Fear of cancer recurrence in colorectal cancer survivors

José A E Custers, Marieke F M Gielissen, Stephanie H V Janssen, Johannes H W de Wilt, Judith B Prins, José A E Custers, Marieke F M Gielissen, Stephanie H V Janssen, Johannes H W de Wilt, Judith B Prins

Abstract

Purpose: Although long-term colorectal cancer (CRC) survivors generally report a good quality of life, fear of cancer recurrence (FCR) remains an important issue. This study investigated whether the Cancer Worry Scale (CWS) can detect high FCR, the prevalence, and characteristics of FCR in CRC survivors.

Methods: Two hundred and eleven patients who had undergone successful CRC surgery in the period 2003-2010 in the Radboud University Medical Center in the Netherlands were asked to participate. All patients were sent an information letter plus questionnaires for collecting information on demographic and medical variables, FCR, distress, and quality of life.

Results: Seventy-six patients (36 %; median age of 67.7 years range 41-88 years) completed the questionnaires a median of 5.1 years after surgery. A cut-off score of 14 or higher on the CWS was optimal to detect high FCR. Twenty-nine patients (38 %) experienced high levels of FCR, characterized by higher levels of distress, post-traumatic stress symptoms, and lower quality of life. These individuals particularly reacted to disease-related triggers, felt helpless, were worried, and experienced limitations in daily functioning. High FCR was not associated with demographic or medical variables.

Conclusion: Long after successful CRC surgery, FCR is a serious problem that impairs the quality of life for a substantial proportion of patients. With the CWS, it is possible to detect high FCR and thereby assist survivors in receiving appropriate care.

Keywords: Colorectal cancer; Fear of cancer recurrence; Oncology; Quality of life.

Figures

Fig. 1
Fig. 1
Receiving operating characteristics curve of Cancer Worry Scale (CWS) scores against the FCRI-SF ≥ 16. Labeled points correspond to the CWS scores as follows: 1: 8 versus 9; 2: 9 versus 10; 3: 10 versus 11; 4: 11 versus 12; 5: 12 versus 13; 6: 13 versus 14; 7: 14 versus 15; 8: 15 versus 16; 9: 16 versus 17; 10: 17 versus 18; 11: 18 versus 19; 12: 20 versus 21; 13: 22 versus 23; 14: 23 versus 24

