Acceptance and commitment therapy for breast cancer survivors with fear of cancer recurrence: A 3‐arm pilot randomized controlled trial
Background Fear of cancer recurrence (FCR) has a profound negative impact on quality of life (QOL) for many cancer survivors. Breast cancer survivors (BCS) are particularly vulnerable, with up to 70% reporting clinically significant FCR. To the authors' knowledge, evidence‐based interventions f...
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| Veröffentlicht in: | Cancer 2020-01, Vol.126 (1), p.211-218 |
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| creator | Johns, Shelley A. Stutz, Patrick V. Talib, Tasneem L. Cohee, Andrea A. Beck‐Coon, Kathleen A. Brown, Linda F. Wilhelm, Laura R. Monahan, Patrick O. LaPradd, Michelle L. Champion, Victoria L. Miller, Kathy D. Giesler, R. Brian |
| description | Background
Fear of cancer recurrence (FCR) has a profound negative impact on quality of life (QOL) for many cancer survivors. Breast cancer survivors (BCS) are particularly vulnerable, with up to 70% reporting clinically significant FCR. To the authors' knowledge, evidence‐based interventions for managing FCR are limited. Acceptance and commitment therapy (ACT) promotes psychological flexibility in managing life's stressors. The current study examined the feasibility and preliminary efficacy of group‐based ACT for FCR in BCS.
Methods
Post‐treatment BCS (91 patients with stage I‐III disease) with clinical FCR randomly were assigned to ACT (6 weekly 2‐hour group sessions), survivorship education (SE; 6 weekly 2‐hour group sessions), or enhanced usual care (EUC; one 30‐minute group coaching session with survivorship readings). FCR severity (primary outcome) and avoidant coping, anxiety, post‐traumatic stress, depression, QOL, and other FCR‐related variables (secondary outcomes) were assessed at baseline (T1), after the intervention (T2), 1 month after the intervention (T3), and 6 months after the intervention (T4) using intent‐to‐treat analysis.
Results
Satisfactory recruitment (43.8%) and retention (94.5%) rates demonstrated feasibility. Although each arm demonstrated within‐group reductions in FCR severity over time, only ACT produced significant reductions at each time point compared with baseline, with between‐group differences at T4 substantially favoring ACT over SE (Cohen d for effect sizes, 0.80; P |
| doi_str_mv | 10.1002/cncr.32518 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_pubme</sourceid><recordid>TN_cdi_pubmedcentral_primary_oai_pubmedcentral_nih_gov_6906228</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>2323465319</sourcerecordid><originalsourceid>FETCH-LOGICAL-c4488-1b89610a510a876002195cc4f391333b4e34a3720d4761fb09685e1c85f3faa83</originalsourceid><addsrcrecordid>eNp9kU1rFTEUhoNU7G114w8ogW5EmJrPmYyLwuXiFxQFUXAXMrkZb8rMZDzJ3HJddevO3-gvMeNtS3XhIuQczsN7zsuL0FNKzigh7IUdLJxxJql6gBaU1FVBqGAHaEEIUYUU_MshOorxMrcVk_wROuRU8pqW9QL9WFrrxmQG67AZ1tiGvvepd0PCaePAjDvcBsANOBMTtjMHOE6w9dsAEV_5tMGtM4BDezsFZycAl-uXeIn5r-ufBno8-i4kDHlH6P13N28aEoSuy2UCb7rH6GFruuie3PzH6PPrV59Wb4uLD2_erZYXhRVCqYI2qi4pMTI_VZXZP62ltaLNhjjnjXBcGF4xshZVSduG1KWSjlolW94ao_gxOt_rjlPTu7XNVsF0egTfG9jpYLz-ezL4jf4atrqsScnYLPDsRgDCt8nFpHsfres6M7gwRc1YLYXilPCMnv6DXoYJhmxPM864KCWndaae7ykLIUZw7d0xlOg5YT0nrP8knOGT--ffobeRZoDugSvfud1_pPTq_erjXvQ3_7yzog</addsrcrecordid><sourcetype>Open Access Repository</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>2323465319</pqid></control><display><type>article</type><title>Acceptance and commitment therapy for breast cancer survivors with fear of cancer recurrence: A 3‐arm pilot randomized controlled trial</title><source>MEDLINE</source><source>Wiley Online Library Journals Frontfile Complete</source><source>Wiley Online Library Free Content</source><source>EZB-FREE-00999 freely available EZB journals</source><source>Alma/SFX Local Collection</source><creator>Johns, Shelley A. ; Stutz, Patrick V. ; Talib, Tasneem L. ; Cohee, Andrea A. ; Beck‐Coon, Kathleen A. ; Brown, Linda F. ; Wilhelm, Laura R. ; Monahan, Patrick O. ; LaPradd, Michelle L. ; Champion, Victoria L. ; Miller, Kathy D. ; Giesler, R. Brian</creator><creatorcontrib>Johns, Shelley A. ; Stutz, Patrick V. ; Talib, Tasneem L. ; Cohee, Andrea A. ; Beck‐Coon, Kathleen A. ; Brown, Linda F. ; Wilhelm, Laura R. ; Monahan, Patrick O. ; LaPradd, Michelle L. ; Champion, Victoria L. ; Miller, Kathy D. ; Giesler, R. Brian</creatorcontrib><description>Background
Fear of cancer recurrence (FCR) has a profound negative impact on quality of life (QOL) for many cancer survivors. Breast cancer survivors (BCS) are particularly vulnerable, with up to 70% reporting clinically significant FCR. To the authors' knowledge, evidence‐based interventions for managing FCR are limited. Acceptance and commitment therapy (ACT) promotes psychological flexibility in managing life's stressors. The current study examined the feasibility and preliminary efficacy of group‐based ACT for FCR in BCS.
