Mrs Sin says, “Many people think that completing surgery marks the end of their cancer journey. While physical wounds may heal over time, the fear of cancer returning can be far more difficult to overcome.”
As medical advances continue to improve cancer treatments, more people are returning to everyday life after overcoming their battles with the disease. Yet recovery extends beyond physical healing. Many still grapple with the emotional toll the disease takes and the fear it may return.
To address gaps in cancer rehabilitation support services, the The University of Hong Kong Jockey Club Institute of Cancer Care (JCICC), with support from The Hong Kong Jockey Club, launched the Jockey Club Cancer Care for Survivors Project to help survivors rebuild their physical and mental well-being and regain their rhythm of life. For Mrs Sin, the project played a pivotal role in helping her move beyond the emotional distress of her breast cancer diagnosis and treatment.
Anxiety and uncertainty after treatment
As she prepared for retirement in December 2024, Mrs Sin was making plans to travel more and take up new hobbies. She was looking forward to a relaxed and fulfilling new chapter in life. However, a routine health check-up changed everything. She was diagnosed with stage zero-to-one breast cancer that required a mastectomy.
While the surgery was successful in removing the tumour, her fear of cancer returning lingered. “After the operation, I often found myself overthinking. I became overly restrictive with my diet and extremely cautious in my daily activities for fear of triggering lymphoedema. This prolonged self-restraint created immense emotional strain and routine follow-up appointments did little to ease my anxiety,” she recalls. Beyond the limitations on her daily life, wearing a breast prosthesis made her self-conscious about her appearance. She often worried about how others might perceive her, adding to the psychological burden she was already carrying.
Learning to live with uncertainty
Dr Wendy Lam Wing-tak, Director of the HKU JCICC, explains that the programme integrates various techniques to build skills among participants. These include exercises to put worries on hold, self-management and acceptance-based strategies and detached mindfulness. “We help cancer survivors to understand that uncertainty is a natural part of the recovery journey,” says Dr Lam. “By learning to distinguish between constructive concerns and unproductive rumination, they can focus their attention on what they are able to manage in the present.” Previous research conducted by the team has shown that this approach can help reduce fear of cancer returning.
After joining the counselling programme, Mrs Sin acquired practical ways to manage her fears over time. She says it was the “worry-postponement” technique that benefited her the most. “When fear and anxiety creep in, I now write it down and set aside a specific time each day to process. For the rest of the day, I focus on living in the present and not allowing fear to dictate the rhythm of my life.”
In addition to changing her mindset, Mrs Sin also reassessed her life goals and values. She gradually resumed her fitness routine by joining running classes and hydrotherapy sessions. These activities helped to improve her physical well-being and reduce emotional negativity. The programme also taught her to step back from unhealthy obsessions such as excessive body monitoring and the compulsion to search for disease‑related information online. Instead, she learned to trust in her schedule of clinical follow-ups. Over time, she came to realise that even when faced with uncertainty and challenges, there is no need to let fear take control of her life.
Her husband, who accompanied her throughout the journey, believes the programme not only helped his wife to overcome anxiety, but also taught him how to let go of unnecessary worries about work and daily life. Today, Mrs Sin has come to accept the physical changes brought about by treatment and no longer fixates on how others might perceive her. She has returned to running and other daily routines, rediscovering both her confidence and sense of optimism about the future.
Dr Lam notes that many cancer survivors experience persistent emotional distress, with the fear of cancer returning being one of the most common concerns. Research conducted by the HKU JCICC found that around 37% of cancer survivors in Hong Kong experience significant fear of cancer recurrence shortly after completing their treatment. This not only affects their daily lives but can also undermine their emotional well-being.
She adds that Hong Kong has yet to establish a routine system for identifying cancer survivors who are suffering from substantial physical and psychological stress. As a result, some people in need of support may not receive timely assistance. One of the project’s core initiatives is to integrate routine symptom screening into clinical workflows by adopting the Edmonton Symptom Assessment System. This patient-reported assessment tool evaluates a range of physical and psychological symptoms including the fear of cancer recurrence, enabling high-risk cases to be identified early and be connected with appropriate support.
Taking back control of life
Dr Lam explains, “Self-management lies at the heart of our project. We empower survivors to recognise and respond to their own needs, strengthen their ability to cope with stress and encourage them to take an active role in their recovery. By developing healthy habits, such as maintaining a balanced diet and exercising regularly, cancer survivors can rebuild their confidence and regain a sense of control over their lives. The project also connects participants with professional and community resources for ongoing support.”
From recovery to a new chapter in life
"Cancer survivors should never shoulder all the pressure on their own," she shares. "Reaching out for community support and connecting with others who have shared similar experiences can help them find a way through difficult emotional periods."
For Mrs Sin, recovery is about more than physical healing. It is also about relearning how to live with uncertainty. Today she is no longer driven by fear of recurrence. Instead, she chooses to focus on the people and things that matter most.
"Clinical treatment is only the starting point of recovery. When you are willing to adjust your mindset and rediscover your values and purpose, you can begin, step by step, to rebuild a life that is truly yours," she says.
Did you know?
The core objective of the project is to build a sustainable community support network for cancer survivors. It integrates diverse community resources to deliver holistic management of physical and psychological symptoms as well as weight-related issues for survivors, helping to lower the risk of cancer recurrence while also training support practitioners. The service targets adult patients who have completed cancer treatment within the past three years. The project also organises regular health talks for patients, family members and the general public and trains peer-support volunteers.
FAQ
During the pandemic, Lok Yin had online classes at home and was diagnosed later with mild short-sightedness. Lok Yin's mother says, “He had to focus on the screen for four to five hours every day. That must have taken a toll on his eyesight. Luckily, we found out about the problem early.”