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Trudel G, Lebel S, Stephens RL, Leclair CS, Leach CR, Westmaas JL. Afraid and tired: A longitudinal study of the relationship between cancer-related fatigue and fear of cancer recurrence in long-term cancer survivors. Cancer Med 2024; 13:e7313. [PMID: 38845458 PMCID: PMC11157147 DOI: 10.1002/cam4.7313] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2023] [Revised: 05/03/2024] [Accepted: 05/08/2024] [Indexed: 06/10/2024] Open
Abstract
OBJECTIVE Cancer-related fatigue (CRF) and fear of cancer recurrence (FCR) are two common concerns experienced by cancer survivors. However, the relationship between these two concerns is poorly understood, and whether CRF and FCR influence each other over time is unclear. METHODS Data were from a national, prospective, longitudinal study, the American Cancer Society's Study of Cancer Survivors-I (SCS-I). Surveys were completed by 1395 survivors of 10 different cancer types at three time-points, including assessment 1.3 years (T1), 2.2 years (T2) and 8.8 years (T3) following their cancer diagnosis. CRF was assessed using the fatigue-inertia subscale of the Profile of Mood States, and FCR by the FCR subscale of the Cancer Problems in Living Scale. Multiple group random intercepts cross-lagged panel models investigated prospective associations between CRF and FCR. RESULTS For younger participants (at or below median age of 55 years, n = 697), CRF at T1 and T2 marginally and significantly predicted FCR at T2 and T3, respectively, but no lagged effects of FCR on subsequent CRF were observed. Cross-lagged effects were not observed for survivors over 55 years of age. CONCLUSION Both CRF and FCR are debilitating side effects of cancer and its treatments. Given that CRF may be predictive of FCR, it possible that early detection and intervention for CRF could contribute to lowering FCR severity.
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Affiliation(s)
| | - Sophie Lebel
- School of PsychologyUniversity of OttawaOttawaOntarioCanada
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Gu L, Shen C, Zhao L, Li N, Wang R, Dai L, Chu Z. The relationship between fear of cancer recurrence and posttraumatic growth: a meta-analysis. Front Psychol 2024; 15:1373102. [PMID: 38887626 PMCID: PMC11181912 DOI: 10.3389/fpsyg.2024.1373102] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2024] [Accepted: 04/01/2024] [Indexed: 06/20/2024] Open
Abstract
Background Theoretically, stress is positively correlated with posttraumatic growth (PTG). However, evidence for a correlation between fear of cancer recurrence (FCR), a cancer-specific stressor, and PTG is mixed. The present study aimed to systematically investigate the overall effect size between the two and to explore moderators that may influence this relationship. Methods From the earliest available date to October 2023, a comprehensive search was conducted in seven databases. Correlation coefficients (r) were calculated using Stata software. Publication type, continent, trauma role, gender, FCR measurements, PTG measurements, sample size, age, and time since diagnosis were used to examine moderating effects. The National Heart, Lung, and Blood Institute's (NHLBI) assessment tool was used to evaluate study quality. Results A total of 14 studies, involving 17 samples and 3,701 participants, were included. The studies found a small association between FCR and PTG (r = 0.161, 95% CI: 0.070-0.249, p < 0.01) and large heterogeneity (I2 = 85.5%). The strength of the association varied according to the publication type and FCR measurement. Conclusion The current review suggests a small but significant positive correlation between FCR and PTG. Future studies would benefit from exploring additional moderators and the use of standardized, validated FCR measurement tools. Systematic review registration PROSPERO, identifier CRD42023460407.
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Affiliation(s)
- Lianqi Gu
- School of Nursing, Nanjing Medical University, Nanjing, China
- The Second Affiliated Hospital of Nanjing Medical University, Nanjing, China
| | - Chen Shen
- School of Nursing, Nanjing Medical University, Nanjing, China
| | - Linlin Zhao
- School of Nursing, Nanjing Medical University, Nanjing, China
| | - Na Li
- The Second Affiliated Hospital of Nanjing Medical University, Nanjing, China
| | - Rao Wang
- The Second Affiliated Hospital of Nanjing Medical University, Nanjing, China
| | - Lili Dai
- The Second Affiliated Hospital of Nanjing Medical University, Nanjing, China
| | - Zhiping Chu
- The Second Affiliated Hospital of Nanjing Medical University, Nanjing, China
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Hampton J, Alam A, Zdenkowski N, Rowe C, Fradgley E, O'Neill CJ. Fear of Cancer Recurrence in Differentiated Thyroid Cancer Survivors: A Systematic Review. Thyroid 2024; 34:541-558. [PMID: 38368547 DOI: 10.1089/thy.2023.0642] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/19/2024]
Abstract
Background: Despite excellent survival rates, health-related quality of life detriments are common in differentiated thyroid cancer survivors and can be driven by fear of cancer recurrence (FCR). This review aims to report the incidence of FCR in thyroid cancer survivors and synthesize evidence regarding contributing factors. An overview and appraisal of the range of tools used to measure FCR is presented. Methods: A systematic review of the English literature was performed. The search across six electronic databases generated 3414 studies. Two reviewers independently screened the citations and full-text articles, of which 31 were included. The data were extracted independently by two reviewers. Results: The incidence of FCR was reported in 27/31 studies and ranged from 15% to 91%. Direct comparisons regarding incidence and severity of FCR were not possible due to heterogeneity in cut-points used to define FCR. A total of eight validated tools were used to measure FCR across all studies, with five studies using self-developed nonvalidated items. There was minimal repetition of validated tools and no clear consensus as to a preferred survey tool. Factors influencing FCR were reported in 11 studies. There was minimal overlap of factors influencing FCR. Risk factors contributing to increased FCR reported in more than one study included young age and an upcoming clinical appointment. Male gender and higher education levels were reported in more than one article as protective. No literature evaluating interventions to address FCR in thyroid cancer survivors was found. Conclusion: FCR is common in thyroid cancer survivors, but significant heterogeneity in the current evidence base limits assessment of incidence, severity, or risk factors. There is a need to use validated tools to assess FCR in both research and clinical contexts. Reliable assessment of FCR may permit routine assessment of FCR in clinical practice and allow interventions to be prospectively evaluated to optimize the holistic well-being of thyroid cancer survivors.
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Affiliation(s)
- Jacob Hampton
- Surgical Services, John Hunter Hospital, Newcastle, New South Wales, Australia
- School of Medicine and Public Health, University of Newcastle, Newcastle, New South Wales, Australia
- Hunter Medical Research Institute, Newcastle, New South Wales, Australia
| | - Ahmad Alam
- Surgical Services, John Hunter Hospital, Newcastle, New South Wales, Australia
- School of Medicine and Public Health, University of Newcastle, Newcastle, New South Wales, Australia
| | - Nicholas Zdenkowski
- School of Medicine and Public Health, University of Newcastle, Newcastle, New South Wales, Australia
| | - Christopher Rowe
- School of Medicine and Public Health, University of Newcastle, Newcastle, New South Wales, Australia
- Hunter Medical Research Institute, Newcastle, New South Wales, Australia
- Department of Endocrinology, John Hunter Hospital, Newcastle, New South Wales, Australia
| | - Elizabeth Fradgley
- School of Medicine and Public Health, University of Newcastle, Newcastle, New South Wales, Australia
- Hunter Medical Research Institute, Newcastle, New South Wales, Australia
| | - Christine J O'Neill
- Surgical Services, John Hunter Hospital, Newcastle, New South Wales, Australia
- School of Medicine and Public Health, University of Newcastle, Newcastle, New South Wales, Australia
- Hunter Medical Research Institute, Newcastle, New South Wales, Australia
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Calderon C, Gustems M, Galán-Moral R, Muñoz-Sánchez MM, Ostios-García L, Jiménez-Fonseca P. Fear of Recurrence in Advanced Cancer Patients: Sociodemographic, Clinical, and Psychological Correlates. Cancers (Basel) 2024; 16:909. [PMID: 38473270 DOI: 10.3390/cancers16050909] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2024] [Revised: 02/18/2024] [Accepted: 02/21/2024] [Indexed: 03/14/2024] Open
Abstract
Fear of cancer recurrence significantly impacts advanced cancer patients, prompting emotional distress and increased healthcare utilization. This present study aims to analyze the fear of recurrence among patients with advanced cancer undergoing systemic treatment and its relationship with sociodemographic, clinical, and psychological factors. A multicenter cross-sectional study was conducted in 15 oncology departments across Spain, involving patients with locally advanced, unresectable, or metastatic cancer eligible for systemic treatment. Participants provided demographic information and completed instruments such as the Cancer Worry Scale, Brief Symptom Inventory, Mishel Uncertainty in Illness Scale, and the Duke-UNC-11 Functional Social Support Questionnaire (DUFSSQ). A total of 1195 participants participated: median age 66, 56% male, mostly metastatic cancers (80%), and common tumor sites. Two fear groups emerged: 28% low and 72% high levels of fear. High fear was associated with being female, being younger, lower levels of education, and worse survival estimates. High fear correlated with more depression, anxiety, somatic symptoms, uncertainty, and stronger social support. Multivariate analyses indicated that younger patients, those with shorter survival estimates, higher depression and anxiety scores, more uncertainty, and stronger social support had a greater likelihood of experiencing fear of recurrence, while the opposite was true for older patients. This study underscores distinct fear of recurrence profiles in advanced cancer patients, emphasizing the need for targeted interventions and support. Future research should delve deeper into understanding their repercussions for improving patient care and well-being.
