Damocles' syndrome revisited: Update on the fear of cancer recurrence in the complex world of today's treatments and survivorship

Hematol Oncol Stem Cell Ther. 2018 Sep;11(3):129-134. doi: 10.1016/j.hemonc.2018.01.005. Epub 2018 Feb 19.


Objective/background: Improvements in curative treatments for many types of cancer have emerged over the past several decades, resulting in a growing population of long-term cancer survivors - of both adult and childhood cancers. Despite this incredible medical achievement, long-term survivors of cancer face a unique fear: the fear of relapse.

Methods: We conducted a review of the literature for data on fear of relapse among cancer survivors.

Results: The fear of cancer recurrence is present in survivors of childhood and adult cancers as well as family members and often leads to psychological sequelae.

Conclusion: Literature on the fear of cancer recurrence has begun to emerge. However, herein we provide a unique approach through the use of a metaphor: Cicero's story of Damocles' sword. We aim to outline the many fear-related and emotional challenges faced by cancer survivors with an extensive review of studies demonstrating such challenges.

Keywords: Anxiety; Cancer; Fear of recurrence; Relapse; Survivorship.

Publication types

  • Review

MeSH terms

  • Adolescent
  • Adult
  • Cancer Survivors / psychology*
  • Child
  • Child, Preschool
  • Fear / psychology*
  • Female
  • Humans
  • Infant
  • Male
  • Neoplasm Recurrence, Local / psychology*
  • Syndrome