SUMO-3 promotes the ubiquitin-dependent turnover of TRIM55.

Human muscle-specific RING fingers (MURFs) are members of the tripartite motif (TRIM) family of proteins characterized by their C-terminal subgroup one signature domain. MURFs play a role in sarcomere formation and microtubule dynamics. It was previously established that some TRIMs undergo post-translational modification by small ubiquitin-like modifier (SUMO). In this study, we explored the putative SUMOylation of MURF proteins as well as their interactions with SUMO. MURF proteins (TRIM54, TRIM55, and TRIM63) were not found to be SUMOylated. However, TRIM55 turnover by proteasomal and lysosomal degradation was higher upon overexpression of SUMO-3 but not of SUMO-1. Furthermore, it is predicted that TRIM55 contains two potential SUMO-interacting motifs (SIMs). We found that SIM1- and SIM2-mutated TRIM55 were more stable than the wild-type (WT) protein partly due to decreased degradation. Consistently, SIM-mutated TRIM55 was less polyubiquitinated than the WT protein, despite similar monoubiquitination levels. Using IF microscopy, we observed that SIM motifs influenced TRIM55 subcellular localization. In conclusion, our results suggest that SUMO-3 or SUMO-3-modified proteins modulate the localization, stability, and RING ubiquitin ligase activity of TRIM55.

The Ottawa clinical fear of recurrence instruments: A screener, self-report, and clinical interview.

OBJECTIVE: Clinical fear of cancer recurrence (FCR) was recently defined by a group of experts during a Delphi study. Five criteria were agreed upon, namely: (a) high levels of preoccupation, (b) high levels of worry, (c) that are persistent, (d) hypervigilance and hypersensitivity to physical sensations that e) may result in functional impairment. No existing instruments comprehensively capture all these criteria for clinical FCR. METHODS: To remedy this gap, a set of three patient-reported outcome instruments including a one-item screener, self-report questionnaire, and semi-structured clinical interview, named the Ottawa Clinical Fear of Recurrence instruments, were developed. To do so, the research team first conducted a literature review of potential items. Additional FCR experts discussed the content of the screener and interview. The self-report's items were assessed for content validity by the same expert panel using Likert ratings and the Content Validity Index to narrow down the number of items. The three instruments were piloted with a group of cancer survivors to assess face validity following the European Organization for Research and Treatment of Cancer recommendations. RESULTS: The literature review and content validity assessment led to a final draft pre-pilot of 23 potential items for the self-report questionnaire. The instruments were piloted. Pilot study participants suggested changing wording and response options (particularly for the self-report) for greater clarity. CONCLUSIONS: Based on the feedback received, minor modifications were made, mostly for the self-report. In general, content and face validity for the three instruments were good for both experts and cancer survivors.

Incidence, factors, and disparities related to cancer among Black individuals in Canada: A scoping review.

BACKGROUND: In Canada, two of five individuals will be diagnosed with cancer in their lifetime and one in four will die from this disease. Given the disparities observed in health research among Black individuals, we conducted a scoping review to analyze the state of cancer research in Canadian Black communities regarding prevalence, incidence, screening, mortality, and related factors to observe advances and identify gaps and disparities. METHODS: A comprehensive search strategy was developed and executed in December 2021 across 10 databases (e.g., Embase). Of 3451 studies generated by the search, 19 were retained for extraction and included in this study. RESULTS: Studies were focused on a variety of cancer types among Black individuals including anal, breast, cervical, colorectal, gastric, lung, and prostate cancers. They included data on incidence, stage of cancer at diagnosis, type of care received, diagnostic interval length, and screening. A few studies also demonstrated racial disparities among Black individuals. This research reveals disparities in screening, incidence, and quality of care among Black individuals in Canada. CONCLUSIONS: Given the gaps observed in cancer studies among Black individuals, federal and provincial governments and universities should consider creating special funds to generate research on this important health issue. PLAIN LANGUAGE SUMMARY: Important gaps were observed on research on cancer among Black communities in Canada. Studies included in the scoping review highlights disparities in screening, incidence, and quality of care among Black individuals in Canada.

A new landscape in illness uncertainty: A systematic review and thematic synthesis of the experience of uncertainty in patients with advanced cancer receiving immunotherapy or targeted therapy.

