Ask Perrie: Got Big Questions

I’m going to do my best here to be a supportive place to land with these concerns, because they are some heavy and really common concerns among YA cancer folks. First, I want to name something important. Fear of recurrence is a huge part of young adult cancer. So much so that research consistently identifies it as one of the top three long-term aftereffects experienced by AYA survivors. I share that not to make it feel inevitable, but to normalize the experience. You are not alone in this fear, and many struggle to navigate it. 

When you’ve lived through something as traumatic and life-altering as cancer, it makes sense that your brain and body remain alert to the possibility that it could happen again. Your mind is trying to protect you! The tricky part is that this protective system sometimes stays on high alert long after treatment ends (or longer than necessary). 

Navigating fear of recurrence will look different for everyone. For some people, it means working with a trusted therapist who understands cancer survivorship. For others, it means finding community spaces where they can talk openly with people who truly understand the experience. And for many others, it takes space and time (ugh, I know, I know….time?!?) for healing as your mind, body, and soul adjust to your reality. 

Here are a few approaches that I’ve found personally and professionally helpful in dealing with fear of recurrence: 

Let the feeling exist.
Trying to force fear away often makes it louder. Acknowledging that fear is present can sometimes soften its grip. For many people, fear of recurrence does not completely disappear; it softens with time and grows quieter with experience navigating it. I don’t say that to scare you, but to name a truth that many experience: Sometimes the work becomes less about getting rid of fear and more about learning how to let the fear exist without letting it run your life. You see, the more we try to avoid fear, the bigger it can become. You might experiment with gently allowing yourself to be scared while still doing the important things in your life. You might even try practicing being with the fear in small increments on purpose. Yes, I know that sounds a little strange, but stay with me. The more you practice letting the feeling exist, the easier it can be to navigate when it inevitably knocks on your door. 

Bring yourself back to what you actually know to be true.
Fear has a way of pulling our minds into imagined futures. When that happens, try to anchor yourself in the present moment. What do you know to be completely true right now? Right now, you are here in this moment. Right now, you are living your life inside of trauma or new symptoms. Right now, you are doing your absolute best to cope. Bringing your brain back to the current moment is not only an exercise in reeling your thoughts in, but an act of mindfulness. The practice of paying attention to the current moment, on purpose, without judgment. Mindfulness has been shown, across a multitude of studies and cultural practices, to be a cornerstone of resilience and psychological health. When you notice your brain in future-tripping land (as I lovingly call it), try to see if you bring it back to what’s right in front of you through art, music, or another novel experience. It should help take the temperature down! 

Additionally, if you are unsure what symptoms should prompt a call to your oncologist, ask them directly. Having that information can be incredibly grounding. Keep a list of those symptoms somewhere accessible (looking at you, iPhone notes app) so when your brain starts spiraling, you have something concrete. Sometimes that reminder helps us see that our mind is trying to protect us from a future that has not arrived.

Give the fear somewhere to go.
Talking about it with trusted people, journaling, creative expression, therapy, or support groups can help move fear out of your head and into a space where it can actually be processed. Giving your body an opportunity to release some of that energy can be really important for your nervous system and overall mood management. Things like movement, physical activity, grounding exercises, or emotional processing in safe spaces are all ways to help your nervous system move through fear instead of holding it alone. Give yourself and your body an opportunity to chew through the feelings by finding which activities work best for you. 

Your second question about choosing a career after cancer is another really big one. Choosing a career that balances your needs is already a complicated process in young adulthood. When cancer enters the picture, those decisions can start to feel even heavier. It makes sense that you might feel overwhelmed or even frozen when trying to choose something that is both meaningful and stable. Cancer often changes our relationship with time. Suddenly, the idea of wasting time can feel terrifying. There can be pressure to find work that feels deeply fulfilling while also making sure you have stability, health insurance, and enough flexibility to take care of your body.

The truth is that most people build meaningful lives in layers rather than through one perfect decision.

Give yourself some grace to make the next best choice you can in this moment, and maybe even some permission to change your mind later. As you continue to grow as a human, your needs and priorities may shift or evolve. That may mean a professional pivot somewhere down the road, and that is okay (and to be expected, growing and changing is so so human). 

Some tough love here: you do not have to solve the rest of your life today, even if your brain is trying to convince you that you should. 

If you still find yourself feeling stuck on the career piece, it may be helpful to work with a career coach, academic advisor, or another professional who can help guide you through what matters most to you right now. Sometimes, simply exploring your options with someone who understands the process can relieve some of the pressure to find a path that checks every box all at once.

The fact that you are asking these questions tells me you are paying close attention to the life you want to build. That kind of reflection can feel heavy sometimes, but it can also lead to a life that feels deeply intentional. What a wonderful paradox. 

Wishing you courage as you keep asking the big questions,
Perrie