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Affiliation(s)
- Caterina Calderon
- Faculty of Psychology, University of Barcelona, 08007 Barcelona, Spain
| | - Marina Gustems
- Faculty of Psychology, University of Barcelona, 08007 Barcelona, Spain
| | - Rocio Galán-Moral
- Department of Medical Oncology, Hospital General Universitario de Ciudad Real, 13005 Madrid, Spain
| | - Maria M Muñoz-Sánchez
- Department of Medical Oncology, Hospital General Virgen de la Luz, 16002 Cuenca, Spain
| | | | - Paula Jiménez-Fonseca
- Department of Medical Oncology, Hospital Universitario Central de Asturias, Instituto de Investigación del Principado de Asturias (ISPA), 33011 Oviedo, Spain
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Nic Giolla Chomhaill C, Ward J, Dowling M. Fear of recurrence in women with ovarian cancer: A qualitative evidence synthesis. Eur J Oncol Nurs 2024; 68:102487. [PMID: 38113769 DOI: 10.1016/j.ejon.2023.102487] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2023] [Revised: 11/16/2023] [Accepted: 12/08/2023] [Indexed: 12/21/2023]
Abstract
PURPOSE Approximately 80% of ovarian cancers recur after first-line treatments. Women with ovarian cancer (OC) are therefore particularly vulnerable to experiencing fear of cancer recurrence (FCR). This study aimed to synthesise experiences of fear of cancer recurrence among women living with ovarian cancer. METHOD A qualitative evidence synthesis (QES) was conducted in accordance with the Enhancing Transparency in Reporting the Synthesis of Qualitative Research (ENTREQ) guidelines. A systematic search of seven databases was undertaken to identify all available qualitative research exploring fear of cancer recurrence in women with OC. Thematic synthesis of extracted data from included studies was undertaken and managed in NVivo. RESULTS Twenty-two papers reporting on eighteen studies were included in the synthesis. Three main themes were developed (triggers, responses, and coping) and included ten subthemes. FCR was triggered by factors relating to awareness of prognosis, treatment, and negative communication. Women responded to FCR by performing body checking and protecting their families. FCR led to adverse effects on women's wellbeing as it exacerbated uncertainty about their future. Women attempted to cope with FCR through seeking support, regaining control, and redirecting negative thoughts and actions. CONCLUSIONS Women use a variety of approaches to manage their fear of recurrence. Further research on the most appropriate interventions for FCR tailored specifically to the needs of women with OC is needed.
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Affiliation(s)
| | - Jana Ward
- Occupational Therapy Department, Galway University Hospital, Ireland.
| | - Maura Dowling
- School of Nursing and Midwifery, University of Galway, Ireland.
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Li Y, Xiao T, Liao H, Qu H, Ren P, Chen X. Fear of progression, loneliness, and hope in patients with gastrointestinal cancer: a cross-sectional relational study. Front Psychol 2024; 14:1279561. [PMID: 38250099 PMCID: PMC10796533 DOI: 10.3389/fpsyg.2023.1279561] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2023] [Accepted: 12/15/2023] [Indexed: 01/23/2024] Open
Abstract
Introduction In recent years, fear of disease progression (FoP) has become one of the most common psychological problems in cancer patients. However, there are fewer studies on the FoP in patients with gastrointestinal tumors. We aimed to assess the level of FoP in patients with gastrointestinal tumors and analyze the factors related to FoP. We also aimed to examine the relationship among loneliness, hope and FoP in patients with gastrointestinal cancer. Methods A cross-sectional survey was conducted on three Grade A hospitals in southwestern China from November 2021 to July 2022. The demographic and clinical characteristics questionnaire, Fear of Disease Progression Scale (FoP-Q-SF), Cancer Loneliness Scale (CLS), and Herth Hope Index (HHI) were included in this study. Data analysis included descriptive statistics, independent samples t-tests, one-way analysis of variance, and multiple linear regression analysis. Results In total, 245 gastrointestinal cancer patients participated in this study. The average (standard deviation) FoP score in patients was 32.94 ± 10.64. In total, 245 gastrointestinal cancer patients participated in this study. The average (standard deviation) FoP score in patients was 32.94 ± 10.64. The average score of CLS was 17.65 ± 6.71, and that for the HHI was 31.27 ± 7.73. Pearson correlation analysis showed that FoP was negatively significant correlated with hope level (r = -0.522) and FoP was positively significant correlated with loneliness (r = 0.545). Linear regression analysis showed that educational level, age, living condition, hope, and loneliness were the significant predictors of FoP and explained 53.10% of the variability in FoP (F = 16.372). Conclusion Findings highlight the need to strengthen attention to FoP in gastrointestinal cancer patients. Our study showed that gastrointestinal cancer patients who have a high school education, are age 45 to 59, live alone, high level of loneliness, and low level of hope have higher FoP. Medical staff should enhance clinical screening of FoP and consider the formulation of relevant interventions for high-risk groups to reduce loneliness among patients, raise their hope level, and reduce their FoP.
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Affiliation(s)
- Yanjun Li
- School of Nursing, Chengdu Medical College, Chengdu, Sichuan, China
- Department of Nursing, Suining Central Hospital, Suining, Sichuan, China
| | - Tian Xiao
- School of Nursing, Chengdu Medical College, Chengdu, Sichuan, China
| | - Haiyan Liao
- Department of Oncology, Chengdu Pidu District People’s Hospital, Chengdu, Sichuan, China
| | - Haimei Qu
- School of Nursing, Chengdu Medical College, Chengdu, Sichuan, China
| | - Pan Ren
- School of Nursing, Chengdu Medical College, Chengdu, Sichuan, China
| | - Xiaoju Chen
- School of Nursing, Chengdu Medical College, Chengdu, Sichuan, China
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Sinclair F, Gillanders D, Rooney N, Bonathan C, Hendry K, McLoone P, Hewitt C. Real-world evaluation of an acceptance and commitment therapy-based group programme for breast cancer survivors with fear of cancer recurrence. Support Care Cancer 2023; 31:700. [PMID: 37966674 PMCID: PMC10651702 DOI: 10.1007/s00520-023-08179-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2023] [Accepted: 11/09/2023] [Indexed: 11/16/2023]
Abstract
PURPOSE To evaluate the effectiveness and acceptability of a 6-week acceptance and commitment therapy (ACT)-based group programme on participants' fear of cancer recurrence (FCR), quality of life (QoL), psychological distress and psychological flexibility at the end of the programme and 12-week follow-up. METHODS A one-group, post-test service evaluation of a real-world psychological programme was carried out to evaluate collected outcome measures and attendance for a total of 21 groups facilitated between 2017 and 2019. Participants were breast cancer survivors who attended a 6-week group programme led by NHS clinicians. Descriptive statistics and repeated measures ANOVA analyses were carried out for each outcome measure. Attendance levels were examined to assess acceptability. RESULTS A total of 97 group participants who had completed curative treatment for breast cancer took part. Of whom, 89% completed at least 4 of the 6 weekly group sessions and 76% attended the 12-week follow-up session. Eighty-four (87%) participants returned outcome measures at all three time points relative to group participation (T1 = pre, T2 = post T3 = 12-week follow-up). Group participants were female, mean age 51.9 years. FCR was highest at T1 (mean 25.2, SD 4.7), reduced T2 (mean 21.2, SD 5.4) and further lowered T3 (mean 19.5, SD 6.2). This difference was statistically significant (p < 0.001). QoL was lowest at T1 (mean 62.4, SD 15.7), increased T2 (mean 71.7, SD 18.1) and further increased at T3 (mean 75.9, SD 17.5). This difference was statistically significant (p < 0.001). Psychological distress measures were shown to reduce, and psychological flexibility increased. CONCLUSIONS This real-world evaluation of an ACT-based group programme led to improvements in FCR, QoL, psychological distress and psychological flexibility in this population. This evaluation provides basis for further investigation to determine if these results can be replicated by controlled research design across diverse populations.
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Affiliation(s)
| | - David Gillanders
- School of Health in Social Sciences, University of Edinburgh, Edinburgh, Scotland
| | | | | | - Kirsty Hendry
- School of Health & Wellbeing, University of Glasgow, Glasgow, Scotland.
| | - Philip McLoone
- School of Health & Wellbeing, University of Glasgow, Glasgow, Scotland
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Lyhne JD, Smith AB, Timm S, Simard S, Jensen LH, Frostholm L, Fink P. Validity and screening capacity of the FCR-1r for fear of cancer recurrence in long-term colorectal cancer survivors. Support Care Cancer 2023; 31:690. [PMID: 37950072 PMCID: PMC10638160 DOI: 10.1007/s00520-023-08159-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2023] [Accepted: 11/02/2023] [Indexed: 11/12/2023]
Abstract
PURPOSE Existing fear of cancer recurrence (FCR) screening measures is being shortened to facilitate clinical use. This study aimed to evaluate the validity and screening capacity of a single-item FCR screening measure (FCR-1r) in long-term colorectal cancer (CRC) survivors with no recurrence and assess whether it performs as well in older as in younger survivors. METHODS All Danish CRC survivors above 18, diagnosed and treated with curative intent between 2014 and 2018, were located through a national patient registry. A questionnaire including the FCR-1r, which measures FCR on a 0-10 visual analog scale, alongside the validated Fear of Cancer Recurrence Inventory Short Form (FCRI-SF) as a reference standard was distributed between November 2021 and May 2023. Screening capacity and cut-offs were evaluated with a receiver-operating characteristic analysis (ROC) in older (≥ 65 years) compared to younger (< 65 years) CRC survivors. Hypotheses regarding associations with other psychological variables were tested as indicators of convergent and divergent validity. RESULTS Of the CRC survivors, 2,128/4,483 (47.5%) responded; 1,654 (36.9%) questionnaires were eligible for analyses (median age 76 (range 38-98), 47% female). Of the responders, 85.2% were aged ≥ 65. Ninety-two participants (5.6%) reported FCRI-SF scores ≥ 22 indicating clinically significant FCR. A FCR-1r cut-off ≥ 5/10 had 93.5% sensitivity and 80.4% specificity for detecting clinically significant FCR (AUC = 0.93, 95% CI 0.91-0.94) in the overall sample. The discrimination ability was significantly better in older (AUC = 0.93, 95% CI 0.91-0.95) compared to younger (0.87, 95% (0.82-0.92), p = 0.04) CRC survivors. The FCR-1r demonstrated concurrent validity against the FCRI-SF (r = 0.71, p < 0.0001) and convergent validity against the short-versions of the Symptom Checklist-90-R subscales for anxiety (r = 0.38, p < 0.0001), depression (r = 0.27, p < 0.0001), and emotional distress (r = 0.37, p < 0.0001). The FCR-1r correlated weakly with employment status (r = - 0.09, p < 0.0001) and not with marital status (r = 0.01, p = 0.66) indicating divergent validity. CONCLUSIONS The FCR-1r is a valid tool for FCR screening in CRC survivors with excellent ability to discriminate between clinical and non-clinical FCR, particularly in older CRC survivors.
