Fear of Cancer Recurrence in Patients with Sarcoma in the United Kingdom

Abstract

Fear of cancer recurrence (FCR) is a persistent concern among those living with cancer and is associated with a variety of negative psychosocial outcomes. However, people with sarcoma have been underrepresented within this area of research. We aimed to determine the prevalence of FCR experienced by people with sarcoma in the United Kingdom and explore factors that may predict FCR, such as the perceived impact of cancer and psychological flexibility. Participants (N = 229) with soft tissue (n = 167), bone (n = 25), and gastrointestinal stromal tumours (n = 33) completed an online survey including the self-reported measures of FCR, the perceived physical and psychological impact of cancer and psychological flexibility, and demographic information. Data were analysed using ANOVA and multiple regression modelling. Mean FCR scores (M = 91.4; SD = 26.5) were higher than those reported in meta-analytic data inclusive of all cancer types (M = 65.2; SD = 28.2). Interest in receiving support for FCR was also high (70%). Significant factors associated with FCR included cognitive and emotional distress and psychological flexibility, but not perceptions of the physical impact of cancer (R2 = 0.56). The negative association between psychological flexibility and FCR suggests the potential benefit of intervention approaches which foster psychological flexibility, such as acceptance and commitment therapy.

Financial difficulties experienced by patients with gastrointestinal stromal tumours (GIST) in the Netherlands: data from a cross-sectional multicentre study

“…In addition, consistent with other studies [ 38 , 39 ], financial difficulties were associated with psychological symptoms, possibly explaining the lower emotional functioning. Previous studies [ 40 , 41 ] in GIST patients already reported that patients with severe fear of cancer recurrence or progression experienced more psychological distress and had a poorer psychological well-being; they also experienced more limitations in work, daily and social activities than did patients who experienced less fear. This leads us to the question, a chicken and the egg dilemma; are patients burdened by their financial difficulties causing them to experience fear and psychological distress, or, are their fear and psychological distress the reasons that they function less well and get into financial problems?…”

Experiences of fear of recurrence in patients with sarcoma

“…However, there were no differences according to the type of sarcoma, and the key factors associated with FCR were time since diagnosis, having previously experienced a recurrence, and perceiving cancer had a psychological impact. 14 Rather than adopting quantitative methods, qualitative methods enable a more in-depth exploration of the meaning patients attribute to a specific situation. There has also been much qualitative work performed around FCR, which Almeida et al summarized thoroughly in a meta-synthesis.…”

“…18 However, five of seven patients in a study with soft tissue sarcoma noted that FCR was constant, debilitating, and impeded how they lived their lives. 19 The sarcoma population is distinct in that recurrence rates are higher than most other solid cancers, 14 and therefore, the prevalence of FCR could be higher based on this clinical reality. 20 The experiences of FCR in patients with sarcoma and the strategies they develop to deal with the fear remain an unexplored but an important area of research.…”

“…However, there were no differences according to the type of sarcoma, and the key factors associated with FCR were time since diagnosis, having previously experienced a recurrence, and perceiving cancer had a psychological impact. 14…”

The First-In-Class Anti-AXL×CD3ε Pronectin™-Based Bispecific T-Cell Engager Is Active in Preclinical Models of Human Soft Tissue and Bone Sarcomas

“…Among them, soft tissue sarcomas (STSs) represent 80%, bone sarcomas 15% and gastrointestinal stromal tumors 5%. Because of their heterogeneity and common aggressive nature, they are resistant to available therapies and clinical management is still highly challenging [ 3 , 4 , 5 ]. Conventional treatment, including surgery, radiation therapy and chemotherapy (Doxorubicin, Ifosfamide, trabectedin, and others), differs from one subtype to another.…”