OBJECTIVE: Over the past 20 years, immunotherapy and targeted therapy (TT) have been extending the life expectancy and providing hope for a growing number of patients with advanced and metastatic cancer. However, the efficacy, side effects, and overall prognosis of these treatments are highly unpredictable. Recent research suggests that these patients may be experiencing significant uncertainty which impacts their functioning. This study reviewed the literature on the experiences of uncertainty for individuals with advanced or metastatic cancer patients who are receiving immunotherapy or TT. METHOD: A systematic literature review was conducted. Data was extracted from studies by pairs of reviewers. Literature quality was appraised using the Critical Appraisal Skills Program checklist. Following data extraction, thematic synthesis was used to summarize findings across studies and generate overarching themes. RESULTS: Fifteen qualitative studies were included. Findings highlighted impacts of various sources of uncertainty (financial, emotional, social), unmet needs related to uncertainty (practical, informational, communication), and recommendations for the management of uncertainty. Clinical implications and study limitations were indicated. CONCLUSIONS: Findings were situated within Mishel's Uncertainty in Illness Theory and the literature on supportive care for advanced cancer populations. Recommendations related to improving healthcare provider communication and balancing hope and expectations for treatment outcomes were highlighted. Further research is needed to investigate experiences of uncertainty in this population. Tailored interventions for uncertainty may be warranted.

Patient quality of life and caregiver experiences in ovarian cancer: How are they related?

PURPOSE: Patients with ovarian cancer and their spousal caregivers report similarities in health-related quality of life (HRQoL) and experiences throughout the cancer process. Previous research has reflected these shared experiences, demonstrating caregivers' capacity to accurately rate their patient-partner's HRQoL as a proxy. In response, this study examines associations between caregivers' perceptions of their patient-partner's HRQoL and their own caregiving responsibilities, consequences to well-being, and desired assistance from the healthcare system. This study will be beneficial when developing supports to assist caregivers throughout the cancer journey. METHODS: Using a cross-sectional survey design, spousal caregivers (N = 82) of patients with ovarian cancer completed measures on perceived patient HRQoL and caregiver experiences. Correlation analyses determined medical and sociodemographic covariates. A multivariate multiple regression was conducted using four proxy HRQoL functioning subscales and three factors of reported experiences as caregivers in cancer. Post-hoc univariate regression analyses were run on significant factors to assess the associations that exist. RESULTS: Caregiver-perceived patient physical functioning was significantly associated with more caregiving tasks after controlling for education, age, and stage of ovarian cancer, but no other HRQoL functioning scale (i.e., role, emotional, social) was associated with caregiver experiences. CONCLUSION: The study provides a unique perspective into the caregiver experience by attending to interpersonal factors in relation to caregiver experiences. Results may be able to guide interventions aimed at supporting caregivers through the cancer process by offering more assistance with tasks as their partner's physical condition worsens.

An evaluation of the Interdisciplinary Psychosocial Oncology Research Group and Laboratory: An initiative to enable intersectoral and interdisciplinary collaboration.

Background: Psychosocial oncology (PSO) is an interdisciplinary field that is often practised and researched in disciplinary silos. The Interdisciplinary PSO Research Group and Laboratory (IPSORGL) was developed in Ottawa (Ontario) to foster interdisciplinary collaboration and training amongst trainees, healthcare professionals (HCPs), and researchers. Methods: The research team conducted an implementation and outcome evaluation of the IPSORGL. Data were collected using sequential mixed methods, including surveys and interviews. Results: Eight trainees, six HCPs, and five researchers completed the survey. Six trainees and four HCPs participated in an interview. Benefits of the IPSORGL included establishing interdisciplinary connections and collaborations and obtaining unique training in a supportive environment. Challenges included members' differing preferences for meeting formats and content, and difficulties prioritizing the IPSORGL over other academic or clinical demands. Conclusions: The IPSORGL fosters essential interdisciplinary training and collaboration, which bolsters psychosocial oncology research and practice. The sustainability of such initiatives, however, requires formal institutional support.

An investigation of fear of recurrence, attachment and caregiving experiences among ovarian cancer partner-caregivers.

