Long-term fear of recurrence in young breast cancer survivors and partners

Abstract

Background Fear of a breast cancer recurrence is the most prevalent and disruptive source of distress for long-term survivors and their partners. However, few studies have focused on predictors of fear of recurrence. The aim of this study is to test the efficacy of the Social Cognitive Processing Theory (SCPT) in predicting fear of recurrence in long-term breast cancer survivors diagnosed at age 45 or younger and their partners. Methods In a large cross-sectional study, breast cancer survivors (N=222) 3–8 years from diagnosis and their partners completed a survey assessing demographic characteristics, fear of recurrence, social constraints, and cognitive processing (intrusive thoughts and cognitive avoidance). Mediation analyses were conducted for survivors and partners separately to determine if cognitive processing would mediate the relationship between social constraints and fear of recurrence. Results Cognitive processing mediated the relationship between social constraints and fear of recurrence both for survivors [F(3,213)= 47.541, R2=.401, p<.001] and partners [F(3,215)= 27.917, R2=.280, p<.001). Demographic variables were not significant predictors of fear of recurrence. Conclusions As predicted, cognitive processing mediated the relationship between social constraints and fear of recurrence. Results expand the utility of the SCPT in long-term survivors and their partners by supporting its use in intervention design.

Relationship Between Depressive Symptoms and Social Cognitive Processing in Partners of Long-Term Breast Cancer Survivors

“…This scale has previously been used as a marker for prolonged or incomplete cognitive processing (Cohee et al, 2015; Lepore, 2001; Mosher et al, 2012). The Cognitive Avoidance subscale consists of 7 questions with responses ranging from 0 (not at all) to 4 (extremely), with higher scores indicating more avoidance.…”

Anxiety and Depression in Cancer Survivors

“…Just over half of young adult breast cancer survivors in one study reported moderate to high levels of FOR. 25 Another study comparing AYA survivors to controls found no differences in anxiety or depressive symptoms but the AYA survivors did report more PTSS. 26 Other cohorts of AYA’s that were much larger (between N=300 and N=6000) found that AYA’s reported more distress than controls.…”

“…31 FOR may be maintained in survivors if they are unable to talk about the cancer experience with their partners. 25 This highlights the importance both of opportunities to process the cancer experience and of tracking these symptoms at least annually in AYAs to identify those with a need for treatment before negative moods become chronic.…”

Fear of cancer recurrence promotes cancer screening behaviors among family caregivers of cancer survivors

“…Fear, worry, or concern about this uncertainty, collectively called fear of cancer recurrence (FCR), has been associated with greater depression and poorer quality of life among cancer survivors . Studies also have reported that FCR among family caregivers sometimes is higher than that of their patients . Caregivers' FCR that their patient's cancer may return or progress has been associated with their own greater anxiety, depression, and loneliness, and a poorer quality of life as well …”