Systematic review of interventions by non-mental health specialists for managing fear of cancer recurrence in adult cancer survivors.

Abstract

Fear of cancer recurrence (FCR) affects 50-70% of cancer survivors. Evidence-based psychological interventions for FCR are effective but resource-/time-consuming. This systematic review identified interventions by non-mental health specialists addressing FCR, evidence of a relationship between specialist communication and FCR and stakeholder perspectives on how specialist communication can address FCR. A systematic literature review was conducted using nine databases (Medline Ovid, EMBASE, Cochrane, CINAHL, Scopus, PsychINFO, Informit, Web of Science and Google Scholar). Included studies were English, published 1997-2018, on adult cancer patients examining 'fear'/'worry' and 'cancer recurrence'/'progression' and 'health communication'/'medical encounter'/'interventions'. Data was extracted, summarised and rated for quality by two authors. Of 6248 articles screened, 16 were included. No phase III randomised controlled trials were found. Five studies piloted an intervention, three were correlational studies, five were cross-sectional patient surveys and three were specialist surveys. Four out of five interventional studies were nurse-led: one trained patients in discussing FCR with their specialist while three delivered supportive counselling and/or taught strategies to manage FCR. The last intervention trained mixed health professionals to manage FCR through normalisation, education and lifestyle strategies. Three intervention studies measured FCR objectively, and two demonstrated a reduction in FCR in the short term. Consultation duration, empathy and clear information delivery were associated with FCR. Patients indicated desire to discuss FCR; however, specialists indicated discomfort with managing FCR. Research on non-mental health practitioner-led interventions to address FCR is lacking. Further studies on whether specialist interventions delivered during follow-up consultations are useful in managing FCR are required.