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01-10-2016 | Original Article

When fear of cancer recurrence becomes a clinical issue: a qualitative analysis of features associated with clinical fear of cancer recurrence

Authors: Brittany Mutsaers, Georden Jones, Nicole Rutkowski, Christina Tomei, Caroline Séguin Leclair, Danielle Petricone-Westwood, Sébastien Simard, Sophie Lebel

Published in: Supportive Care in Cancer | Issue 10/2016

Abstract

Purpose

Fear of cancer recurrence (FCR) is a common experience for cancer survivors. However, it remains unclear what characteristics differentiate non-clinical from clinical levels of FCR. The goal of this study was to investigate the potential hallmarks of clinical FCR.

Methods

A convenience sample of 40 participants (n = 19 female) was drawn from another study (Lebel et al. in Qual Life Res 25:311–321. doi: 10.1007/s11136-015-1088-2, 2016). The semi-structured interview for fear of cancer recurrence (Simard and Savard in J Cancer Surviv 9:481–491. doi:10.1007/s11764-015-0424-4, 2015) was used to identify participants with non-clinical and clinical FCR and qualitative analysis of these interviews was performed.

Results

Individuals with clinical FCR reported the following features: death-related thoughts, feeling alone, belief that the cancer would return, experiencing intolerance of uncertainty, having cancer-related thoughts and imagery that were difficult to control, daily and recurrent, lasted 30 minutes or more, increased over time, caused distress and impacted their daily life. Triggers of FCR and coping strategies did not appear to be features of clinical FCR as they were reported by participants with a range of FCR scores.

Conclusions

While features of clinical FCR found in this analysis such as intrusive thoughts, distress and impact on functioning confirmed previous FCR research, other features spontaneously emerged from the interviews including “death-related thoughts,” “feeling alone,” and “belief that the cancer will return.” The participants’ descriptions of cancer-specific fear and worry suggest that FCR is a distinct phenomenon related to cancer survivorship, despite similarities with psychological disorders (e.g., Anxiety Disorders). Future research investigating the construct of FCR, and the distinguishing features of clinical FCR across a range of cancer types and gender is required.

When referring to our own work we use the words non-clinical and clinical FCR. Quotation marks are used when referring to terms used by other authors to indicate FCR severity.

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Title: When fear of cancer recurrence becomes a clinical issue: a qualitative analysis of features associated with clinical fear of cancer recurrence
Authors: Brittany Mutsaers
Georden Jones
Nicole Rutkowski
Christina Tomei
Caroline Séguin Leclair
Danielle Petricone-Westwood
Sébastien Simard
Sophie Lebel
Publication date: 01-10-2016
Publisher: Springer Berlin Heidelberg
Published in: Supportive Care in Cancer / Issue 10/2016
Print ISSN: 0941-4355
Electronic ISSN: 1433-7339
DOI: https://doi.org/10.1007/s00520-016-3248-5

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