Montrealer finds hope in program helping cancer survivors face fear of recurrence
Posted December 30, 2025 6:43 pm.
Last Updated December 30, 2025 6:57 pm.
For many cancer survivors, the end of treatment does not mean the end of fear. The final chemotherapy session or last radiation appointment may mark a medical milestone, but emotionally, a new chapter often begins — one filled with uncertainty, anxiety, and a lingering question: what if the cancer comes back?
Across Canada, a program called Fear of Recurrence Therapy (FORT) is helping survivors confront that fear and move forward.
Co-developed by Christine Maheu, associate professor at McGill’s Ingram School of Nursing and researcher at the McGill University Health Centre (MUHC), and University of Ottawa researcher Sophie Lebel, FORT addresses what many experts now describe as a major blind spot in cancer care: emotional recovery after treatment ends.
Finding strength after treatment
Fear of cancer recurrence is common, yet often poorly addressed once treatment is complete. Survivors lose the routine appointments that once provided reassurance, leaving long stretches of waiting between follow-ups. According to Maheu, that sudden loss of structure can be deeply unsettling.
“We give individuals who’ve been touched by cancer that hope that they can get back some of the strengths to get back onto their lives following the end of cancer treatment,” she said.
Maheu explained that the program emerged directly from what patients were reporting once treatment ended; many described feeling abandoned, left alone to manage overwhelming anxiety without structured support.
“At the end of the treatment, what we were hearing from cancer patients is that often they felt almost like abandoned alone. The cancer treatment ended, they didn’t have their regular medical checkup, it was more after for their follow-ups every three and six months. A lot of worrying and anxiety went into those waiting periods before they could see another medical personnel for a follow-up,” she said.
Maheu said she repeatedly heard survivors voice the same concern during survivorship care planning: fear that the cancer would return. Despite how common it was, there were few targeted interventions to help people cope.
“The majority would say, ‘yes, now that the treatment is finished, I’m having these thoughts and worry what if the cancer comes back,’” she recounted.
That gap led Maheu and Lebel to develop FORT, drawing on existing research and evidence-based psychological strategies. The result is a six-week group program, with two-hour sessions involving six to eight participants who have completed cancer treatment.
Why fear lingers after cancer
Maheu explained that fear of recurrence is not simply worry; it is often tied to trauma. Cancer, she said, is experienced by many as a life-threatening event that fundamentally alters how they see the world and their future. That anxiety can surface as intrusive thoughts, hypervigilance about bodily sensations, and existential questioning about mortality and the future.
“There’s a lot of psychological impact that comes from being diagnosed with a condition that threatens your existence, your life existence,” Maheu said.
The power of shared experience
A core element of FORT is group therapy, which allows survivors to connect with others who understand their fears firsthand. Maheu said the group setting helps normalize emotions that many people feel ashamed to admit.
“It also gives others a chance to also support each other,” she said.
Participants learn to identify triggers for their anxiety, challenge unhelpful thoughts, and distinguish between normal physical sensations and symptoms that warrant medical attention. Over time, the sessions build toward confronting deeper fears, including thoughts about death and loss of control.
“What we’ve seen following the sixth session is that some individuals within these groups continue to support each other; they stay in contact,” Maheu said. “So that’s how we see how powerful it is in terms of getting that community, building that support system around you.”
A survivor’s perspective
For Montreal breast cancer survivor Elise Monaghan Joubert, joining FORT marked a turning point. Diagnosed in early 2023, she underwent a bilateral mastectomy followed by chemotherapy and radiation, completing treatment by the end of the year.
Despite having strong support from friends and family, Joubert said something was missing once treatment ended.
“It was so much more reassuring to be in a room with other women who got it,” she said. “I have a fantastic support system of friends and family, but there was always a sense that they didn’t truly understand.”
She described feeling validated by the shared experience of the group and less alone in her fears.
“I felt much less lonely in my thoughts and feelings. And it was a really special experience to be in a group like that,” she said.
When fear puts life on hold
Before FORT, Joubert said fear quietly dictated how she lived. She avoided making plans, even small ones, out of concern they would be disrupted by bad news.
“From the time I was diagnosed till this past summer, two years, I hadn’t been able to plan a weekend away or any vacation time or anything that would resemble something that would be fun for me,” she said.
She only realized the extent of that fear once she began the program.
“I was realizing I was just existing,” Joubert said.
One of the most powerful moments in the program involved directly confronting the worst possible fear.
“We went to the deep thoughts that you don’t speak about out loud, but what happens if you die?” she said. “You have to write it down and you have to visualize it. And you have to literally go there, go to that absolute worst fear of being gone in order to put everything else back into perspective.”
Externalizing that fear, she said, helped loosen its grip.
“You realize then once you face that hardest fear and you write it down, you externalize it. It’s no longer inside you. Then all of a sudden the floodgates break and you’re able to sort of visualize what’s next.”
Expanding across Canada
After more than a decade of research, pilot studies and clinical trials, FORT is now moving into broader implementation. The program has been delivered in cancer centres in Quebec, Ontario and British Columbia, and is now available online nationwide through a partnership with Wellspring Cancer Canada.
“We’re no longer having to provide the evidence that it works, but more on how can we make it part of clinical care, clinical cancer survivorship care,” Maheu said.
More than 200 health-care professionals have been trained to deliver FORT, with plans to expand both virtual and in-person offerings across the country.
Emotional recovery matters
Both Maheu and Joubert stress that survivorship care must extend beyond physical healing.
“When treatment ends, it’s not the end for the individual,” Maheu said. “They still have to go through and process a lot of the emotion and the cancer’s impact they’ve had on them.”
For Joubert, the program restored something she feared she had lost.
“This program gave me so many more tools on how to live my life now, having experienced what I’ve experienced,” she said.
Joubert encourages anyone who may be struggling to seek support.
“Find a community. If it’s online, it’s online; if it’s in person, even better. But there are so many more people out there who are feeling exactly the way you do or close enough. And it’s really important to have those people in your lives as much as it is to have your friends and your family.”
