Novel Psychosocial Intervention for Fear of Cancer Recurrence


Key Points

  • The ConquerFear group had significant reductions in Fear of Cancer Recurrence Inventory total scores immediately after therapy and at 3 and 6 months.
  • Significant improvements on the severity subscale were observed for up to 3 months.

An Australian trial has shown that a novel theoretically/empirically based intervention (ConquerFear) reduced the fear of cancer recurrence compared with relaxation therapy among patients treated for curable cancers. These results were reported by Butow et al in the Journal of Clinical Oncology.

Study Details

The study, performed at 17 sites, involved survivors with curable breast or colorectal cancer or melanoma who had completed treatment (excluding endocrine therapy) 2 months to 5 years prior to study entry and had scores above the clinical cutoff on the Fear of Cancer Recurrence Inventory (FCRI) severity subscale. Patients were randomized to five 60- to 90-minute face-to-face sessions of ConquerFear, an intervention comprising attention training, metacognitions, acceptance/mindfulness, screening behavior, and values-based goal setting, or five sessions of an attention control (Taking-it-Easy relaxation therapy). Patients were assessed with the FCRI at baseline (T0), immediately after therapy (T1), and at 3 (T2) and 6 months (T3). The primary outcome was FCRI total score.

Reduction in Fear

Among 704 potentially eligible survivors, 533 were contactable, and 222 (42%) provided informed consent. Of them, 121 were randomized to undergo intervention and 101 to serve as a control. Most patients (89%) had breast cancer.

The ConquerFear group showed clinically and statistically greater improvements vs the control group in FCRI total score from T0 to T1 (P < .001), T2 (P = .017), and T3 (P = .018) and in the severity subscale score from T0 to T1 (P = .001) and T2 (P = .023). The ConquerFear group had significantly greater improvement in both FCRI psychological distress and total cancer-specific distress scores at T3. From T0 to T1, the intervention group had significantly better outcomes on the subscales of coping, psychological distress, and triggers and for general anxiety, total cancer-specific distress, and total mental quality of life and metacognitions.

The investigators concluded: “This randomized trial demonstrated efficacy of ConquerFear compared with attention control (Taking-it-Easy) in reduction of FCRI total scores immediately post-therapy and 3 and 6 months later and in many secondary outcomes immediately post-therapy. Cancer-specific distress (total) remained more improved at 3- and 6-month follow-up.”

The study was supported by beyondblue, the National Breast Cancer Foundation, Cancer Australia, the National Health and Medical Research Council, and Cancer Institute NSW.

Phyllis N. Butow, PhD, of the University of Sydney, is the corresponding author of the Journal of Clinical Oncology article.

The content in this post has not been reviewed by the American Society of Clinical Oncology, Inc. (ASCO®) and does not necessarily reflect the ideas and opinions of ASCO®.