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Affiliation(s)
- Johanne Dam Lyhne
- Department of Clinical Oncology, University Hospital of Southern Denmark, Beriderbakken 4, 7100, Vejle, Denmark.
| | - Allan Ben Smith
- South West Sydney Clinical Campuses, Faculty of Medicine and Health, University of New South Wales (UNSW Sydney), Liverpool, Australia
- Ingham Institute for Applied Medical Research, Liverpool Hospital, Locked Bag 7103, Liverpool BC, NSW, 1871, Australia
| | - Signe Timm
- Department of Clinical Oncology, University Hospital of Southern Denmark, Beriderbakken 4, 7100, Vejle, Denmark
| | - Sébastien Simard
- Université du Québec À Chicoutimi (UQAC), Health Sciences Department, 555, Boul. de L'Université, Chicoutimi (Qc), Canada
| | - Lars Henrik Jensen
- Department of Clinical Oncology, University Hospital of Southern Denmark, Beriderbakken 4, 7100, Vejle, Denmark
| | - Lisbeth Frostholm
- Research Clinic for Functional Disorders and Psychosomatics, Aarhus University Hospital, Palle Juul-Jensens Boulevard 99, 8200, Aarhus N, Denmark
- Department of Clinical Medicine, Aarhus University, Nordre Ringgade 1, 8000, Aarhus C, Denmark
| | - Per Fink
- Research Clinic for Functional Disorders and Psychosomatics, Aarhus University Hospital, Palle Juul-Jensens Boulevard 99, 8200, Aarhus N, Denmark
- Department of Clinical Medicine, Aarhus University, Nordre Ringgade 1, 8000, Aarhus C, Denmark
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Zheng M, Wang S, Zhu Y, Wan H. Trajectories of fear of progression in nasopharyngeal carcinoma patients receiving proton and heavy ion therapy. Support Care Cancer 2023; 31:630. [PMID: 37843679 DOI: 10.1007/s00520-023-08085-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2023] [Accepted: 09/26/2023] [Indexed: 10/17/2023]
Abstract
OBJECTIVE The study examined the growth trajectory of fear of progression(FOP) in nasopharyngeal carcinoma (NPC) patients. In addition, sociodemographic and clinical variables of each trajectory class were analyzed. METHOD Two hundred sixteen NPC patients undergoing proton and heavy ion therapy were measured beginning (T0) and end of a 4-week proton and heavy ion therapy (T1), 3 months (T2) and 6 months (T3) after discharge. And data from the final 197 NPC patients were analyzed. NPC patients' FOP was investigated by the Fear of Progression Questionnaire-Short Form (FOP-Q-SF) form T0 to T3. SPSS and Mplus were used for statistical analysis. The LGMM was used to analyze the trajectory of FOP followed up over 6 months after proton and heavy ion therapy. The logistic regression was utilized to compare the differences in sociodemographic and clinical characteristics of patients in different trajectory groups of FOP. RESULTS One hundred ninety-seven NPC patients were analyzed. LGMM analysis showed that three-group trajectory solution was the best fitting (low-fear decline FOP (14.21%), the moderate-fear stable FOP(43.15%), and high-fear rising FOP (42.64%). Significant positive associations were found between age < 30 years (β = 3.399, p = 0.023), with or without children (β = 3.1, p = 0.002), primary/recurrence (β = -6.196, p < 0.001), diagnosis < 3 months (β = 4.435, p = 0.031), high school education (β = 2.98, p = 0.048), and high fear rising FOP. Patients who had moderate financial stress (β = 2.51, p = 0.041), with or without children (β = 1.564, p = 0.003), primary/recurrence (β = -2.578, p = 0.005), less than 30 radiotherapy times (β = 0.979, p = 0.046) tended to report significant moderate-fear stable FOP over time. CONCLUSION 42.64% of the NPC patients showed high-fear rising FOP over the 6 months after treatment. Age 18-30 years, with or without children, relapsed, diagnosis < 3 months, and high school education and reporting being a pessimist predicts higher FOP scores. Early identification of age 18-30 years, with or without children, relapsed, diagnosis < 3 months, and high school education might help to identify populations experiencing long-term FOP. Clinical teams responsible to develop the target interventions for management of FCR in clinical practice.
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Affiliation(s)
- Mimi Zheng
- Department of Nursing, Shanghai Proton and Heavy Ion Center, Fudan University Cancer Hospital, Shanghai Key Laboratory of Radiation Oncology (20dz2261000), Shanghai Engineering Research Center of Proton and Heavy Ion Radiation Therapy, Shanghai, China
| | - Shuman Wang
- Department of Nursing, Shanghai Proton and Heavy Ion Center, Fudan University Cancer Hospital, Shanghai Key Laboratory of Radiation Oncology (20dz2261000), Shanghai Engineering Research Center of Proton and Heavy Ion Radiation Therapy, Shanghai, China
| | - Yu Zhu
- Department of Nursing, Shanghai Proton and Heavy Ion Center, Fudan University Cancer Hospital, Shanghai Key Laboratory of Radiation Oncology (20dz2261000), Shanghai Engineering Research Center of Proton and Heavy Ion Radiation Therapy, Shanghai, China
| | - Hongwei Wan
- Department of Nursing, Shanghai Proton and Heavy Ion Center, Fudan University Cancer Hospital, Shanghai Key Laboratory of Radiation Oncology (20dz2261000), Shanghai Engineering Research Center of Proton and Heavy Ion Radiation Therapy, Shanghai, China.
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Wang X, Liu M, Li J, Wang Z, Liang Q, Yan Z, Wang J, Luan X. Relationship between quality of life, fear of disease progression, and coping styles in patients with pulmonary hypertension: A network analysis. Res Nurs Health 2023; 46:546-557. [PMID: 37537879 DOI: 10.1002/nur.22333] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2022] [Revised: 07/04/2023] [Accepted: 07/23/2023] [Indexed: 08/05/2023]
Abstract
A poor quality of life (QoL) in patients with pulmonary hypertension (PH) is often associated with emotional disturbances and the ability to cope. Little is known, however, about the intrinsic links among the QoL, fear of disease progression (FoP), and coping styles in patients with PH. The purpose of this study was to elucidate the relationships among QoL, FoP, and coping styles in patients with PH. We conducted a cross-sectional survey of 247 patients from a tertiary hospital in Jinan, China and analyzed the relationships using network analysis. Participants completed the World Health Organization's Quality of Life Questionnaire, Fear of Disease Progression Questionnaire and Simple Coping Style Questionnaire during the survey period. The total QoL, positive coping, and negative coping scores were 46.55 ± 10.46, 31.75 ± 6.85, and 18.75 ± 4.66, respectively. The QoL psychological domain had the strongest centrality, deserving more attention than other domains. The coping styles were bridge nodes that connected the whole network, where negative coping and social family FoP, and positive coping and both social and psychological QoL had the strongest positive correlations. There were no significant sex-based or age-based differences in the networks. To improve QoL and psychological well-being in people with PH, healthcare professionals must focus on issues beyond the patient's physical health. Specifically, they should focus on positive coping styles, while developing interventions to promote positive coping and reduce negative coping styles.
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Affiliation(s)
- Xiaoli Wang
- School of Nursing and Rehabilitation, Shandong University, Jinan, Shandong, China
| | - Mengqi Liu
- School of Nursing and Rehabilitation, Shandong University, Jinan, Shandong, China
| | - Jing Li
- Cardiovascular Medicine, Qilu Hospital of Shandong University, Jinan, Shandong, China
| | - Zhiwei Wang
- School of Nursing and Rehabilitation, Shandong University, Jinan, Shandong, China
| | - Qian Liang
- School of Nursing and Rehabilitation, Shandong University, Jinan, Shandong, China
| | - Zeping Yan
- School of Nursing and Rehabilitation, Shandong University, Jinan, Shandong, China
| | - Jiurui Wang
- School of Nursing and Rehabilitation, Shandong University, Jinan, Shandong, China
| | - Xiaorong Luan
- School of Nursing and Rehabilitation, Qilu Hospital, Shandong University, Jinan, Shandong, China
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Magnani C, Smith AB, Rey D, Sarradon-Eck A, Préau M, Bendiane MK, Bouhnik AD, Mancini J. Fear of cancer recurrence in young women 5 years after diagnosis with a good-prognosis cancer: the VICAN-5 national survey. J Cancer Surviv 2023; 17:1359-1370. [PMID: 35318569 DOI: 10.1007/s11764-022-01193-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2021] [Accepted: 02/18/2022] [Indexed: 10/18/2022]
Abstract
PURPOSE Fear of cancer recurrence (FCR) is frequent in survivors, but less is known about FCR in long-term survivors with very low risk of relapse. Our aim was to estimate the prevalence and clinical and socio-behavioural factors associated with FCR in young women 5 years after diagnosis of a good-prognosis cancer. METHODS Using data from the VICAN-5 survey, conducted in 2015-2016 amongst a national representative French sample of cancer survivors, we included women with non-metastatic melanoma, breast, or thyroid cancer, aged 55 years or under at diagnosis, who experienced no disease progression in the 5 years post-diagnosis. Multinomial logistic regression was used to identify factors associated with FCR, characterised using a three-level indicator: no, mild, and moderate/severe FCR. RESULTS Amongst the 1153 women included, mean age was 44 years at diagnosis, and 81.8% had breast cancer, 12.5% thyroid cancer, and 5.8% melanoma. Five years after diagnosis, 35.4% reported no FCR, 46.0% mild FCR, and 18.6% moderate/severe FCR. Women with thyroid cancer were less likely to suffer from mild or moderate/severe FCR, while cancer-related treatment sequelae, fatigue, and anxiety were more likely. Limited health literacy was associated with mild FCR. Women who reported only occasionally consulting a general practitioner (GP) for the management of their cancer had a higher probability of FCR. CONCLUSION Moderate/severe FCR affected nearly 20% of young female long-term survivors diagnosed with a good-prognosis cancer, particularly those reporting cancer-related sequelae, suffering from fatigue or anxiety, with breast cancer or melanoma (versus thyroid cancer), and consulting a GP only occasionally for cancer management. IMPLICATIONS FOR CANCER SURVIVORS Given the recognised impact of FCR on quality of life, it is essential to detect it as early as possible, and to implement targeted interventions in routine care.
