Prospective longitudinal study on fear of cancer recurrence in patients newly diagnosed with head and neck cancer: Course, trajectories, and associated factors

Deuning-Smit, Esther; Custers, José A. E.; Miroševič, Špela; Takes, Robert P.; Jansen, Femke; Langendijk, Johannes A.; Terhaard, Chris H.J.; Jong, Robert J. Baatenburg de; Leemans, C. René; Smit, Johannes H.; Kwakkenbos, Linda; Leeuw, Irma M. Verdonck‐de; Prins, Judith B.

doi:10.1002/hed.26985

Cited by 24 publications

(19 citation statements)

References 57 publications

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“…Previously, we conducted a meta-analysis study on factors associated with FCR, which confirmed that FCR may be strongly associated with the occurrence of anxiety and depression, increased fatigue, and decreased well-being and quality of life in cancer survivors [ 7 ]. In addition, longitudinal studies have shown that while FCR may decline slightly over time, approximately 20% of cancer survivors experience persistently high FCR, and even 10 years after a cancer diagnosis, FCR remains a dominant psychological health problem for survivors [ 8 , 9 ]. Therefore, it is particularly important to explore the triggers and coping strategies of FCR.…”

Section: Introductionmentioning

confidence: 99%

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Triggers and Coping Strategies for Fear of Cancer Recurrence in Cancer Survivors: A Qualitative Study

et al. 2022

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Background: Fear of cancer recurrence (FCR) has been demonstrated to be one of the most frequently reported unmet psychological needs among cancer survivors. The aim of this study was to explore and describe the potential triggers and coping strategies for FCR in Chinese cancer survivors. Methods: The study process was conducted using an interpretive phenomenological research method, and Chinese cancer survivors were interviewed face-to-face in a semi-structured interview, using purposive sampling combined with a maximum variance sampling strategy, and the interviews were transcribed, organized, and analyzed by applying Giorgi analysis with the help of NVivo11 software. Results: A total of 10 participants, 4 males and 6 females, were interviewed. Three themes emerged in terms of potential triggers for FCR: (1) intrusive thoughts; (2) disease symptoms; and (3) awaiting medical examination. Two themes regarding positive coping and avoidance coping emerged with regard to coping strategies adopted by cancer survivors when experiencing FCR. Under these 2 themes were 5 sub-themes: (1) seeking medical support; (2) self-health management; (3) spiritual coping; (4) unaccompanied toleration; and (5) attention shifting. Conclusion: FCR as the most common psychological problem for cancer survivors, and it should be given more attention. Early identification and precise intervention for potential triggers of FCR may prevent the emergence and development of FCR. The guidance toward and cultivation of positive coping strategies when cancer survivors experience FCR could be an important direction in future nursing education.

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Section: Introductionmentioning

confidence: 99%

“…Most of the current studies on FCR are quantitative [ 7 , 8 , 9 ]. However, because FCR is recognized as a unique, independent, and multidimensional structure with its own characteristics and mechanisms, targeted interventions need to be constructed.…”

Section: Introductionmentioning

confidence: 99%

Triggers and Coping Strategies for Fear of Cancer Recurrence in Cancer Survivors: A Qualitative Study

et al. 2022

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“…Change trajectories in previous research involved numerically small groups, and failure to replicate these may reflect inherent difficulties in reliably detecting trajectories with low numbers (Nasserinejad et al, 2017). We note that other studies have not found them (Costa et al, 2019;Duening-Smit et al, 2022;Gonzales et al, 2017;McGinty et al, 2016;Shim et al, 2020;Yang et al, 2018). Also, we predominantly made yearly observations and may have missed any rapid changes.…”

Section: Discussionmentioning

confidence: 84%

“…McGinty et al (2016) found that breast cancer patients with higher FCR trajectories had lower baseline self-efficacy, higher perceptions of illness risk, and increased reassurance seeking. Duening-Smit et al (2022) found that higher FCR trajectories in head and neck cancer patients were related to lower self-efficacy, higher passive coping and self-reassurance scores, and lower avoidance scores. Gonzales et al (2017) found that baseline withholding of concerns and greater pain medication use in gynecological cancer patients predicted depression, poorer quality of life, and disability.…”

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confidence: 89%

Seven-year distress trajectories in uveal melanoma survivors.

