One of the most prominent sequels of living on after cancer is the fear of it returning. Fear of recurrence is thought to be a widespread problem but has perhaps been underscrutinized.
There are several reasons for this neglect -- chiefly the absence of a universal definition of fear of recurrence and its characteristics. However, those of us who live or work with cancer survivors know this is a common corollary of living on after cancer.
German authors Koch, et al. (2013) recently published
a systematic review of studies that addressed fear of recurrence. Their analysis revealed some interesting findings of note to oncology nurses who have ongoing contact with survivors. Consider the following:
- Cancer survivors five or more years post-treatment cessation still suffer from fear of recurrence.
- Fear of recurrence is often triggered by follow-up care appointments, stories in the media, and significant anniversaries (e.g., diagnosis).
- Heightened recurrence anxiety has been associated with decreased quality of life.
- While survivorship care plans have been recommended to optimize long-term follow-up, survivors' needs as they relate to fear of recurrence have not been addressed.
For oncology nurses these facts require us to critique how we care for our cancer survivors. Do we ask them about their concerns about recurrence? How can we support this cohort of ex-patients who have their unique triggers of discomfort and impaired quality of life?
Those of us in clinical practice need to solicit the support of nurse researcher colleagues in schools of nursing to address the unmet needs of our cancer survivors. Few evidence-based interventions exist to help us know how to best support this growing number of patients who live on after cancer. It is timely to address this pressing reality, which will only expand in our immediate future.