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Affiliation(s)
| | - Allan Ben Smith
- Ingham Institute for Applied Medical Research, New South Wales, Sydney, Australia
- South Western Sydney Clinical School, University of New South Wales, New South Wales, Liverpool, Australia
| | - Dominique Rey
- Aix Marseille Univ, Inserm, IRD, SESSTIM, Sciences Economiques & Sociales de la Santé & Traitement de L'Information Médicale, ISSPAM, Equipe CANBIOS Labellisée Ligue 2019, Marseille, France
| | - Aline Sarradon-Eck
- Aix Marseille Univ, Inserm, IRD, SESSTIM, Sciences Economiques & Sociales de la Santé & Traitement de L'Information Médicale, ISSPAM, Equipe CANBIOS Labellisée Ligue 2019, Marseille, France
- Institut Paoli-Calmettes, SESSTIM, Marseille, France
| | - Marie Préau
- Unité UMR 1296 «Radiations: Défense, Santé, Environnement», Lyon, France
- Institut de Psychologie, Université Lumière Lyon 2, Bron, France
| | - Marc-Karim Bendiane
- Aix Marseille Univ, Inserm, IRD, SESSTIM, Sciences Economiques & Sociales de la Santé & Traitement de L'Information Médicale, ISSPAM, Equipe CANBIOS Labellisée Ligue 2019, Marseille, France
| | - Anne-Déborah Bouhnik
- Aix Marseille Univ, Inserm, IRD, SESSTIM, Sciences Economiques & Sociales de la Santé & Traitement de L'Information Médicale, ISSPAM, Equipe CANBIOS Labellisée Ligue 2019, Marseille, France.
| | - Julien Mancini
- Aix Marseille Univ, APHM, Inserm, IRD, SESSTIM, Sciences Economiques & Sociales de la Santé & Traitement de L'Information Médicale, ISSPAM, Equipe CANBIOS Labellisée Ligue 2019, Hop Timone, BioSTIC, Biostatistique et Technologies de l'Information et de la Communication, Marseille, France
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12
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Podina IR, Todea D, Fodor LA. Fear of cancer recurrence and mental health: A comprehensive meta-analysis. Psychooncology 2023; 32:1503-1513. [PMID: 37596855 DOI: 10.1002/pon.6205] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2023] [Revised: 07/28/2023] [Accepted: 08/06/2023] [Indexed: 08/20/2023]
Abstract
OBJECTIVE This study aimed to examine the relationship between fear of cancer recurrence (FCR) and symptoms of anxiety, depression, and emotional distress in cancer survivors. Additionally, potential effect modifiers of this link were investigated. METHODS A systematic search was conducted in PsychInfo, PubMed/Medline, Web of Science, and the Cochrane Central Register of Controlled Trials until June 2022. Studies reporting the association between FCR and mental health indices in adolescent and young adult survivors (15-39 years) and adult survivors (>18 years) were included. Study quality was assessed using the Joanna Briggs Institute checklist for cross-sectional studies. RESULTS A total of 72 primary studies with 31,740 participants were identified, with the majority having a low risk of bias. The results revealed a significant association between FCR and depression, anxiety, and emotional distress. This association was observed whether FCR was examined in relation to each factor individually or collectively. The effect sizes fell within the medium range. Notably, the relationship between FCR and mental health strengthened over the years of publication. Additionally, lengthier FCR assessment instruments yielded larger effect sizes compared to shorter and single-item instruments, underscoring the significance of instrument selection. CONCLUSIONS This meta-analysis provides further evidence that FCR is linked to a range of common mental health problems. The medium effect sizes observed indicate the need to consider FCR when evaluating the mental health of cancer survivors, and vice versa. Further research is required to elucidate the underlying mechanisms of the FCR-mental health link.
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Affiliation(s)
- Ioana R Podina
- Laboratory of Cognitive Clinical Sciences, University of Bucharest, Bucharest, Romania
| | - Diana Todea
- Interdisciplinary School of Doctoral Studies, University of Bucharest, Bucharest, Romania
| | - Liviu-Andrei Fodor
- International Institute for the Advanced Studies of Psychotherapy and Applied Mental Health, Babeș-Bolyai University, Cluj-Napoca, Romania
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Sawka AM, Ghai S, Rotstein L, Irish JC, Pasternak JD, Gullane PJ, Monteiro E, Zahedi A, Gooden E, Eskander A, Chung J, Devon K, Su J, Xu W, Jones JM, Gafni A, Baxter NN, Goldstein DP. Gender Differences in Fears Related to Low-Risk Papillary Thyroid Cancer and Its Treatment. JAMA Otolaryngol Head Neck Surg 2023; 149:803-810. [PMID: 37410454 PMCID: PMC10326729 DOI: 10.1001/jamaoto.2023.1642] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2023] [Accepted: 05/16/2023] [Indexed: 07/07/2023]
Abstract
Importance Fear is commonly experienced by individuals newly diagnosed with papillary thyroid cancer (PTC). Objective To explore the association between gender and fears of low-risk PTC disease progression, as well as its potential surgical treatment. Design, Setting, and Participants This single-center prospective cohort study was conducted at a tertiary care referral hospital in Toronto, Canada, and enrolled patients with untreated small low risk PTC (<2 cm in maximal diameter) that was confined to the thyroid. All patients had a surgical consultation. Study participants were enrolled between May 2016 and February 2021. Data analysis was performed from December 16, 2022, to May 8, 2023. Exposures Gender was self-reported by patients with low-risk PTC who were offered the choice of thyroidectomy or active surveillance. Baseline data were collected prior to the patient deciding on disease management. Main Outcomes and Measures Baseline patient questionnaires included the Fear of Progression-Short Form and Surgical Fear (referring to thyroidectomy) questionnaires. The fears of women and men were compared after adjustment for age. Decision-related variables, including Decision Self-Efficacy, and the ultimate treatment decisions were also compared between genders. Results The study included 153 women (mean [SD] age, 50.7 [15.0] years) and 47 men (mean [SD] age, 56.3 [13.8] years). There were no significant differences in primary tumor size, marital status, education, parental status, or employment status between the women and men. After adjustment for age, there was no significant difference observed in the level of fear of disease progression between men and women. However, women reported greater surgical fear compared with men. There was no meaningful difference observed between women and men with respect to decision self-efficacy or the ultimate treatment choice. Conclusions and Relevance In this cohort study of patients with low-risk PTC, women reported a higher level of surgical fear but not fear of the disease compared with men (after adjustment for age). Women and men were similarly confident and satisfied with their disease management choice. Furthermore, the decisions of women and men were generally not significantly different. The context of gender may contribute to the emotional experience of being diagnosed with thyroid cancer and its treatment perception.
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Affiliation(s)
- Anna M. Sawka
- Division of Endocrinology, University Health Network and University of Toronto, Toronto, Ontario, Canada
| | - Sangeet Ghai
- Joint Department of Medical Imaging, University Health Network–Mount Sinai Hospital–Women’s College Hospital, University of Toronto, Toronto, Ontario, Canada
| | - Lorne Rotstein
- Department of Surgery, University Health Network and University of Toronto, Toronto, Ontario, Canada
| | - Jonathan C. Irish
- Department of Otolaryngology–Head and Neck Surgery/Surgical Oncology, Princess Margaret Cancer Centre, University Health Network and University of Toronto, Toronto, Ontario, Canada
| | - Jesse D. Pasternak
- Department of Surgery, University Health Network and University of Toronto, Toronto, Ontario, Canada
| | - Patrick J. Gullane
- Department of Otolaryngology–Head and Neck Surgery/Surgical Oncology, Princess Margaret Cancer Centre, University Health Network and University of Toronto, Toronto, Ontario, Canada
| | - Eric Monteiro
- Department of Otolaryngology and Head and Neck Surgery, Mount Sinai Hospital and University of Toronto, Toronto, Ontario, Canada
| | - Afshan Zahedi
- Division of Endocrinology, Women’s College Hospital and University of Toronto, Toronto, Ontario, Canada
| | - Everton Gooden
- Department of Otolaryngology and Head and Neck Surgery, North York General Hospital and University of Toronto, Toronto, Ontario, Canada
| | - Antoine Eskander
- Department of Otolaryngology and Head and Neck Surgery, Sunnybrook Health Sciences Centre and University of Toronto, Toronto, Ontario, Canada
| | - Janet Chung
- Department of Otolaryngology and Head and Neck Surgery, Trillium Health Partners and University of Toronto, Toronto, Ontario, Canada
| | - Karen Devon
- Division of Endocrinology, Women’s College Hospital and University of Toronto, Toronto, Ontario, Canada
| | - Jie Su
- Department of Biostatistics, Princess Margaret Cancer Centre, University Health Network, Toronto, Ontario, Canada
| | - Wei Xu
- Department of Biostatistics, Princess Margaret Cancer Centre, University Health Network, Toronto, Ontario, Canada
- Department of Biostatistics, Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
| | - Jennifer M. Jones
- Department of Psychosocial Oncology, University Health Network and University of Toronto, Toronto, Ontario, Canada
| | - Amiram Gafni
- Centre for Health Economics and Policy Analysis, Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, Ontario, Canada
| | - Nancy N. Baxter
- Melbourne School of Population and Global Health, University of Melbourne, Melbourne, Victoria, Australia
| | - David P. Goldstein
- Department of Otolaryngology–Head and Neck Surgery/Surgical Oncology, Princess Margaret Cancer Centre, University Health Network and University of Toronto, Toronto, Ontario, Canada
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14
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Liu J, Griva K, Mahendran R. Latent Profiles of Fear of Cancer Recurrence and Associations with Physical and Mental Health Outcomes. Ann Behav Med 2023; 57:743-752. [PMID: 37203254 DOI: 10.1093/abm/kaad023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/20/2023] Open
Abstract
BACKGROUND Fear of cancer recurrence (FCR) is a multidimensional construct; however, few studies have meaningfully integrated FCR severity (i.e., level of fear) with FCR-related concepts (e.g., triggers). PURPOSE The present study determined (a) latent profiles of FCR; (b) socio-demographic variations between identified profiles; (c) interactions between identified profiles and resilience and rumination on chronic physical disorders, depressive/anxiety symptoms, and quality of life. METHODS The present study is a secondary data analysis of which 404 cancer survivors were included in this study. All participants completed the Fear of Cancer Recurrence Inventory and measures of resilience, rumination, depressive/anxiety symptoms, and quality of life. RESULTS Latent profile analysis identified three distinct profiles based on varying levels of FCR and FCR-related concepts; Profile 1 "Low FCR" (n = 108; 26.4%), Profile 2 "Moderate FCR, High coping" (n = 197; 49.4%), and Profile 3 "High FCR, distress and impairment" (n = 99; 24.3%). Profile 3 was associated with younger age and history of radiotherapy. Latent profiles of FCR significantly interacted with resilience and rumination on depressive/anxiety symptoms. CONCLUSIONS Latent profile analysis integrates FCR severity and FCR-related concepts to support a nuanced understanding of FCR. Our results suggest specific points of intervention, which extend beyond addressing FCR severity.
