Benefits of a brief psychological intervention targeting fear of cancer recurrence in people at high risk of developing another melanoma: 12‐month follow‐up results of a randomized controlled trial

Abstract

Summary Background People with melanoma want and need effective interventions for living with fear of cancer recurrence (FCR). Objectives This study reports the 12‐month outcomes of a brief, psychological intervention designed to reduce FCR in people at high risk of developing another primary melanoma compared with usual care. Methods In this two‐arm randomized controlled trial, adults previously diagnosed with stage 0, I or II melanoma were randomly allocated to the intervention (n = 80) or control (usual care) arm (n = 84). The trial was registered with the Australian and New Zealand Clinical Trials Registry on 19 March 2013 (registration: ACTRN12613000304730). The intervention comprised a 76‐page psychoeducational resource and three individually tailored, telephone‐based sessions with a psychologist, scheduled at specific time points around participants’ dermatological appointments. The primary outcome was the level of self‐reported fear of new or recurrent melanoma assessed at 12 months postintervention using the severity subscale of the Fear of Cancer Recurrence Inventory. Results Compared with the control arm, the intervention group reported significantly lower FCR at 12 months postintervention; the between‐group mean difference was −1·41 for FCR severity [95% confidence interval (CI) −2·6 to −0·2; P = 0·02] and −1·32 for FCR triggers (95% CI −2·6 to −0·02; P = 0·04). The odds ratio for FCR severity scores ≥13 (54% intervention, 63% control) was 0·59 (95% CI 0·30–1·14, P = 0·12). There were no differences between groups in secondary outcomes, such as anxiety, depression or health‐related quality of life. Conclusions The previously reported 6‐month benefits of this brief, patient‐centred psychological intervention in reducing FCR were found to continue 12 months postintervention, with no known adverse effects, supporting implementation as part of routine melanoma care.

Prevalence and indicators of fear of melanoma in patients with familial melanoma during surveillance

“…All had probable neuropathic pain according to a commonly used grading system. 2 They had normal nerve conduction studies assessing large-diameter nerve fibres, while small-diameter nerve fibres were investigated by specific neurophysiological tests [3][4][5] : laser-evoked potentials and cold detection threshold for A-delta sensory fibres; warm detection threshold and electrochemical skin conductance for C sensory and autonomic fibres, respectively. The following clinical data were collected: age, gender, past medical history, culprit drug, location and extent of skin and mucosal detachment, SCORTEN, 6 cyclosporine treatment, admission in intensive care unit (ICU), hospital stay duration, mucocutaneous sequelae and various pain features (location, mean daily intensity, interference with daily life, affectiveemotional aspect, and presence of burning, electric shock or tingling sensations, or mechanical allodynia).…”

“…These patients may be in need of psychological interventions that have been shown to be effective in reducing fear of cancer. 5 DOI: 10.1111/jdv.16939…”

It's the worry that got him in the end: the importance in treating melanoma holistically and dealing with fear of recurrence

“…In this issue of the BJD , Dieng et al . summarize the studies that have investigated psychological interventions to tackle excessive postcancer treatment worrying.…”

“…The ‘brief multifaceted, patient‐centred psychological intervention’ that was deployed by Dieng et al . appeared to have lasting effects, insofar as those in the treatment arm of the trial had significantly reduced cancer‐related worry or fear of recurrence when reassessed at the 12‐month follow‐up.…”

“…http://www.skinsupport.org.uk). However, the studies of Dieng et al . indicate that people receiving treatment for melanoma may also benefit from targeted psychological intervention, particularly when it is embedded within routine dermatology service delivery.…”