title: When fear of cancer recurrence becomes a clinical issue: a qualitative analysis of features associated with clinical fear of cancer recurrence.
abstract: Fear of cancer recurrence (FCR) is a common experience for cancer survivors. However, it remains unclear what characteristics differentiate non-clinical from clinical levels of FCR. The goal of this study was to investigate the potential hallmarks of clinical FCR.
  
  
  
  A convenience sample of 40 participants (n = 19 female) was drawn from another study (Lebel et al. in Qual Life Res 25:311-321. doi: 10.1007/s11136-015-1088-2 , 2016). The semi-structured interview for fear of cancer recurrence (Simard and Savard in J Cancer Surviv 9:481-491. doi: 10.1007/s11764-015-0424-4 , 2015) was used to identify participants with non-clinical and clinical FCR and qualitative analysis of these interviews was performed.
  
  
  
  Individuals with clinical FCR reported the following features: death-related thoughts, feeling alone, belief that the cancer would return, experiencing intolerance of uncertainty, having cancer-related thoughts and imagery that were difficult to control, daily and recurrent, lasted 30 minutes or more, increased over time, caused distress and impacted their daily life. Triggers of FCR and coping strategies did not appear to be features of clinical FCR as they were reported by participants with a range of FCR scores.
  
  
  
  While features of clinical FCR found in this analysis such as intrusive thoughts, distress and impact on functioning confirmed previous FCR research, other features spontaneously emerged from the interviews including "death-related thoughts," "feeling alone," and "belief that the cancer will return." The participants' descriptions of cancer-specific fear and worry suggest that FCR is a distinct phenomenon related to cancer survivorship, despite similarities with psychological disorders (e.g., Anxiety Disorders). Future research investigating the construct of FCR, and the distinguishing features of clinical FCR across a range of cancer types and gender is required.
authors.affiliation: School of Psychology, University of Ottawa, 136 Jean Jacques Lussier PVT, Room 4016, Ottawa, ON, K1N 6N5, Canada. bmuts031@uottawa.ca.
authors.forename: Brittany
authors.initials: B
authors.lastname: Mutsaers
authors.affiliation: School of Psychology, University of Ottawa, 136 Jean Jacques Lussier PVT, Room 4016, Ottawa, ON, K1N 6N5, Canada.
authors.forename: Georden
authors.initials: G
authors.lastname: Jones
authors.affiliation: School of Psychology, University of Ottawa, 136 Jean Jacques Lussier PVT, Room 4016, Ottawa, ON, K1N 6N5, Canada.
authors.forename: Nicole
authors.initials: N
authors.lastname: Rutkowski
authors.affiliation: School of Psychology, University of Ottawa, 136 Jean Jacques Lussier PVT, Room 4016, Ottawa, ON, K1N 6N5, Canada.
authors.forename: Christina
authors.initials: C
authors.lastname: Tomei
authors.affiliation: School of Psychology, University of Ottawa, 136 Jean Jacques Lussier PVT, Room 4016, Ottawa, ON, K1N 6N5, Canada.
authors.forename: Caroline
authors.initials: C
authors.lastname: Séguin Leclair
authors.affiliation: School of Psychology, University of Ottawa, 136 Jean Jacques Lussier PVT, Room 4016, Ottawa, ON, K1N 6N5, Canada.
authors.forename: Danielle
authors.initials: D
authors.lastname: Petricone-Westwood
authors.affiliation: Institut universitaire de cardiologie et de pneumologie de Québec (IUCPQ), 2725, Chemin Ste-Foy, Québec, QC, G1V 4G5, Canada.
authors.forename: Sébastien
authors.initials: S
authors.lastname: Simard
authors.affiliation: School of Psychology, University of Ottawa, 136 Jean Jacques Lussier PVT, Room 4016, Ottawa, ON, K1N 6N5, Canada.
authors.forename: Sophie
authors.initials: S
authors.lastname: Lebel
mesh_terms: D000223:Adaptation, Psychological; D000368:Aged; D000369:Aged, 80 and over; D001007:Anxiety / Q000523:psychology*; D005239:Fear / Q000523:psychology*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000523:psychology*; D009369:Neoplasms / Q000523:psychology*; D017741:Survivors / Q000523:psychology*
keywords: Clinical fear of cancer recurrence; Fear of cancer recurrence; Psychosocial oncology; Qualitative analysis; Semi-structured interview