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Affiliation(s)
- Jianlin Liu
- Research Division, Institute of Mental Health, Singapore
| | - Konstadina Griva
- Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore
| | - Rathi Mahendran
- Department of Psychological Medicine, National University of Singapore, Singapore
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15
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Jung W, Park J, Jeong A, Cho JH, Jeon YJ, Shin DW. Fear of cancer recurrence and its predictors among patients with non-small cell lung cancer (NSCLC). J Cancer Surviv 2023:10.1007/s11764-023-01419-9. [PMID: 37351732 DOI: 10.1007/s11764-023-01419-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2023] [Accepted: 06/15/2023] [Indexed: 06/24/2023]
Abstract
PURPOSE Fear of cancer recurrence (FCR) is a multidimensional phenomenon among cancer survivors. This cross-sectional study aimed to identify the prevalence of FCR and its predictors among survivors of non-small cell lung cancer (NSCLC) in Korea. METHODS Participants who finished NSCLC treatment one or more months prior completed the Korean version of Fear of Cancer Recurrence Inventory-Short Form (K-FCRI-SF) and the European Organisation for Research and Treatment of Cancer Quality of Life Core Questionnaire (EORTC QLQ-C30) at single tertiary hospital in Korea. Multivariate-adjusted logistic regression and stepwise backward selection were used to determine the potential predictors of FCR. RESULTS Of the total 949 participants (mean age 63.4 ± 8.8 years, 44.3% women), 55.8% had high FCR. Female (adjusted odds ratio [aOR] 1.44, 95% confidence interval [CI] 1.06-1.95), pathologic stage III (aOR 1.97, 95% CI 1.18-3.30), poor overall quality of life (aOR 1.42, 95% CI 1.03-1.95), poor emotional functioning (aOR 3.91, 95% CI 2.64-5.81), poor social functioning (aOR 1.87, 95% CI 1.31-2.68), and severe dyspnea (aOR 2.91, 95% CI 1.03-8.21) were independent predictors of high FCR. Old age (≥ 70 years) was included in the final model (aOR 0.74, 95% CI 0.51-1.06) but did not show clinical significance. CONCLUSIONS Our study demonstrated that high FCR was prevalent in NSCLC patients in Korea. To prevent this, we suggest screening and early detection of FCR based on sex, pathologic stage, quality of life, emotional and social functioning, and dyspnea. IMPLICATIONS FOR CANCER SURVIVORS Screening and early detection of FCR based on sex, pathologic stage, quality of life, emotional and social functioning, and dyspnea is suggested.
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Affiliation(s)
- Wonyoung Jung
- Department of Family Medicine & Supportive Care Center, Samsung Medical Center, Seoul, Republic of Korea
- Department of Medicine, School of Medicine, Sungkyunkwan University, Seoul, Republic of Korea
| | - Junhee Park
- Department of Family Medicine & Supportive Care Center, Samsung Medical Center, Seoul, Republic of Korea
| | - Ansuk Jeong
- Department of Psychology, DePaul University, Chicago, IL, USA
| | - Jong Ho Cho
- Department of Thoracic and Cardiovascular Surgery, Samsung Medical Center, Seoul, Republic of Korea
| | - Yeong Jeong Jeon
- Department of Thoracic and Cardiovascular Surgery, Samsung Medical Center, Seoul, Republic of Korea
| | - Dong Wook Shin
- Department of Family Medicine & Supportive Care Center, Samsung Medical Center, Seoul, Republic of Korea.
- Department of Clinical Research Design & Evaluation, Samsung Advanced Institute for Health Science & Technology (SAIHST), Sungkyunkwan University, 81 Irwon-Ro, Gangnam-Gu, Seoul, 06351, Republic of Korea.
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16
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Bugaj TJ, Maatouk I, Hanslmeier T, Zschäbitz S, Huber J, Flock C, Friederich HC, Ihrig A. Couples coping with advanced prostate cancer: an explorative study on decision-making preferences, self-efficacy and fear of progression. World J Urol 2023; 41:1041-1046. [PMID: 36810686 DOI: 10.1007/s00345-023-04325-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2022] [Accepted: 01/27/2023] [Indexed: 02/24/2023] Open
Abstract
PURPOSE To date, there is a lack of understanding of the treatment/disease-related health behaviors of patients with advanced prostate cancer (PCa) and their spouses. The purpose of this study was to explore the characteristics of treatment decision-making (DM) preferences, general self-efficacy (SE) and fear of progression (FoP) among couples coping with advanced PCa. METHODS In this explorative study, 96 patients with advanced PCa and their spouses answered the multiple choice version of the Control Preferences Scale (CPS, regarding DM), General Self-Efficacy Short Scale (ASKU, regarding SE), and short form of the Fear of Progression Questionnaire (FoP-Q-SF, regarding FoP). Corresponding questionnaires were employed for patients' spouses were evaluated, and correlations were subsequently drawn. RESULTS More than half of the patients (61%) and spouses (62%) preferred active DM. Collaborative DM was preferred by 25% of patients and 32% of spouses, and 14% of patients and 5% of spouses preferred passive DM. FoP was significantly higher among spouses than among patients (p < 0.001). The difference in SE was not significant between patients and spouses (p = 0.064). FoP and SE negatively correlated among patients (r = - 0.42; p < 0.001) and among spouses (r = - 0.46; p < 0.001). DM preference did not correlate with SE and FoP. CONCLUSIONS High FoP and low general SE are related among both patients with advanced PCa and their spouses. FoP seems to be higher among female spouses than among patients. Couples seem to be largely in agreement when it comes to playing an active role in treatment DM. TRIAL REGISTRATION www.germanctr.de , number DRKS 00013045.
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Affiliation(s)
- Till Johannes Bugaj
- Division of Psycho-Oncology, Department of General Internal Medicine and Psychosomatics, University Hospital of Heidelberg, INF 410, 69120, Heidelberg, Germany
| | - Imad Maatouk
- Division of Psycho-Oncology, Department of General Internal Medicine and Psychosomatics, University Hospital of Heidelberg, INF 410, 69120, Heidelberg, Germany
- Section of Psychosomatic Medicine, Psychotherapy and Psycho-Oncology, Department of Internal Medicine II, Julius-Maximilian University of Würzburg, Würzburg, Germany
| | - Tobias Hanslmeier
- Division of Psycho-Oncology, Department of General Internal Medicine and Psychosomatics, University Hospital of Heidelberg, INF 410, 69120, Heidelberg, Germany
| | - Stefanie Zschäbitz
- Department of Medical Oncology, National Centre for Tumour Diseases (NCT), University Hospital of Heidelberg, Heidelberg, Germany
| | - Johannes Huber
- Department of Urology, Philipps-University of Marburg, Marburg, Germany
| | - Charlotte Flock
- Division of Psycho-Oncology, Department of General Internal Medicine and Psychosomatics, University Hospital of Heidelberg, INF 410, 69120, Heidelberg, Germany
| | - Hans-Christoph Friederich
- Division of Psycho-Oncology, Department of General Internal Medicine and Psychosomatics, University Hospital of Heidelberg, INF 410, 69120, Heidelberg, Germany
| | - Andreas Ihrig
- Division of Psycho-Oncology, Department of General Internal Medicine and Psychosomatics, University Hospital of Heidelberg, INF 410, 69120, Heidelberg, Germany.
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Riggauer J, Blaser D, Elicin O, Gahl B, Giger R, Mueller SA. Risk Factors for Fear of Recurrence in Head and Neck Cancer Patients. Laryngoscope 2022. [DOI: 10.1002/lary.30340] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2022] [Revised: 07/06/2022] [Accepted: 07/26/2022] [Indexed: 11/08/2022]
Affiliation(s)
- Julia Riggauer
- Inselspital Head and Neck Anticancer Center Bern University Hospital Bern Switzerland
- Department of ENT, Head and Neck Surgery, Inselspital Bern University Hospital, University of Bern Bern Switzerland
| | - Daniela Blaser
- Inselspital Head and Neck Anticancer Center Bern University Hospital Bern Switzerland
- Department of ENT, Head and Neck Surgery, Inselspital Bern University Hospital, University of Bern Bern Switzerland
| | - Olgun Elicin
- Inselspital Head and Neck Anticancer Center Bern University Hospital Bern Switzerland
- Department of Radiation Oncology, Inselspital Bern University Hospital Bern Switzerland
| | - Brigitta Gahl
- Clinical Trials Unit University of Bern Bern Switzerland
| | - Roland Giger
- Inselspital Head and Neck Anticancer Center Bern University Hospital Bern Switzerland
- Department of ENT, Head and Neck Surgery, Inselspital Bern University Hospital, University of Bern Bern Switzerland
| | - Simon Andreas Mueller
- Inselspital Head and Neck Anticancer Center Bern University Hospital Bern Switzerland
- Department of ENT, Head and Neck Surgery, Inselspital Bern University Hospital, University of Bern Bern Switzerland
- Department of Otolaryngology, Head & Neck Surgery University Hospital Zurich, University of Zurich Zurich Switzerland
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18
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Braun SE, Willis KD, Mladen SN, Aslanzadeh F, Lanoye A, Langbein J, Reid M, Loughan AR. Introducing FCR 6 – Brain: Measuring Fear of Cancer Recurrence in Brain Tumor Patients and Their Caregivers. Neurooncol Pract 2022; 9:509-519. [PMID: 36388416 PMCID: PMC9665059 DOI: 10.1093/nop/npac043] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Abstract
Background
Fear of cancer recurrence (FCR) is a psychological consequence of cancer diagnosis that impacts quality of life in neuro-oncology. However, the instruments used to assess FCR have not been tested for validity in patients with brain tumors. The present study explored the psychometric properties of a brief FCR scale in patients with primary brain tumor (PBT) and their caregivers.
