1: Cognitive behaviour therapy can reduce fear of recurrence in cancer patients
Fear of cancer recurrence (FCR) is one of the most common concerns for cancer patients and affects up to a third of men with prostate cancer. Despite this, there have been few controlled trials that test strategies to meet this unmet need. While there is evidence that cognitive behaviour therapy (CBT) may be a promising strategy, it is a resource and time-intensive intervention. To address these challenges the Dutch SWORD trial randomised 88 cancer survivors (breast (41%), prostate (34%) and colorectal (25%)) to blended CBT (bCBT), composed of a mixture of face to face and web-based consultations, or no intervention for the control group (care as usual). All participants had completed treatment between 6 months to 5 years previously and had FCR, defined as a score ≥14 on the Cancer Worry Scale. FCR and other measures of distress were collected at baseline and at 3 months.
At baseline, FCR was similar for both groups (Cancer Worry Scale mean score 19.6) but after 3 months was significantly reduced for the bCBT compared to the control group (15.2 vs 18.7). Secondary measures such as severity, distress, global quality of life and emotional functioning were also significantly improved in the bCBT compared to the control group. These results are particularly impressive when considering the fact that a third of bCBT participants did not complete all sessions. Overall, almost one third (29%) of bCBT participants demonstrated clinically significant improvement, while no participants in the control group did.
This was a small study and results may vary in larger or different population settings or if the therapy is led by more diverse/less experienced counsellors. However, this study represents an important first step in providing evidence for treatments that could be used to support patients with FCR.