An exploratory study of the worst-case scenario exercise as an exposure treatment for fear of cancer recurrence

Purpose The worst-case scenario (WCS) exercise is part of a manualized cognitive-existential group intervention for fear of cancer recurrence (FCR). It requires cancer survivors to describe the scenario they most fear when they think about the possibility of their cancer returning and to re-read the...

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Bibliographic Details
Published in:Supportive care in cancer 2017-05, Vol.25 (5), p.1373-1375
Main Authors: Moran, Chelsea, Tomei, Christina, Lefebvre, Monique, Harris, Cheryl, Maheu, Christine, Lebel, Sophie
Format: Article
Language:English
Subjects:
Breast Neoplasms - psychology
Breast Neoplasms - therapy
Cancer
Cancer recurrence
Cancer research
Cancer treatment
Care and treatment
Cognitive Therapy - methods
Commentary
Existentialism
Fear & phobias
Fear - psychology
Female
Follow-Up Studies
Genital Neoplasms, Female - psychology
Genital Neoplasms, Female - therapy
Health aspects
Humans
Intervention
Medicine
Medicine & Public Health
Middle Aged
Neoplasm Recurrence, Local - psychology
Neoplasm Recurrence, Local - therapy
Nursing
Nursing Research
Oncology
Pain Medicine
Psychotherapy
Rehabilitation Medicine
Survivor
Survivors
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Summary:Purpose The worst-case scenario (WCS) exercise is part of a manualized cognitive-existential group intervention for fear of cancer recurrence (FCR). It requires cancer survivors to describe the scenario they most fear when they think about the possibility of their cancer returning and to re-read the scenario daily for 1 week as homework. The purpose of this study was to present this novel clinical treatment for FCR and to examine whether at-home repeated exposure to the WCS was related to pre- and post-therapy FCR levels. Methods Women with breast and gynaecological cancers who received care at The Ottawa Hospital Cancer Centre were recruited to participate in this follow-up study. Consenting participants provided copies of their WCS exercises. Results The WCS of ten female cancer survivors were collected to examine the homework portion of the exercise. Higher adherence to homework was significantly related to lower post-therapy FCR but not to pre-therapy scores. Conclusions Baseline levels of FCR may not be a factor influencing inter-session homework adherence to the WCS, while exposure to the WCS resulting from adherence to the homework exercise may influence post-therapy FCR outcomes. These effects remain to be differentiated from the overall therapeutic effect of the 6-week cognitive-existential intervention for FCR, using a larger sample. This study presents preliminary evidence for an upcoming multi-centre trial in which the WCS exercise will be re-examined with larger sample sizes.
ISSN:0941-4355
1433-7339
DOI:10.1007/s00520-017-3600-4