Towards a Stepped Care Model for Managing Fear of Cancer Recurrence or Progression in Cancer Survivors

Poorva Pradhan, Louise Sharpe, Rachel E Menzies School of Psychology, Faculty of Science, The University of Sydney, Sydney, NSW, 2006, AustraliaCorrespondence: Louise SharpeSchool of Psychology, The University of Sydney, Sydney, NSW, 2006, AustraliaTel +61 93514558Email louise.sharpe@Sydney.edu.auBa...

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Autores principales:	Pradhan P, Sharpe L, Menzies RE
Formato:	article
Lenguaje:	EN
Publicado:	Dove Medical Press 2021
Materias:	cancer oncology fear of cancer recurrence fear of progression fcr interventions Neoplasms. Tumors. Oncology. Including cancer and carcinogens RC254-282
Acceso en línea:	https://doaj.org/article/84ecf2f9f2244946b89257ca2026f41f
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spelling	oai:doaj.org-article:84ecf2f9f2244946b89257ca2026f41f2021-12-02T19:17:36ZTowards a Stepped Care Model for Managing Fear of Cancer Recurrence or Progression in Cancer Survivors1179-1322https://doaj.org/article/84ecf2f9f2244946b89257ca2026f41f2021-12-01T00:00:00Zhttps://www.dovepress.com/towards-a-stepped-care-model-for-managing-fear-of-cancer-recurrence-or-peer-reviewed-fulltext-article-CMARhttps://doaj.org/toc/1179-1322Poorva Pradhan, Louise Sharpe, Rachel E Menzies School of Psychology, Faculty of Science, The University of Sydney, Sydney, NSW, 2006, AustraliaCorrespondence: Louise SharpeSchool of Psychology, The University of Sydney, Sydney, NSW, 2006, AustraliaTel +61 93514558Email louise.sharpe@Sydney.edu.auBackground: Fear of cancer recurrence or progression (FCR) is common amongst cancer survivors and an important minority develop clinically significant levels of FCR. However, it is unclear how current clinical services might best support the growing numbers of cancer survivors.Purpose: The aim of this study is to develop recommendations for future research in the management of FCR and propose a model of care to help manage FCR in the growing population of cancer survivors.Methods: This is a narrative review and synthesis of empirical research relevant to managing FCR. We reviewed meta-analyses, systematic reviews and individual studies that had investigated interventions for FCR.Results: A recent, well-conducted meta-analysis confirmed a range of moderately effective treatments for FCR. However, many survivors continued to experience clinical levels of FCR after treatment, indicating a clear need to improve the gold standard treatments. Accessibility of interventions is arguably a greater concern. The majority of FCR treatments require face-to-face therapy, with highly skilled psycho-oncologists to produce moderate changes in FCR. With increasing numbers of cancer survivors, we need to consider how to meet the unmet need of cancer survivors in relation to FCR. Although there have been attempts to develop minimal interventions, these are not yet sufficiently well supported to warrant implementation. Attempts to help clinicians to provide information which might prevent the development of clinically significant FCR have shown some early promise, but research is needed to confirm efficacy.Conclusion: The next decade of research needs to focus on developing preventative approaches for FCR, and minimal interventions for those with mild-to-moderate symptoms. When evidence-based approaches to prevent FCR or manage moderate levels of FCR are available, stepped care approaches that could meet the needs of survivors could be implemented. However, we also need to improve existing interventions for severe FCR.Keywords: cancer, oncology, fear of cancer recurrence, fear of progression, FCR interventionsPradhan PSharpe LMenzies REDove Medical Pressarticlecanceroncologyfear of cancer recurrencefear of progressionfcr interventionsNeoplasms. Tumors. Oncology. Including cancer and carcinogensRC254-282ENCancer Management and Research, Vol Volume 13, Pp 8953-8965 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	cancer oncology fear of cancer recurrence fear of progression fcr interventions Neoplasms. Tumors. Oncology. Including cancer and carcinogens RC254-282
spellingShingle	cancer oncology fear of cancer recurrence fear of progression fcr interventions Neoplasms. Tumors. Oncology. Including cancer and carcinogens RC254-282 Pradhan P Sharpe L Menzies RE Towards a Stepped Care Model for Managing Fear of Cancer Recurrence or Progression in Cancer Survivors
description	Poorva Pradhan, Louise Sharpe, Rachel E Menzies School of Psychology, Faculty of Science, The University of Sydney, Sydney, NSW, 2006, AustraliaCorrespondence: Louise SharpeSchool of Psychology, The University of Sydney, Sydney, NSW, 2006, AustraliaTel +61 93514558Email louise.sharpe@Sydney.edu.auBackground: Fear of cancer recurrence or progression (FCR) is common amongst cancer survivors and an important minority develop clinically significant levels of FCR. However, it is unclear how current clinical services might best support the growing numbers of cancer survivors.Purpose: The aim of this study is to develop recommendations for future research in the management of FCR and propose a model of care to help manage FCR in the growing population of cancer survivors.Methods: This is a narrative review and synthesis of empirical research relevant to managing FCR. We reviewed meta-analyses, systematic reviews and individual studies that had investigated interventions for FCR.Results: A recent, well-conducted meta-analysis confirmed a range of moderately effective treatments for FCR. However, many survivors continued to experience clinical levels of FCR after treatment, indicating a clear need to improve the gold standard treatments. Accessibility of interventions is arguably a greater concern. The majority of FCR treatments require face-to-face therapy, with highly skilled psycho-oncologists to produce moderate changes in FCR. With increasing numbers of cancer survivors, we need to consider how to meet the unmet need of cancer survivors in relation to FCR. Although there have been attempts to develop minimal interventions, these are not yet sufficiently well supported to warrant implementation. Attempts to help clinicians to provide information which might prevent the development of clinically significant FCR have shown some early promise, but research is needed to confirm efficacy.Conclusion: The next decade of research needs to focus on developing preventative approaches for FCR, and minimal interventions for those with mild-to-moderate symptoms. When evidence-based approaches to prevent FCR or manage moderate levels of FCR are available, stepped care approaches that could meet the needs of survivors could be implemented. However, we also need to improve existing interventions for severe FCR.Keywords: cancer, oncology, fear of cancer recurrence, fear of progression, FCR interventions
format	article
author	Pradhan P Sharpe L Menzies RE
author_facet	Pradhan P Sharpe L Menzies RE
author_sort	Pradhan P
title	Towards a Stepped Care Model for Managing Fear of Cancer Recurrence or Progression in Cancer Survivors
title_short	Towards a Stepped Care Model for Managing Fear of Cancer Recurrence or Progression in Cancer Survivors
title_full	Towards a Stepped Care Model for Managing Fear of Cancer Recurrence or Progression in Cancer Survivors
title_fullStr	Towards a Stepped Care Model for Managing Fear of Cancer Recurrence or Progression in Cancer Survivors
title_full_unstemmed	Towards a Stepped Care Model for Managing Fear of Cancer Recurrence or Progression in Cancer Survivors
title_sort	towards a stepped care model for managing fear of cancer recurrence or progression in cancer survivors
publisher	Dove Medical Press
publishDate	2021
url	https://doaj.org/article/84ecf2f9f2244946b89257ca2026f41f
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Towards a Stepped Care Model for Managing Fear of Cancer Recurrence or Progression in Cancer Survivors

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