Cancer Recurrence Fear Reduced by Novel Psychological Intervention

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Approximately half of all cancer survivors report moderate to high fear of disease recurrence.
Approximately half of all cancer survivors report moderate to high fear of disease recurrence.
The following article features coverage from the 2017 American Society of Clinical Oncology Annual Meeting in Chicago, Illinois. Click here to read more of Oncology Nurse Advisor's conference coverage. 

CHICAGO — Conquer Fear, an experimental psychological intervention, can help decrease the fear of cancer recurrence among cancer survivors, according to study findings presented at the 2017 American Society of Clinical Oncology (ASCO) Annual Meeting.

In a phase II clinical trial, investigators led by Jane McNeil Beith, MD, PhD, randomly assigned 222 survivors of stage I-III breast cancer, colorectal cancer, or melanoma who reported a high fear of cancer recurrence (FCR) to receive the Conquer Fear intervention (101 patients) or relaxation training (control group, 121 patients).

“The reduction in fear of recurrence in the psychological intervention group was large enough to improve survivors' psychological and emotional well-being,” Dr Beith, a medical oncologist at the University of Sydney in Australia, said in an ASCO news release. “The majority of participants were young women with breast cancer, but we expect the intervention may be appropriate for other patients who have moderate to high fear of recurrence.”

Approximately 50% of all cancer survivors and 70% of young breast cancer survivors report moderate to high fear of recurrence, according to the release.

Developed by Dr Beith and her colleagues, Conquer Fear is delivered to patients in five 60-minute to 90-minute individual face-to-face sessions over 10 weeks. The intervention emphasizes acceptance of the inherent uncertainty of whether cancer would return, teaching strategies to control worry, giving survivors more control over where they place their attention, helping them focus on what they want out of life, and choosing a sensible level of cancer screening and sticking to it.

To measure the change in FCR, Dr Beith and her colleagues used total scores from a validated 42-item questionnaire called the Fear of Cancer Recurrence Inventory (FCRI). Scores range from 1 to 168, with higher scores indicating worse FCR. Patients completed the questionnaire at enrollment, immediately after the intervention, and 3 and 6 months later. The study's primary end point was reduction in FCR immediately after completion of intervention. The investigators considered a difference of 14.5 points in FCR to be clinically significant.

The average FCRI score at baseline was 82.7 and 85.7 in the intervention and control arms, respectively. The total average FCRI score decreased significantly more in the intervention than the control arm (−10.5 points; 95% CI, −16.1, −4.9; P <.001) immediately after the intervention.

Results showed that FCRI scores continued to decrease over time, with significant differences between the interventions observed at 3 and 6 months.

Speaking on behalf of ASCO, Don S. Dizon, MD, clinical co-director of Gynecologic Oncology at Massachusetts General Hospital in Boston, commented, “The number of people surviving cancer is higher than ever before, but many survivors fear that the cancer will return even long after they have finished treatment. The hope is that the positive results of this fear-reducing intervention will pave the way for making it more widely available to patients.” 

Read more of Oncology Nurse Advisor's coverage of the 2017 American Society of Clinical Oncology Annual Meeting by visiting the conference page.

Reference

1. Beith JM, Thewes B, Turner J, et al. Long-term results of a phase II randomized controlled trial (RCT) of a psychological intervention (Conquer Fear) to reduce clinical levels of fear of cancer recurrence in breast, colorectal, and melanoma cancer survivors. Oral presentation at: 2017 American Society of Clinical Oncology Annual Meeting; June 2-6, 2017; Chicago, IL.

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