Methods
Adult patients with PBT (n = 165) and their caregivers (n = 117) completed the FCR–7-item scale (FCR7) and measures of psychological functioning. Exploratory factor analyses (EFA) were conducted for both patient and caregiver FCR7. Convergent validity, prevalence, the difference between FCR in patients and caregivers, and relationships with relevant medical and demographic variables were explored.
Results
EFAs revealed a single factor with one item demonstrating poor loading for both patients and caregivers. Removal of the item measuring hypervigilance symptoms (checking for physical signs of tumor) greatly improved the single factor metrics. The amended scale (FCR6-Brain) demonstrated good convergent validity. Caregiver FCR was significantly higher than patient. Clinical guidance to identify clinically significant FCR was introduced. Age, gender, and time since diagnosis were related to FCR, with higher FCR in younger women more recently diagnosed.
Conclusions
The FCR6-Brain is the first validated instrument to assess FCR in this population and should be used to identify individuals at risk for FCR and guide development of future psychotherapeutic interventions. This study highlights the distinct characteristics of FCR in neuro-oncology. Symptoms of hypervigilance in PBT patients need further investigation.
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Affiliation(s)
- Sarah Ellen Braun
- Virginia Commonwealth University, Department of Neurology : Richmond VA
- Virginia Commonwealth University, Massey Cancer Center : Richmond, VA
| | - Kelcie D Willis
- Virginia Commonwealth University, Department of Psychology: Richmond, Virginia , Richmond, VA
| | - Samantha N Mladen
- Virginia Commonwealth University, Department of Psychology: Richmond, Virginia , Richmond, VA
| | - Farah Aslanzadeh
- Baltimore VA Medical Center, Department of Neuropsychology , Baltimore, MD
| | - Autumn Lanoye
- Virginia Commonwealth University, Massey Cancer Center : Richmond, VA
- Virginia Commonwealth University School of Medicine, Department of Health Behavior and Policy : Richmond, VA
| | - Jenna Langbein
- Virginia Commonwealth University School of Medicine: Richmond , VA
| | - Morgan Reid
- Virginia Commonwealth University, Department of Psychology: Richmond, Virginia , Richmond, VA
| | - Ashlee R Loughan
- Virginia Commonwealth University, Department of Neurology : Richmond VA
- Virginia Commonwealth University, Massey Cancer Center : Richmond, VA
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19
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Luigjes‐Huizer YL, Tauber NM, Humphris G, Kasparian NA, Lam WWT, Lebel S, Simard S, Smith AB, Zachariae R, Afiyanti Y, Bell KJL, Custers JAE, de Wit NJ, Fisher PL, Galica J, Garland SN, Helsper CW, Jeppesen MM, Liu J, Mititelu R, Monninkhof EM, Russell L, Savard J, Speckens AEM, van Helmondt SJ, Vatandoust S, Zdenkowski N, van der Lee ML. What is the prevalence of fear of cancer recurrence in cancer survivors and patients? A systematic review and individual participant data meta-analysis. Psychooncology 2022; 31:879-892. [PMID: 35388525 PMCID: PMC9321869 DOI: 10.1002/pon.5921] [Citation(s) in RCA: 101] [Impact Index Per Article: 50.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2021] [Revised: 02/14/2022] [Accepted: 03/09/2022] [Indexed: 12/20/2022]
Abstract
OBJECTIVE Care for fear of cancer recurrence (FCR) is considered the most common unmet need among cancer survivors. Yet the prevalence of FCR and predisposing factors remain inconclusive. To support targeted care, we provide a comprehensive overview of the prevalence and severity of FCR among cancer survivors and patients, as measured using the short form of the validated Fear of Cancer Recurrence Inventory (FCRI-SF). We also report on associations between FCR and clinical and demographic characteristics. METHODS This is a systematic review and individual participant data (IPD) meta-analysis on the prevalence of FCR. In the review, we included all studies that used the FCRI-SF with adult (≥18 years) cancer survivors and patients. Date of search: 7 February 2020. Risk of bias was assessed using the Joanna Briggs Institute critical appraisal tool. RESULTS IPD were requested from 87 unique studies and provided for 46 studies comprising 11,226 participants from 13 countries. 9311 respondents were included for the main analyses. On the FCRI-SF (range 0-36), 58.8% of respondents scored ≥13, 45.1% scored ≥16 and 19.2% scored ≥22. FCR decreased with age and women reported more FCR than men. FCR was found across cancer types and continents and for all time periods since cancer diagnosis. CONCLUSIONS FCR affects a considerable number of cancer survivors and patients. It is therefore important that healthcare providers discuss this issue with their patients and provide treatment when needed. Further research is needed to investigate how best to prevent and treat FCR and to identify other factors associated with FCR. The protocol was prospectively registered (PROSPERO CRD42020142185).
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Affiliation(s)
- Yvonne L. Luigjes‐Huizer
- Helen Dowling InstituteBilthovenThe Netherlands
- Julius Centre for Health Sciences and Primary CareUniversity Medical Centre UtrechtUtrechtThe Netherlands
| | - Nina M. Tauber
- Unit for Psychooncology and Health PsychologyAarhus University and Aarhus University HospitalAarhusDenmark
| | | | - Nadine A. Kasparian
- Cincinnati Children's Center for Heart Disease and Mental HealthHeart Institute and the Division of Behavioral Medicine & Clinical PsychologyCincinnati Children's Hospital Medical Center and Department of PediatricsUniversity of Cincinnati College of MedicineCincinnatiOhioUSA
| | - Wendy W. T. Lam
- Division of Behavioural SciencesSchool of Public Health, and LKS Faculty of Medicine Jockey Club Institute of Cancer CareUniversity of Hong KongHong KongChina
| | - Sophie Lebel
- Faculty of Social SciencesUniversity of OttawaOttawaOntarioCanada
| | - Sébastien Simard
- Université du Québec à Chicoutimi (UQAC)Centre Intersectoriel en santé durableQuébecQuébecCanada
| | - Allan Ben Smith
- Ingham Institute for Applied Medical Research and South West Sydney Clinical CampusesUNSWSydneyNew South WalesAustralia
| | - Robert Zachariae
- Unit for Psychooncology and Health PsychologyAarhus University and Aarhus University HospitalAarhusDenmark
| | - Yati Afiyanti
- Department of Maternity and Women HealthFaculty of NursingUniversitas IndonesiaDepokIndonesia
| | - Katy J. L. Bell
- Sydney School of Public HealthFaculty of Medicine and HealthThe University of SydneySydneyNew South WalesAustralia
| | - José A. E. Custers
- Department of Medical PsychologyRadboud University Medical CenterRadboud Institute for Health SciencesNijmegenThe Netherlands
| | - Niek J. de Wit
- Julius Centre for Health Sciences and Primary CareUniversity Medical Centre UtrechtUtrechtThe Netherlands
| | - Peter L. Fisher
- Department of Psychological SciencesUniversity of LiverpoolLiverpoolUK
| | - Jacqueline Galica
- Division of Cancer Care and EpidemiologyQueen's UniversityKingstonOntarioCanada
| | - Sheila N. Garland
- Department of PsychologyFaculty of ScienceMemorial UniversitySt. John'sNewfoundlandCanada
| | - Charles W. Helsper
- Julius Centre for Health Sciences and Primary CareUniversity Medical Centre UtrechtUtrechtThe Netherlands
| | - Mette M. Jeppesen
- Department of Gynaecology and ObstetricsOdense University HospitalOdenseDenmark
| | - Jianlin Liu
- Research DivisionInstitute of Mental HealthSingaporeSingapore
| | | | - Evelyn M. Monninkhof
- Julius Centre for Health Sciences and Primary CareUniversity Medical Centre UtrechtUtrechtThe Netherlands
| | - Lahiru Russell
- Centre for Quality and Patient Safety Research & Institute for Health TransformationSchool of Nursing and MidwiferyDeakin UniversityGeelongVictoriaAustralia
- Centre for Quality and Patient Safety Research – Eastern Health PartnershipBox HillVictoriaAustralia
| | - Josée Savard
- School of PsychologyUniversité LavalCHU de Québec‐Université Laval Research CenterUniversité Laval Cancer Research CentreQuebecQuébecCanada
| | - Anne E. M. Speckens
- Department of PsychiatryRadboud University Medical CentreNijmegenThe Netherlands
| | - Sanne J. van Helmondt
- Helen Dowling InstituteBilthovenThe Netherlands
- Department of Medical and Clinical PsychologyCenter of Research on Psychology in Somatic diseasesTilburg UniversityTilburgThe Netherlands
| | - Sina Vatandoust
- College of Medicine and Public HealthFlinders UniversityBedford ParkSouth AustraliaAustralia
| | - Nicholas Zdenkowski
- School of Medicine and Public HealthUniversity of NewcastleNewcastleNew South WalesAustralia
| | - Marije L. van der Lee
- Helen Dowling InstituteBilthovenThe Netherlands
- Department of Medical and Clinical PsychologyCenter of Research on Psychology in Somatic diseasesTilburg UniversityTilburgThe Netherlands
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20
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Bergerot CD, Philip EJ, Bergerot PG, Siddiq N, Tinianov S, Lustberg M. Fear of Cancer Recurrence or Progression: What Is It and What Can We Do About It? Am Soc Clin Oncol Educ Book 2022; 42:1-10. [PMID: 35561298 DOI: 10.1200/edbk_100031] [Citation(s) in RCA: 16] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
Patients with cancer face a trajectory marked by emotional and physical distress that can be associated with both diagnosis and treatment. Fear of cancer recurrence or progression has been considered one of the most common unmet needs reported by patients diagnosed with both localized and metastatic disease. Fear of cancer recurrence or progression has been defined as the "fear, worry, or concern relating to the possibility that cancer will come back or progress." Often overlooked by health care teams, fear of cancer recurrence or progression has been associated with impaired quality of life and psychosocial adjustment, elevated emotional distress, and a range of physical symptoms. Several interventions for fear of cancer recurrence or progression are currently under investigation. Early recognition, support, and validation of feelings associated with fear of cancer recurrence or progression, and appropriate referrals to psychosocial oncology, can be beneficial for many patients. Assessing patients early in their cancer trajectory, and at important milestones, including a change in therapies, at the end of active treatment, and during follow-up visits, can help identify individuals at risk and help individuals engage in supportive programs.
