e-Poster Presentation Clinical Oncology Society of Australia Annual Scientific Meeting 2021

Implementing screening for, and management of fear of cancer recurrence, in clinical cancer care (#389)

Mei Tran 1 , Michael Jefford 2 3 , Lachlan McDowell 4 , Joanne Shaw 5 , Fiona Lynch 1 , Ben Smith 6 , Steve Ellen 1 , Haryana Dhillon 5 7 , Lynda Katona 8 , David Wiesenfeld 2 9 , Orla McNally 10 11 12 , Maria Ftanou 1
  1. Psychosocial Oncology Program, Peter MacCallum Cancer Centre, Parkville, VIC, Australia
  2. Department of Medical Oncology, Peter MacCallum Cancer Centre, Melbourne, VIC, Australia
  3. Australian Cancer Survivorship Centre, Melbourne, VIC, Australia
  4. Department of Radiation Oncology, Peter MacCallum Cancer Centre, Melbourne, VIC, Australia
  5. Psycho-oncology Co-operative Research Group, University of Sydney, Sydney, NSW , Australia
  6. Ingham Institute for Applied Medical Research and South West Sydney Clinical Campuses, University of New South Wales, Sydney, NSW, Australia
  7. Centre for Medical Psychology and Evidence-Based Decision-Making, University of Sydney, Sydney, NSW , Australia
  8. Department of Psychology and Consultation Liaison Psychiatry, Alfred Health, Melbourne, VIC, Australia
  9. Head and Neck Tumour Stream, The Royal Melbourne Hospital, Melbourne, VIC, Australia
  10. Oncology and Dysplasia Unit, The Royal Women's Hospital, Melbourne, VIC, Australia
  11. Gynaecological Cancer Tumour Stream, Peter MacCallum Cancer Centre, Melbourne, VIC, Australia
  12. Department of Obstetrics and Gynaecology, University of Melbourne, Melbourne, VIC, Australia

Aims: Fear of Cancer Recurrence (FCR) is a significant unmet need of cancer survivors and is consistently associated with psychological distress and impaired quality of life1,2. Psychological interventions developed to treat FCR, such as ConquerFear, have demonstrated efficacy in reducing FCR and improving emotional wellbeing, particularly for individuals with high FCR3,4. To maximise the uptake of evidence-based treatment in clinical practice and address the treatment gap for those with lower FCR, this project aims to evaluate the acceptability and feasibility of a stepped-care model of care (Fear-Less) to treat FCR in early stage cancer survivors. 

Methods: Over a 15-week period, we aim to recruit sixty early stage cancer survivors who have completed initial curative treatment, and have been routinely screened for FCR using the Fear of Cancer Recurrence Inventory – Short Form5 and Fear of Cancer Recurrence – 1 Item Measure6,7. Survivors will be recruited from a number of outpatient units at Peter MacCallum Cancer Centre, Royal Melbourne Hospital and Royal Women’s Hospital. As per the Fear-Less model of care, individuals reporting mild-to-moderate FCR will be offered a self-management resource and those reporting high FCR will be offered individual therapy using ConquerFear. Fear-Less will be evaluated in terms of 1) acceptability (i.e., referral uptake, treatment adherence, patient and clinician experience); 2) feasibility (i.e., time taken to screen and deliver interventions); and 3) impact (i.e., pre- to post-intervention changes in FCR). 

Results: The rate of FCR experienced by early stage cancer survivors will be presented alongside demographic details including age, sex, diagnosis and treatment received. Preliminary data on acceptability (e.g., referral uptake) will also be presented. 

Conclusion: If Fear-Less is shown to be a feasible and acceptable model of care, a significant need for cancer survivors can be addressed via improved FCR identification and treatment.

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  2. Lisy K, Langdon L, Piper A, Jefford M. Identifying the most prevalent unmet needs of cancer survivors in Australia: A systematic review. Asia-Pacific Journal of Clinical Oncology. 2019;15:e68-e78.
  3. Butow P, Turner J, Gilchrist J, Sharpe L, Smith AB, Fardell JE, et al. Randomized Trial of ConquerFear: A Novel, Theoretically Based Psychosocial Intervention for Fear of Cancer Recurrence. Journal of Clinical Oncology. 2017;35:4066-77.
  4. Sharpe L, Turner J, Fardell JE, Thewes B, Smith AB, Gilchrist J, et al. Psychological intervention (ConquerFear) for treating fear of cancer recurrence: mediators and moderators of treatment efficacy. Journal of Cancer Survivorship. 2019;13:695-702.
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  6. Rudy L, Maheu C, Körner A, Lebel S, Gélinas C. The FCR-1: Initial validation of a single-item measure of fearof cancer recurrence. Psycho-Oncology. 2020;29:788-95.
  7. Smith AB. Integrating fear of cancer recurrence screening into routine care: opportunities and challenges. Psycho‐Oncology. 2021;30:134-7.