OBJECTIVE: Fear of cancer recurrence (FCR) is a common concern for both cancer patients and their caregivers. Attachment insecurity is an established contributor to poorer mental health, particularly as it relates to social support. This study sought to evaluate whether attachment and caregiver experiences in cancer care were predictors of FCR. METHODS: A cross-sectional questionnaire study involving partner-caregivers of patients with ovarian cancer was conducted. Correlation analyses and multiple hierarchical regressions were used to determine the roles of attachment and caregiving experiences in cancer care on FCR, including the possible moderating role of attachment on the relationship between caregiving experiences and FCR. RESULTS: Participants (n = 82), mostly identified as white men, had post-secondary education and incomes of over $100,000 CAD, and cared for patients with advanced ovarian cancer. Forty percent of participants had clinically elevated FCR. Among the evaluated caregiving experiences in cancer care, caregiving workload (r = 0.33; p = 0.005), needing more help from healthcare providers (r = 0.28; p = 0.02), and lacking time for social relations because of caregiving (r = 0.47; p < 0.001) correlated with FCR. Attachment anxiety correlated significantly with FCR (r = 0.43; p < 0.001), but attachment avoidance did not. Attachment anxiety (ΔR2  = 0.14; p = 0.002) and lacking time for social relations (ΔR2  = 0.18; p < 0.001) contributed to the variance on FCR. Attachment insecurity did not moderate the relationships between caregiving experiences and FCR. CONCLUSIONS: Partner-caregiver attachment anxiety correlates with FCR; however, this does not influence FCR's relationship with poorer perceived support from cancer care institutions. Partner-caregivers may benefit from psychotherapies for FCR and more practical support from cancer care teams.

What is the prevalence of fear of cancer recurrence in cancer survivors and patients? A systematic review and individual participant data meta-analysis.

OBJECTIVE: Care for fear of cancer recurrence (FCR) is considered the most common unmet need among cancer survivors. Yet the prevalence of FCR and predisposing factors remain inconclusive. To support targeted care, we provide a comprehensive overview of the prevalence and severity of FCR among cancer survivors and patients, as measured using the short form of the validated Fear of Cancer Recurrence Inventory (FCRI-SF). We also report on associations between FCR and clinical and demographic characteristics. METHODS: This is a systematic review and individual participant data (IPD) meta-analysis on the prevalence of FCR. In the review, we included all studies that used the FCRI-SF with adult (≥18 years) cancer survivors and patients. Date of search: 7 February 2020. Risk of bias was assessed using the Joanna Briggs Institute critical appraisal tool. RESULTS: IPD were requested from 87 unique studies and provided for 46 studies comprising 11,226 participants from 13 countries. 9311 respondents were included for the main analyses. On the FCRI-SF (range 0-36), 58.8% of respondents scored ≥13, 45.1% scored ≥16 and 19.2% scored ≥22. FCR decreased with age and women reported more FCR than men. FCR was found across cancer types and continents and for all time periods since cancer diagnosis. CONCLUSIONS: FCR affects a considerable number of cancer survivors and patients. It is therefore important that healthcare providers discuss this issue with their patients and provide treatment when needed. Further research is needed to investigate how best to prevent and treat FCR and to identify other factors associated with FCR. The protocol was prospectively registered (PROSPERO CRD42020142185).

What do partners of patients with ovarian cancer need from the healthcare system? An examination of caregiving experiences in the healthcare setting and reported distress.

PURPOSE: Ovarian cancer is typically characterized by late-stage diagnoses, frequent recurrences, and treatment changes. Ovarian cancer caregivers (OCC) are thus heavily involved with cancer care and often are highly distressed. METHODS: We explored the relationship with OCC distress and caregiving experiences within the healthcare system and with the healthcare providers (HCP), using a cross-sectional questionnaire study. OCC provided sociodemographic and patient medical information, and completed measures of consequences of caregiving and needs from HCP, and of depression and anxiety. We recruited participants through advertisements and two cancer centers. RESULTS: N = 82 OCC provided complete questionnaires. Participants on average were 57.2 years old, English-speaking white men, and were partnered for 28.5 years. On average, patients were diagnosed at stage III, and treated with surgery and chemotherapy. Eight percent met clinical cut-offs for depression (23.2% in sub-clinical range), and 23.2% met clinical cut-offs for anxiety (20.7% in sub-clinical range). Depression and anxiety were significantly correlated with lacking time for social relationships, higher workload, lacking information, and needing more help from HCP. Only depression was correlated with problematic quality of information from HCP. CONCLUSIONS: OCC distress is related to their caregiving roles within the cancer care system, and how HCP support them in their responsibilities, which may contribute to a lack of time to access their supports. Perceived involvement by the HCP has an important influence on OCC distress. Higher demands of caregiving and insufficient support from the cancer care system may relate to increased distress. Our study supports the need for better integration of caregiver supports from within the healthcare system.

Standardized versus personalized survivorship care plans for breast cancer survivors: A program evaluation.

