title: A qualitative exploration of fear of cancer recurrence (FCR) amongst Australian and Canadian breast cancer survivors.
abstract: OBJECTIVE
  Few studies have explored coping strategies used by cancer survivors to deal with fear of cancer recurrence (FCR), and little research has been conducted on the specific content of recurrence fears. This study aims to qualitatively explore the strategies used by younger breast cancer survivors to cope with FCR and whether women with low, medium and high levels of FCR employ different coping strategies. An additional aim was to understand the specific content of worst recurrence fears.
  
  
  METHODS
  Twenty Australian and 10 Canadian women aged ≤ 45 years diagnosed with stages 0-II disease at least 1 year prior completed telephone interviews. The transcripts of audio-taped interviews were analysed using the qualitative methodology of transcendental realism.
  
  
  RESULTS
  Women with higher FCR described using distraction and avoidance and fewer coping skills. The fear of death was a common worst fear at all levels of FCR. However, participants with higher FCR described more elaborate fears of death often involving themes of pain and suffering. Cross-cultural differences were not observed.
  
  
  CONCLUSIONS
  Women with higher FCR report using fewer and more avoidance-based coping techniques. Whilst many participants feared death, those with higher FCR reported more elaborate death fears. Women with high levels of FCR may benefit from learning a greater repertoire of coping skills. Understanding the specific content of FCR can help refine existing psychological treatment protocols for FCR. Implications for FCR treatment are discussed.
authors.affiliation: Department of Medical Psychology, Radboud University Medical Centre, Postbus 9101, 6500 HB, Nijmegen (840), The Netherlands. belinda.thewes@radboudumc.nl.|School of Psychology, The University of Sydney, Sydney, Australia. belinda.thewes@radboudumc.nl.
authors.forename: B
authors.initials: B
authors.lastname: Thewes
authors.affiliation: School of Psychology, University of Ottawa, Ottawa, ON, Canada.|Montfort Hospital Research Institute, Ottawa, ON, Canada.
authors.forename: S
authors.initials: S
authors.lastname: Lebel
authors.affiliation: School of Psychology, University of Ottawa, Ottawa, ON, Canada.
authors.forename: C
authors.initials: C
authors.lastname: Seguin Leclair
authors.affiliation: School of Psychology, The University of Sydney, Sydney, Australia.
authors.forename: P
authors.initials: P
authors.lastname: Butow
mesh_terms: D000328:Adult; D001315:Australia; D001943:Breast Neoplasms / Q000523:psychology*; D002170:Canada; D005239:Fear / Q000523:psychology*; D005260:Female; D006801:Humans; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local; D017741:Survivors / Q000523:psychology*
keywords: Breast cancer; Coping; FCR; Fear of recurrence; Oncology; Worst fear