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

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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.

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Notes

  1. 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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Acknowledgments

We would like to thank Sara Beattie, Megan McCallum, Andrea Feldstain, and our volunteers for their assistance with this project. We would also like to thank our participants for sharing their experiences.

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Authors and Affiliations

  1. School of Psychology, University of Ottawa, 136 Jean Jacques Lussier PVT, Room 4016, Ottawa, ON, K1N 6N5, Canada

    Brittany Mutsaers, Georden Jones, Nicole Rutkowski, Christina Tomei, Caroline Séguin Leclair, Danielle Petricone-Westwood & Sophie Lebel

  2. Institut universitaire de cardiologie et de pneumologie de Québec (IUCPQ), 2725, Chemin Ste-Foy, Québec, QC, G1V 4G5, Canada

    Sébastien Simard

Authors
  1. Brittany Mutsaers
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  2. Georden Jones
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  3. Nicole Rutkowski
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  4. Christina Tomei
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  5. Caroline Séguin Leclair
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  6. Danielle Petricone-Westwood
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  7. Sébastien Simard
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  8. Sophie Lebel
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Corresponding author

Correspondence to Brittany Mutsaers.

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Funding

This study was supported by Research Development Funds from the University of Ottawa awarded to Dr. Sophie Lebel.

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

Conflict of interest

The authors declare no conflict of interest.

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Mutsaers, B., Jones, G., Rutkowski, N. et al. When fear of cancer recurrence becomes a clinical issue: a qualitative analysis of features associated with clinical fear of cancer recurrence. Support Care Cancer 24, 4207–4218 (2016). https://doi.org/10.1007/s00520-016-3248-5

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  • DOI: https://doi.org/10.1007/s00520-016-3248-5

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