Fear of cancer recurrence: An exploratory study on its impact on quality of life and emotional distress in patients undergoing systemic cancer therapy

Abstract

Objective. Fear of cancer recurrence (FCR), defined as worry about cancer progression or return, is a common concern among patients and survivors. This study aims to identify factors influencing the onset of FCR and to evaluate its impact on emotional distress and quality of life (QoL) in patients undergoing systemic cancer treatment. Methods. A sample of 175 patients undergoing systemic cancer treatment completed selfreport questionnaires assessing socio-demographics, clinical factors and fear of cancer recurrence, anxiety, depression and QoL (FCRI, HADS, EORTC-QLQ-C30). Results. Data analysis using linear and generalized linear models revealed that FCR is inversely associated with QoL and positively correlated with anxiety and depression. These associations were independent of socio-demographic and clinical variables, with anxiety and depression fully mediating the FCR-QoL relationship. Gender and time since diagnosis emerged as significant predictors, with an increase in FCR at 12 months post-diagnosis. Significance of the results. Our results indicate that FCR, anxiety and depression linked, are present after several months post-diagnosis, suggesting that FCR tends to intensify over time. These findings carry important psychological implications, highlighting the need to support patients in recognizing and managing their fear and emotional distress. Implementing a psychoeducational counseling approximately six months after diagnosis – engaging oncologists, psycho-oncologists, and patients within a “stepped-care” framework – may be effective in mitigating FCR and its emotional consequences.