Skip to main content

Advertisement

SpringerLink
Log in

Dyadic effects of fear of recurrence on the quality of life of cancer survivors and their caregivers

  • Published:
Quality of Life Research Aims and scope Submit manuscript

Abstract

Background

Although the 5 years cancer survival rate has increased to 66%, fear of cancer recurrence (FOR) continues to be a major concern for both cancer survivors and their family caregivers. It remains unknown, however, to what extent cancer severity is associated with the level of FOR reported by each individual in the survivor–caregiver dyad, which, in turn, is also associated with their quality of life (QOL).

Method

A total of 455 cancer survivor–caregiver dyads, who participated in national surveys targeting 2 years post-diagnosis, provided complete data for variables studied.

Results

Results of the Actor Partner Interdependence Model suggested that higher cancer severity was related to greater levels of FOR among both survivors and caregivers, which, in turn, was related to poorer QOL. Caregivers’ FOR was related to survivors’ poorer physical health. The associations between FOR and QOL were significant, above and beyond those of general anxiety.

Conclusion

Findings suggest that as expected, cancer severity was significantly related to individuals’ FOR, which, in turn, played a key role in their mental health. Caregivers’ FOR was also related to survivors’ physical health, which suggests that programs aimed to manage FOR effectively should be provided not only to survivors but also caregivers, thereby improving the QOL of each person.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1

Similar content being viewed by others

Notes

  1. Coding for the cancer severity index can be obtained upon request to the author.

References

  1. American Cancer Society. (2010). Cancer facts and figures, 2010. Atlanta, GA: American Cancer Society.

    Google Scholar 

  2. Dunkel-Schetter, C., Feinstein, L. G., Taylor, S. E., & Falke, R. L. (1992). Patterns of coping with cancer. Health Psychology, 11, 79–87.

    Article  PubMed  CAS  Google Scholar 

  3. Ashing-Giwa, K. T., Padilla, G., Tejero, J., Kraemer, J., Wright, K., Coscarelli, A., et al. (2004). Understanding the breast cancer experience of women: A qualitative study of African American, Asian American, Latina and Caucasian cancer survivors. Psycho-Oncology, 13, 408–428.

    Article  PubMed  Google Scholar 

  4. Ferrell, B. R., Grant, M. M., Funk, B., Otis-Green, S., & Garcia, N. (1997). Quality of life in breast cancer survivors as identified by focus groups. Psycho-Oncology, 6, 13–23.

    Article  PubMed  CAS  Google Scholar 

  5. Kissane, D. W., Bloch, S., Miach, P., Smith, G. C., Seddon, A., & Keks, N. (1997). Cognitive-existential group therapy for patients with primary breast cancer-techniques and themes. Psycho-Oncology, 6, 25–33.

    Article  PubMed  CAS  Google Scholar 

  6. Mullens, A. B., McCaul, K. D., Erickson, S. C., & Sandgren, A. K. (2004). Coping after cancer: Risk perceptions, worry, and health behaviors among colorectal cancer survivors. Psycho-Oncology, 13, 367–376.

    Article  PubMed  Google Scholar 

  7. Walker, B. L. (1997). Adjustment of husbands and wives to breast cancer. Cancer Practice, 5, 92–98.

    PubMed  CAS  Google Scholar 

  8. Zahlis, E. H., & Shands, M. E. (1993). The impact of breast cancer on the partner 18 months after diagnosis. Seminars in Oncology Nursing, 9, 83–87.

    Article  PubMed  CAS  Google Scholar 

  9. Bellizzi, K. M., Latini, D. M., Cowan, J. E., Duchane, J., & Carroll, P. R. (2008). Fear of recurrence, symptom burden, and health-related quality of life in men with prostate cancer. Urology, 72, 1269–1273.

    Article  PubMed  Google Scholar 

  10. Mellon, S., Northouse, L. L., & Weiss, L. K. (2006). A population-based study of the quality of life of cancer survivors and their family caregivers. Cancer Nursing, 29, 120–131.

    Article  PubMed  Google Scholar 

  11. Saleh, U. S., & Brockopp, D. Y. (2001). Quality of life 1 year following bone marrow transplantation: psychometric evaluation of the quality of life in bone marrow transplant survivors tool. Oncology Nursing Forum, 28, 1457–1464.