Methods
Post‐treatment BCS (91 patients with stage I‐III disease) with clinical FCR randomly were assigned to ACT (6 weekly 2‐hour group sessions), survivorship education (SE; 6 weekly 2‐hour group sessions), or enhanced usual care (EUC; one 30‐minute group coaching session with survivorship readings). FCR severity (primary outcome) and avoidant coping, anxiety, post‐traumatic stress, depression, QOL, and other FCR‐related variables (secondary outcomes) were assessed at baseline (T1), after the intervention (T2), 1 month after the intervention (T3), and 6 months after the intervention (T4) using intent‐to‐treat analysis.
Results
Satisfactory recruitment (43.8%) and retention (94.5%) rates demonstrated feasibility. Although each arm demonstrated within‐group reductions in FCR severity over time, only ACT produced significant reductions at each time point compared with baseline, with between‐group differences at T4 substantially favoring ACT over SE (Cohen d for effect sizes, 0.80; P < .001) and EUC (Cohen d, 0.61; P < .01). For 10 of 12 secondary outcomes, only ACT produced significant within‐group reductions across all time points. By T4, significant moderate to large between‐group comparisons favored ACT over SE and EUC with regard to avoidant coping, anxiety, depression, QOL, and FCR‐related psychological distress.
Conclusions
Group‐based ACT is a feasible and promising treatment for FCR and associated outcomes in BCS that warrants testing in larger, fully powered trials.
Evidence‐based interventions to treat survivors' fear of cancer recurrence are limited. This pilot study supports the feasibility and preliminary efficacy of acceptance and commitment therapy for the fear of cancer recurrence among breast cancer survivors.</description><identifier>ISSN: 0008-543X</identifier><identifier>EISSN: 1097-0142</identifier><identifier>DOI: 10.1002/cncr.32518</identifier><identifier>PMID: 31539169</identifier><language>eng</language><publisher>United States: Wiley Subscription Services, Inc</publisher><subject>acceptance and commitment therapy (ACT) ; Adult ; Aged ; Anxiety ; Anxiety - drug therapy ; Anxiety - epidemiology ; Anxiety - pathology ; Breast - pathology ; Breast cancer ; breast neoplasms ; Breast Neoplasms - drug therapy ; Breast Neoplasms - epidemiology ; Breast Neoplasms - pathology ; Breast Neoplasms - psychology ; Cancer ; Cancer Survivors ; Clinical trials ; Depression - drug therapy ; Depression - epidemiology ; Depression - pathology ; Fear ; Fear - psychology ; Feasibility studies ; Female ; Humans ; Intervention ; Involuntary Commitment ; Mental depression ; Middle Aged ; Neoplasm Recurrence, Local - drug therapy ; Neoplasm Recurrence, Local - pathology ; Neoplasm Recurrence, Local - prevention & control ; Neoplasm Recurrence, Local - psychology ; Neoplasm Staging ; Oncology ; Phobic Disorders - drug therapy ; Phobic Disorders - epidemiology ; Phobic Disorders - pathology ; Quality of Life ; Stress Disorders, Post-Traumatic - complications ; Stress Disorders, Post-Traumatic - epidemiology ; Stress Disorders, Post-Traumatic - pathology ; Stress Disorders, Post-Traumatic - psychology ; Survival ; survivorship ; Therapy</subject><ispartof>Cancer, 2020-01, Vol.126 (1), p.211-218</ispartof><rights>2019 American Cancer Society</rights><rights>2019 American Cancer Society.