Revision of the fear of cancer recurrence cognitive and emotional model by Lee-Jones et al with women with breast cancer.

BACKGROUND: Fear of cancer recurrence (FCR) is among the top unmet concerns reported by breast cancer survivors. Despite the sizable literature on FCR, few theoretical models have been empirically tested. One of the most cited is the FCR model. AIM: This study seeks to understand the nature of women's cognitive and emotional issues from FCR using specific guidance from the model by Lee-Jones and to provide suggestions for modifications to the model based on empirical results from the reported experiences of women living with breast cancer. METHODS AND RESULTS: A qualitative descriptive study using semi-structured interviews was conducted at an urban hospital. Recruited by convenience sampling, 12 breast cancer survivors concerned with FCR and who had recently completed active treatment participated in the study. Seven thematic categories emerged from the women's descriptions of their cognitive and emotional experiences with FCR: (a) FCR is always there; (b) beliefs about risk of recurrence; (c) beliefs about eradication of cancer; (d) preferences not to seek information about recurrence; (e) derailment of normal life; (f) worries related to recurrence; and (g) need for support. Adjustments to the model by Lee-Jones et al1 specifically to women living with breast cancer include the addition of new variables-the fear is always present, a preference not to seek information, and the need for support beyond treatment-and the merging of two variables, anxiety and worry, as participants viewed these concepts as interchangeable and experienced in similar ways. Lastly, participants did not report any remorse related to not opting for more aggressive treatments. CONCLUSION: The refinement of a more comprehensive FCR theoretical model, such as through the modifications derived from this study, provides a deeper understanding of breast cancer survivors' experiences with FCR and can more effectively guide health care professionals to develop appropriately tailored interventions aimed at decreasing FCR levels.

Fear of cancer recurrence: A study of the experience of survivors of ovarian cancer.

PURPOSE: The purpose of this study is to better understand fear of cancer (FCR) through the experience of ovarian and fallopian tube cancer survivors. METHODS: This study used a descriptive qualitative design. Twelve participants in remission from ovarian or fallopian tube cancer were recruited. Researchers conducted face-to-face, semi-structured interviews and the content, transcribed verbatim, underwent content analysis. RESULTS: FCR has been identified as a significant concern for women in remission from ovarian cancer. Four themes emerged from the participants' FCR experience: (a) uncertainty surrounding recurrence; (b) varied beliefs and sources of worry; (c) perceived risk of recurrence; (d) management of FCR. IMPLICATIONS: Survivorship support can be optimized by nurses by screening for FCR, offering psychosocial support for women at risk for FCR, teaching and reinforcing adaptive coping strategies.