    PubMed  CAS  Google Scholar 

  12. Schover, L. R. (2005). Motivation for parenthood after cancer: A review. Journal National Cancer Institute Monograph, 2005, 2–5.

    Article  Google Scholar 

  13. Stanton, A. L., Danoff-Burg, S., & Huggins, M. E. (2002). The first year after breast cancer diagnosis: Hope and coping strategies as predictors of adjustment. Psycho-Oncology, 11, 93–102.

    Article  PubMed  Google Scholar 

  14. Vickberg, S. M. (2003). The concerns about recurrence scale (CARS): A systematic measure of women’s fears about the possibility of breast cancer recurrence. Annals of Behavioral Medicine, 25, 16–24.

    Article  PubMed  Google Scholar 

  15. Alfano, C. M., & Rowland, J. H. (2006). Recovery issues in cancer survivorship: A new challenge for supportive care. Cancer Journal, 12, 432–443.

    Article  Google Scholar 

  16. Stefanek, M. E., Shaw, A., DeGeorge, D., & Tsottles, N. (1989). Illness-related worry among cancer patients: Prevalence, severity, and content. Cancer Investigation, 7, 365–371.

    Article  PubMed  CAS  Google Scholar 

  17. Ganz, P. A., Coscarelli, A., Fred, C., Kahn, B., Polinsky, M. L., & Petersen, L. (1996). Breast cancer survivors: Psychosocial concerns and quality of life. Breast Cancer Research and Treatment, 38, 183–199.

    Article  PubMed  CAS  Google Scholar 

  18. Leake, R. L., Gurrin, L. C., & Hammond, I. G. (2001). Quality of life in patients attending a low-risk gynaecological oncology follow-up clinic. Psycho-Oncology, 10, 428–435.

    Article  PubMed  CAS  Google Scholar 

  19. Northouse, L. L. (1981). Living with cancer. American Journal of Nursing, 81, 961–962.

    PubMed  CAS  Google Scholar 

  20. Mellon, S., Kershaw, T. S., Northouse, L. L., & Freeman-Gibb, L. (2007). A family-based model to predict fear of recurrence for cancer survivors and their caregivers. Psycho-Oncology, 16, 214–223.

    Article  PubMed  Google Scholar 

  21. Nordin, K., Wasteson, E., Hoffman, K., Glimelius, B., & Sjoden, P. O. (2001). Discrepancies between attainment and importance of life values and anxiety and depression in gastrointestinal cancer patients and their spouses. Psycho-Oncology, 10, 479–489.

    Article  PubMed  CAS  Google Scholar 

  22. Harrison, J., Haddad, P., & Maguire, P. (1995). The impact of cancer on key relatives: A comparison of relative and patient concerns. European Journal of Cancer, 31A, 1736–1740.

    Article  PubMed  CAS  Google Scholar 

  23. Leventhal, H., Meyer, D., & Nerenz, D. R. (1980). The common-sense representation of illness danger. In S. Rachman (Ed.), Medical psychology (pp. 7–30). New York: Pergamon.

    Google Scholar 

  24. Ries, L., Melbert, D., Krapcho, M., Mariotto, A., Miller, B. A., Feuer, E. J. et al. (2007). SEER cancer statistics review, 1975–2004. National Cancer Institute [On-line]. Available: http://seer.cancer.gov/csr/1975_2004/.

  25. Golden-Kreutz, D. M., Thornton, L. M., Wells-Di, G. S., Frierson, G. M., Jim, H. S., Carpenter, K. M., et al. (2005). Traumatic stress, perceived global stress, and life events: Prospectively predicting quality of life in breast cancer patients. Health Psychology, 24, 288–296.

    Article  PubMed  Google Scholar 

  26. Manne, S. L., Glassman, M., & Du, H. K. (2001). Intrusion, avoidance, and psychological distress among individuals with cancer. Psychosomatic Medicine, 63, 658–667.

