236 INTRODUCTION Ovarian cancer is the deadliest of the gynecological cancers and has an average two-year recurrence rate of 50-75% (Ferrell et al., 2005;Ferrell, Smith, Ervin, Itano, & Melancon, 2003;Cannistra 2004;Karlan, Markman, & Eifel, 2005). Not surprisingly, given this high recurrence rate, fear of cancer recurrence (FCR) is a common and important concern reported by women diagnosed with ovarian cancer (Ozga, et al., 2015). FCR is defined as "fear that cancer could return or progress in the same place or in another part of the body" (Simard, Savard & Ivers, 2010;Vickberg, 2003). Unmanaged FCR can lead to anxiety, depression and change in quality of life, all leading to higher emotional, psychological and physical dysfunction (Ozga et al., 2015;Simard et al., 2013). Most studies that previously evaluated the evolution of FCR were conducted in breast cancer patients. To address the significant psychological concern associated with a diagnosis of ovarian cancer, there is a need to better understand the experience of FCR in women diagnosed with this disease (Ozga et al., 2015).Ovarian cancer is generally diagnosed at an advanced stage due to a lack of a screening tool, resulting in a five-year survival rate of 10-45% (Surveillance, Epidemiology and End Results Program, n.d.). According to the National Institutes of Health, a survivor is defined as "anyone who has ever been diagnosed with cancer and is living today" (NIH Senior Health, 2015). To date, only one recent systematic review on FCR in ovarian cancer survivor population has been conducted (Ozga et al., 2015). The results of that review (total of fifteen studies, three qualitative and nine quantitative) reported that FCR is an ovarian cancer-specific symptom and its importance is largely a reflection of the high recurrence rate. Due to the various methods of assessing presence of FCR, the reported prevalence range of 22-80% is broad. Furthermore, FCR levels are similar in participants regardless if they were diagnosed at an early or advanced stage. Presence of FCR was also associated with psychosocial health concerns such as hopelessness, anxiety in the context of death and dying and uncertainty surrounding health status. The poor prognosis for ovarian cancer survivors may explain the paucity of research focusing on the survivorship of these women and, consequently, the examination of their psychosocial needs remains in its infancy (Lockwood-Rayermann, 2006).Due to the high recurrence rate, the period of remission is brief and is, thus, frequently overlooked as a topic for research, making this the first study to qualitatively explore FCR in ovarian cancer survivors in this timeframe. Specifically, the purpose of this study was to better understand fear of cancer (FCR) through the experience of ovarian and fallopian tube cancer survivors. METHODS DesignThe study used a descriptive qualitative design to obtain a comprehensive description of participants' experiences in their own words (Sandelowski, 2000). Participants and RecruitmentParticipants were r...

Background Fear of cancer recurrence (FCR) is among the top unmet concerns reported by breast cancer survivors. Despite the sizable literature on FCR, few theoretical models have been empirically tested. One of the most cited is the FCR model. Aim This study seeks to understand the nature of women's cognitive and emotional issues from FCR using specific guidance from the model by Lee‐Jones and to provide suggestions for modifications to the model based on empirical results from the reported experiences of women living with breast cancer. Methods and results A qualitative descriptive study using semi‐structured interviews was conducted at an urban hospital. Recruited by convenience sampling, 12 breast cancer survivors concerned with FCR and who had recently completed active treatment participated in the study. Seven thematic categories emerged from the women's descriptions of their cognitive and emotional experiences with FCR: (a) FCR is always there; (b) beliefs about risk of recurrence; (c) beliefs about eradication of cancer; (d) preferences not to seek information about recurrence; (e) derailment of normal life; (f) worries related to recurrence; and (g) need for support. Adjustments to the model by Lee‐Jones et al1 specifically to women living with breast cancer include the addition of new variables—the fear is always present, a preference not to seek information, and the need for support beyond treatment—and the merging of two variables, anxiety and worry, as participants viewed these concepts as interchangeable and experienced in similar ways. Lastly, participants did not report any remorse related to not opting for more aggressive treatments. Conclusion The refinement of a more comprehensive FCR theoretical model, such as through the modifications derived from this study, provides a deeper understanding of breast cancer survivors' experiences with FCR and can more effectively guide health care professionals to develop appropriately tailored interventions aimed at decreasing FCR levels.

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