Leah Curran1,2, Louise Sharpe1, Phyllis Butow1,3,4. 1. School of Psychology, University of Sydney, Brennan MacCallum Building A18, Manning Road, Camperdown, Sydney, New South Wales, NSW 2050, Australia. 2. The Kinghorn Cancer Centre, St Vincent's Healthcare Network, Sydney, NSW, Australia. 3. PoCoG & CeMPED, School of Psychology, University of Sydney, Sydney, NSW, Australia. 4. SoURCe, Institute of Surgery, Sydney, NSW, Australia.
Abstract
BACKGROUND: Treatments for cancer-related anxiety show modest benefits, but most have been trialled in patients with early stage disease or patients who are currently disease free. However, many patients with cancer have incurable disease, or their disease is slowly progressing or likely to recur. Treating anxiety in the context of realistic threat and ongoing uncertainty is particularly challenging. Based on a theoretical model of cancer-related anxiety, we developed a transdiagnostic intervention for patients with advanced or recurred disease who are experiencing clinically significant anxieties. The intervention was a novel integration of traditional and contemporary CBT. AIMS: To evaluate the feasibility, acceptability and preliminary efficacy of the intervention in a pilot with patients with advanced or recurred cancer. METHOD: Twelve patients with advanced or recurred cancer, who were experiencing anxiety, participated. Feasibility and acceptability were assessed with participant's ratings and adherence and retention rates. Psychological outcomes (anxiety, traumatic symptoms, fear of progression, depression, death anxiety and quality of life) were assessed pre-intervention, post-intervention and at 2-month follow-up. RESULTS: Eleven of the 12 participants completed at least five therapy sessions of whom eight completed all nine sessions. Participants rated the intervention as having excellent face validity. Post-intervention, statistically significant improvements were demonstrated for anxiety, traumatic symptoms, fear of progression, depression and quality of life. These improvements were maintained at follow-up for anxiety, traumatic symptoms and depression. CONCLUSIONS: This pilot provides preliminary evidence for the feasibility, acceptability and effectiveness of the novel intervention for cancer-related anxiety in the context of advanced disease.
BACKGROUND: Treatments for cancer-related anxiety show modest benefits, but most have been trialled in patients with early stage disease or patients who are currently disease free. However, many patients with cancer have incurable disease, or their disease is slowly progressing or likely to recur. Treating anxiety in the context of realistic threat and ongoing uncertainty is particularly challenging. Based on a theoretical model of cancer-related anxiety, we developed a transdiagnostic intervention for patients with advanced or recurred disease who are experiencing clinically significant anxieties. The intervention was a novel integration of traditional and contemporary CBT. AIMS: To evaluate the feasibility, acceptability and preliminary efficacy of the intervention in a pilot with patients with advanced or recurred cancer. METHOD: Twelve patients with advanced or recurred cancer, who were experiencing anxiety, participated. Feasibility and acceptability were assessed with participant's ratings and adherence and retention rates. Psychological outcomes (anxiety, traumatic symptoms, fear of progression, depression, death anxiety and quality of life) were assessed pre-intervention, post-intervention and at 2-month follow-up. RESULTS: Eleven of the 12 participants completed at least five therapy sessions of whom eight completed all nine sessions. Participants rated the intervention as having excellent face validity. Post-intervention, statistically significant improvements were demonstrated for anxiety, traumatic symptoms, fear of progression, depression and quality of life. These improvements were maintained at follow-up for anxiety, traumatic symptoms and depression. CONCLUSIONS: This pilot provides preliminary evidence for the feasibility, acceptability and effectiveness of the novel intervention for cancer-related anxiety in the context of advanced disease.