Your treatment is over, and your life finally is back to normal. You look fine, and you feel good physically. Everyone else is relieved that the worst is behind you. So why are you so scared now?

Relax. It's not uncommon for women to feel anxiety when treatment for breast cancer stops. When you first started treatment, regular medical appointments, clinic visits, or hospitalizations probably seemed disruptive. After a while, though, they became an ordinary part of your schedule, and the members of your health care team began to seem more familiar than many of your friends. In addition, there was something reassuring about the constant monitoring of your health. Now all that is ending, and it's really not surprising that, on some level, you will miss it.

One of the biggest fears you may face during this period is that you will have a recurrence of your cancer. Little aches and pains that you barely would have noticed before suddenly may seem to take on huge significance. It's natural to be afraid that your cancer might return. However, it may help to remind yourself that everyone has minor symptoms now and then. If you have a symptom that is urgent or severe, or one that lasts for several days, by all means see your doctor. But keep in mind that most breast cancer survivors never have a recurrence.

"It's not uncommon for women to feel anxiety when treatment for breast cancer stops."

These are some more tips for managing your fear of cancer returning:

• Don't neglect your medical care once cancer treatment is over. Make sure you know who is in charge of your care now and when your next checkup should be.
• Discuss your worries with an understanding friend. Or join a support group, where you can talk about your feelings with other women who have been there.
• Find other things that help you keep anxiety at bay. Try reading a good book, working in the garden, or watching a funny movie—whatever works for you.
• Know that your anxiety is likely to fade with the passing years. Eventually, cancer will stop being the center of your life and start receding to the background.

As you move into the post-treatment phase of your life, it's normal to feel a little uneasy. If your anxiety starts to spiral out of control, however, you may begin to feel overwhelmed by constant fear or worry that doesn't go away and that just grows worse with time. For some women, the anxiety itself may get so bad that it causes disturbing symptoms, such as insomnia, fatigue, muscle tension, trembling, headaches, hot flashes, or irritability. In addition, it may start to interfere with the ability to function at home or work. If your anxiety reaches this point, it may be time to consult a mental health professional. Ask your doctor, nurse, or minister for a referral. Today, most people with severe anxiety can be helped by counseling, medications, or both.

BreastCancer.org http://www.breastcancer.org —This website has a Shrink the Whale section

http://www.breastcancer.org/cmn_copi_fear_shrink.html which takes its name from an anecdote in the book Living Beyond Breast Cancer, by Dr. Marisa Weiss and Ellen Weiss. In the book, a breast cancer survivor describes her lingering fear of the disease as being like a whale that sometimes grows and sometimes shrinks, but never completely goes away. The website lets you list things that make your own whale bigger or smaller and get ideas from other women's lists.

Living Beyond Breast Cancer http://www.lbbc.org —This nonprofit organization, founded by Dr. Weiss, sponsors conferences, a newsletter, online message boards, and other educational materials for breast cancer survivors. It also operates a survivors' helpline: (888) 753-LBBC.

U.S. National Institute of Mental Health http://www.nimh.nih.gov —This government institute publishes fact sheets about anxiety disorders. It also has an information line: (888) 8-ANXIETY.

Love, Susan M., with Karen Lindsey. Dr. Susan Love's Breast Book, 3rd edition. Cambridge, MA: Perseus Publishing; 2000.

American Cancer Society. A Breast Cancer Journey: Your Personal Guidebook. Atlanta, GA: American Cancer Society; 2001.

Link, John. The Breast Cancer Survival Manual: A Step-by-Step Guide for the Woman With Newly Diagnosed Breast Cancer, 2nd edition. New York: Owl Books; 2000.

Weiss, Marisa C., and Ellen Weiss. Living Beyond Breast Cancer: A Survivor's Guide for When Treatment Ends and the Rest of Your Life Begins. New York: Times Books; 1998.

National Institute of Mental Health. Facts about anxiety disorders. January 1999. Available at: http://www.nimh.nih.gov/anxiety/adfacts.cfm. Accessed on July 28, 2001.

National Institute of Mental Health. Facts about generalized anxiety disorder. September 1999. Available at: http://www.nimh.nih.gov/anxiety/gadfacts.cfm. Accessed on July 28, 2001.

BreastCancer.org. What makes the whale shrink? Available at: http://www.breastcancer.org/whale/ Accessed on July 28, 2001.