</rights><rights>2020 American Cancer Society</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c4488-1b89610a510a876002195cc4f391333b4e34a3720d4761fb09685e1c85f3faa83</citedby><cites>FETCH-LOGICAL-c4488-1b89610a510a876002195cc4f391333b4e34a3720d4761fb09685e1c85f3faa83</cites><orcidid>0000-0003-2731-7641 ; 0000-0002-6153-0713 ; 0000-0001-7928-6491 ; 0000-0001-5730-1822</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://onlinelibrary.wiley.com/doi/pdf/10.1002%2Fcncr.32518$$EPDF$$P50$$Gwiley$$H</linktopdf><linktohtml>$$Uhttps://onlinelibrary.wiley.com/doi/full/10.1002%2Fcncr.32518$$EHTML$$P50$$Gwiley$$H</linktohtml><link.rule.ids>230,314,776,780,881,1411,1427,27903,27904,45553,45554,46387,46811</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/31539169$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Johns, Shelley A.</creatorcontrib><creatorcontrib>Stutz, Patrick V.</creatorcontrib><creatorcontrib>Talib, Tasneem L.</creatorcontrib><creatorcontrib>Cohee, Andrea A.</creatorcontrib><creatorcontrib>Beck‐Coon, Kathleen A.</creatorcontrib><creatorcontrib>Brown, Linda F.</creatorcontrib><creatorcontrib>Wilhelm, Laura R.</creatorcontrib><creatorcontrib>Monahan, Patrick O.</creatorcontrib><creatorcontrib>LaPradd, Michelle L.</creatorcontrib><creatorcontrib>Champion, Victoria L.</creatorcontrib><creatorcontrib>Miller, Kathy D.</creatorcontrib><creatorcontrib>Giesler, R. Brian</creatorcontrib><title>Acceptance and commitment therapy for breast cancer survivors with fear of cancer recurrence: A 3‐arm pilot randomized controlled trial</title><title>Cancer</title><addtitle>Cancer</addtitle><description>Background
Fear of cancer recurrence (FCR) has a profound negative impact on quality of life (QOL) for many cancer survivors. Breast cancer survivors (BCS) are particularly vulnerable, with up to 70% reporting clinically significant FCR. To the authors' knowledge, evidence‐based interventions for managing FCR are limited. Acceptance and commitment therapy (ACT) promotes psychological flexibility in managing life's stressors. The current study examined the feasibility and preliminary efficacy of group‐based ACT for FCR in BCS.
Methods
Post‐treatment BCS (91 patients with stage I‐III disease) with clinical FCR randomly were assigned to ACT (6 weekly 2‐hour group sessions), survivorship education (SE; 6 weekly 2‐hour group sessions), or enhanced usual care (EUC; one 30‐minute group coaching session with survivorship readings). FCR severity (primary outcome) and avoidant coping, anxiety, post‐traumatic stress, depression, QOL, and other FCR‐related variables (secondary outcomes) were assessed at baseline (T1), after the intervention (T2), 1 month after the intervention (T3), and 6 months after the intervention (T4) using intent‐to‐treat analysis.
Results
Satisfactory recruitment (43.8%) and retention (94.5%) rates demonstrated feasibility. Although each arm demonstrated within‐group reductions in FCR severity over time, only ACT produced significant reductions at each time point compared with baseline, with between‐group differences at T4 substantially favoring ACT over SE (Cohen d for effect sizes, 0.80; P < .001) and EUC (Cohen d, 0.61; P < .01). For 10 of 12 secondary outcomes, only ACT produced significant within‐group reductions across all time points. By T4, significant moderate to large between‐group comparisons favored ACT over SE and EUC with regard to avoidant coping, anxiety, depression, QOL, and FCR‐related psychological distress.
Conclusions
Group‐based ACT is a feasible and promising treatment for FCR and associated outcomes in BCS that warrants testing in larger, fully powered trials.
