Eindwerk psycho-oncologie 2016-2018: Fear of cancer recurrence after breast and colorectal cancer treatment: reported optimism during treatment as a stable and resilient factor?

Previous research indicated fear of cancer recurrence (FCR) as one of the most prevalent reported unmet needs of cancer survivors. Despite these findings as well as the proven association of heightened FCR with negative consequences (e.g. more depressive symptoms), clinical care for cancer patients struggling with FCR is limited. Psychosocial support by caregivers is often provided during treatment, however, mostly is no longer present at the time FCR arises. As a result, research is needed to identify risk factors that can be detected during treatment, predicting the development of high levels of FCR. The aim of the present study was to examine the role of optimism during breast and colorectal cancer treatment in relation to FCR outcome. The time course of optimism as well as the predictive value of it towards FCR was examined. Next to the bidimensional approach of dispositional optimism and pessimism, the predictive value of situated optimism and pessimism towards illness and treatment was investigated.

Onderzoeksopzet

Breast and colorectal cancer patients (n = 11) undergoing curative treatment completed an adjusted version of the Life Orientation Test-Revised (LOT-R-NL) to measure dispositional and situated optimism as well as pessimism. Several months later, participants completed the LOT-R-NL for a second time as well as the Concerns about Recurrence Scale- questionnaire (CARS) to measure FCR. Friedman’s tests were used to examine stability of optimism and pessimism. A multiple regression analysis was performed to test for predictive values of optimism and pessimism.

Resultaten

The results confirmed the stability of dispositional and situated optimism as well as pessimism over a period of time from undergoing (T1) to after completion of curative treatment (T2). Regression analyses demonstrated that occurrence of higher FCR after treatment was directly predicted by higher situated pessimism during treatment, i.e. pessimism towards illness and treatment. Although dispositional and situated optimism were correlated with FCR, situated pessimism was found to be the only predictor of FCR.

Given the small sample size, the results of the current research do not represent a heterogeneous sample. As a result, significant findings can only be considered as valuable quantitative indications and trends. Hence, future research will be needed.

Klinische, maatschappelijke en/of wetenschappelijke relevantie

A considerable number of respondents of the present study reported high FCR scores and/or a need for help in dealing with FCR. Overall, the current study confirmed that more attention towards dealing with FCR is needed. The role of situated pessimism as predictor of FCR severity was highlighted, which may contribute to research regarding risk factors of FCR development. Based on such findings, appropriate screening tools may be developed. Furthermore, modifiable characteristics related to heightened FCR may help the development of interventions. Future research is needed to explore whether changes in, for example, situated pessimistic beliefs could reduce the development or maintenance of heightened FCR. Regarding future research, the current findings confirmed that using a bidimensional structure of optimism and pessimism as well as approaching dispositional and situated optimism/pessimism as separated factors can be valuable.