The Wellness Beyond Cancer Program provides survivorship care plans (SCPs) to cancer survivors, as they transition from cancer centres back to their primary care provider (PCP) upon treatment completion. A program evaluation examined whether standardized SCPs resulted in comparable outcomes on perceived knowledge and patient activation as personalized SCPs. Breast cancer survivors who received either standardized or personalized SCPs completed pre- and post-surveys during their discharge appointment, which included an in-house measure on perceived knowledge, The Perceived Efficacy in Patient-Physician Interactions, and The Patient Activation Measure. Eighty-seven breast cancer survivors completed the surveys (personalized SCP n = 43; standardized SCP n = 44). Standardized SCPs resulted in comparable knowledge and activation outcomes as personalized SCPs. Cost-efficient standardized SCPs may help alleviate human resource constraints and may be considered for further evaluation and implementation in cancer centres.

An evaluation of a cancer survivorship education class for follow-up care.

The Wellness Beyond Cancer Program is part of a tertiary care hospital in Ontario, Canada. It provides cancer survivors with information and resources needed to self-manage their follow-up care (i.e., learn relevant information and skills to adapt to life with a chronic illness) after active cancer treatment (i.e., chemotherapy, radiation). A program evaluation was conducted on the two-hour survivorship education class (one component of the overall Wellness Beyond Cancer Program) with the purpose of evaluating whether attendance increased survivors' perceived knowledge and intent to self-manage follow-up care. Breast (n = 107) and colorectal (n = 38) cancer survivors who attended classes completed questionnaires on information needs and intent to self-manage pre- and postclass. Perceived increase in knowledge and intent to self-manage follow-up care were unrelated to age, gender, or time since diagnosis. After attending the class, survivors reported increased knowledge (F(1,11) = 144.6, p < .001) and intent to participate in self-management of their follow-up care (F(1,103) = 57.3, p < .001). Improvements in knowledge predicted increased intent to self-manage (R2 = .64; F(4,86) = 38.5, p < .001). Colorectal cancer survivors showed greater improvement in intent to self-manage than breast cancer survivors (ß = .14, t = 2.2, p < .05). These results can inform the development and implementation of future education classes for survivors.

The FCR-1: Initial validation of a single-item measure of fear of cancer recurrence.

OBJECTIVE: Fear of cancer recurrence (FCR) is characterized by the fear, worry or concern that cancer will come back or progress. The negative effects associated with FCR are consistently identified by cancer survivors as one of their most prominent unmet needs. Current measures of FCR can be long, complex and burdensome for survivors to complete. The objective of the present study is to develop and validate a one-item measure of FCR. METHODS: The ability of the FCR-1 to detect change in FCR over time was analyzed using a repeated-measures ANOVA and paired-samples t-tests. Pearson correlations were used to measure the concurrent, convergent and discriminant validity of the FCR-1, and a ROC analysis was conducted to determine an optimal clinical cut-off score. RESULTS: The FCR-1 was found to be responsive to change in FCR over time. It demonstrated concurrent validity with the FCRI (r = .395, P = .010), and convergent validity with the Mishel Uncertainty in Illness Scale (r = .493, P = .001) and the Reassurance Questionnaire (r = .325, P = .044). Discriminant validity was confirmed when the FCR-1 did not significantly correlate with unrelated measures. A ROC analysis pinpointed an optimal clinical cut-off score of 45.0. CONCLUSIONS: The FCR-1 is a promising tool that can be incorporated in clinical and research settings. Due to its brevity, the care needs of highly distressed patients can be met quickly and efficiently. In research settings, the FCR-1 can reduce the cognitive burden experienced by survivors.

Identifying the key characteristics of clinical fear of cancer recurrence: An international Delphi study.

OBJECTIVE: Without an agreed-upon set of characteristics that differentiate clinical from nonclinical levels of fear of cancer recurrence (FCR), it is difficult to ensure that FCR severity is appropriately measured, and that those in need of intervention are identified. The objective of this study was to establish expert consensus on the defining features of clinical FCR. METHOD: A three-round Delphi was used to reach consensus on the defining features of clinical FCR. Sixty-five experts in FCR (researchers, psychologists, physicians, nurses, and allied health professionals) were recruited to suggest and rate potential features of clinical FCR. Participants who indicated they could communicate diagnoses within their clinical role were also asked to consider the application of established DSM-5 and proposed ICD-11 diagnostic criteria (Health Anxiety, Illness Anxiety Disorder, Somatic Symptom Disorder) to clinical FCR. RESULTS: Participants' ratings suggested that the following four features are key characteristics of clinical FCR: (a) high levels of preoccupation; (b) high levels of worry; (c) that are persistent; and (d) hypervigilance to bodily symptoms. Of participants whose professional role allowed them to diagnose mental disorders, 84% indicated it would be helpful to diagnose clinical FCR, but the use of established diagnostic criteria related to health anxiety or somatic-related disorders to clinical FCR was not supported. This suggests that participants consider clinical FCR as a presentation that is specific to cancer survivors. CONCLUSION: Clinical FCR was conceptualized as a multidimensional construct. Further research is needed to empirically validate the proposed defining features.