References

    1. van Erning FN, van Steenbergen LN, Lemmens VE, Rutten HJ, Martijn H, van Spronsen DJ, et al. Conditional survival for long-term colorectal cancer survivors in the Netherlands: who do best? Eur J Cancer. 2014;50:1731–9. doi: 10.1016/j.ejca.2014.04.009.
    1. Bouvier AM, Jooste V, Bonnetain F, Cottet V, Bizollon MH, Bernard MP, et al. Adjuvant treatments do not alter the quality of life in elderly patients with colorectal cancer: a population-based study. Cancer. 2008;113:879–86. doi: 10.1002/cncr.23629.
    1. Gall CA, Weller D, Esterman A, Pilotto L, McGorm K, Hammett Z, et al. Patient satisfaction and health-related quality of life after treatment for colon cancer. Dis Colon Rectum. 2007;50:801–9. doi: 10.1007/s10350-006-0815-8.
    1. Wilson TR, Alexander DJ, Kind P. Measurement of health-related quality of life in the early follow-up of colon and rectal cancer. Dis Colon Rectum. 2006;49:1692–702. doi: 10.1007/s10350-006-0709-9.
    1. Smith-Gagen J, Cress RD, Drake CM, Romano PS, Yost KJ, Ayanian JZ. Quality-of-life and surgical treatments for rectal cancer—a longitudinal analysis using the California Cancer Registry. Psychooncology. 2010;19:870–8. doi: 10.1002/pon.1643.
    1. Jansen L, Koch L, Brenner H, Arndt V (2010) Quality of life among long-term (≥5 years) colorectal cancer survivors—systematic review. Eur J Cancer 46:2879–88
    1. Wallner C, Lange MM, Bonsing BA, Maas CP, Wallace CN, Dabhoiwala NF, et al. Causes of fecal and urinary incontinence after total mesorectal excision for rectal cancer based on cadaveric surgery: a study from the Cooperative Clinical Investigators of the Dutch total mesorectal excision trial. J Clin Oncol. 2008;26:4466–72. doi: 10.1200/JCO.2008.17.3062.
    1. Santin O, Murray L, Prue G, Gavin A, Gormley G, Donnelly M. Self-reported psychosocial needs and health-related quality of life of colorectal cancer survivors. Eur J Oncol Nurs. 2015
    1. Vickberg SM. The Concerns About Recurrence Scale (CARS): a systematic measure of women’s fears about the possibility of breast cancer recurrence. Ann Behav Med. 2003;25:16–24. doi: 10.1207/S15324796ABM2501_03.
    1. Lee-Jones C, Humphris G, Dixon R, Hatcher MB. Fear of cancer recurrence—a literature review and proposed cognitive formulation to explain exacerbation of recurrence fears. Psychooncology. 1997;6:95–105. doi: 10.1002/(SICI)1099-1611(199706)6:2<95::AID-PON250>;2-B.
    1. Simard S, Thewes B, Humphris G, Dixon M, Hayden C, Mireskandari S, et al. Fear of cancer recurrence in adult cancer survivors: a systematic review of quantitative studies. J Cancer Surviv. 2013;7:300–22. doi: 10.1007/s11764-013-0272-z.
    1. Hodges LJ, Humphris GM. Fear of recurrence and psychological distress in head and neck cancer patients and their carers. Psychooncology. 2009;18:841–48. doi: 10.1002/pon.1346.
    1. Simard S, Savard J, Ivers H. Fear of cancer recurrence: specific profiles and nature of intrusive thoughts. J Cancer Surviv. 2010;4:361–71. doi: 10.1007/s11764-010-0136-8.
    1. Skaali T, Fossa SD, Bremnes R, Dahl O, Haaland CF, Hauge ER, et al. Fear of recurrence in long-term testicular cancer survivors. Psychooncology. 2009;18:580–88. doi: 10.1002/pon.1437.
    1. Cannon AJ, Darrington DL, Reed EC, Loberiza FR., Jr Spirituality, patients’ worry, and follow-up health-care utilization among cancer survivors. J Support Oncol. 2011;9:141–48. doi: 10.1016/j.suponc.2011.03.001.
    1. Mikkelsen T, Sondergaard J, Sokolowski I, Jensen A, Olesen F. Cancer survivors’ rehabilitation needs in a primary health care context. Fam Pract. 2009;26:221–30. doi: 10.1093/fampra/cmp004.
    1. Deimling GT, Bowman KF, Sterns S, Wagner LJ, Kahana B. Cancer-related health worries and psychological distress among older adult, long-term cancer survivors. Psychooncology. 2006;15:306–20. doi: 10.1002/pon.955.
    1. Phipps E, Braitman LE, Stites S, Leighton JC. Quality of life and symptom attribution in long-term colon cancer survivors. J Eval Clin Pract. 2008;14:254–58. doi: 10.1111/j.1365-2753.2007.00842.x.
    1. Mullens AB, McCaul KD, Erickson SC, Sandgren AK. Coping after cancer: risk perceptions, worry, and health behaviors among colorectal cancer survivors. Psychooncology. 2004;13:367–76. doi: 10.1002/pon.751.
    1. Baker F, Denniston M, Smith T, West MM. Adult cancer survivors: how are they faring? Cancer. 2005;104(S11):2565–76. doi: 10.1002/cncr.21488.
    1. Steele N, Haigh R, Knowles G, Mackean M. Carcinoembryonic antigen (CEA) testing in colorectal cancer follow up: what do patients think? Postgrad Med J. 2007;83:612–14. doi: 10.1136/pgmj.2007.059634.
    1. Simard S, Savard J. Screening and comorbidity of clinical levels of fear of cancer recurrence. J Cancer Surviv. 2015
    1. Custers JAE, van den Berg SW, van Laarhoven HWM, Bleiker EMA, Gielissen MFM, Prins JB. The cancer worry scale: detecting fear of recurrence in breast cancer survivors. Cancer Nurs. 2014;37:E44–50. doi: 10.1097/NCC.0b013e3182813a17.
