Original Article

Supportive Care in Cancer

, Volume 18, Issue 4, pp 471-479

Evaluation of two group therapies to reduce fear of progression in cancer patients

  • Peter HerschbachAffiliated withDepartment of Psychosomatic Medicine and Psychotherapy, Division of Psychosocial Oncology, Klinikum rechts der Isar, Technische Universität München Email author 
  • , Katrin BookAffiliated withDepartment of Psychosomatic Medicine and Psychotherapy, Division of Psychosocial Oncology, Klinikum rechts der Isar, Technische Universität München
  • , Andreas DinkelAffiliated withDepartment of Psychosomatic Medicine and Psychotherapy, Division of Psychosocial Oncology, Klinikum rechts der Isar, Technische Universität München
  • , Petra BergAffiliated withPsychotherapeutische Ambulanz der IFT-Gesundheitsförderung
  • , Sabine WaadtAffiliated withDepartment of Psychosomatic Medicine and Psychotherapy, Division of Psychosocial Oncology, Klinikum rechts der Isar, Technische Universität München
  • , Gabriele DuranAffiliated withDepartment of Psychosomatic Medicine and Psychotherapy, Division of Psychosocial Oncology, Klinikum rechts der Isar, Technische Universität München
  • , Ursula Engst-HastreiterAffiliated withRheumatology Rehabilitation Centre of Federal Insurance Institute for Salaried Employees (BfA)
  • , Gerhard HenrichAffiliated withDepartment of Psychosomatic Medicine and Psychotherapy, Division of Psychosocial Oncology, Klinikum rechts der Isar, Technische Universität München

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Abstract

Purpose

This paper aims to evaluate the effects of two psychotherapeutic interventions on dysfunctional fear of progression (FoP) in cancer patients and to investigate illness-specific influences.

Methods

One hundred seventy-four cancer patients were recruited from two rehabilitation clinics and randomly assigned to either a four-session cognitive-behavioral group therapy or a supportive-experiential group therapy. The main outcome criterion was FoP that was assessed with the Fear of Progression Questionnaire (FoP-Q) directly before (T1) and after (T2) the intervention, as well as 3 (T3) and 12 months (T4) after discharge. Secondary outcomes were anxiety, depression, and quality of life that were assessed with the following questionnaires: Questions on Life Satisfaction, Questionnaire for General Health Status, and the Hospital Anxiety and Depression Scale. Patients from the control group (n = 91) who received treatment as usual were recruited 1 year later with the same inclusion criteria and assessed with the FoP-Q at T1, T2, and T4.

Results

Analyses showed a significant main effect for time and a significant interaction for group × time for the main outcome variable. FoP decreased significantly over time in both intervention groups in contrast to the control group that showed only short-term improvements. The interventions were also effective in improving secondary outcomes except general life satisfaction. Analyses of cancer specific influences on FoP indicated a significant influence of disease status, i.e., patients with metastases and recurrence of cancer gained most from the interventions.

Conclusions

Fear of progression, one of the main sources of distress for cancer patients, can be reduced with short psychotherapeutic interventions.

Keywords

Cancer Psychosocial oncology Fear of progression Group therapy Controlled trial