New psychological intervention may help cancer survivors cope with fear of recurrence
A psychological intervention, Conquer Fear, may help alleviate fear of cancer recurrence (FCR) in cancer survivors, according to a study presented at the American Society of Clinical Oncology (ASCO) Annual Meeting 2017 held in Chicago, Illinois, US.
Conquer Fear, an intervention developed for research purposes and has yet to be used for clinical application, aims to reduce clinically significant FCR and relevant psychological morbidities such as cancer-specific or general distress (eg, anxiety, depression, and stress).
Researchers randomized 222 disease-free, stage I–III breast, colorectal, or melanoma cancer survivors (2 months to 5 years post-treatment) with a high FCR (≥13 on the FCR Inventory [FCRI] severity subscale) to a psychological intervention arm (n=121, five sessions) or a relaxation training control arm (n=101, five 60-minute, individual, face-to-face sessions). Follow-ups were performed immediately after the intervention, and 3 and 6 months after treatment. [ASCO 2017, abstract LBA10000]
Based on the FCRI severity subscale ranging between 0 and 168 (higher scores indicate worse FCR), the average scores at baseline were 82.7 and 85.7 in the intervention and control arms, respectively.
Compared with relaxation training, participants in the psychological intervention arm had substantially reduced FCR immediately after treatment (difference, -10.5, 95 percent confidence interval [CI], -16.1 to -4.9; p<0.001), which continued to decrease over time (difference, -7.6, 95 percent CI, -13.9 to -1.4; p=0.02 at 3 months and difference, -7.8, 95 percent CI, -14.2 to -1.4; p=0.02 at 6 months).
“The reduction in fear of recurrence in the psychological intervention group was large enough to improve survivors’ psychological and emotional well-being,” said lead author Dr Jane Beith from the University of Sydney, Australia.
The pattern of change in outcomes remained consistent between the treatment groups over time, said the researchers, with no significant linear trends in treatment effects observed.
Although delivered in a face-to-face format, researchers indicated that CF may also be provided through other formats (eg, group, online, stepped care approach).
“In this study, the interventions were delivered by experienced psycho-oncologists. It is possible that community psychologists or other professionals who have basic training in cognitive therapy could deliver the interventions, given appropriate training and supervision,” said Dr Beith.
While a majority of the subjects included young women with breast cancer, Beith hoped that the intervention would be suitable for other cancer patients exhibiting moderate to high FCR.
FCR may negatively influence patients’ psychological framework that can eventually affect quality of life. Psychological intervention may help alleviate the condition with strategies that will allow cancer survivors to control their worries about recurrence, thereby helping them have a better outlook and an improved quality of life, noted the researchers.