New insights into frequency and contents of fear of cancer progression/recurrence (FOP/FCR) in outpatients with colorectal carcinoma (CRC) receiving oral capecitabine: a pilot study at a comprehensive cancer center

Abstract

BackgroundFear of cancer progression/recurrence (FOP/FCR) is considered one of the most prevalent sources of distress in cancer survivors and associated with lower quality of life and functional impairment. Detailed measures of FOP/FCR are needed because little is known about the knowledge of FOP/FCR, its associations with the patient–doctor relationship, and the rate of adequate therapy. Colorectal cancer (CRC) is one of the most prevalent cancer entities, and oral capecitabine is widely prescribed as treatment. Therefore, we initiated a pilot study to expand the literature on FOP/FCR in CRC outpatients receiving capecitabine and to generate hypotheses for future investigations.MethodsThis study included 58 patients treated at a comprehensive cancer center. FOP/FCR was assessed with the Fear of Progression Questionnaire (FOP-Q-SF). Satisfaction with the relationships with doctors was assessed with the Patient–Doctor Relationship Questionnaire-9 (PRDQ-9). Levels of side effects were rated by the patients on a visual analog scale. Clinical data were extracted from the charts.ResultsA total of 19 out of 58 patients (36%) suffered from FOP/FCR according to our assessment. Levels of FOP/FCR seemed to be mostly moderate to high. Only four out of the 19 distressed patients (21%) were treated accordingly. Typical side effects of oncological treatment were associated with higher FOP/FCR. Satisfaction with doctor–patient relationships was not associated with FOP/FCR. Regarding single items of FOP/FCR, three out of the five most prevalent fears were associated with close relatives.DiscussionFOP/FCR occurred frequently in more than one in three patients, but was mostly untreated in this sample of consecutive outpatients with CRC receiving oral capecitabine. In detail, most fears were related to family and friends. In addition to an unmet need of patients, our data indicate sources of distress not considered thus far. If replicated in larger studies, results may help to inform intervention development and improve patient care.

Fear of disease progression and relevant correlates in acute leukemia patients prior to allogeneic hematopoietic stem cell transplantation

“…The most frequently cited concern about the family's future is consistent with various investigations across different cancer diagnoses. 32,34,39 With regard to the worries about treatment damages or severe medical treatment, our results differ from findings of investigations in other cancer populations, where these concerns played a minor part. 19,32,34,39 In two studies with mixed cancer samples, the most common concern was being nervous prior to their doctors' appointment.…”

“…32,34,39 With regard to the worries about treatment damages or severe medical treatment, our results differ from findings of investigations in other cancer populations, where these concerns played a minor part. 19,32,34,39 In two studies with mixed cancer samples, the most common concern was being nervous prior to their doctors' appointment. 19,32 However, these studies were conducted after active treatment, during which the patients may be reminded of the disease by visits to the doctor.…”

“…However, the results are inconsistent-different studies found links between higher FoP and younger age or female sex, whereas other studies could not identify these links. 11,12,32,34,38,39 Concerning age, our findings extend the results of Sarkar and colleagues, who also failed to demonstrate an association between FoP and age. 16 In terms of gender, we could not identify any relationship with FoP.…”

“…Several studies have investigated whether sociodemographic factors are associated with FoP for different cancer diagnoses. However, the results are inconsistent—different studies found links between higher FoP and younger age or female sex, whereas other studies could not identify these links 11,12,32,34,38,39 . Concerning age, our findings extend the results of Sarkar and colleagues, who also failed to demonstrate an association between FoP and age 16 .…”

A prevalence and psychometric study on fear of cancer in women with abnormal cervical cytology undergoing colposcopy

“…6,9,10 Tests to diagnose cervical pre-cancerous cell changes might lead to anxiety. 3,11 Women with a risk of cervical cancer may have severe worry due to the possibility of separation from their spouse, children, and loved ones; especially in families with a patriarchal structure, the other concern of these women is that if something happens, it is unclear who is going to take care of the children. 5,11 The fact that healthcare providers must be allowed to see the most private and intimate organs during examination and maintenance therapy is the most decisive feature that distinguishes the gynaecological cancer screening process from that of other cancers.…”