While advanced or metastatic cancer is incurable, recent treatment advances mean many affected patients can survive longer. Psychological well-being is inevitably challenged in individuals with metastatic cancer because of the profound and diverse stresses and burdens associated with it. These invariably include physical suffering and disability, the threat of impending mortality, dramatic alterations in support needs and personal relationships, and the challenge of navigating a complex health care system and making treatment decisions that have life and death implications. While the primary task at the end of life may be to face death with comfort, dignity and a sense of meaning, those with advanced disease earlier in the illness trajectory and/or with a longer expected survival, face the simultaneous challenges of engaging in life while facing the imminence of death. Sustaining such “double awareness” is challenging and the inability to do so may lead to high fear of cancer progression. There is evidence that as high as 70% of patients with advanced cancer experience moderate to high levels of fear of cancer progression. Hence, it is imperative to develop interventions for patients in managing the challenges of advanced cancer.
This randomised controlled trial aims to test the effect of a metacognition-based ConquerFear intervention and a brief, manualised psychotherapetic intervention, namely CALM on fear of cancer progression. We focus on cancer patients diagnosed with advanced or metastatic cancer.
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