Evidence‐based interventions to treat survivors' fear of cancer recurrence are limited. This pilot study supports the feasibility and preliminary efficacy of acceptance and commitment therapy for the fear of cancer recurrence among breast cancer survivors.</description><subject>acceptance and commitment therapy (ACT)</subject><subject>Adult</subject><subject>Aged</subject><subject>Anxiety</subject><subject>Anxiety - drug therapy</subject><subject>Anxiety - epidemiology</subject><subject>Anxiety - pathology</subject><subject>Breast - pathology</subject><subject>Breast cancer</subject><subject>breast neoplasms</subject><subject>Breast Neoplasms - drug therapy</subject><subject>Breast Neoplasms - epidemiology</subject><subject>Breast Neoplasms - pathology</subject><subject>Breast Neoplasms - psychology</subject><subject>Cancer</subject><subject>Cancer Survivors</subject><subject>Clinical trials</subject><subject>Depression - drug therapy</subject><subject>Depression - epidemiology</subject><subject>Depression - pathology</subject><subject>Fear</subject><subject>Fear - psychology</subject><subject>Feasibility studies</subject><subject>Female</subject><subject>Humans</subject><subject>Intervention</subject><subject>Involuntary Commitment</subject><subject>Mental depression</subject><subject>Middle Aged</subject><subject>Neoplasm Recurrence, Local - drug therapy</subject><subject>Neoplasm Recurrence, Local - pathology</subject><subject>Neoplasm Recurrence, Local - prevention & control</subject><subject>Neoplasm Recurrence, Local - psychology</subject><subject>Neoplasm Staging</subject><subject>Oncology</subject><subject>Phobic Disorders - drug therapy</subject><subject>Phobic Disorders - epidemiology</subject><subject>Phobic Disorders - pathology</subject><subject>Quality of Life</subject><subject>Stress Disorders, Post-Traumatic - complications</subject><subject>Stress Disorders, Post-Traumatic - epidemiology</subject><subject>Stress Disorders, Post-Traumatic - pathology</subject><subject>Stress Disorders, Post-Traumatic - psychology</subject><subject>Survival</subject><subject>survivorship</subject><subject>Therapy</subject><issn>0008-543X</issn><issn>1097-0142</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2020</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp9kU1rFTEUhoNU7G114w8ogW5EmJrPmYyLwuXiFxQFUXAXMrkZb8rMZDzJ3HJddevO3-gvMeNtS3XhIuQczsN7zsuL0FNKzigh7IUdLJxxJql6gBaU1FVBqGAHaEEIUYUU_MshOorxMrcVk_wROuRU8pqW9QL9WFrrxmQG67AZ1tiGvvepd0PCaePAjDvcBsANOBMTtjMHOE6w9dsAEV_5tMGtM4BDezsFZycAl-uXeIn5r-ufBno8-i4kDHlH6P13N28aEoSuy2UCb7rH6GFruuie3PzH6PPrV59Wb4uLD2_erZYXhRVCqYI2qi4pMTI_VZXZP62ltaLNhjjnjXBcGF4xshZVSduG1KWSjlolW94ao_gxOt_rjlPTu7XNVsF0egTfG9jpYLz-ezL4jf4atrqsScnYLPDsRgDCt8nFpHsfres6M7gwRc1YLYXilPCMnv6DXoYJhmxPM864KCWndaae7ykLIUZw7d0xlOg5YT0nrP8knOGT--ffobeRZoDugSvfud1_pPTq_erjXvQ3_7yzog</recordid><startdate>20200101</startdate><enddate>20200101</enddate><creator>Johns, Shelley A.</creator><creator>Stutz, Patrick V.</creator><creator>Talib, Tasneem L.</creator><creator>Cohee, Andrea A.</creator><creator>Beck‐Coon, Kathleen A.</creator><creator>Brown, Linda F.</creator><creator>Wilhelm, Laura R.</creator><creator>Monahan, Patrick O.</creator><creator>LaPradd, Michelle L.</creator><creator>Champion, Victoria L.</creator><creator>Miller, Kathy D.</creator><creator>Giesler, R. Brian</creator><general>Wiley Subscription Services, Inc</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7TO</scope><scope>7U7</scope><scope>C1K</scope><scope>H94</scope><scope>K9.</scope><scope>NAPCQ</scope><scope>7X8</scope><scope>5PM</scope><orcidid>https://orcid.org/0000-0003-2731-7641</orcidid><orcidid>https://orcid.org/0000-0002-6153-0713</orcidid><orcidid>https://orcid.org/0000-0001-7928-6491</orcidid><orcidid>https://orcid.org/0000-0001-5730-1822</orcidid></search><sort><creationdate>20200101</creationdate><title>Acceptance and commitment therapy for breast cancer survivors with fear of cancer recurrence: A 3‐arm pilot randomized controlled trial</title><author>Johns, Shelley A. ; Stutz, Patrick V. ; Talib, Tasneem L. ; Cohee, Andrea A. ; Beck‐Coon, Kathleen A. ; Brown, Linda F. ; Wilhelm, Laura R. ; Monahan, Patrick O. ; LaPradd, Michelle L. ; Champion, Victoria L. ; Miller, Kathy