Fear of cancer recurrence: a theoretical review and novel cognitive processing formulation
- 1.7k Downloads
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.
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.
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.
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.
KeywordsFear of cancer recurrence Cancer Oncology Survivorship Metacognitive Therapy Acceptance and Commitment Therapy
The work presented in this paper was co-funded by beyondblue, National Breast Cancer Foundation and Cancer Australia (CAPdCCRS 1022584).
Compliance with ethical standards
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.
No studies with human participants or animals were performed by any of the authors as part of this review.
- 7.Simard S, Savard J. Screening and psychiatric comorbidity of clinical fear of cancer recurrence. 4th Canadian breast cancer research alliance reasons for hope scientific conference. Vancouver, Canada. 2008.Google Scholar
- 15.Hodgkinson K. What is the psychosocial impact of cancer? In: Hodgkinson K, Gilchrist J, editors. Psychosocial care of cancer patients: a health professionals guide to what to say and do. Melbourne: Ausmed Publications; 2008.Google Scholar
- 38.Koch L, Bertram H, Eberle A, et al. Fear of recurrence in long-term breast cancer survivors-still an issue. Results on prevalence, determinants, and the association with quality of life and depression from the cancer survivorship—a multi-regional population-based study. Psycho-Oncology. 2014;23:547–54.CrossRefPubMedGoogle Scholar
- 40.Humphries G, Rogers S. AFTER and beyond: cancer recurrence fears and test of an intervention in oropharyngeal patients. Soc Sci Dent. 2012;2:29–38.Google Scholar
- 43.Cavanagh M, Franklin J. Attention training and hypochondriasis: preliminary results of a controlled treatment trial. World congress of cognitive and behavioral therapy. Vancouver, Canada 2000.Google Scholar
- 48.Cook S, Salmon P, Dunn G et al. A prospective study of the association of metacognitive beliefs and processes with persistent emotional distress after diagnosis of cancer. Cogn Ther Res. 2014: 1–10.Google Scholar
- 49.Cook SA, Salmon P, Dunn G et al. The association of metacognitive beliefs with emotional distress after diagnosis of cancer. Health Psychol. 2014: No Pagination Specified.Google Scholar
- 57.Hayes S, Strohsahl K, Wilson K. Acceptance and commitment therapy; an experiential approach to behaviour change. New York: Guildford Press; 2003.Google Scholar
- 69.Lichtenthal WG, Tuman M, Beard C, et al. Development of attention and interpretation modification for fear of breast cancer recurrence (AIM-FBCR): preliminary findings. Psycho-Oncology. 2013;22:72–3.Google Scholar
- 70.Smith AB, Thewes B, Turner J et al. Pilot of a theoretically grounded psychologist-delivered intervention for fear of cancer recurrence (Conquer Fear). Psycho-Oncology 2015: n/a-n/a.Google Scholar