No illness to lament?
"When fear becomes extreme, it can give rise to strange physical symptoms," says Dr. Lin Geng-li, an attending physician at Taipei's Song De Psychiatry Clinic, commenting on his clinical experience. Lin says that the anxieties of people with cancerophobia often manifest physically as headaches, dizziness, tightness in the chest, shortness of breath, and a weak heartbeat.
"Most of these patients have become extraordinarily worried about their own health after seeing a family member suffer through cancer," Lin explains. He recalls the case of a male patient of about 40 who began complaining of chronic pain in the upper right part of his abdomen two years after his father died of liver cancer. The man was terrified that he too was having liver problems.
"Generally speaking, liver disease doesn't show symptoms in its early stages," says Lin. "But this man continued to experience liver pain even after every possible test confirmed that his liver was completely healthy."
Some of those who suffer from cancerophobia have no physical symptoms, but are instead simply unable to accept the fact that they don't have cancer. Clinically speaking, this is a form of hypochondria.
Freud first proposed the existence of hypochondria in a letter to his good friend Dr. Wilhelm Fliess, a German ear, nose, and throat specialist, calling it a variety of chronic anxiety neurosis. Later, in his essay "On Narcissism," Freud described it as a kind of withdrawal: sufferers withdraw their interest and libido from the outside world and turn them inwards towards themselves.
Freud argued that hypochondriacs worried about their health to such an extent that the slightest symptom would have them imagining the direst of diseases. Yang Tsung-tsair, director of the Department of Psychiatry at Cardinal Tien Hospital, explains that hypochondria can be triggered by major changes in people's lives, such as the loss of a family member, the end of a relationship, or the loss of a job. They find the blow too much to accept and withdraw from the outside world, losing their interest in people, objects, and events. Instead, they obsess over their health, seeking medical treatment for the most minor symptoms or abnormalities. Yang says the condition is most common among women in their 30s and 40s, especially those who are poorly educated.
As their turn approaches, hypochondriacs who fear they have cancer look forward to their diagnoses with both anticipation and more than a little fear.