D. ; Giesler, R. Brian</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c4488-1b89610a510a876002195cc4f391333b4e34a3720d4761fb09685e1c85f3faa83</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2020</creationdate><topic>acceptance and commitment therapy (ACT)</topic><topic>Adult</topic><topic>Aged</topic><topic>Anxiety</topic><topic>Anxiety - drug therapy</topic><topic>Anxiety - epidemiology</topic><topic>Anxiety - pathology</topic><topic>Breast - pathology</topic><topic>Breast cancer</topic><topic>breast neoplasms</topic><topic>Breast Neoplasms - drug therapy</topic><topic>Breast Neoplasms - epidemiology</topic><topic>Breast Neoplasms - pathology</topic><topic>Breast Neoplasms - psychology</topic><topic>Cancer</topic><topic>Cancer Survivors</topic><topic>Clinical trials</topic><topic>Depression - drug therapy</topic><topic>Depression - epidemiology</topic><topic>Depression - pathology</topic><topic>Fear</topic><topic>Fear - psychology</topic><topic>Feasibility studies</topic><topic>Female</topic><topic>Humans</topic><topic>Intervention</topic><topic>Involuntary Commitment</topic><topic>Mental depression</topic><topic>Middle Aged</topic><topic>Neoplasm Recurrence, Local - drug therapy</topic><topic>Neoplasm Recurrence, Local - pathology</topic><topic>Neoplasm Recurrence, Local - prevention & control</topic><topic>Neoplasm Recurrence, Local - psychology</topic><topic>Neoplasm Staging</topic><topic>Oncology</topic><topic>Phobic Disorders - drug therapy</topic><topic>Phobic Disorders - epidemiology</topic><topic>Phobic Disorders - pathology</topic><topic>Quality of Life</topic><topic>Stress Disorders, Post-Traumatic - complications</topic><topic>Stress Disorders, Post-Traumatic - epidemiology</topic><topic>Stress Disorders, Post-Traumatic - pathology</topic><topic>Stress Disorders, Post-Traumatic - psychology</topic><topic>Survival</topic><topic>survivorship</topic><topic>Therapy</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Johns, Shelley A.</creatorcontrib><creatorcontrib>Stutz, Patrick V.</creatorcontrib><creatorcontrib>Talib, Tasneem L.</creatorcontrib><creatorcontrib>Cohee, Andrea A.</creatorcontrib><creatorcontrib>Beck‐Coon, Kathleen A.</creatorcontrib><creatorcontrib>Brown, Linda F.</creatorcontrib><creatorcontrib>Wilhelm, Laura R.</creatorcontrib><creatorcontrib>Monahan, Patrick O.</creatorcontrib><creatorcontrib>LaPradd, Michelle L.</creatorcontrib><creatorcontrib>Champion, Victoria L.</creatorcontrib><creatorcontrib>Miller, Kathy D.</creatorcontrib><creatorcontrib>Giesler, R. Brian</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>Oncogenes and Growth Factors Abstracts</collection><collection>Toxicology Abstracts</collection><collection>Environmental Sciences and Pollution Management</collection><collection>AIDS and Cancer Research Abstracts</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Nursing & Allied Health Premium</collection><collection>MEDLINE - Academic</collection><collection>PubMed Central (Full Participant titles)</collection><jtitle>Cancer</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Johns, Shelley A.</au><au>Stutz, Patrick V.</au><au>Talib, Tasneem L.</au><au>Cohee, Andrea A.</au><au>Beck‐Coon, Kathleen A.</au><au>Brown, Linda F.</au><au>Wilhelm, Laura R.</au><au>Monahan, Patrick O.</au><au>LaPradd, Michelle L.</au><au>Champion, Victoria L.</au><au>Miller, Kathy D.</au><au>Giesler, R. Brian</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Acceptance and commitment therapy for breast cancer survivors with fear of cancer recurrence: A 3‐arm pilot randomized controlled trial</atitle><jtitle>Cancer</jtitle><addtitle>Cancer</addtitle><date>2020-01-01</date><risdate>2020</risdate><volume>126</volume><issue>1</issue><spage>211</spage><epage>218</epage><pages>211-218</pages><issn>0008-543X</issn><eissn>1097-0142</eissn><abstract>Background
Fear of cancer recurrence (FCR) has a profound negative impact on quality of life (QOL) for many cancer survivors. Breast cancer survivors (BCS) are particularly vulnerable, with up to 70% reporting clinically significant FCR. To the authors' knowledge, evidence‐based interventions for managing FCR are limited. Acceptance and commitment therapy (ACT) promotes psychological flexibility in managing life's stressors. The current study examined the feasibility and preliminary efficacy of group‐based ACT for FCR in BCS.
