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Pilot of a novel theoretically derived intervention for cancer-related anxiety with patients with advanced or recurred disease

Published online by Cambridge University Press:  01 October 2020

Leah Curran*
Affiliation:
School of Psychology, University of Sydney, Brennan MacCallum Building A18, Manning Road, Camperdown, Sydney, New South Wales, NSW 2050, Australia The Kinghorn Cancer Centre, St Vincent’s Healthcare Network, Sydney, NSW, Australia
Louise Sharpe
Affiliation:
School of Psychology, University of Sydney, Brennan MacCallum Building A18, Manning Road, Camperdown, Sydney, New South Wales, NSW 2050, Australia
Phyllis Butow
Affiliation:
School of Psychology, University of Sydney, Brennan MacCallum Building A18, Manning Road, Camperdown, Sydney, New South Wales, NSW 2050, Australia PoCoG & CeMPED, School of Psychology, University of Sydney, Sydney, NSW, Australia SoURCe, Institute of Surgery, Sydney, NSW, Australia
*
*Corresponding author. Email: lcur6474@sydney.edu.au

Abstract

Background:

Treatments for cancer-related anxiety show modest benefits, but most have been trialled in patients with early stage disease or patients who are currently disease free. However, many patients with cancer have incurable disease, or their disease is slowly progressing or likely to recur. Treating anxiety in the context of realistic threat and ongoing uncertainty is particularly challenging. Based on a theoretical model of cancer-related anxiety, we developed a transdiagnostic intervention for patients with advanced or recurred disease who are experiencing clinically significant anxieties. The intervention was a novel integration of traditional and contemporary CBT.

Aims:

To evaluate the feasibility, acceptability and preliminary efficacy of the intervention in a pilot with patients with advanced or recurred cancer.

Method:

Twelve patients with advanced or recurred cancer, who were experiencing anxiety, participated. Feasibility and acceptability were assessed with participant’s ratings and adherence and retention rates. Psychological outcomes (anxiety, traumatic symptoms, fear of progression, depression, death anxiety and quality of life) were assessed pre-intervention, post-intervention and at 2-month follow-up.

Results:

Eleven of the 12 participants completed at least five therapy sessions of whom eight completed all nine sessions. Participants rated the intervention as having excellent face validity. Post-intervention, statistically significant improvements were demonstrated for anxiety, traumatic symptoms, fear of progression, depression and quality of life. These improvements were maintained at follow-up for anxiety, traumatic symptoms and depression.

Conclusions:

This pilot provides preliminary evidence for the feasibility, acceptability and effectiveness of the novel intervention for cancer-related anxiety in the context of advanced disease.

Type
Brief Clinical Report
Copyright
© British Association for Behavioural and Cognitive Psychotherapies 2020

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References

Butow, P. N., Turner, J., Gilchrist, J., Sharpe, L., Smith, A. B., Fardell, J. E., … & Thewes, B. (2017). Randomized trial of ConquerFear: a novel, theoretically based psychosocial intervention for fear of cancer recurrence. Journal of Clinical Oncology, 35, 40664077. https://ascopubs.org/doi/10.1200/JCO.2017.73.1257 CrossRefGoogle ScholarPubMed
Curran, L., Sharpe, L., & Butow, P. (2017). Anxiety in the context of cancer: a systematic review and development of an integrated model. Clinical Psychology Reviews, 56, 4054. https://doi.org/10.1016/j.cpr.2017.06.003 CrossRefGoogle ScholarPubMed
Kang, K. A., Han, S. J., Lim, Y. S., & Kim, S. J. (2019). Meaning-centered interventions for patients with advanced or terminal cancer: a meta-analysis. Cancer Nursing, 42, 332340. https://doi.org/10.1097/NCC.0000000000000628 CrossRefGoogle ScholarPubMed
Mehnert, A., Brähler, E., Faller, H., Härter, M., Keller, M., Schulz, H., … & Hund, B. (2014). Four-week prevalence of mental disorders in patients with cancer across major tumor entities. Journal of Clinical Oncology, 32, 35403546. https://doi.org/10.1200/JCO.2014.56.0086 CrossRefGoogle ScholarPubMed
Sanjida, S., McPhail, S. M., Shaw, J., Couper, J., Kissane, D., Price, M. A., & Janda, M. (2018). Are psychological interventions effective on anxiety in cancer patients? A systematic review and meta-analyses. Psycho-Oncology, 27, 20632076. https://doi.org/10.1002/pon.4794 CrossRefGoogle ScholarPubMed
Simard, S., & Savard, J. (2015). Screening and comorbidity of clinical levels of fear of cancer recurrence. Journal of Cancer Survivorship, 9, 481491. https://doi.org/10.1007/s11764-015-0424-4 CrossRefGoogle ScholarPubMed
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