Fear of cancer recurrence following allogeneic haematopoietic stem cell transplantation (HSCT) for haematological malignancy: A cross-sectional study

Lisa Brice; Gemma McErlean; Caroline Donovan; Caley Tapp; Nicole Gilroy; Masura Kabir; Matt Greenwood; Stephen R Larsen; John Moore; David Gottlieb; Mark Hertzberg; Louisa Brown; Megan Hogg; Gillian Huang; Jeff Tan; Christopher Ward; Ian Kerridge

doi:10.1016/j.ejon.2020.101845

Fear of cancer recurrence following allogeneic haematopoietic stem cell transplantation (HSCT) for haematological malignancy: A cross-sectional study

Eur J Oncol Nurs. 2020 Dec:49:101845. doi: 10.1016/j.ejon.2020.101845. Epub 2020 Oct 10.

Authors

Lisa Brice¹, Gemma McErlean², Caroline Donovan³, Caley Tapp³, Nicole Gilroy⁴, Masura Kabir⁵, Matt Greenwood⁶, Stephen R Larsen⁷, John Moore⁸, David Gottlieb⁹, Mark Hertzberg¹⁰, Louisa Brown¹¹, Megan Hogg⁹, Gillian Huang⁹, Jeff Tan⁸, Christopher Ward¹², Ian Kerridge¹²

Affiliations

¹ Department of Haematology, Royal North Shore Hospital, Sydney, NSW, Australia.
² Blood and Marrow Transplant Network, New South Wales Agency for Clinical Innovation, Sydney, NSW, Australia; Northern Clinical School, Faculty of Medicine, University of Sydney, Sydney, NSW, Australia; Graduate School of Health, University of Technology, Sydney, NSW, Australia. Electronic address: gemma.mcerlean@uts.edu.au.
³ School of Applied Psychology, Griffith University, QLD, Australia.
⁴ Blood and Marrow Transplant Network, New South Wales Agency for Clinical Innovation, Sydney, NSW, Australia.
⁵ Westmead Breast Cancer Institute, Sydney, NSW, Australia.
⁶ Department of Haematology, Royal North Shore Hospital, Sydney, NSW, Australia; Northern Blood Research Centre, Kolling Institute, University of Sydney, NSW, Australia.
⁷ Institute of Haematology, Royal Prince Alfred Hospital, Sydney, NSW, Australia.
⁸ Department of Haematology, St Vincents Hospital, Sydney, NSW, Australia.
⁹ Department of Haematology, Westmead Hospital, Sydney, NSW, Australia.
¹⁰ Department of Haematology, Prince of Wales Hospital, Sydney, NSW, Australia.
¹¹ Calvary Mater Hospital, Newcastle, NSW, Australia.
¹² Department of Haematology, Royal North Shore Hospital, Sydney, NSW, Australia; Northern Clinical School, Faculty of Medicine, University of Sydney, Sydney, NSW, Australia; Westmead Breast Cancer Institute, Sydney, NSW, Australia.

PMID: 33128994
DOI: 10.1016/j.ejon.2020.101845

Abstract

Purpose: The aim of this study was to quantify the prevalence of Fear of Cancer Recurrence (FCR) in patients with a prior haematology malignancy surviving more than one year post allogeneic haematopoietic stem cell transplantation (HSCT), and to identify the demographic, medical and psychological factors associated with FCR occurrence.

Method: Participants were adult allogeneic HSCT recipients who had undergone the procedure for acute leukaemia or other haematological malignancy between the years 2000-2012 in Sydney, Australia. They completed a purpose designed survey and six other validated instruments which assessed FCR, psychological functioning, quality of life, demographic, social and clinical variables.

Results: Of the 364 respondents, approximately 11% of the sample lived with severe FCR while only 5% of subjects reported having no FCR. Variables significantly associated with higher FCR included unemployment, a shorter time (years) post-transplant, not attending to health screening (PAP smear), a secondary diagnosis of skin cancer, younger age, referral to a psychiatrist and taking psychotropic medication. Higher psychological distress (depression, anxiety, stress) and lower quality of life made a significant contribution to the prediction of FCR.

Conclusions: Post HSCT follow-up care should include an assessment and discussion regarding FCR to balance both realistic and unrealistic cancer recurrence risks. Managing FCR is one of the most ubiquitous unmet needs of survivors of haematological disease and it is important that HSCT nurses are both aware of the fear, and are equipped with knowledge on how to help patients navigate it with realistic expectations.

Keywords: Blood and marrow transplant; Cancer survivors; Fear of cancer recurrence; Haematological malignancy; Haematopoietic stem cell transplantation; Psychological functioning; Quality of life.

MeSH terms

Adult
Aged
Australia
Cancer Survivors / psychology*
Cross-Sectional Studies
Fear*
Female
Hematologic Neoplasms / psychology*
Hematologic Neoplasms / therapy*
Hematopoietic Stem Cell Transplantation / psychology*
Humans
Male
Middle Aged
Neoplasm Recurrence, Local / psychology*
Prevalence
Quality of Life / psychology*
Surveys and Questionnaires
Young Adult