    PubMed  CAS  Google Scholar 

  27. Holland, J. C., & Reznick, I. (2005). Pathways for psychosocial care of cancer survivors. Cancer, 104, 2624–2637.

    Article  PubMed  Google Scholar 

  28. Brown, S. L., Nesse, R. M., Vinokur, A. D., & Smith, D. M. (2003). Providing social support may be more beneficial than receiving it: Results from a prospective study of mortality. Psychological Science, 14, 320–327.

    Article  PubMed  Google Scholar 

  29. Hagedoorn, M., Kuijer, R. G., Buunk, B. P., DeJong, G. M., Wobbes, T., & Sanderman, R. (2000). Marital satisfaction in patients with cancer: Does support from intimate partners benefit those who need it the most? Health Psychology, 19, 274–282.

    Article  PubMed  CAS  Google Scholar 

  30. Kim, Y., Kashy, D. A., Spillers, R. L., & Evans, T. V. (2010). Needs assessment of family caregivers of cancer survivors: Three cohorts comparison. Psycho-Oncology, 19, 573–582.

    Article  PubMed  Google Scholar 

  31. Manne, S. L., Ostroff, J., Sherman, M., Glassman, M., Ross, S., Goldstein, L., et al. (2003). Buffering effects of family and friend support on associations between partner unsupportive behaviors and coping among women with breast cancer. Journal of Social and Personal Relationships, 20, 771–792.

    Article  Google Scholar 

  32. Kim, Y., Kashy, D. A., Wellisch, D. K., Spillers, R. L., Kaw, C., & Smith, T. (2008). Quality of life of couples dealing with cancer: Dyadic and individual adjustment among breast and prostate cancer survivors and their spousal caregivers. Annals of Behavioral Medicine, 35, 230–238.

    Article  PubMed  Google Scholar 

  33. Watson, D., & Pennebaker, J. W. (1989). Health complaints, stress, and distress: Exploring the central role of negative affectivity. Psychological Review, 96, 234–254.

    Article  PubMed  CAS  Google Scholar 

  34. Smith, T., Stein, K. D., Mehta, C. C., Kaw, C., Kepner, J. L., Buskirk, T., et al. (2007). The rationale, design, and implementation of the American cancer society’s studies of cancer survivors. Cancer, 109, 1–12.

    Article  PubMed  Google Scholar 

  35. Curtis, R. E., Freedman, D. M., Ron, E., Ries, L. A. G., Hacker, D. G., Edwards, B. K. et al. (2006). New malignancies among cancer survivors: SEER cancer registries, 1973–2000. Bethesda, MD: National Cancer Institute, NIH Publ. No. 05–5302.

  36. Kim, Y., Baker, F., & Spillers, R. L. (2007). Cancer caregivers’ quality of life: effects of gender, relationship, and appraisal. Journal of Pain and Symptom Management, 34, 294–304.

    Article  PubMed  Google Scholar 

  37. Zhao, L., Portier, K., Stein, K., Baker, F., & Smith, T. (2009). Exploratory factor analysis of the cancer problems in living scale: A report from the American cancer society’s studies of cancer survivors. Journal of Pain and Symptom Management, 37, 676–686.

    Article  PubMed  Google Scholar 

  38. Ware, J. E., Kosinski, M., & Keller, S. (1994). SF-36 physical and mental health summary scales: A user’s manual (2nd ed.). Boston, MA: Health Institute, New England Medical Center.

    Google Scholar 

  39. Shacham, S. (1983). A shortened version of the profile of mood states. Journal of Personality Assessment, 47, 305–306.

    Article  PubMed  CAS  Google Scholar 

  40. Kenny, D. A., Kashy, D. A., & Cook, W. L. (2006). Dyadic data analysis. New York, NY: Guilford Press.

    Google Scholar 

  41. Arbuckle, J. L., & Wothke, W. (2005). Amos users’ guide, version 6.0. Chicago: SmallWaters Corporation.

    Google Scholar 

  42. Bollen, K. A., & Stine, R. A. (1993). Bootstrapping goodness-of-fit measures in structural equation models. In K. A. Bollen & J. S. Long (Eds.), Testing structural equation models (pp. 111–135). Newbury Park, CA: Sage.