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Affiliation(s)
| | - Errol J Philip
- University of California San Francisco, San Francisco, CA
| | - Paulo Gustavo Bergerot
- Centro de Câncer de Brasília, Instituto Unity de Ensino e Pesquisa, Brasília, DF, Brazil
| | - Namrah Siddiq
- Yale Cancer Center, Yale School of Medicine, New Haven, CT
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21
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Richter D, Clever K, Mehnert-Theuerkauf A, Schönfelder A. Fear of Recurrence in Young Adult Cancer Patients—A Network Analysis. Cancers (Basel) 2022; 14:cancers14092092. [PMID: 35565220 PMCID: PMC9105535 DOI: 10.3390/cancers14092092] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2022] [Revised: 04/04/2022] [Accepted: 04/14/2022] [Indexed: 02/07/2023] Open
Abstract
Simple Summary Fear of cancer recurrence is a main concern for the majority of cancer patients during their disease. Young adults with cancer may experience fear of recurrence throughout their lives, given their relatively long potential survival time. More research is needed to identify evidence-based interventions that can adequately address this fear. Investigating the underlying mechanisms that trigger and sustain fear of cancer recurrence is an important step toward this goal. Network analysis is a useful tool to study symptoms and their structural relationships. The aim of this study is to apply the network analysis approach in a sample of young cancer patients to comprehend their specific symptomatology and define the optimal structure of a questionnaire to assess fear of recurrence in this patient group. Future studies may seek to replicate our findings among different age group samples to identify network structures and potential targets for clinical intervention. Abstract Due to the high survival rates of many young cancer patients and a high risk of second tumors, fear of cancer recurrence (FCR) can cause serious impairment for adolescent and young adult (AYA) cancer patients. The aim of this study is to analyze the structure of the Fear of Disease Progression Questionnaire (FoP-Q-12) to better understand the construct of FCR. We performed a cross-sectional survey on a sample of AYA patients aged 15–39 years with different tumor entities. FCR was measured using the FoP-Q-12, and a network analysis was conducted to examine the relationship of FCR symptoms. The importance of individual items in the network was determined using centrality analyses. A total of 247 AYA patients (81.8% female, median age 31.0 years) participated in the study. The mean FCR score in the sample was 35.9 (SD = 9.9). The majority of patients reported having high FCR (59.5%), according to the established cut-off. The two questionnaire items with the strongest association related to fears about work, and the most central symptom was the fear of serious medical interventions. The centrality of emotional issues in the sample indicates that these symptoms should be prioritized in the development of interventions targeting FCR. Further research should address this topic with larger samples of patients in other age groups and in longitudinal studies.
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Affiliation(s)
- Diana Richter
- Department of Medical Psychology and Medical Sociology, University Medical Center Leipzig, 04103 Leipzig, Germany; (A.M.-T.); (A.S.)
- Correspondence: ; Tel.: +49-341-97-15438
| | - Katharina Clever
- Department of Psychosomatics and Psychotherapy, MEDIAN Centre for Rehabilitation Schmannewitz, 04774 Dahlen, Germany;
| | - Anja Mehnert-Theuerkauf
- Department of Medical Psychology and Medical Sociology, University Medical Center Leipzig, 04103 Leipzig, Germany; (A.M.-T.); (A.S.)
| | - Antje Schönfelder
- Department of Medical Psychology and Medical Sociology, University Medical Center Leipzig, 04103 Leipzig, Germany; (A.M.-T.); (A.S.)
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22
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Deuning‐Smit E, Custers JAE, Miroševič Š, Takes RP, Jansen F, Langendijk JA, Terhaard CHJ, Baatenburg de Jong RJ, Leemans CR, Smit JH, Kwakkenbos L, Verdonck‐de Leeuw IM, Prins JB. Prospective longitudinal study on fear of cancer recurrence in patients newly diagnosed with head and neck cancer: Course, trajectories, and associated factors. Head Neck 2022; 44:914-925. [PMID: 35084079 PMCID: PMC9305148 DOI: 10.1002/hed.26985] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2021] [Revised: 12/06/2021] [Accepted: 01/12/2022] [Indexed: 01/08/2023] Open
Abstract
Background This study assessed the course of fear of cancer recurrence (FCR) in patients newly diagnosed with head and neck cancer (HNC), identified FCR trajectories and factors associated with FCR trajectories. Methods Six hundred and seventeen HNC patients from the NET‐QUBIC cohort study completed the Cancer Worry Scale‐6 at diagnosis, 3 and 6 months post‐treatment. FCR trajectories were identified using Latent Class Growth Analysis. Associations were explored between FCR trajectories and baseline demographic and medical variables, coping and self‐efficacy. Results Overall, FCR decreased slightly between baseline and 3 months post‐treatment and remained stable up to 6 months. Two FCR trajectories were identified: “high stable” (n = 125) and “low declining” (n = 492). Patients with high stable FCR were younger, reported more negative adjustment, passive coping, and reassuring thoughts, and less avoidance. Conclusions The majority of HNC patients have low declining FCR after diagnosis, but one in five patients experience persistent high FCR up to 6 months post‐treatment.
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Affiliation(s)
- Esther Deuning‐Smit
- Department of Medical Psychology Radboud Institute for Health Sciences, Radboud University Medical Center Nijmegen The Netherlands
| | - José A. E. Custers
- Department of Medical Psychology Radboud Institute for Health Sciences, Radboud University Medical Center Nijmegen The Netherlands
| | - Špela Miroševič
- Department of Family Medicine Faculty of Medicine, University of Ljubljana Ljubljana Slovenia
| | - Robert P. Takes
- Department of Otorhinolaryngology—Head and Neck Surgery Radboud University Medical Center Nijmegen The Netherlands
| | - Femke Jansen
- Department of Otolaryngology—Head and Neck Surgery Cancer Center Amsterdam, Amsterdam UMC, Vrije Universiteit Amsterdam Amsterdam The Netherlands
- Department of Clinical, Neuro and Development Psychology Amsterdam Public Health Research Institute, Vrije Universiteit Amsterdam Amsterdam The Netherlands
| | - Johannes A. Langendijk
- Department of Radiation Oncology University Medical Center Groningen, University of Groningen Groningen The Netherlands
| | | | - Robert J. Baatenburg de Jong
- Department of Otolaryngology and Head and Neck Surgery Erasmus Cancer Institute, ErasmusMC Rotterdam The Netherlands
| | - C. René Leemans
- Department of Otolaryngology—Head and Neck Surgery Cancer Center Amsterdam, Amsterdam UMC, Vrije Universiteit Amsterdam Amsterdam The Netherlands
| | - Johannes H. Smit
- Department of Psychiatry Amsterdam Public Health Research Institute, Amsterdam UMC, Vrije Universiteit Amsterdam Amsterdam The Netherlands
| | - Linda Kwakkenbos
- Department of Medical Psychology Radboud Institute for Health Sciences, Radboud University Medical Center Nijmegen The Netherlands
- Clinical Psychology, Behavioural Science Institute Radboud University Nijmegen The Netherlands
| | - Irma M. Verdonck‐de Leeuw
- Department of Otolaryngology—Head and Neck Surgery Cancer Center Amsterdam, Amsterdam UMC, Vrije Universiteit Amsterdam Amsterdam The Netherlands
- Department of Clinical, Neuro and Development Psychology Amsterdam Public Health Research Institute, Vrije Universiteit Amsterdam Amsterdam The Netherlands
| | - Judith B. Prins
- Department of Medical Psychology Radboud Institute for Health Sciences, Radboud University Medical Center Nijmegen The Netherlands
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23
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Luo X, Li W, Chen Y, Sun H, Humphris G, Liu T, Zhang J, Yang Y, Zhang B. Fear of Recurrence in Chinese Cancer Patients: Prevalence, Correlates, and Network Analysis. Front Psychiatry 2022; 13:803543. [PMID: 35197876 PMCID: PMC8859333 DOI: 10.3389/fpsyt.2022.803543] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/28/2021] [Accepted: 01/11/2022] [Indexed: 12/11/2022] Open
Abstract
BACKGROUND Fear of cancer recurrence (FCR) is a significant issue for most cancer patients. Until now, a detailed investigation of the structure of FCR and the interaction among its constituent elements is lacking. This study aims to investigate the phenomenon of FCR by means of network analysis in Chinese cancer patients. METHODS This is a multi-center, cross-sectional study that included 996 cancer patients from southern China. All participants were assessed by the 7-item Chinese version Fear of Cancer Recurrence Scale (FCR-7). Multivariate logistic regression, and network analyses were conducted. Central symptoms (nodes) in the FCR network were identified. RESULTS Among the 996 patients, 543 (54.52%) reported moderate FCR, and 137 (13.76%) reported high FCR. Chemotherapy (OR = 2.954, P = 0.016), and childhood severe illness experience (OR = 2.331, P = 0.016) were positively associated with high FCR, while higher monthly income (OR = 0.403, P = 0.046) was negative associated with high FCR. The node #FCR2 (Worried/anxious about recurrence) was the most central node within the FCR network (Strength = 1.190), while node #FCR6 (Examining for physical signs) was the least central node (Strength = 0.373). The edge FCR1-FCR2 ("Afraid"-"Worried/anxious") was the thickest and most saturated edge in the network. After controlling for age and gender, an almost identical network was obtained with respect to edges magnitude and strength. CONCLUSION Fear of recurrence is a frequently reported issue among Chinese cancer patients. Patients with chemotherapy and childhood severe illness experience were more vulnerable and should be particularly monitored. Compared to behavioral component (i.e., body checking, overscreening and overtreatment) and cognitive component (i.e., intrusions), emotional component (i.e., worry/anxious) is more central to identify FCR and might be potential targets for further interventions.
