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After medical treatment for cancer, the majority of patients experience fear or worry that the cancer will return or progress. Fear of cancer recurrence (FCR) is a normal reaction after cancer, but approximately 20% of patients experience high fear that does not decrease over time and severely impacts daily life. High FCR often remains undetected, and oncology professionals report a need for tools to timely identify these individuals to refer them to adequate psychological help.
The research group from the department of Medical Psychology (Esther Deuning-Smit, José Custers and Judith Prins) in collaboration with the department of IQ healthcare (Rosella Hermens) conducted a study to evaluate the suitability of the Distress Thermometer to detect high FCR. The Distress Thermometer includes a thermometer on which patients rate the level of distress (0-10) and a problem list, with items in in 5 life domains. The emotional domain contains a ‘fears’ item. The results were published in Psycho-Oncology in February 2023.
Sensitivity analyses were performed with data from breast- and colorectal cancer survivors who completed the Distress Thermometer. The Dutch Cancer Worry Scale‐6 was used as reference measure for high FCR. The results showed that the thermometer score could not discriminate between individuals with low and high FCR. Additionally, most individuals with high FCR did not select the fears item. Also the emotional domain score had no acceptable cut-off to identify high FCR.
While the Distress Thermometer is currently recommended in oncology care guidelines for distress screening, it is not suitable to detect FCR. This might be related to the fact that distress is a very broad construct while FCR is a specific problem. To improve patients access to psychosocial care, it is essential to implement FCR‐specific measures into routine follow-up care. Furthermore, it is important to raise more awareness about FCR amongst doctors and patients in order to normalize FCR in clinical consultations and to help clinicians recognize patients with high FCR in need for support.
Publication
Deuning-Smit, E, Custers, JAE, Kwakkenbos, L, Hermens, RPMG, Prins, JB. Evaluating the capacity of the distress thermometer to detect high fear of cancer recurrence. Psychooncology. 2023; 32( 2): 266- 274.
