Fear of cancer recurrence (FCR) is a significant issue for most cancer survivors, which is now extensively confirmed by the scientific literature in the psycho-oncology field. We aimed to further explore the experience of having FCR from the point of view of patients by systematically reviewing qualitative studies. Following PRISMA guidelines, 64 qualitative studies were selected. All participants' quotes about FRC were identified, then analysed using a conceptual framework based on the emotion-focused therapy theory of emotion schemes, which consist of experienced/implicit emotions, along with perceptual-situational, bodily-expressive, symbolic-conceptual and motivationalbehavioral elements. FCR was found to be an intense, difficult, multi-dimensional experience. According to participant descriptions, FCR resembles a trauma-like phenomenon, including forms of re-experiencing, avoidance, negative thoughts and feelings, and arousal or reactivity related to cancer-related triggers or memories. Vivid metaphors expressing vulnerability and conflict also reflect the strong impact of FCR in patients' lives. Implications for psychotherapeutic work are discussed.
Highlights• Qualitative data complement and can expand our current knowledge about fear of cancer recurrence. • FCR is described qualitatively by patients as a complex experience involving emotional, perceptual, conceptual, bodily and behavioral dimensions. • FCR is a post trauma-like phenomenon: it is an intense and extensive experience; it has a flashback-like quality in which painful episodic memories related to cancer return repeatedly; it is described through vivid metaphors of conflict and vulnerability that emphasize fragility and helplessness. • Humanistic-experiential therapeutic approaches might be considered for treating maladaptive FCR, which needs further investigation.