Randomized Trial of ConquerFear: A Novel, Theoretically Based Psychosocial Intervention for Fear of Cancer Recurrence

2017 ◽  
Vol 35 (36) ◽  
pp. 4066-4077 ◽  
Author(s):  
Phyllis N. Butow ◽  
Jane Turner ◽  
Jemma Gilchrist ◽  
Louise Sharpe ◽  
Allan Ben Smith ◽  
...  
Keyword(s):  
Psychological Distress ◽  
Randomized Trial ◽  
Cancer Recurrence ◽  
Attention Control ◽  
Fear Of Cancer Recurrence ◽  
General Anxiety ◽  
Face To Face ◽  
Fear Of Cancer ◽  
The Impact ◽  
Post Therapy

Purpose Fear of cancer recurrence (FCR) is prevalent, distressing, and long lasting. This study evaluated the impact of a theoretically/empirically based intervention (ConquerFear) on FCR. Methods Eligible survivors had curable breast or colorectal cancer or melanoma, had completed treatment (not including endocrine therapy) 2 months to 5 years previously, were age > 18 years, and had scores above the clinical cutoff on the FCR Inventory (FCRI) severity subscale at screening. Participants were randomly assigned at a one-to-one ratio to either five face-to-face sessions of ConquerFear (attention training, metacognitions, acceptance/mindfulness, screening behavior, and values-based goal setting) or an attention control (Taking-it-Easy relaxation therapy). Participants completed questionnaires at baseline (T0), immediately post-therapy (T1), and 3 (T2) and 6 months (T3) later. The primary outcome was FCRI total score. Results Of 704 potentially eligible survivors from 17 sites and two online databases, 533 were contactable, of whom 222 (42%) consented; 121 were randomly assigned to intervention and 101 to control. Study arms were equivalent at baseline on all measured characteristics. ConquerFear participants had clinically and statistically greater improvements than control participants from T0 to T1 on FCRI total ( P < .001) and severity subscale scores ( P = .001), which were maintained at T2 ( P = .017 and P = .023, respectively) and, for FCRI total only, at T3 ( P = .018), and from T0 to T1 on three FCRI subscales (coping, psychological distress, and triggers) as well as in general anxiety, cancer-specific distress (total), and mental quality of life and metacognitions (total). Differences in FCRI psychological distress and cancer-specific distress (total) remained significantly different at T3. Conclusion This randomized trial demonstrated efficacy of ConquerFear compared with attention control (Taking-it-Easy) in reduction of FCRI total scores immediately post-therapy and 3 and 6 months later and in many secondary outcomes immediately post-therapy. Cancer-specific distress (total) remained more improved at 3- and 6-month follow-up.

scholarly journals 1041 Sleep Quality Mediates The Relationship Between Fear Of Cancer Recurrence And Psychological Distress In Young Adults With Cancer

SLEEP ◽  
2020 ◽  
Vol 43 (Supplement_1) ◽  
pp. A395-A396
Author(s):  
L C Daniel ◽  
S Garland ◽  
E Zhou ◽  
K Chalifour ◽  
G Eaton ◽  
...  
Keyword(s):  
Young Adults ◽  
Psychological Distress ◽  
Young Adult ◽  
Sleep Quality ◽  
Cancer Recurrence ◽  
Fear Of Cancer Recurrence ◽  
Young Adult Cancer Survivors ◽  
Adult Cancer Survivors ◽  
Fear Of Cancer ◽  
Young Adult Cancer