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Affiliation(s)
- Xian Luo
- Department of Psychiatry, Southern Medical University Nanfang Hospital, Guangzhou, China
| | - Wengao Li
- Department of Psychiatry, 999 Brain Hospital, Guangzhou, China
| | - Yu Chen
- School of Nursing, Southern Medical University, Guangzhou, China
| | - Hengwen Sun
- Department of Radiotherapy, Cancer Center, Guangdong Provincial People's Hospital (Guangdong Academy of Medical Sciences), Guangzhou, China
| | - Gerry Humphris
- Department of Health Psychology, School of Medicine, University of St Andrews, St Andrews, United Kingdom
| | - Ting Liu
- Department of Psychiatry, Southern Medical University Nanfang Hospital, Guangzhou, China
| | - Jingying Zhang
- Department of Psychiatry, Southern Medical University Nanfang Hospital, Guangzhou, China
| | - Yuan Yang
- Guangdong Mental Health Center, Guangdong Academy of Medical Sciences, Guangdong Provincial People's Hospital, Guangzhou, China
| | - Bin Zhang
- Department of Psychiatry, Southern Medical University Nanfang Hospital, Guangzhou, China
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24
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Anthony S, Harrell R, Martin C, Hawkins T, Khan S, Naniwadekar A, Sears SF. Fear of Recurrence of Atrial Fibrillation: Translating a Cancer Fear Model to the Atrial Fibrillation Patient Experience. Front Psychiatry 2022; 13:915327. [PMID: 35859607 PMCID: PMC9289241 DOI: 10.3389/fpsyt.2022.915327] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/22/2022] [Accepted: 06/09/2022] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Atrial fibrillation occurs when rapid and disorganized electrical signals cause the atria in the heart to beat irregularly and is associated with an increased risk for stroke. Despite medical advancements, first and second line atrial fibrillation treatments exhibit significant recurrence rates. Because of this, atrial fibrillation patients often experience disease-specific fears that are not routinely assessed and targeted in clinical management. Fear of recurrence models in cancer research and other cardiac-specific fears have paved the way for a patient-centric approach to disease intervention. PURPOSE Clinical assessment focused solely on the taxonomy of anxiety disorders may miss key components unique to the atrial fibrillation patient experience. An anxiety disorder diagnosis in the presence of an arrhythmia could be misleading and ultimately fail to address patient needs. Modeled from the cancer literature, providers may benefit from a broader disease specific conceptualization for AF patients that differs from a general DSM-5 diagnosis. AIMS The objectives of this paper are: (1) to review the medical aspects of atrial fibrillation, (2) to examine the comparability of fear of recurrence concept from cancer literature to the atrial fibrillation patient, and (3) to suggest considerations of these novel concepts in patient care. FUTURE DIRECTIONS Increased understanding of fear of recurrence among atrial fibrillation patients aims to define and assess fear of recurrence components, determine treatment targets, and ultimately improve patient outcomes.
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Affiliation(s)
- Scarlett Anthony
- Department of Psychology, East Carolina University, Greenville, NC, United States
| | - Rebecca Harrell
- Department of Psychology, East Carolina University, Greenville, NC, United States
| | - Caroline Martin
- Department of Psychology, East Carolina University, Greenville, NC, United States
| | - Taylor Hawkins
- Department of Cardiovascular Sciences, East Carolina University, Greenville, NC, United States
| | - Saleen Khan
- Department of Cardiovascular Sciences, East Carolina University, Greenville, NC, United States
| | - Aditi Naniwadekar
- Department of Cardiovascular Sciences, East Carolina University, Greenville, NC, United States
| | - Samuel F Sears
- Department of Psychology, East Carolina University, Greenville, NC, United States.,Department of Cardiovascular Sciences, East Carolina University, Greenville, NC, United States
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25
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Rogers SN, Monssen C, Humphris GM, Lowe D, Kanatas A. Which Head and Neck Cancer Patients Are Most at Risk of High Levels of Fear of Cancer Recurrence. Front Psychol 2021; 12:671366. [PMID: 34335384 PMCID: PMC8322117 DOI: 10.3389/fpsyg.2021.671366] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2021] [Accepted: 06/07/2021] [Indexed: 01/14/2023] Open
Abstract
Background: Fear of cancer recurrence (FCR) is recognized as a common concern for patients with head and neck cancer (HNC). The aim of this study is to describe in greater detail the demographic and clinical characteristics of HCN patients who indicate a high level of FCR in their review consultation. Methods: A pragmatic cluster-controlled trial was conducted between January 2017 and December 2018 at two UK HNC centers (Leeds and Liverpool) to test the efficacy of a prompt tool called the Patient Concerns Inventory (PCI). Patients completed the PCI and the UW-QOLv4 which included a single 5 category rating of FCR. Secondary statistical analyses focused on variables associated with high FCR. Results: Two hundred and eighty-eight trial patients were recruited in this trial. At a median of 194 days after diagnosis and 103 days after the end of treatment 8% stated (n = 24) “I get a lot of fears of recurrence and these can really preoccupy my thoughts” and 3% (n = 8) “I am fearful all the time that my cancer might return, and I struggle with this.” Thus, 11% (n = 32) responded in the worst two categories, 95% Confidence interval 7.7–15.3% for high FCR. Stepwise logistic regression resulted in female gender (p < 0.001), age (p = 0.007), and receiving financial benefits (p = 0.01) as independent predictors. Conclusions: Around one in ten HNC patients attending routine outpatient follow-up consultations report high FCR, however for female patients under the age of 55 the rate was one in three. This group requires specialist attention and could be the focus of a multicenter intervention trial.
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Affiliation(s)
- Simon N Rogers
- Faculty of Health and Social Care, Edge Hill University, Ormskirk, United Kingdom.,Liverpool Head and Neck Centre, Liverpool University Hospital Aintree, Liverpool, United Kingdom
| | - Camilla Monssen
- School of Medicine, Medical and Biological Sciences, North Haugh, St. Andrews, United Kingdom
| | - Gerald M Humphris
- School of Medicine, Medical and Biological Sciences, North Haugh, St. Andrews, United Kingdom
| | - Derek Lowe
- Astraglobe Ltd., Congleton, United Kingdom
| | - Anastasios Kanatas
- Leeds Teaching Hospitals and St. James Institute of Oncology, Leeds Dental Institute and Leeds General Infirmary, Leeds, United Kingdom
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26
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Weber R, Ehrenthal JC, Brock-Midding E, Halbach S, Würstlein R, Kowalski C, Ernstmann N. Defense Mechanisms and Repressive Coping Among Male Breast Cancer Patients. Front Psychiatry 2021; 12:718076. [PMID: 34955906 PMCID: PMC8703166 DOI: 10.3389/fpsyt.2021.718076] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/31/2021] [Accepted: 11/16/2021] [Indexed: 11/17/2022] Open
Abstract
Objectives: The concept of defense mechanisms has undergone extensive revision and expansion since Freud first described these processes. Initially formulated as an unconscious repression of unpleasant memories, with further development focusing on the role of defense mechanisms in the regulation of internal conflicts, the concept shifted and evolved to incorporate the adaptation to external demands, including intrapsychic and interpersonal handling of burden of illness. In addition to defense mechanisms, coping provides another perspective on human adjustment to difficult life events. While there is substantial research on both coping and defense mechanisms in various psychiatric and somatic diseases, including cancer, little is known about defensive regulation, coping, and their interaction in male breast cancer patients. Methods: The present study is part of the N-Male project conducted between 2016 and 2018 in Germany (Male breast cancer: patients' needs in prevention, diagnosis, treatment, rehabilitation, and follow-up care). Semi-standardized interviews with 27 male breast cancer patients were analyzed with regard to defense mechanisms. In addition, fear of progression and repressive coping was assessed by self-report. Results: There was considerable variety in levels of defensive functioning as well as repressive coping in our sample. We found no difference in overall levels of defensive functioning between men with vs. without repressive coping. However, patients with repressive coping demonstrated a decopupled association between fear of progression and defensive functioning as compared to patients without repressive coping. Discussion: The study provides the first evidence of disease processing in male breast cancer patients Knowledge of patients' defense patterns and repressive coping seems promising for better planning targeted intervention strategies.
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Affiliation(s)
- Rainer Weber
- Department of Psychosomatic and Psychotherapy, Faculty of Medicine, University Hospital Cologne, Cologne, Germany
| | - Johannes C Ehrenthal
- Department of Psychology, Faculty of Human Sciences, University of Cologne, Cologne, Germany
| | - Evamarie Brock-Midding
- Center for Health Communication and Health Services Research, Department for Psychosomatic Medicine and Psychotherapy, University Hospital Bonn, Bonn, Germany.,Center for Integrated Oncology (CIO Bonn), Bonn, Germany
| | - Sarah Halbach
- Center for Health Communication and Health Services Research, Department for Psychosomatic Medicine and Psychotherapy, University Hospital Bonn, Bonn, Germany.,Center for Integrated Oncology (CIO Bonn), Bonn, Germany
| | - Rachel Würstlein
- Breast Center, Department of Gynecology and Obstetrics (Comprehensive Cancer Center Munich), University Hospital of Munich (Ludwig Maximilian University), Munich, Germany
| | | | - Nicole Ernstmann
- Center for Health Communication and Health Services Research, Department for Psychosomatic Medicine and Psychotherapy, University Hospital Bonn, Bonn, Germany.,Center for Integrated Oncology (CIO Bonn), Bonn, Germany
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