Cognitive Behavior Therapy for Fear of Cancer Recurrence: A Case Study

Marieke Van De Wal,Belinda Thewes,Rebecca Berry,Judith Prins,Petra Servaes

doi:10.1007/s10880-018-9545-z

Abstract

This case study describes the course and content of cognitive behavior therapy (CBT) for clinical fear of cancer recurrence (FCR) in a breast cancer survivor. The CBT for clinical FCR consisted of seven face-to-face therapy sessions and one telephone session. The primary treatment goal was to reduce FCR severity by modifying cognitive processes and dysfunctional behavior. Assessments of FCR and quality of life were completed by the breast cancer survivor pre-therapy, post-therapy, and at 6 and 12 months of post-therapy. In each treatment session, perceived control over FCR was assessed. A clinical nurse specialist participated in evaluation interviews. The patient’s perceived control over FCR increased during the therapy, and FCR severity declined to a non-clinical level. This improvement was still evident at the 6- and 12-month follow-up assessments and was supported by results for secondary and exploratory outcomes measures. FCR offers a great challenge for health care professionals due to the lack of effective treatment options. This case study shows how clinical FCR can be addressed with CBT and can contribute to the improvement of care for cancer survivors.

Highlights

Fear of cancer recurrence (FCR) is “the fear, worry or concern about cancer returning or progressing” (Lebel, Ozakinci, et al, 2016)
We developed an individually delivered cognitive behavior therapy (CBT) program in order to reduce clinical FCR in cancer survivors (van de Wal et al, 2015; van de Wal, 1 3 Vol:.(1234567890)
Whereas the other two therapies rely on cognitive existential therapy or meta-cognitive therapy, the intervention we describe is based on tenets of CBT, and consists of eight therapy sessions

Summary

Introduction

Fear of cancer recurrence (FCR) is “the fear, worry or concern about cancer returning or progressing” (Lebel, Ozakinci, et al, 2016). In 30–70% of individuals, FCR becomes a chronic concern that detrimentally affects their emotional wellbeing, quality of life, and daily functioning (Crist & Grunfeld, 2013; Koch, Jansen, Brenner, & Arndt, 2013; Simard et al, 2013). This fear may persist long after completion of cancer treatment. Health professionals acknowledge that FCR is a common problem in clinical practice but are unsure about how to manage it They often do not refer survivors for extra psychosocial care (Thewes et al, 2014).

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Results

Conclusion