Rapid Fire Best of the Best Poster Oral Clinical Oncology Society of Australia Annual Scientific Meeting 2022

Evaluation of the Fear-Less self-management intervention for managing fear of cancer recurrence (#118)

Mei Jun Tran 1 , Michael Jefford 2 3 4 , Ben Smith 5 , Haryana Dhillon 6 7 , Lachlan McDowell 8 , Joanne Shaw 6 , Fiona Lynch 1 9 , Alan White 10 11 , Clare Halloran 10 , Orla McNally 12 13 14 , David Wiesenfeld 15 16 17 , Maria Ftanou 1 18
  1. Psychosocial Oncology Program, Peter MacCallum Cancer Centre, Parkville, VIC, Australia
  2. Australian Cancer Survivorship Centre, Melbourne, VIC, Australia
  3. Department of Health Services Research, Peter MacCallum Cancer Centre, Melbourne, VIC, Australia
  4. Sir Peter MacCallum Department of Oncology, The University of Melbourne, Melbourne, VIC, Australia
  5. Ingham Institute for Applied Medical Research and South West Sydney Clinical Campuses, University of New South Wales, Sydney, NSW, Australia
  6. Psycho-oncology Co-operative Research Group, University of Sydney, Sydney, NSW , Australia
  7. Centre for Medical Psychology and Evidence-Based Decision-Making, University of Sydney, Sydney, NSW , Australia
  8. Department of Radiation Oncology, Peter MacCallum Cancer Centre, Melbourne, VIC, Australia
  9. Andrew Love Cancer Centre, Barwon Health, Geelong, VIC, Australia
  10. Consumer Representative, Peter MacCallum Cancer Centre, Melbourne, VIC, Australia
  11. Consumer Representative, Continence Foundation of Australia, Melbourne, VIC, Australia
  12. Oncology and Dysplasia Unit, The Royal Women's Hospital, Melbourne, VIC, Australia
  13. Gynaecological Cancer Tumour Stream, Peter MacCallum Cancer Centre, Melbourne, VIC, Australia
  14. Department of Obstetrics and Gynaecology, University of Melbourne, Melbourne, VIC, Australia
  15. Head and Neck Tumour Stream, The Royal Melbourne Hospital, Melbourne, VIC, Australia
  16. Research and Education Head and Neck, VCCC Alliance, Melbourne, VIC, Australia
  17. The University of Melbourne, Melbourne, VIC, Australia
  18. Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, VIC, Australia

Aims: Assistance managing fear of cancer recurrence (FCR) is a significant unmet need for cancer survivors. Existing FCR treatments are efficacious, but resource intensive. Evidence-based interventions that can support large numbers of survivors are needed. This study assessed the acceptability and preliminary efficacy of a clinician-guided self-management intervention for FCR, within a stepped-care framework.

Methods: Survivors of breast, head and neck, or gynaecological cancer, who had completed curative treatment were screened for FCR using the Fear of Cancer Recurrence Inventory – Short Form (FCRI-SF) and Fear of Cancer Recurrence – 1 Item Measure (FCR-1) at three metropolitan hospitals. Survivors experiencing moderate FCR (mFCR) were offered a purpose-developed self-management resource (Fear-Less booklet) with two follow-up phone calls, while those experiencing severe FCR (sFCR) were offered individual therapy. Re-screening and evaluation measures were completed after five weeks. Acceptability was assessed by engagement with the Fear-Less resource (reading ≥75% of the booklet). Efficacy was assessed by a meaningful (≥10%) reduction on FCRI-SF scores at re-screening.

Results: 53 survivors were screened. 19 had mFCR and 20 had sFCR. 11 of 19 with mFCR accepted the intervention, 8 declined (felt they were coping with FCR). An additional 9 with sFCR declined individual therapy but accepted self-management. Of 20 commencing self-management, 18 have completed and been re-screened to date.

14 of 18 (78%) participants reported reading ≥75% of the Fear-Less resource, with 11 of 18 (61%) showing a meaningful reduction on the FCRI-SF at re-screening. Among participants with sFCR who completed re-screening, 4 of 7 (57%) reported reading ≥75% of the resource and 5 (71%) showed a meaningful reduction on the FCRI-SF.

Conclusions: The Fear-Less self-management intervention appears acceptable to survivors and is potentially efficacious, including among individuals reporting sFCR. Guided self-management may be a suitable option for supporting survivors experiencing FCR requiring limited healthcare resources.

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