Fear of Cancer Recurrence in Patients with Sarcoma in the United Kingdom

SIMPLE SUMMARY: After a cancer diagnosis, the fear that it could come back is one of the most difficult negative emotions to manage. Sarcoma is a rare cancer of connective tissue affecting soft tissue and bone that has a high rate of recurrence and metastases. It can present itself in any age group from childhood to older adulthood. The experience of fear of cancer recurrence has not yet been explored in-depth among those with sarcoma. We, therefore, conducted an online survey to identify the prevalence of fear of cancer recurrence and factors that may be associated with it. A total of 229 people with sarcoma submitted responses, and the majority expressed interest in receiving support for fear of cancer recurrence. Overall, fear of cancer recurrence levels was found to be higher than those reported by patients with most other types of cancer. Emotional distress and being able to manage emotions were associated with fear of cancer recurrence. ABSTRACT: Fear of cancer recurrence (FCR) is a persistent concern among those living with cancer and is associated with a variety of negative psychosocial outcomes. However, people with sarcoma have been underrepresented within this area of research. We aimed to determine the prevalence of FCR experienced by people with sarcoma in the United Kingdom and explore factors that may predict FCR, such as the perceived impact of cancer and psychological flexibility. Participants (n = 229) with soft tissue (n = 167), bone (n = 25), and gastrointestinal stromal tumours (n = 33) completed an online survey including the self-reported measures of FCR, the perceived physical and psychological impact of cancer and psychological flexibility, and demographic information. Data were analysed using ANOVA and multiple regression modelling. Mean FCR scores (M = 91.4; SD = 26.5) were higher than those reported in meta-analytic data inclusive of all cancer types (M = 65.2; SD = 28.2). Interest in receiving support for FCR was also high (70%). Significant factors associated with FCR included cognitive and emotional distress and psychological flexibility, but not perceptions of the physical impact of cancer (R(2) = 0.56). The negative association between psychological flexibility and FCR suggests the potential benefit of intervention approaches which foster psychological flexibility, such as acceptance and commitment therapy.