A recurrence can bring up all the emotions that accompanied your first diagnosis - plus the additional distress of realizing that your cancer was not gone despite suffering through treatment and doubt about whether you chose the right doctor or treatment.

A recurrence is likely to bring up all the emotions that you experienced when you were first diagnosed with cancer. You may also feel any of the following:

• Anger -- especially if you have been following a cancer prevention lifestyle.
• Distress at realizing that your cancer was not gone despite suffering through treatment.
• Doubt about whether you made the right treatment decision originally, or had the right doctor(s).
• Fear that was greater than before because of a feeling that you are closer to death - whether it is true or not.
• "I know what this is like. I can't go through this again."

Focus on what got you through your first bout with cancer. You made it through once. You can do it again. In fact, it may be a bit easier this time because you have a relationship with your doctor and his or her staff. You likely also know your way around the treatment facility. 

If you didn't before, consider speaking with a breast cancer buddy - another woman who is living through a recurrence of breast cancer. Your cancer center may have a survivors program. You can also contact the American Cancer Society's Reach To Recovery program: www.cancer.org  or call 800.ACS.2345. 

Also consider joining a support group of other women living through breast cancer recurrence. In addition to the support, you are likely to learn practical information. In addition to in person meetings, you can attend a support group on line or on the telephone. See the document in "To Learn More" which lists organizations which sponsor or know about breast cancer support groups. 

When fear comes in, keep in mind that it is a thought, a projection. You can change the thought. It takes practice and time, but you can do it. The more you practice it, the easier it becomes. Plus there are techniques to help deal with stress. 

When it comes to doubt, keep in mind that you made the best decision you could with the facts you had at the time. There never was a guarantee that your cancer wouldn't return. All we can ever do is our best. 

Stay hopeful. Breast cancer is becoming a disease that doctors can manage. To help build your sense of hope:     

• Plan your days as you have always planned your days.
• Don't limit the things you like to do just because you have cancer.
• Look for your own reasons to have hope.

Look for humor. It helps. Art Linkletter got it right when he said that "Laughter is the best medicine." 

You can help assure your comfort with the treatment decision you have to make now by doing the following:

• Tell your doctor about the emotions the recurrence has brought up just as you tell him or her about your other concerns. If you don't like the way decisions were made the first time, discuss making a change. If you are no longer comfortable with the doctor, consider changing doctors. Changing doctors is not something to do lightly, but your health is the issue. You may find that a fresh start with a new health care team will help you improve your attitude and feel better about your current situation. Survivorship A to Z provides suggestions for working through issues with your doctor, and changing doctors if things don't work out. See "To Learn More."
• Get a second opinion - particularly from an NCI designated Comprehensive Cancer Center.  Second opinions are generally covered by insurance. Our treatment evaluator can help you compare treatments.

It can help to set goals. Planning something takes your mind off the disease each day. Aim for small goals each day, such as: 

• Exercising 
• Completing tasks you have been wanting to do 
• Making phone calls 
• Having lunch with a friend     
• Reading one chapter of a book or doing a puzzle 
• Listening to music or a relaxation tape. 

Many people also set longer-term goals. They say that they do much better if they set goals or look forward to something special. It could be an anniversary, the birth of a child or grandchild, a wedding, a graduation, or a vacation. If you set a long-term goal, make sure you are realistic about how you will achieve it. 

Remember that being flexible is important. You may have to change your plans if your energy level drops. You may have to adjust your goals if the cancer causes new challenges. Whatever your goals, try to spend your time in a way that you enjoy.

Review the tips we provide in "To Learn More" about coping with specific emotions if they appear.  

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