Pradhan Poorva, Sharpe Louise, Menzies Rachel E
School of Psychology, Faculty of Science, The University of Sydney, Sydney, NSW, 2006, Australia.
Cancer Manag Res. 2021 Dec 1;13:8953-8965. doi: 10.2147/CMAR.S294114. eCollection 2021.
Fear of cancer recurrence or progression (FCR) is common amongst cancer survivors and an important minority develop clinically significant levels of FCR. However, it is unclear how current clinical services might best support the growing numbers of cancer survivors.
The aim of this study is to develop recommendations for future research in the management of FCR and propose a model of care to help manage FCR in the growing population of cancer survivors.
This is a narrative review and synthesis of empirical research relevant to managing FCR. We reviewed meta-analyses, systematic reviews and individual studies that had investigated interventions for FCR.
A recent, well-conducted meta-analysis confirmed a range of moderately effective treatments for FCR. However, many survivors continued to experience clinical levels of FCR after treatment, indicating a clear need to improve the gold standard treatments. Accessibility of interventions is arguably a greater concern. The majority of FCR treatments require face-to-face therapy, with highly skilled psycho-oncologists to produce moderate changes in FCR. With increasing numbers of cancer survivors, we need to consider how to meet the unmet need of cancer survivors in relation to FCR. Although there have been attempts to develop minimal interventions, these are not yet sufficiently well supported to warrant implementation. Attempts to help clinicians to provide information which might prevent the development of clinically significant FCR have shown some early promise, but research is needed to confirm efficacy.
The next decade of research needs to focus on developing preventative approaches for FCR, and minimal interventions for those with mild-to-moderate symptoms. When evidence-based approaches to prevent FCR or manage moderate levels of FCR are available, stepped care approaches that could meet the needs of survivors could be implemented. However, we also need to improve existing interventions for severe FCR.
癌症复发或进展恐惧（FCR）在癌症幸存者中很常见，并且有相当一部分人出现了具有临床意义的FCR水平。然而，目前尚不清楚当前的临床服务如何才能最好地支持越来越多的癌症幸存者。
本研究的目的是为未来FCR管理的研究制定建议，并提出一种护理模式，以帮助管理日益增多的癌症幸存者中的FCR。
这是一篇对与FCR管理相关的实证研究的叙述性综述和综合分析。我们回顾了对FCR干预措施进行调查的荟萃分析、系统评价和个别研究。
最近一项实施良好的荟萃分析证实了一系列对FCR有中等疗效的治疗方法。然而，许多幸存者在治疗后仍有临床水平的FCR，这表明明显需要改进金标准治疗方法。干预措施的可及性可能是一个更大的问题。大多数FCR治疗需要面对面治疗，由高技能的心理肿瘤学家进行，才能使FCR产生适度变化。随着癌症幸存者数量的增加，我们需要考虑如何满足癌症幸存者在FCR方面未得到满足的需求。尽管已经尝试开发最小化干预措施，但这些措施尚未得到充分支持以保证实施。帮助临床医生提供可能预防具有临床意义的FCR发生的信息的尝试已显示出一些早期前景，但需要研究来证实其疗效。
未来十年的研究需要专注于开发FCR的预防方法，以及针对轻至中度症状患者的最小化干预措施。当有基于证据的预防FCR或管理中度FCR水平的方法可用时，可以实施能够满足幸存者需求的逐步护理方法。然而，我们也需要改进现有的针对严重FCR的干预措施。
