Shift in Nurse-Led Mindset Helps Quell Fear of Cancer Recurrence

An intervention focusing on techniques to better focus patients’ attention may be beneficial in improving fear of cancer recurrence, according to recent research presented at the 21st International Conference of the Society for Integrative Oncology.¹

In a recent interview, study author Anne M. Reb, PhD, NP, discusses her abstract on a nurse-led videoconferencing intervention for patients with advanced cancer who may experience the fear of recurrence. Reb, who is an assistant professor of Nursing Research and Education at City of Hope, Duarte, California, explained that fear of recurrence is common, occurring in up to 70% of patients with advanced cancer.2 However, mindfulness interventions may help.

Transcript

We teach mindset skills and we teach mindfulness-based skills. So we teach mindset skills to help people manage these thoughts and feelings that become sometimes overwhelming and intrusive, and we help them to know that they have more control over their thoughts than they think they have, because many people feel like they can't control their thoughts. None of us can control our thoughts and our feelings, they’re right.

But you can control where you focus your attention. You can choose how you manage these thoughts. And there's some exercises that you can do that we teach to help you better manage your thoughts. And you know, our thoughts and our feelings and our actions are all closely interrelated. Sometimes, if we have [a lot of] worries, [we may] believe that worry is really going to help us, or, in turn…that worry is harmful, these beliefs and these thoughts that we have influence our behaviors and our actions.

For example, some people might be so worried they feel like they need to worry, because it's going to help them keep on top of any new symptom that they get. They're going to report it to their doctor or to their nurse right away, so that if there is a cancer recurrence, they're going to catch it early. So, they think that worrying is going to protect them in some way.

Some people believe that worry is really harmful, and [they think] “worry is going to make my cancer come back,” or, “I believe that this new ache or pain that I'm having is going to mean that cancer is coming back.” Or they might think that their worries are uncontrollable, and that's a very common thing.

In this program, we teach them skills to think about how they're thinking. Our thought processes are very automatic, and we teach skills to notice your thought patterns, notice what you're believing, notice your actions.

So, for example, one patient, she was on the internet several times a day—up to 10 and 12 times—looking for new cancer trials and treatments. That was helping her to feel more comfortable that if…her cancer did progress, that she would be able to quickly tap into 1 of these new trials.

But I asked, “How's that working for you?” And she said, “Well, it's actually making me a little anxious, because I feel like I'm tired of the computer.” And I so I said, “Is there any way that you can cut back on that a little bit. How would that feel to you?” And she said, “Well, I could give that a try.”

So instead of checking the internet 10 times a day, she would check it in the morning and in the evening, and then that gave her more time to focus on what really was most important to her—spending time on things that she enjoyed, like pickleball and hanging out with her friends. So it really helps you to focus on the skills we teach to help you to really focus your attention with the goal of being able to have improved concentration and focus on the things that matter most to you.

References

1. Reb AM. A Nurse-Led Videoconferencing Intervention for Fear of Progression in Advanced Cancer: A Pilot Study. Presented at: 21st International Conference of the Society for Integrative Oncology. October 25-27, 2024.

2. Lebel S, Ozakinci G, Humphris G, et al. Current state and future prospects of research on fear of cancer recurrence. Psychooncology. Apr;26(4):424-427. doi: 10.1002/pon.4103.