Fear of cancer recurrence and death anxiety

Abstract

In 2013, 3 systematic reviews of fear of cancer recurrence (FCR) and its predictors were published. All 3 concurred that FCR is a highly prevalent problem and amongst the largest unmet needs of cancer survivors, even 5 or more years after treatment. However, between them they identified only 1 study that had investigated the relationship between death anxiety and FCR. This is surprising because it is well acknowledged that a diagnosis of cancer, a potentially life-threatening illness, is associated with a number of existential issues that give rise to psychological sequelae such as intrusive thoughts about death and other post-traumatic symptoms. Outside the cancer literature, there has recently been a call to identify death anxiety as a transdiagnostic construct that underlies many anxiety disorders even in healthy people. And yet, the relevance of death anxiety to FCR has not been studied. We explore the barriers to the study of death anxiety and FCR and the reasons that a potential link between the 2 might have important theoretical and clinical implications. We conclude that establishing the relationship between death anxiety, FCR and other existential issues is essential in order to fully understand FCR, particularly in the context of advanced disease. We further conclude that whether death anxiety underlies FCR has important clinical implications which would potentially allow us to optimise currently available evidence-based treatments.

The effect of positive psychotherapy on the meaning of life in patients with cancer: A randomized clinical trial

“…(2011), and Lindblad et al (2018). [5657585960] The passage of time, unstable business, fear of recurrence of disease, being a woman and lack of purpose in life can be the reasons for the low score in this group. Are these variables measured?…”

Existential distress in cancer: Alleviating suffering from fundamental loss and change

“…A better understanding of the dynamics of how individuals approach versus deflect from existential threat would be of value to psycho‐oncology interventions . A renewed interest in cognitive‐existential interventions for fear of cancer recurrence supports this direction …”

“…Fear of cancer recurrence has been one recent focus of inquiry . Its conceptual closeness to death anxiety is supported by a recent integrative model identifying threat of loss and death, ongoing uncertainty and limited control, and continual reminders of cancer as relevant sources of anxiety for all patients with cancer .…”

Impact of fear of cancer recurrence on survival among lymphoma patients

“…Most cancer patients worry about their risk of recurrence regardless of cancer type, stage at diagnosis, disease progression, and length of survivorship, although the degree of FCR may be variable among individuals . Although some degree of FCR is natural and understandable and may be helpful as a motivator for positive health behavior, severe FCR is associated with poorer psychological well‐being and quality of life (QOL) . Patients with severe FCR have been found to be more likely to experience greater distress, depression, anxiety, decision regret, and difficulties in making future plans .…”