In studies to be presented at the 2020 Genitourinary Cancers Symposium (Abstracts 649 and 665), researchers examined the prevalence of fear of cancer recurrence in patients with renal cell carcinoma and evaluated the prognostic understanding patients with genitourinary cancer possess of their diagnosis.
Fear of Recurrence
Cristiane Decat Bergerot, PhD
Cristiane Decat Bergerot, PhD, of City of Hope, and colleagues examined fear of cancer recurrence among patients with renal cell carcinoma.
Over the course of 2 months in 2019, 1,150 patients participated in an international online survey. Four hundred and twelve patients had localized renal cell carcinoma and were assessed for fear of recurrence using the FCR-7, a 7-item measure with scores ranging from 0 to 28. A score of 17 classifies the patient’s fear of recurrence as moderate, and a cutoff of 27 determines a severe fear of recurrence.
Approximately 80% of the patients who replied to the survey were female; the median age was 54 among responders; 58% were well educated; most were from the United States and lived in suburban or rural areas. Over half of patients had stage I renal cell carcinoma.
Fifty-five percent of patients reported either a moderate or severe fear of recurrence. Patients who were younger and who were female were more likely to have a higher level of fear of recurrence.
The authors speculated, “…high rates of fear of cancer recurrence were associated with female [sex] and younger age, possibly driven by the fact that women may be more open to disclosing emotional symptoms and younger patients are still to pass through many life milestones and thus fear may be more pronounced.”
The researchers noted that targeted assessment and interventions are needed in the future to address fear of recurrence among patients with renal cell carcinoma.
Prognostic Understanding
In a second study led by Dr. Decat Bergerot, researchers looked to identify clinical factors associated with patient expectations of cure in genitourinary cancers.
The team conducted a cross-sectional survey in patients diagnosed with incurable disease in which expectations of cure were assessed based on four quartiles:
- Cure is very likely and is in the range of 76% to 100% certainty
- Cure is likely and is in the range of 51% to 75% certainty
- Cure is possible, but not likely and is in the range of 26% to 50% certainty
- Cure is not at all likely and is in the range of 0% to 25% certainty.
One hundred and forty-five patients were enrolled in the study. Seventy-six percent of patients were male and 70% were white; patients were diagnosed with advanced kidney (66%), bladder (20%), or prostate (14%) cancers. Nearly three-quarters of patients were receiving either first-line or second-line therapy, mostly immunotherapy or targeted therapy.
Nearly half of patients—47%—had an inaccurate expectation of the likelihood of cure for their disease, classified as in the range of 26% to 100% certainty of cure. Those with inaccurate expectations were more likely to be older and were more likely to be receiving first- or second-line therapy vs those receiving later-line therapies.
The authors concluded, “Our findings highlight the high proportion of patients harboring inaccurate perceptions regarding prognosis, more pronounced with older age and within the first two lines of therapy for metastatic disease. These groups may be ideal target populations for more extensive counseling around prognosis.”
Disclosure: For full disclosures of the study authors, visit coi.asco.org (Abstract 649, Abstract 665).