Methods
Post‐treatment BCS (91 patients with stage I‐III disease) with clinical FCR randomly were assigned to ACT (6 weekly 2‐hour group sessions), survivorship education (SE; 6 weekly 2‐hour group sessions), or enhanced usual care (EUC; one 30‐minute group coaching session with survivorship readings). FCR severity (primary outcome) and avoidant coping, anxiety, post‐traumatic stress, depression, QOL, and other FCR‐related variables (secondary outcomes) were assessed at baseline (T1), after the intervention (T2), 1 month after the intervention (T3), and 6 months after the intervention (T4) using intent‐to‐treat analysis.
Results
Satisfactory recruitment (43.8%) and retention (94.5%) rates demonstrated feasibility. Although each arm demonstrated within‐group reductions in FCR severity over time, only ACT produced significant reductions at each time point compared with baseline, with between‐group differences at T4 substantially favoring ACT over SE (Cohen d for effect sizes, 0.80; P < .001) and EUC (Cohen d, 0.61; P < .01). For 10 of 12 secondary outcomes, only ACT produced significant within‐group reductions across all time points. By T4, significant moderate to large between‐group comparisons favored ACT over SE and EUC with regard to avoidant coping, anxiety, depression, QOL, and FCR‐related psychological distress.
Conclusions
Group‐based ACT is a feasible and promising treatment for FCR and associated outcomes in BCS that warrants testing in larger, fully powered trials.
Evidence‐based interventions to treat survivors' fear of cancer recurrence are limited. This pilot study supports the feasibility and preliminary efficacy of acceptance and commitment therapy for the fear of cancer recurrence among breast cancer survivors.</abstract><cop>United States</cop><pub>Wiley Subscription Services, Inc</pub><pmid>31539169</pmid><doi>10.1002/cncr.32518</doi><tpages>8</tpages><orcidid>https://orcid.org/0000-0003-2731-7641</orcidid><orcidid>https://orcid.org/0000-0002-6153-0713</orcidid><orcidid>https://orcid.org/0000-0001-7928-6491</orcidid><orcidid>https://orcid.org/0000-0001-5730-1822</orcidid><oa>free_for_read</oa></addata></record> |
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| ispartof | Cancer, 2020-01, Vol.126 (1), p.211-218 |
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| source | MEDLINE; Wiley Online Library Journals Frontfile Complete; Wiley Online Library Free Content; EZB-FREE-00999 freely available EZB journals; Alma/SFX Local Collection |
| subjects | acceptance and commitment therapy (ACT) Adult Aged Anxiety Anxiety - drug therapy Anxiety - epidemiology Anxiety - pathology Breast - pathology Breast cancer breast neoplasms Breast Neoplasms - drug therapy Breast Neoplasms - epidemiology Breast Neoplasms - pathology Breast Neoplasms - psychology Cancer Cancer Survivors Clinical trials Depression - drug therapy Depression - epidemiology Depression - pathology Fear Fear - psychology Feasibility studies Female Humans Intervention Involuntary Commitment Mental depression Middle Aged Neoplasm Recurrence, Local - drug therapy Neoplasm Recurrence, Local - pathology Neoplasm Recurrence, Local - prevention & control Neoplasm Recurrence, Local - psychology Neoplasm Staging Oncology Phobic Disorders - drug therapy Phobic Disorders - epidemiology Phobic Disorders - pathology Quality of Life Stress Disorders, Post-Traumatic - complications Stress Disorders, Post-Traumatic - epidemiology Stress Disorders, Post-Traumatic - pathology Stress Disorders, Post-Traumatic - psychology Survival survivorship Therapy |
| title | Acceptance and commitment therapy for breast cancer survivors with fear of cancer recurrence: A 3‐arm pilot randomized controlled trial |
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