When fear of cancer recurrence becomes a clinical issue: a qualitative analysis of features associated with clinical fear of cancer recurrence.
PURPOSE
Fear of cancer recurrence (FCR) is a common experience for cancer survivors. However, it remains unclear what characteristics differentiate non-clinical from clinical levels of FCR. The goal of this study was to investigate the potential hallmarks of clinical FCR.


METHODS
A convenience sample of 40 participants (n = 19 female) was drawn from another study (Lebel et al. in Qual Life Res 25:311-321. doi: 10.1007/s11136-015-1088-2 , 2016). The semi-structured interview for fear of cancer recurrence (Simard and Savard in J Cancer Surviv 9:481-491. doi: 10.1007/s11764-015-0424-4 , 2015) was used to identify participants with non-clinical and clinical FCR and qualitative analysis of these interviews was performed.


RESULTS
Individuals with clinical FCR reported the following features: death-related thoughts, feeling alone, belief that the cancer would return, experiencing intolerance of uncertainty, having cancer-related thoughts and imagery that were difficult to control, daily and recurrent, lasted 30 minutes or more, increased over time, caused distress and impacted their daily life. Triggers of FCR and coping strategies did not appear to be features of clinical FCR as they were reported by participants with a range of FCR scores.


CONCLUSIONS
While features of clinical FCR found in this analysis such as intrusive thoughts, distress and impact on functioning confirmed previous FCR research, other features spontaneously emerged from the interviews including "death-related thoughts," "feeling alone," and "belief that the cancer will return." The participants' descriptions of cancer-specific fear and worry suggest that FCR is a distinct phenomenon related to cancer survivorship, despite similarities with psychological disorders (e.g., Anxiety Disorders). Future research investigating the construct of FCR, and the distinguishing features of clinical FCR across a range of cancer types and gender is required.
['Mutsaers|Brittany|B|', 'Jones|Georden|G|', 'Rutkowski|Nicole|N|', 'Tomei|Christina|C|', 'Séguin Leclair|Caroline|C|', 'Petricone-Westwood|Danielle|D|', 'Simard|Sébastien|S|', 'Lebel|Sophie|S|']
D000223:Adaptation, Psychological D000368:Aged D000369:Aged, 80 and over D001007:Anxiety D005239:Fear D005260:Female D006801:Humans D008297:Male D008875:Middle Aged D009364:Neoplasm Recurrence, Local D009369:Neoplasms D017741:Survivors
Fear of cancer recurrence Qualitative analysis Clinical fear of cancer recurrence Semi-structured interview Psychosocial oncology