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Case Presentation: How often in the oncology setting do patients express fear, worry, or concern about the cancer experience? A 41-year-old woman with a diagnosis of stage I ductal carcinoma treated with lumpectomy, radiation therapy, chemotherapy, and hormonal manipulation had no evidence of disease four years later. The patient had trouble sleeping at night and felt nervous most of the time. She expressed that her feelings have been worse since her cancer diagnosis.