Cancer Recurrence Fear Reduced by Novel Psychological Intervention

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In a study, 'Conquer Fear' decreased fear among survivors of breast and colorectal cancer and melanoma compared with relaxation techniques.
In a study, 'Conquer Fear' decreased fear among survivors of breast and colorectal cancer and melanoma compared with relaxation techniques.

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 American Society of Clinical Oncology (ASCO) annual meeting.

In a phase II clinical trial, study 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 wellbeing,” Dr Beith, a medical oncologist at the University of Sydney in Australia, said in an ASCO press release. “The majority of participants were young women with breast cancer, but we expect the intervention may be appropriate for other patients where 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- to 90-minute individual face-to-faces 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 endpoint 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 < 0.001) 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 survival 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.”

Reference

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. J Clin Oncol 2017;35 (suppl; abstr LBA10000. Presented at the American Society of Clinical Oncology annual meeting in Chicago on June 2, 2017.

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