Smoking versus quitting and fear of cancer recurrence 9 years after diagnosis in the American Cancer Society's Longitudinal Study of Cancer Survivors-I (SCS-I).

BACKGROUND: Fear of cancer recurrence (FCR) adversely affects quality of life. Cigarette smoking increases the risk of recurrence and may exacerbate FCR among survivors who smoke. FCR also may motivate quitting, but research on whether quitting reduces long-term survivors' FCR is lacking. Among long-term survivors of various cancers, the authors investigated relationships between quitting (vs smoking) and FCR, controlling for sociodemographic, cancer-related, and health-related variables. METHODS: Data from the American Cancer Society's Longitudinal Study of Cancer Survivors-I were used in generalized estimating equations to compare FCR at 3 waves (T1-T3) after diagnosis between 2 groups; survivors who reported current smoking (n = 196) approximately 9 years after diagnosis (at T3) or who, based on T3 recall of quitting age, had quit smoking after diagnosis (n = 97). T3 cross-sectional analyses among current smokers examined associations of FCR with smoking level and intentions of quitting. RESULTS: A significant smoking status × time interaction (P = .003) indicated that only quitters experienced decreases in FCR from T1 to T3 (P = .007). At T3, FCR was significantly lower among quitters than among current smokers (P = .05), and current smokers reported that FCR caused more functioning impairments (eg, disruption of relationships, everyday activities, mood) than quitters (P = .001). Cross-sectional analyses (T3) among smokers found that heavier smoking predicted less attempts to cope with FCR (P = .04) and that reassurance behaviors (eg, self-examination for cancer) predicted stronger quitting intentions (P = .02). CONCLUSIONS: Quitting smoking lowers FCR, and FCR may disrupt functioning among continuing smokers. Interventions for FCR should be multimodal and should treat both psychological distress and health-related behaviors such as smoking.

A Systematic Review of Interventions for Health Anxiety Presentations Across Diverse Chronic Illnesses.

PURPOSE: Health anxiety (HA) is associated with reduced quality of life among individuals with chronic illnesses. However, little is known about effective interventions for reducing HA in this context. This study aimed to comprehensively review the literature on interventions for the treatment of HA in chronic illness. METHODS: This study was conducted as part of a larger systematic review on HA among individuals diagnosed with a chronic illness, using literature published between January 1996 and October 2017. A total of 51 articles were selected as they reported on interventions with pre-post measures and described the impact of the intervention on HA. RESULTS: The data on psychotherapy (CBT, third-wave CBT, and mindfulness), patient education, and rehabilitation programs demonstrated effectiveness in cancer and cardiac patients. Exercise interventions demonstrated effectiveness in patients with Parkinson's disease, and medical interventions showed limited effectiveness in reducing HA in diabetes and epilepsy. Most interventions yielding significant outcomes were at least 6 to 8 weeks long. CONCLUSIONS: The literature supports that a variety of interventions may be effective in reducing HA in individuals with chronic illness. Future research should test single interventions across several illnesses, as well as several interventions within a single illness to better understand how HA can be managed across chronic illnesses.

Exploring the screening capacity of the Fear of Cancer Recurrence Inventory-Short Form for clinical levels of fear of cancer recurrence.

