Emotional responses to the experience of cancer 'alarm' symptoms.

K L Whitaker,K Winstanley,J Wardle,S Cromme,C Renzi

doi:10.1002/pon.3964

Abstract

ObjectiveTo qualitatively explore associations between emotional responses to experience of cancer ‘alarm’ symptoms and help‐seeking in a community sample of adults.MethodInterviewees (n = 62) were recruited from a community sample (n = 2042) of adults aged ≥50 years, who had completed a health survey that included a list of cancer alarm symptoms. Participants who had reported an alarm symptom both at baseline and 3‐month follow‐up (n = 271), and who had consented to contact (n = 215), constituted the pool for invitations to interview.ResultsOver a third of participants (37%) described an emotional response to their symptom experience. In all these cases, there was evidence of awareness of the risk of cancer. Emotional responses were usually either classified as mild (‘worry’) or severe (‘fear’). Worry was often described in the context of a desire to seek medical help, either to rule out cancer or to minimise patient delay. In contrast, the ‘fear’ group described associations with death, the perceived incurability of cancer, and the consequence of a cancer diagnosis. Where the emotional reaction was fear, medical contact was seen as something to be avoided either because it had no value or because it was preferable not to be told a diagnosis.ConclusionIn this community sample, worry about the possibility of cancer was associated with help‐seeking, either for reassurance or as part of a ‘sensible’ strategy to deal with the risk. In contrast, fear was associated with avoiding help‐seeking or even thinking about cancer, which could lead to prolonged help‐seeking intervals. © 2015 The Authors. Psycho‐Oncology published by John Wiley & Sons Ltd.

Highlights

Emotional responses to symptoms are likely to be an important influence on behavioural responses [1]
It is possible that a better understanding of the role of emotional responses could help explain some of the variation in help-seeking
Fear was identified as a key reason for delay, second only to not recognising the significance of the symptom [4]

Summary

Introduction

Emotional responses to symptoms are likely to be an important influence on behavioural responses [1]. There have been many studies in which patients/people diagnosed with cancer are asked to reflect back on how they responded to their first symptom, often focusing on delay in help-seeking. The fear was of cancer itself or its treatment or side effects, and included aspects of the help-seeking process (e.g. being seen as neurotic). Other studies have identified fear of investigations, and fear of diagnosis or treatment as risk factors for patient delay in upper gastrointestinal, colorectal, urological, gynaecological, and lung cancers [5]. Patients who recalled being more anxious when they detected a breast symptom tended to have sought help more promptly than those who had less of an emotional response [6]. A recent systematic review of studies with patients highlighted the mixed impact of emotions on time to presentation, concluding that more emotion-focused research was needed in order to unravel its complexity [8]

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Results

Conclusion