    Google Scholar 

  43. Hu, L., & Bentler, P. M. (1999). Cutoff criteria for fit indices in covariance structure analysis: Conventional criteria versus new alternatives. Structural Equation Modeling, 6, 1–55.

    Article  Google Scholar 

  44. Andersen, B. L., Shapiro, C. L., Farrar, W. B., Crespin, T., & Wells-Digregorio, S. (2005). Psychological responses to cancer recurrence. Cancer, 104, 1540–1547.

    Article  PubMed  Google Scholar 

  45. Brady, S. S., & Helgeson, V. (1999). Social support and adjustment to recurrence of breast cancer. Journal of Psychosocial Oncology, 17, 37–55.

    Article  Google Scholar 

  46. Northouse, L. L., Mood, D., Kershaw, T., Schafenacker, A., Mellon, S., Walker, J., et al. (2002). Quality of life of women with recurrent breast cancer and their family members. Journal of Clinical Oncology, 20, 4050–4064.

    Article  PubMed  Google Scholar 

  47. Oh, S., Heflin, L., Meyerowitz, B. E., Desmond, K. A., Rowland, J. H., & Ganz, P. A. (2004). Quality of life of breast cancer survivors after a recurrence: A follow-up study. Breast Cancer Research and Treatment, 87, 45–57.

    Article  PubMed  Google Scholar 

  48. Northouse, L., Kershaw, T., Mood, D., & Schafenacker, A. (2005). Effects of a family intervention on the quality of life of women with recurrent breast cancer and their family caregivers. Psycho-Oncology, 14, 478–491.

    Article  PubMed  Google Scholar 

  49. Andrykowski, M. A., & Manne, S. L. (2006). Are psychological interventions effective and accepted by cancer patients? I. Standards and levels of evidence. Annals of Behavioral Medicine, 32, 93–97.

    Article  PubMed  Google Scholar 

  50. Antoni, M. H., Lechner, S. C., Kazi, A., Wimberly, S. R., Sifre, T., Urcuyo, K. R., et al. (2006). How stress management improves quality of life after treatment for breast cancer. Journal of Consulting and Clinical Psychology, 74, 1143–1152.

    Article  PubMed  Google Scholar 

  51. Sheard, T., & Maguire, P. (1999). The effect of psychological interventions on anxiety and depression in cancer patients: Results of two meta-analyses. British Journal of Cancer, 80, 1770–1780.

    Article  PubMed  CAS  Google Scholar 

  52. Burisch, M. (1984). Approaches to personality inventory construction: A comparison of merits. American Psychologist, 39, 214–227.

    Article  Google Scholar 

  53. Burisch, M. (1984). You don’t always get what you pay for: Measuring depression with short and simple versus long and sophisticated scales. Journal of Research in Personality, 18, 81–98.

    Article  Google Scholar 

  54. Helgeson, V. S. (1992). Moderators of the relation between perceived control and adjustment to chronic illness. Journal of Personality and Social Psychology, 63, 656–666.

    Article  PubMed  CAS  Google Scholar 

Download references

Acknowledgments

This study was funded by the American Cancer Society National Home Office, intramural research. We appreciate Corinne Crammer for her assistance with manuscript preparation and we extend our appreciation to all the families who participated in this investigation. The first author dedicates this research to the memory of Heekyoung Kim.

Author information

Authors and Affiliations

  1. Department of Psychology, University of Miami, 5665 Ponce de Leon Blvd, Coral Gables, FL, 33124-0751, USA

    Youngmee Kim & Charles S. Carver

  2. American Cancer Society, Atlanta, GA, USA

    Rachel L. Spillers, Melissa Love-Ghaffari & Chiew-Kwei Kaw

Authors
  1. Youngmee Kim
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Charles S. Carver
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Rachel L. Spillers
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Melissa Love-Ghaffari
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Chiew-Kwei Kaw
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Youngmee Kim.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Kim, Y., Carver, C.S., Spillers, R.L. et al. Dyadic effects of fear of recurrence on the quality of life of cancer survivors and their caregivers. Qual Life Res 21, 517–525 (2012). https://doi.org/10.1007/s11136-011-9953-0

Download citation

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s11136-011-9953-0

Keywords

Search

Navigation