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Educational intervention reduces fear of cancer recurrence in melanoma survivors
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A psychoeducational intervention program reduced fear of cancer recurrence among survivors of melanoma, according to results of a randomized controlled trial.
The intervention also increased patients’ melanoma-related knowledge.
“Studies show that, across cancer sites and assessment strategies, an average of 49% of cancer survivors report moderate to high levels of fear of cancer recurrence,” Mbathio Dieng, PhD, of the department of cancer epidemiology and prevention research at The Lifehouse in New South Wales, Australia, and colleagues wrote. “In patients with melanoma, we recently found that 72% with at least one previous melanoma reported levels of fear of cancer recurrence, which suggests a need for clinical intervention. Few studies have evaluated interventions designed to reduce fear of cancer recurrence in people with early-stage cancer. No studies have been developed specifically for people with melanoma.”
The analysis included 164 adults who had at least one (mean, 2.6) prior diagnosis of stage 0, I or II melanoma.
Investigators randomly assigned participants to usual care (n = 84) or a novel intervention that consisted of educational resources and three phone-based psychotherapeutic phone sessions during 1 month (n = 80).
Dieng and colleagues conducted assessments at baseline, 1 month and 6 months.
After 6 months, adults in the intervention group demonstrated a significantly lower Fear of Cancer Recurrence Inventory severity score than those in the control group (mean difference, –1.9 points; 95% CI, –3.1 to –0.7).
Those in the intervention group also had lower trigger scores (between-group mean difference: –2; 95% CI, –3.3 to –0.7) and distress scores (between-group mean difference: –0.7; 95% CI, –1.3 to –0.1).
The difference in cancer recurrence fear among those assigned the intervention persisted after adjustments for covariates (P = .04). However, after these adjustments, the differences in trigger scores and distress scores were no longer statistically significant.
Participants in the intervention group also reported lower levels of stress at 6 months (–1.6; 95% CI, –3.1 to –0.2), as well as better melanoma-related knowledge (1.7; 95% CI, 0.8-2.6).
The researchers acknowledged that additional research is needed to evaluate long-term efficacy, the impact on health-related quality of life, the effect for patients with higher-stage disease or other cancers, and the cost-effectiveness of the intervention.
“The persistence of positive effects 6 months after the intervention was completed suggests that participants developed confidence and skills to more effectively manage their fears and stress over the long term,” Dieng and colleagues wrote. “Initially, this intervention could be implemented in settings where ongoing dermatologic care is routinely provided for patients with melanoma.”
– by Andy Polhamus
Disclosure: Dieng reports no relevant financial disclosures. Please see the full study for a list of all other researchers’ relevant financial disclosures.
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