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Fear of cancer recurrence: a theoretical review and novel cognitive processing formulation

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Abstract

Purpose

Fear of cancer recurrence (FCR) is prevalent among survivors. However, a comprehensive and universally accepted theoretical framework of FCR to guide intervention is lacking. This paper reviews theoretical frameworks previously used to explain FCR and describes the formulation of a novel theoretical framework for FCR.

Methods

A systematic review of the literature was undertaken to identify conceptual frameworks or theories applied to FCR. MEDLINE, PubMED, CINAHL, AMED, PsycINFO and Web of Science were searched. Identified conceptual frameworks were reviewed for strength of evidence supporting their validity.

Results

Of 558 papers initially identified, 16 made reference to six different conceptual frameworks relating to FCR. The most comprehensive and evidence-based theoretical approach is the Common Sense Model (CSM). Other approaches have limited evidence supporting their application to FCR. Two theoretical approaches developed in the context of emotional disorders that appear to be highly relevant to FCR: the Self-Regulatory Executive Function (S-REF) model and Relational Frame Theory were combined with the CSM to produce a novel cognitive processing account of FCR.

Conclusions

Few conceptual frameworks have been used consistently to guide FCR research, and not all frameworks are empirically well supported, suggesting that further discussion regarding the conceptualisation of FCR is needed. The novel theoretical framework for FCR presented highlights the multidimensional nature of FCR and the importance of cognitive processing and metacognitions in the development and maintenance of FCR.

Implications for Cancer Survivors

The novel theoretical formulation of FCR outlined here provides a much-needed comprehensive framework to further investigate and address FCR in cancer survivors.

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Acknowledgments

The work presented in this paper was co-funded by beyondblue, National Breast Cancer Foundation and Cancer Australia (CAPdCCRS 1022584).

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Authors and Affiliations

  1. Psycho-Oncology Co-operative Research Group (PoCoG), University of Sydney, Sydney, Australia

    Joanna E Fardell, Belinda Thewes, Allan ‘Ben’ Smith & Phyllis Butow

  2. Behavioural Sciences Unit, School of Women’s and Children’s Health, University of New South Wales, Sydney, Australia

    Joanna E Fardell

  3. Mental Health Centre, School of Medicine, University of Queensland, St Lucia, Australia

    Jane Turner

  4. Crown Princess Mary Cancer Centre, Breast Cancer Institute, Westmead Hospital, Sydney, Australia

    Jemma Gilchrist

  5. School of Psychology, University of Sydney, Sydney, Australia

    Louise Sharpe

  6. Centre for Oncology Education and Research Translation (CONCERT), Ingham Institute for Applied Medical Research, South Western Sydney Clinical School, UNSW Medicine, University of New South Wales, Sydney, Australia

    Afaf Girgis

  7. Chris O’Brien Lifehouse (C39Z), School of Psychology, The University Of Sydney, Sydney, Australia

    Phyllis Butow

  8. Department of Medical Psychology, Radboud University Medical Centre, Postbus 9101, 6500, HB, Nijmegen (840), The Netherlands

    Belinda Thewes

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  1. Joanna E Fardell
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  2. Belinda Thewes
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  3. Jane Turner
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  5. Louise Sharpe
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Correspondence to Phyllis Butow.

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Funding

This review was co-funded by Cancer Australia, beyondblue and National Breast Cancer Foundation (grant number 1022584).

Conflict of interest

The authors declare that they have no competing interests.

Ethical approval

No studies with human participants or animals were performed by any of the authors as part of this review.

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Fardell, J.E., Thewes, B., Turner, J. et al. Fear of cancer recurrence: a theoretical review and novel cognitive processing formulation. J Cancer Surviv 10, 663–673 (2016). https://doi.org/10.1007/s11764-015-0512-5

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  • DOI: https://doi.org/10.1007/s11764-015-0512-5

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