Psychosocial-Oncology Certification, QPO, LAGO Brandenburg, Potsdam, 2025). If you would like support while living with cancer, you can book a session with me in English, Spanish or German.
How therapy with me works →References
- Almeida, S. N., Elliott, R., Silva, E. R., & Sales, C. M. D. (2019). Fear of cancer recurrence: A qualitative systematic review and meta-synthesis of patients’ experiences. Clinical Psychology Review, 68, 13–24. https://doi.org/10.1016/j.cpr.2018.12.001
- Hall, D. L., Luberto, C. M., Philpotts, L. L., Song, R., Park, E. R., & Yeh, G. Y. (2018). Mind-body interventions for fear of cancer recurrence: A systematic review and meta-analysis. Psycho-oncology, 27(11), 2546–2558. https://doi.org/10.1002/pon.4757
- Luigjes-Huizer, Y. L., Tauber, N. M., Humphris, G., Kasparian, N. A., Lam, W. W. T., Lebel, S., Simard, S., Smith, A. B., Zachariae, R., Afiyanti, Y., Bell, K. J. L., Custers, J. A. E., de Wit, N. J., Fisher, P. L., Galica, J., Garland, S. N., Helsper, C. W., Jeppesen, M. M., Liu, J., . . . van der Lee, M. L. (2022). What is the prevalence of fear of cancer recurrence in cancer survivors and patients? A systematic review and individual participant data meta-analysis. Psycho-oncology, 31(6), 879–892. https://doi.org/10.1002/pon.5921
- Seiler, A., & Jenewein, J. (2019). Resilience in cancer patients. Frontiers in Psychiatry, 10, 208. https://doi.org/10.3389/fpsyt.2019.00208
- Tauber, N. M., O’Toole, M. S., Dinkel, A., Galica, J., Humphris, G., Lebel, S., Maheu, C., Ozakinci, G., Prins, J., Sharpe, L., Smith, A. B., Thewes, B., Simard, S., & Zachariae, R. (2019). Effect of psychological intervention on fear of cancer recurrence: A systematic review and meta-analysis. Journal of Clinical Oncology, 37(31), 2899–2915. https://doi.org/10.1200/jco.19.00572
This article is exploratory and meant for information and reflection. It cannot capture the full complexity of any individual situation, and your own experience may be different. It does not replace a diagnosis or treatment.
