Trajectory of fear of cancer recurrence and beliefs and rates of medication adherence in patients with breast cancer

Abstract

Objective: This study examined the growth trajectory of fear of cancer recurrence (FCR) and its predictors, and the association of that trajectory with the beliefs and rates of medication adherence in patients with breast cancer. Methods: Two hundred and ten patients with breast cancer undergoing adjuvant endocrine therapy in a university hospital in Seoul, Korea, were followed up five times over 18 months following surgery, and data from the final 162 patients were analyzed. Results: Latent class growth analysis identified three classes. Classes 1 (38.31%) and 2 (39.89%) showed low and moderate FCR levels, respectively, with a decreasing trend over time. Class 3 (21.80%) showed a high FCR level with an initially decreasing but increasing trend afterward s. Lower education and unemployed status were associated with the high FCR class. Higher depression was more associated with the moderate FCR class than the low FCR class. Higher emotional representation was more associated with the high FCR class than with low FCR class, and greater illness comprehension was more associated with the moderate FCR class than with the high FCR class. Both necessity and concerns about medication were the highest in the high FCR class. However, self-reported medication adherence rates did not significantly differ between the classes. Conclusions: A high level of FCR appears to persist over time, and given its association with greater concerns about medication, monitoring and management of FCR throughout the cancer trajectory.

Hot flushes and sweating, sleep problems, joint and muscular discomfort, and physical and mental exhaustion in breast cancer survivors during the first 24 months of tamoxifen therapy: a prospective observational study

“…In this study, patient adherence to TAM was found to be relatively high (> 91%), which is consistent with a previous study that reported > 94% of Korean patients with BC ( 21 ), although up to 50% of patients with BC are generally known not to take TAM for the full duration ( 23 ). A previous study has suggested that this result is due to the ceiling effect.…”

“…Women with distant metastases at diagnosis (stage IV BC); local or regional recurrent tumors; or medical history of psychiatric or neurologic illness were excluded. The detailed sampling and attrition process has been described in a previous study ( 21 ). Among 370 eligible patients, 210 consented to participate in this study (137 declined to participate, and 23 could not be contacted).…”

Prospective longitudinal study on fear of cancer recurrence in patients newly diagnosed with head and neck cancer: Course, trajectories, and associated factors

“…With LCGA, we found a subgroup with high FCR, similar to what has been reported in trajectory studies in patients with breast cancer. One study found a low (75%) and high FCR (25%) group, 23 and two other studies reported a moderate FCR group (47% and 40%) in addition to a low (40% and 38%) and high FCR group (13% and 22%) 22,55 . Overall, these findings suggest that while most patients have low or moderate FCR, there is a distinct group of patients with persistent high FCR up to 6 months after treatment for whom psychological treatment may be indicated.…”

The Correlation Between Radiotherapy and Patients' Fear of Cancer Recurrence

“…Fear of cancer recurrence is defined as “a feeling caused by the recurrence or progression of cancer in the same organ or other part of the body.” 9 Cancer survivors with high levels of FCR may experience psychological distress (eg, anxiety, depression, and posttraumatic stress symptoms) 10 and disorder of cognitive functions (eg, excessive checking behaviors and increased health service use), 11 even suicide. 10 , 12 A patient's FCR level is influenced by various factors. 13 Young age, degree of education, severity of somatic symptoms, and course of disease have been reported to be correlated with higher FCR.…”