Abstract Introduction Fear of cancer recurrence is common in young adults with cancer and also related to poorer psychological outcomes. Sleep may be disrupted by anxious thoughts about cancer, causing long-term psychological distress. Thus, the current study tests sleep as a putative mediator of the association between fear of cancer recurrence and overall psychological distress in young adult cancer survivors. Methods In a national cross-sectional survey of Canadians, 436 young adults diagnosed with cancer between the ages of 15-39 (current age range 20-39, m=32.39, SD=4.70; 88% female) completed the Pittsburgh Sleep Quality Index, the Fear of Cancer Recurrence Inventory—Short Form, and the Kessler 10 Distress Inventory. Mediation was estimated using PROCESS. Age, sex, and on/off treatment status were entered into models as covariates. Results In the current sample, average fear of cancer recurrence was above the clinical cut-point (m=22.92, SD=6.84), psychological distress was high (m=25.18, SD=7.81), and sleep quality was poor (m=9.11, SD=3.95). Females reported significantly higher fear of cancer recurrence than males [F(1, 435)=15.49, p &lt;.001]. Patients on treatment reported significantly higher fear of cancer recurrence [F(1,435)=11.43, p=.001], poorer sleep quality [F(1,435)=6.48, p=.011], and greater psychological distress [F(1,435)=4.73, p &lt;.001] than patients off treatment. Using a bootstrapping model with covariates, higher fear of cancer recurrence was related to poorer sleep quality and, in turn, higher psychological distress as indicated by the indirect effect’s confidence interval not containing 0 (indirect effect=.13; 95%CI=0.081, 0.189). Conclusion Sleep quality may play an important role in connecting the common experience of fear of cancer recurrence to psychological distress in young adult cancer survivors. Future longitudinal research is needed to examine this possible mediator of young adult cancer patients’ psychological distress outcomes over time. Support This research was supported by a grant from the Newfoundland and Labrador Support for People and Patient-Oriented Research and Trials (NL-SUPPORT) Unit. Sheila Garland is supported by a Scotiabank New Investigator Award from the Beatrice Hunter Cancer Research Institute (BHCRI).

Evaluation of psychological distress in breast cancer patients during the COVID- 19 pandemic

2021 ◽  
pp. 36-41
Author(s):  
Md Rassell ◽  
KM Shaiful Islam ◽  
Hasan Shahrear Ahmed ◽  
Mohammad Jayedul Islam ◽  
Krisna Rani Majumdar
Keyword(s):  
Breast Cancer ◽  
Cancer Patients ◽  
Psychological Symptoms ◽  
Cancer Recurrence ◽  
Metastatic Breast ◽  
Stressful Events ◽  
Fear Of Cancer Recurrence ◽  
Breast Cancer Patients ◽  
Fear Of Cancer ◽  
The Impact

Cancer patients are the vulnerable group of population and have more chances of contracting Corona virus disease 2019 (COVID-19). They are at great risk of passing through very stressful events during this COVID-19 pandemic that may lead to different psychological problems. Different psychological symptoms of breast cancer patients are evaluated in this study during the COVID- 19 pandemic. Consecutive fifty women selected with a non-metastatic breast cancer, scheduled to receive cancer treatment in the upcoming days/weeks not. Received treatment in the past, completed the Impact of Event Scale-Revised(IES-R), the Hospital Anxiety and Depression Scale (HADS-A and HADS-D), the Fear of Cancer Recurrence Inventory (FCRI). and the Insomnia Severity Index (ISI) and questionnaires. The study was conducted at Bangabandhu Sheikh Mujib Medical University (BSMMU), Dhaka, Bangladesh from the 1st July 2020 to the 30th June 2021.. Patients were investigated about their worries regarding the impact of COVID-19 on their lives as carcinoma breast patients. Since the 1st July 2020 to the 30th June 2021, Consecutive 50 patients were prospectively evaluated. They were diagnosed with non-metastatic breast cancer. The mean age was 42.3 (range 30–70). Most of the patients (90%, n. 45) are married, 8% (n.4) patients are single and 2% (n. 1) patients are widowed. Among the patients 24 (48%) patients have high school or less education level, 19 (38%) have college experience and 7 (14%) have university degrees. Ten patients (20%) lived alone, 8 (16%) with one or two family members, and 32 (64%) with three or more family members. Concerning their working life, 36 (72%) were not working (namely housewives, retired, unemployed, or students) and 14 (28%) was occupied. In consideration of economic status 52% (n. 26) patients have annual family income in BDT 250001- 350000. On the other hand 22% (n. 11) within BDT 350001- 450000, 14% (n. 7) within BDT 150000- 250000, 6% (n. 3) within BDT 450001-550000 and 6% (n. 3) within BDT >550000 respectively. We found that 62% of patients had anxiety (HADS-A), 66% depression (HADS-D), and 68% fulfilled the diagnostic criteria for mild post-traumatic stress disorder (PTSD), 2% patients for moderate and 2% patients for severe PTSD. Results revealed that 50% (n.25) patients were suffering from subthreshold insomnia. On the other hand 46% (n.23) patients had no clinically significant Insomnia but 2% (n.1) patients had moderate and severe insomnia in each category. The Fear of Cancer Recurrence Inventory (FCRI) score was 14.7(SD±6.2) which was more than the cut-off value..Breast cancer patients pass through many stressful events that may develop significant psychological symptoms during this COVID-19 pandemic. The outcome of this study definitely contributes to understand the psychological distress of cancer patients and a to formulate a better plan for their management and psychological support. BSMMU J 2021; 14 (COVID -19 Supplement): 36-41

