The development of a group-based version of ConquerFear – a psychological intervention for fear of cancer recurrence

Cancer survival rates are improving, and many of the growing number of cancer survivors experience negative psychosocial consequences, even many years after completed treatment. Fear of cancer recurrence (FCR) is a highly prevalent late effect after cancer treatment, which can refer to both the fear or worry about cancer recurrence as well as the fear or worry about cancer progressing, depending on the individual’s circumstances (Lebel et al., 2016).

Most cancer survivors experience some degree of fear of cancer recurrence, and transitory and low levels of FCR may be adaptive in alerting survivors to signs of a new or recurring cancer and encouraging relevant health behaviors. However, one in five survivors report high levels of FCR (Luigjes-Huizer et al., 2022), with a substantial negative impact on psychological well-being and quality of life.

In addition, high levels of FCR have been associated with maladaptive behaviors, including overuse of healthcare services or avoidance of relevant examinations and tests to identify recurrence in a timely fashion. The considerable costs to cancer survivors and their families call for systematic screening followed up by evidence-based treatments of FCR.       

Due to the clear need for interventions to deal with this late effect, the Psycho-oncology Co-operative Research Group (PoCoG) at the University of Sydney developed ConquerFear, a novel, theory-based psychological intervention aimed specifically at reducing the impact of fear of cancer recurrence.

The individual-format ConquerFear intervention has been found efficacious in reducing symptoms of fear of cancer recurrence and other secondary outcomes, when compared with an active control group (Butow et al., 2017).

The PoCoG intervention team has since collaborated with researchers from the Unit for Psycho-Oncology and Health Psychology at Aarhus University and Aarhus University Hospital in Denmark in developing and evaluating a group-delivered version of ConquerFear (ConquerFear-Group).

First, two single-arm pilot studies were conducted to evaluate the integration of the intervention components in a group format. Then, a randomized controlled pilot trial was conducted to evaluate the feasibility and preliminary efficacy of ConquerFear-Group, compared with an active control group receiving relaxation training. The promising results (Tauber et al., 2022) informed a larger-scale randomized controlled trial, which is currently (June, 2022) nearing its completion.

Many researchers and clinicians have expressed interest in ConquerFear, and we are therefore very pleased that the ConquerFear manuals are now freely available for clinicians around the world to use. It is our hope that the availability of both an individual format and a group format will increase the number of cancer patients and survivors who will benefit from this intervention.

To access the ConquerFear manuals, click here

 

References

Butow, P. N., Turner, J., Gilchrist, J., Sharpe, L., Smith, A. B., Fardell, J. E., Tesson, S., O’Connell, R., Girgis, A., Gebski, V. J., Asher, R., Mihalopoulos, C., Bell, M. L., Zola, K. G., Beith, J., & Thewes, B. (2017). Randomized trial of ConquerFear: A novel, theoretically based psychosocial intervention for fear of cancer recurrence. Journal of Clinical Oncology, 35(36), 4066–4077. Scopus. https://doi.org/10.1200/JCO.2017.73.1257

Lebel, S., Ozakinci, G., Humphris, G., Mutsaers, B., Thewes, B., Prins, J., Dinkel, A., & Butow, P. (2016). From normal response to clinical problem: Definition and clinical features of fear of cancer recurrence. Supportive Care in Cancer, 24(8), 3265–3268. Scopus. https://doi.org/10.1007/s00520-016-3272-5

Luigjes-Huizer, Y. L., Tauber, N. M., Humphris, G., Kasparian, N. A., Lam, W. W. T., Lebel, S., Simard, S., Smith, A. B., Zachariae, R., Afiyanti, Y., Bell, K. J. L., Custers, J. A. E., de Wit, N. J., Fisher, P. L., Galica, J., Garland, S. N., Helsper, C. W., Jeppesen, M. M., Liu, J., … van der Lee, M. L. (2022). What is the prevalence of fear of cancer recurrence in cancer survivors and patients? A systematic review and individual participant data meta-analysis. Psycho-Oncology, 31(6), 879–892. https://doi.org/10.1002/pon.5921

Tauber, N. M., Zachariae, R., Jensen, A. B., Thewes, B., Skyt, I., Elkjaer, E., Butow, P. N., & O’Toole, M. S. (2022). ConquerFear-group: Feasibility study with pilot results of a psychological intervention for fear of cancer recurrence delivered in groups. Psycho-Oncology, 31(1), 30–38. https://doi.org/10.1002/pon.5772