Addressing fear of cancer recurrence among women with cancer: a feasibility and preliminary outcome study
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Evidence suggests that fear of cancer recurrence (FCR) is one of the most frequently cited unmet needs among cancer survivors and is associated with psychological distress, stress-response symptoms, and lower quality of life, as well as increased use of health care resources. Despite these factors, few manualized interventions exist to address FCR among cancer survivors.
To develop, manualize, and pilot test the feasibility and preliminary efficacy of a 6-week cognitive-existential (CE) group intervention designed to address FCR in women with breast or ovarian cancer.
This study was a single-arm multi-site study with pre-, post-, and 3-month follow-up measurement occasions.
A total of 56 breast or ovarian cancer survivors enrolled in the study; 44 completed the CE group intervention. Following the intervention, women experienced a reduction in the primary study outcome measure of FCR and secondary study outcome measures of cancer-specific distress and uncertainty. They also reported improvements in secondary study outcome measures of quality of life and coping. The effect sizes of the observed changes were for the most part in the medium to large effect range; furthermore, almost all changes were sustained at 3-month follow-up.
This brief intervention appears feasible and has shown promising results in addressing FCR and related secondary outcomes of cancer-specific distress, uncertainty, quality of life, and coping; however, it should be further tested using a randomized controlled study design to more definitively assess its efficacy.
Implications for Cancer Survivors
FCR is a near-universal worry for cancer survivors that, when left unaddressed, tends to remain stable over time. This study has important implications for all cancer survivors as it is the first published intervention that provides preliminary evidence of its efficacy in decreasing fear of cancer recurrence.
KeywordsFear of cancer recurrence Pilot study Cognitive-existential intervention Breast cancer Ovarian cancer
This research was supported in by the Canadian Institutes of Health Research through a Catalyst grant to Sophie Lebel (PI) and Christine Maheu (co-PI) and from a matching fund from the Canadian Nurses Foundation, Nursing Care Partnership Program to Christine Maheu (PI) and Sophie Lebel (co-PI). We appreciate the efforts of our research assistants on this project: Megan McCallum, Christina Tomei, and Ai Tinamizu.
Conflict of interest
I, Sophie Lebel, declare that myself or my institution (University of Ottawa) or my co-authors have no relationship, financial or otherwise, with individuals or organizations that could influence the authors’ work inappropriately.
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