Background: Fear of cancer recurrence (FCR) is one of the most frequently cited unmet needs among cancer survivors. Moderate to high levels of FCR affect 33 to 56% of cancer patients and can persist for several years after diagnosis. FCR is associated with impairment in functioning, 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.
Objectives: The goals were to develop, describe, standardize and do preliminary testing of a 6-week cognitive-existential group intervention to address FCR in women with breast or ovarian cancer. It is hypothesized that the group intervention will result in lower FCR, better psychological functioning, better coping, enhanced quality of life, and better adherence to screening guidelines.
Methods: The development of the cognitive-existential intervention was theoretically guided by Leventhal’s Common Sense Model, Mishel’s Uncertainty in illness theory, and cognitive models of worry. The earlier sessions focus on the acquisition of skills such as cognitive restructuring and relaxation techniques. The latter ones focus on exploration of each participant’s specific fears about FCR and exposure to these fears. We have completed 6 groups consisting of 5-8 women with either breast or ovarian cancer.Women were asked to complete the following questionnaires before beginning the group, after completion of the group, and at a 3-month follow-up.
Results: We found a moderate effect of the intervention in reducing FCR, cancer-specific distress, and maladaptive coping strategies and improving quality of life. Most of the improvements were sustained at the 3-month follow-up.
Conclusion: This brief intervention has shown promising results in addressing FCR among women with breast or ovarian cancer and in providing substantive evidence to support testing of this intervention in a RCT format.