Fear is present from the moment you are in the process of running tests to find out whether you might have cancer.  

Fear jumps at you at the moment of your cancer diagnosis: ‘you might well die from this cancer’.  At that very moment the world stops spinning, your life has changed forever (you don’t quite know how yet), there is only the unknown ahead of you and suddenly you’re terrified you might not be around for your children.  All of that, and more, crosses your mind in those very first few seconds when you hear you have cancer.   

The fear clings to you.  It’s a natural response to the life-threatening situation you’re in.  

It sits on your lap and it is there all the time during your treatment; you’re wondering whether the treatment is doing the job. Is it really ‘fixing you’?  Are the doctors saving your life?

It’s difficult to deal with fear during treatment, as you are still in an area of the unknown and there is simply no space to get to terms with your fear as you are in ‘survival-mode’.  

Fear is just one of many emotional responses to a cancer diagnosis, but it is the most frequently reported source of distress for people affected by cancer:  

I was hoping to say goodbye to my fear when I finished my treatment.  It’s all over now, right?  Should I be ‘fixed’ now?  I remember celebrating the end of my treatment with a big party, like celebrating an important milestone or achievement of a project.  I invited all my family and friends and celebrated life with them.  I felt very determined to get on with my life.  I intended to begin the day after the party.  I really had no idea of what was to come!

I remember sitting on my couch, the day after that party, the dust of the party was still settling, and everyone had returned to their ‘normal lives’, their families and work.  

At that very moment, fear left my lap and jumped to my throat!  It was that very first time of realisation of what had actually happened to me that hit me.  I didn’t realise that with finishing treatment I stepped out of my ‘survival-mode’ and had stepped into a ‘transition-mode’; a phase of recovery, both physically and mentally.   

Instead of hoping to get back to my life as before and to work as soon as possible, a whole new phase of uncertainty and the unknown unfolded ahead of me.  It felt like I had left the woods of treatment and had stepped into an open space.  There are no paths there, the light is blinding me, space was overwhelming, I was tired and confused, there was no hiding, just vulnerability.  

Fear was the prominent emotion at this phase, regularly overtaken by frustration, depression, isolation and guilt.  My hormone treatment only amplifying it all.

There was also a great fear of recurrence, and I panicked with every little pain.  My GP assured me that I should come as often as I needed, and that this fear would fade with time.  She was right.

For anyone who has experienced cancer, there is always a degree of fear that it might recur.  For some, their natural tendency is to get on with life and this fear perhaps just appears now and again when they develop a new pain or symptom or are feeling low for some reason.  However, for others the fear of recurrence can dominate their lives to an extreme extent such that it interferes with their ability to live their lives and get enjoyment from them.

Fear is often fuelled by worries and these worries exist as your thoughts.  The good news is that thoughts aren’t facts.  A worried thought is just your interpretation: it is not a fact.

With a coach you can take the time to explore your (thoughts about) fear, your responses and what actions you can take to support yourself in the best possible way:  

- What are the “triggers”?   
- When, where, what, with whom?  
- How do you feel (physically and emotionally)?  
- What are you saying to yourself?   
- What do you usually DO when you experience fear/worry?  
- Rate your fear on a scale 1 to 10 to keep track of any progress.
- Listen to the thoughts leading to the fear: are they truth?  
- What strategies work best for you to tame your thoughts?  
- How can you reframe your thinking so it’s not a threat anymore?  
- How can you embrace your fear?  
- How can you change your behaviour to support yourself at these moments? E.g. going out for a walk, taking a hot bath, pick-up the phone and call someone, listen to music, curl up in your sofa with a cup of tea, do a mindfulness exercise.  Basically, any TLC you can think of to support yourself.

There are endless possibilities to explore with your coach and to find out what’s working best for YOU.  Then you can turn this into an action plan to embed in your day-to-day life to support yourself in managing fear.

Isabel van der Ven, Cancer Survivor, Life Coach & Trainer and Co-founder of LYLAC: Live Your Life After Cancer, www.lylac.net