Melanoma

2021 ◽  
pp. 155-161
Author(s):  
Nadine A. Kasparian ◽  
Iris Bartula
Keyword(s):  
Psychological Distress ◽  
Clinical Care ◽  
Cancer Recurrence ◽  
Clinical Intervention ◽  
Multidisciplinary Care ◽  
Fear Of Cancer Recurrence ◽  
Risk And Resilience ◽  
Diagnostic Uncertainty ◽  
Effective Interventions ◽  
Fear Of Cancer

Comprehensive psychological care of people with melanoma spans all phases of the disease trajectory, including risk assessment, diagnosis, treatment, recovery, and survivorship, as well as the transition from curative to palliative care, death, and bereavement. At least one-third of people with melanoma report levels of psychological distress indicative of a need for clinical intervention, and over 70% report high levels of fear of cancer recurrence or progression. Many patients experience the period of diagnostic uncertainty between detection of a suspicious lesion and receipt of biopsy results as particularly stressful. High psychological distress is associated with reduced participation in cancer screening, treatment and risk management recommendations, delays in seeking medical advice, lower satisfaction with clinical care, higher health care costs, poorer social functioning, greater morbidity and mortality, and poorer overall quality of life. Screening for distress in people with melanoma is strongly recommended as part of routine, multidisciplinary care, followed by a stepped approach to psychological support and treatment, based on patient risk and resilience factors, needs, values, and preferences. A range of psychotherapeutic and psychoeducational interventions, delivered via a variety of modalities, are effective in reducing psychological distress in people with melanoma in the short and longer term. Cutting-edge research is focused on harnessing technology to bring effective interventions to scale.

scholarly journals Remote Psychological Interventions for Fear of Cancer Recurrence: Scoping Review (Preprint)

2021 ◽  
Author(s):  
Clizia Cincidda ◽  
Silvia Francesca Maria Pizzoli ◽  
Gabriella Pravettoni
Keyword(s):  
Cancer Recurrence ◽  
Fear Of Cancer Recurrence ◽  
Current Evidence ◽  
Psychological Interventions ◽  
Face To Face ◽  
Patients With Cancer ◽  
Acceptance And Commitment ◽  
Evidence Based Treatments ◽  
Behavioral Therapies ◽  
Fear Of Cancer

BACKGROUND Patients with cancer and survivors may experience the fear of cancer recurrence (FCR), a preoccupation with the progression or recurrence of cancer. During the spread of COVID-19 in 2019, patients and survivors experienced increased levels of FCR. Hence, there is a greater need to identify effective evidence-based treatments to help people cope with FCR. Remotely delivered interventions might provide a valuable means to address FCR in patients with cancer. OBJECTIVE The aim of this study is to first discuss the available psychological interventions for FCR based on traditional cognitive behavioral therapies (CBTs) or contemporary CBTs, in particular, mindfulness and acceptance and commitment therapy, and then propose a possible approach based on the retrieved literature. METHODS We searched key electronic databases to identify studies that evaluated the effect of psychological interventions such as CBT on FCR among patients with cancer and survivors. RESULTS Current evidence suggests that face-to-face psychological interventions for FCR are feasible, acceptable, and efficacious for managing FCR. However, there are no specific data on the interventions that are most effective when delivered remotely. CONCLUSIONS CBT interventions can be efficacious in managing FCR, especially at posttreatment, regardless of whether it is delivered face to face, on the web, or using a blended approach. To date, no study has simultaneously compared the effectiveness of face-to-face, web-based, and blended interventions. On the basis of the retrieved evidence, we propose the hypothetical program of an intervention for FCR based on both traditional CBT and contemporary CBT, named Change Of Recurrence, which aims to improve the management of FCR in patients with cancer and survivors.

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