Brown¹,

Hope‐Stone²,

Cherry³

2023

Health Psychology

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Objective: Severe or persistent distress is associated with poorer quality of life in cancer survivors. Distress follows distinct trajectories within different population subgroups. Identifying characteristics and causes of trajectories can assist intervention development and targeting. In a 7-year study of uveal melanoma survivors, we aimed to characterize anxiety, depression, and fear of cancer recurrence (FCR) trajectories, and identify whether concerns about symptoms and functional problems over the first 3 years of survivorship predict memberships of high distress trajectories. Method: In a closed cohort study, we used growth mixture modeling (GMM) to identify statistically optimal trajectories over 6-, 12-, 24-, 36-, 48-, 60-, 72-, and 84-month time point posttreatment in 475 patients. We then regressed trajectory memberships onto a 3-year series of measures of concerns about symptoms and functional problems, controlling demographic, clinical, and 6-month anxiety, depression, or FCR indicators. Results: Anxiety, depression, and FCR were represented by two-class linear GMMs. The majority scored consistently low, but 17.5% showed consistently elevated anxiety, 10.9% consistently elevated depression, and 19.4% consistently elevated FCR. Higher anxiety trajectory membership was predicted by greater concerns about symptoms at 6 and 24 months, higher depression trajectory membership by symptoms at 24 months, and higher FCR trajectory membership by symptoms at 6 and 24 months and functional problems at 12 months. Conclusions: Much of the burden of persistent distress in cancer patients falls on a small proportion of survivors. Concerns about symptoms and functional problems are potential risk factors for distress.

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“…Taking into account the growing number of cancer survivors, from a practical and economical point of view, but also from the perspective of the patients, HCP's and the organizational context, the combination of a first universal step of normalizing FCR in consultations with the doctor or nurse followed by matched care for those experiencing elevated feelings of FCR [3 ▪▪ ] might be most feasible to implement. This approach is supported by trajectory studies indicating a large group of patients experiencing low levels of FCR over time [28,29] a large group of patients experiencing moderate and fluctuating FCR over time [29], and a smaller proportion experiencing continuous high FCR over time [28,29] all benefitting from normalizing FCR and those with moderate or high FCR in need of matched supportive care [29].…”

Section: Current Challengesmentioning

confidence: 94%

Interventions addressing fear of cancer recurrence: challenges and future perspectives

Prins

Deuning-Smit

Custers

2022

Current Opinion in Oncology

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Purpose of reviewFear of cancer recurrence (FCR) is a common concern among cancer survivors and support for FCR is one of the most cited unmet needs. High FCR was found to be related to increased use of healthcare services, specifically primary healthcare and medical consultations, and lower quality of life. In the past decade screening instruments for FCR and interventions have been developed and proven effective.Recent findingsSystematic reviews and meta-analyses have shown that psychological treatments are effective for reducing FCR. The cost-effectiveness of FCR interventions could be increased by considering stepped or matched models for supportive care. Despite availability of evidence-based interventions, the proposed care models are not implemented and most cancer survivors still do not benefit from supportive care.SummaryThe time is right to focus on implementation of FCR interventions into clinical practice. The complexity of optimizing FCR care is characterized by barriers and facilitators in the domains of patients, healthcare professionals, healthcare organizations and the broader economic, and political context. The main challenge for future research is to address these issues so that former investments in high-quality FCR intervention research will pay out in actual practice changes in the benefit of cancer survivors.

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Prospective longitudinal study on fear of cancer recurrence in patients newly diagnosed with head and neck cancer: Course, trajectories, and associated factors

Cited by 24 publications

References 57 publications

Triggers and Coping Strategies for Fear of Cancer Recurrence in Cancer Survivors: A Qualitative Study

Triggers and Coping Strategies for Fear of Cancer Recurrence in Cancer Survivors: A Qualitative Study

Seven-year distress trajectories in uveal melanoma survivors.

Interventions addressing fear of cancer recurrence: challenges and future perspectives

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