Psychoeducational Intervention Reduces Fear of Melanoma Recurrence in Patients With High-Risk Melanoma
In an Australian trial reported in the Journal of Clinical Oncology, Dieng et al found that use of a psychoeducational intervention reduced the fear of cancer recurrence and stress among patients at high risk of developing a second primary melanoma.
Study Details
In the trial, 164 patients from 3 high-risk melanoma clinics in New South Wales were randomized to receive the psychoeducational intervention (n = 80) or usual care (n = 84). The intervention consisted of a newly developed psychoeducational booklet and three individual telephone-based psychotherapeutic sessions with a psychologist over a 1-month period coordinated with dermatologic appointments. Usual care consisted of usual dermatologic appointments and a copy of a Cancer Council Australia booklet on melanoma, which includes information about melanoma diagnosis, treatment, and emotional and practical issues.
Assessments were performed at baseline, 1 month, and 6 months after dermatologic appointments. The primary outcome was self-reported fear of new or recurring melanoma using the severity subscale of the validated 42-item Fear of Cancer Recurrence Inventory (FCRI); other FCRI subscales consisted of triggers, psychological distress, functional impairment, reassurance, insight, and coping strategies. Differences were also examined for anxiety, stress, depression, melanoma-related knowledge, health behaviors, satisfaction with melanoma care, unmet needs, and health-related quality of life.
Outcomes
At 6 months, the intervention group reported a lower fear of cancer recurrence severity (P = .002), triggers (P = .003), and distress (P = .003) scores in baseline score–adjusted analysis. After adjustment for other covariates (age, sex, marital status, education level, and family income), only the difference in fear of cancer recurrence severity remained significant (P = .04). At 6 months, the intervention group also reported lower stress (P = .03) and improved melanoma-related knowledge (P < .001). There were no differences between the groups with regard to other secondary outcomes.
The investigators concluded: “This newly developed evidence-based psychoeducational intervention was effective in reducing [fear of cancer recurrence] and stress and with increasing melanoma-related knowledge in people at high risk for another melanoma.”
The study was supported by a Cancer Institute New South Wales Translational Program grant, a grant from beyondblue: The National Depression Initiative, a Sydney Catalyst Top-Up Research Scholar Award.
Mbathio Dieng, PhD, of The University of Sydney, is the corresponding author of the Journal of Clinical Oncology article.
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