OBJECTIVE: Fear of cancer recurrence (FCR) is a common concern among cancer survivors. Identifying survivors with clinically significant FCR requires validated screening measures and clinical cut-offs. We evaluated the Fear of Cancer Recurrence Inventory-Short Form (FCRI-SF) clinical cut-off in 2 samples. METHODS: Level of FCR in study 1 participants (from an Australian randomized controlled trial: ConquerFear) was compared with FCRI-SF scores. Based on a biopsychosocial interview, clinicians rated participants as having nonclinical, subclinical, or clinical FCR. Study 2 participants (from a Canadian FCRI-English validation study) were classified as having clinical or nonclinical FCR by using the semistructured clinical interview for FCR (SIFCR). Receiver operating characteristic analyses evaluated the screening ability of the FCRI-SF against clinician ratings (study 1) and the SIFCR (study 2). RESULTS: In study 1, 167 cancer survivors (mean age: 53 years, SD = 10.1) participated. Clinicians rated 43% as having clinical FCR. In study 2, 40 cancer survivors (mean age: 68 years, SD = 7.0) participated; 25% met criteria for clinical FCR according to the SIFCR. For both studies 1 and 2, receiver operating characteristic analyses suggested a cut-off ≥22 on the FCRI-SF identified cancer survivors with clinical levels of FCR with adequate sensitivity and specificity. CONCLUSIONS: Establishing clinical cut-offs on FCR screening measures is crucial to tailoring individual care and conducting rigorous research. Our results suggest using a higher cut-off on the FCRI-SF than previously reported to identify clinically significant FCR. Continued evaluation and validation of the FCRI-SF cut-off is required across diverse cancer populations.

Towards the validation of a new, blended theoretical model of fear of cancer recurrence.

OBJECTIVE: Fear of cancer recurrence (FCR) is defined as "fear, worry, or concern about cancer returning or progressing". To date, only the seminal model proposed by Lee-Jones and colleagues has been partially validated, so additional model testing is critical to inform intervention efforts. The purpose of this study is to examine the validity of a blended model of FCR that integrates Leventhal's Common Sense Model, Mishel's Uncertainty in Illness Theory, and cognitive theories of worry. METHODS: Participants (n = 106) were women diagnosed with stage I to III breast or gynecological cancer who were enrolled in a Randomized Controlled Trial of a group cognitive-existential intervention for FCR. We report data from standardized questionnaires (Fear of Cancer Recurrence Inventory-Severity and Triggers subscales; Illness Uncertainty Scale; perceived risk of recurrence; Intolerance of Uncertainty Scale; Why do people Worry about Health questionnaire; Reassurance-seeking Behaviors subscale of the Health Anxiety Questionnaire, and the Reassurance Questionnaire) that participants completed before randomization. Path analyses were used to test the model. RESULTS: Following the addition of four paths, the model showed an excellent fit (χ2 = 13.39, P = 0.20; comparative fit index = 0.99; root mean square error of approximation = 0.06). Triggers, perceived risk of recurrence, and illness uncertainty predicted FCR. FCR was associated with maladaptive coping. Positive beliefs about worrying and intolerance of uncertainty did not predict FCR but led to more maladaptive coping. CONCLUSIONS: These results provide support for a blended FCR model.

Examining the preliminary efficacy of an intervention for fear of cancer recurrence in female cancer survivors: a randomized controlled clinical trial pilot study.

PURPOSE: Among cancer survivors, fear of cancer recurrence (FCR) is the most frequently reported unmet need. Despite this, research on psychosocial interventions that target FCR is limited. To address this gap, an individual cognitive-existential psychotherapy intervention for FCR was pilot tested via small-scale RCT. METHODS: Participants were recruited via study posters, healthcare professionals' referrals, and an electronic hospital database. Twenty-five female cancer survivors were randomized to experimental or wait-list control groups. Sessions included cognitive restructuring techniques, behavioral experiments, discussion of existential concerns, and relaxation exercises. Nineteen women completed the 6-week intervention and completed questionnaire packages at various time points. All participants completed self-administered questionnaires at pre-intervention (T1), post-intervention (T2), and at 3-month follow-up (T3). Participants in the control group also completed the same questionnaires, including at baseline (T0). RESULTS: Statistically significant results of between-within ANOVAs included time by condition interactions in the primary outcome measure of FCR and, for the experimental group participants, time by condition interactions in the secondary outcome measures of cancer-specific distress and uncertainty in illness. Statistically significant results of repeated measures ANOVAs included reductions in FCR, cancer-specific distress, uncertainty in illness, reassurance seeking, cognitive avoidance, and intolerance of uncertainty, as well as improvements in positive reinterpretation and growth, emotional coping, and quality of life (improved mental health), when compared to the control group. Most changes were maintained at 3-month follow-up. CONCLUSIONS: This intervention responds to a need for evidence-based individual modality interventions targeting quality of life in cancer survivors. Our results demonstrate preliminary promising results in addressing FCR in female cancer survivors. Future research could seek to replicate results with a larger sample. Further research is needed to test this intervention with patients of mixed cancer sites.