50% of the survivors of the cancer experiences the fear of having to go through that ordeal again due to a possible relapse. To help people who have successfully overcome a tumor, a digital tool has been developed that has the ability to manage all the uncertainties of the case, albeit legitimate.
A team of experts from UNSW Sydney is studying a way to increase access to much-needed cancer care through e-health. In fact, among the most widespread concerns that cancer survivors have experienced after treatment ends is that their cancer may come back. For many, this fear can be debilitating and can significantly affect one’s well-being and ability to enjoy life.
Dr Ben Smith, Cancer Institute NSW Career Development Fellow and Senior Research Fellow at South West Sydney Clinical School, UNSW Medicine & Health, along with Dr Adeola Bamgboje-Ayodele at Ingham Institute for Applied Medical Research led a national team of doctors and researchers and cancer survivors to develop a digital intervention to help survivors manage their post-treatment fears.
The results of the Research have been published in the scientific journal Journal of Cancer Survivorship.
Cancer survivors: here is a great help to overcome the fear of a recurrence
The program, iConquerFear , is a self-guided online tool for managing the fear of cancer recurrence. It is an adaptation of ConquerFear, a therapist-provided treatment for fear of relapse, originally developed by the Psycho-Oncology Co-operative Research Group, a national cancer clinical trial group, which has been shown to be effective in reducing psychological distress. .
IConquerFear’s goal is to provide cancer survivors with different strategies and techniques to manage the fear of repetition and develop actions in line with their values. Through five small-sized modules, participants complete interactive exercises on goal setting, attention training, and mindfulness, providing them with a range of practical tools to help reduce unnecessary thoughts about recurrences.
“Recurrence concerns are rational and normal, and it is important to understand that they cannot simply be eliminated,” said Dr. Smith: “The iConquerFear approach is about changing the way people interact with their thoughts about recurrence. . It is about helping them not to get caught up in negative thoughts that affect their well-being ”.
More than 50 million people are living with and beyond cancer around the world. About half of all cancer survivors experience a clinically significant fear of relapse associated with psychological distress, poorer quality of life, and increased use of health care.
“Getting help coping with the fear of cancer recurrence is a cancer survivor’s main unmet need, over and above pain, fatigue and other physical symptoms,” added Dr. Smith. “This fear causes considerable distress. and it has an impact on the quality of life, disrupting their ability to engage with daily activities, loved ones and planning for the future ”.
Various interventions delivered by the therapist for fear of recurrence have been shown to be effective in helping cancer survivors manage their concerns. However, such services can have many obstacles, including distance and resources: “Existing interventions, while effective, are inaccessible to many Australian cancer survivors, particularly those in rural and remote areas,” explained Dr Smith. “The health system is also under severe strain to cope with the mental health burden with insufficient resources.”
Not only that, face-to-face is not always a treatment model that all patients love or are able to engage in, Dr. Bamgboje-Ayodele specified: “So, there is a growing need for more scalable digital interventions to bridge this significant gap ”.
According to Dr. Smith, self-guided digital interventions significantly promise to address unmet fear of relapse-related needs and to provide timely and accessible treatment not constrained by the patient’s location. But to date, many existing digital interventions have shown limited engagement and effectiveness.
“It is an emerging field, but current digital interventions for fear of repetition either do not use cognitive behavioral strategies that we know are particularly effective in reducing fears or have not been designed with as much input or feedback from cancer survivors,” said the Dr. Smith.
Dr Bamgboje-Ayodele noted that, with its focus on patient experience, interactive exercises and personalized feedback, iConquerFear has the potential to satisfy the fear of recurrence-related needs, be more accessible and more scalable than existing treatments: “Participants feel like they are managing their fears and are supported to do so as they perform these activities and get tailored feedback,” said Dr. Smith: “The program is designed with recognizable examples to engage users while supporting behaviors such as self-examination and follow-up which could help minimize the risk of their cancer returning ”.
The team of scholars recently conducted research to investigate the potential of the iConquerFear intervention. Scientists revealed that most of the 54 breast cancer survivor participants recruited for the study showed decreased fear of relapse severity soon after participating in the program three months after surgery. About a quarter of the participants also reported clinically significant improvements in reducing the fear of relapse.
Although participation in subsequent modules of the program decreased slightly, Dr. Smith noted that initial adoption and engagement with iConquerFear proved its promise as an effective intervention tool for fear of cancer recurrence.
“We have seen strong initial uptake and engagement and a promising reduction in fear recurrence, equivalent in size to what we have seen face to face,” explained Dr. Smith. “It suggests that digital interventions can actually improve access to psychosocial support and facilitate self-management by survivors ”.
In its next study, the team is partnering with Ovarian Cancer Australia to conduct a randomized control pilot study to further investigate the effectiveness of iConquerFear before embarking on a full-scale rollout.
The project is also attracting international interest from therapeutic companies. Blue Note Therapeutics, a US-based digital therapeutic prescription company, recently licensed the iConquerFear and ConquerFear programs to develop a product for the North American market: “We are open to exploring business models with partners that would maximize accessibility and the impact of iConquerFear in Australia and beyond, ”concluded Dr. Smith.
As for cancer survivors in Italy, according to the AIRC: “Survival rates improve: 65 percent of women and 59.4 percent of men are alive five years after diagnosis. In Italy, about 6 out of 10 patients are alive five years after one cancer diagnosis (59.4 percent of men and 65 percent of women). These are average values for all types of cancer. For some they are lower, but for others they can also be much higher ”.
“For example, for thyroid cancers in women it comes to 96.2 percent five-year survival and for those of the testis, 93.2 percent. Therefore, more and more people are able to overcome the disease oa cohabit even for many years with a tumor that it was possible to assimilate to one chronic disease”.
Marco Venturini, elected president of the Italian Association of Medical Oncology (Aiom), declared: “Five years after the discovery of the disease, 57 percent survive today. Timeliness is the watchword: the sooner we intervene, the higher they will be. the chances of recovery. The successes obtained in the treatment of breast and testicular neoplasms are the most evident: if you act during the very first stages, survival reaches 98% in the first case and almost 100% in the second. An unimaginable progress until a few years ago ”.
It is important to talk about cancer survivors. Both to encourage people who are still struggling with cancer, and because the story of those who have overcome such an important battle helps to overcome any prejudice about the outcome of this disease which for many translates into a death sentence even before having started the therapies and all the treatments available, more and more effective and innovative. Prevention plays a very important role, but even those who are struggling with an advanced stage of the disease must know that today there are all the tools necessary to move forward and improve the quality of life.
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