    1. Douma KFL, Aaronson NK, Vasen HFA, Gerritsma MA, Gundy CM, Janssen EP, et al. Psychological distress and use of psychosocial support in familial adenomatous polyposis. Psychooncology. 2010;19:289–98. doi: 10.1002/pon.1570.
    1. Simard S, Savard J. Fear of cancer recurrence inventory: development and initial validation of a multidimensional measure of fear of cancer recurrence. Support Care Cancer. 2009;17:241–51. doi: 10.1007/s00520-008-0444-y.
    1. Van der Ploeg E, Mooren TT, Kleber RJ, van der Velden PG, Brom D. Construct validation of the Dutch version of the impact of event scale. Psychol Assess. 2004;16:16–26. doi: 10.1037/1040-3590.16.1.16.
    1. Horowitz M, Wilner N, Alvarez W. Impact of Event Scale: a measure of subjective stress. Psychosom Med. 1979;41:209–18. doi: 10.1097/00006842-197905000-00004.
    1. Vodermaier A, Millman RD. Accuracy of the Hospital Anxiety and Depression Scale as screening tool in cancer patients: a systematic review and meta-analysis. Support Care Cancer. 2011;19:1899–908. doi: 10.1007/s00520-011-1251-4.
    1. Spinhoven PH, Ormel J, Sloekers PPA, Kempen GIJM, Speckens AEM, van Hemert AM. A validation study of the Hospital Anxiety and Depression Scale (HADS) in different groups of Dutch subjects. Psychol Med. 1997;27:363–370. doi: 10.1017/S0033291796004382.
    1. Aaronson N, Ahmedzai A, Bergman B, Bullinger M, Cull A, Duez NJ, et al. The European Organization for Research and Treatment of Cancer QLQ-C30: a quality-of-life instrument for use in international clinical trials in oncology. J Natl Cancer Inst. 1993;85:365–76. doi: 10.1093/jnci/85.5.365.
    1. Sprangers MA, Te Velde A, Aaronson NK. The construction and testing of the EORTC colorectal cancer-specific quality of life questionnaire module (QLQ-CR38). European Organization for Research and Treatment of Cancer Study Group on Quality of Life. Eur J Cancer. 1999;35:238–47. doi: 10.1016/S0959-8049(98)00357-8.
    1. Osoba D, Rodrigues G, Myles J, Zee B, Pater J. Interpreting the significance of changes in health-related quality-of-life scores. J Clin Oncol. 1998;16:139–44.
    1. Weintraub D, Oehlberg KA, Katz IR, Stern MB. Test characteristics of the 15-item geriatric depression scale and Hamilton depression rating scale in Parkinson disease. Am J Geriatr Psychiatry. 2006;14:169–175. doi: 10.1097/01.JGP.0000192488.66049.4b.
    1. Kangas M, Henry JL, Bryant RA. The relationship between acute stress disorder and posttraumatic stress disorder following cancer. J Consult Clin Psychol. 2005;73:360–64. doi: 10.1037/0022-006X.73.2.360.
    1. Lebel S, Rosberger Z, Edgar L, Devins GM. Comparison of four common stressors across the breast cancer trajectory. J Psychosom Res. 2007;63:225–32. doi: 10.1016/j.jpsychores.2007.02.002.
    1. McNally RJ. Progress and controversy in the study of posttraumatic stress disorder. Annu Rev Psychol. 2003;54:229–52. doi: 10.1146/annurev.psych.54.101601.145112.
    1. Whitaker KL, Brewin CR, Watson M. Intrusive cognitions and anxiety in cancer patients. J Psychosom Res. 2008;64:509–17. doi: 10.1016/j.jpsychores.2008.02.009.
    1. Whitaker KL, Watson M, Brewin CR. Intrusive cognitions and their appraisal in anxious cancer patients. Psychooncology. 2009;18:1147–55. doi: 10.1002/pon.1512.
    1. Borkovec TD, Robinson E, Pruzinsky T, DePree JA. Preliminary exploration of worry: some characteristics and processes. Behav Res Ther. 1983;21:9–16. doi: 10.1016/0005-7967(83)90121-3.
    1. Rachman S. A cognitive theory of obsessions. Behav Res Ther. 1997;35:793–802. doi: 10.1016/S0005-7967(97)00040-5.
    1. Herschbach P, Berg P, Waadt S, Duran G, Engst-Hastreiter U, Henrich G, Book K, Dinkel A. Group psychotherapy of dysfunctional fear of progression in patients with chronic arthritis or cancer. Psychother Psychosom. 2010;79:31–8. doi: 10.1159/000254903.
    1. Herschbach P, Book K, Dinkel A, Berg P, Waadt S, Duran G, Engst-Hastreiter U, Hendrick G. Evaluation of two group therapies to reduce fear of progression in cancer patients. Support Care Cancer. 2010;18:471–479. doi: 10.1007/s00520-009-0696-1.
    1. Lebel S, Maheu C, Lefebvre M, Secord S, Courbasson C, Singh M, Jolicoeur L, Benea A, Harris C, Fung Kee Fung M, Rosberger Z, Catton P. Addressing fear of cancer recurrence among women with cancer: a feasibility and preliminary outcome study. J Cancer Surviv. 2014;8:485–496. doi: 10.1007/s11764-014-0357-3.
    1. Van de Wal MA, Gielissen MFM, Speckens AS, Prins JB. Managing fear of cancer recurrence with the SWORD study (Survivors’ Worries Of Recurrent Disease) Psycho-Oncology. 2013;22(Suppl 3):342.
    1. Integraal Kankercentrum Nederland. Cijfers over kanker. Bron: Nederlandse Kankerregistratie, beheerd door IKNL© [Januari] (2015) Incidentie_darmkanker/img54dded375b587. Accessed 12 January 2015

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