Many survivors of cancer report a fear of cancer recurrence (FCR), often without receiving professional support in dealing with this fear. In a new study, researchers reported on a cognitive-existential intervention called fear of cancer recurrence therapy (FORT), which appeared to provide benefits in reduction of FCR. They reported the study’s findings in the journal Health Psychology.

The FORT approach blends cognitive-behavioral therapy with existential therapy strategies. The study was a randomized controlled trial (RCT) evaluating the use of FORT in survivors of breast and gynecologic cancer demonstrating clinical FCR, in comparison with an attention placebo control group, which included a living well with cancer (LWWC) support group. LWWC features an aim of helping survivors with adjusting to life after treatment with various approaches in support of this aim.

The FORT intervention, like the LWWC group, involved 6 weekly sessions of 90 to 120 minutes, but with attention to FCR, consideration of worst-case scenarios, and other tools such as muscular relaxation and mindfulness exercises. The researchers hypothesized that the FORT intervention would result in greater reduction of FCR Inventory (FCRI) scores after treatment, in addition to other related outcomes.

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Survivors were evaluated at baseline (T1), posttreatment (T2), and at 3 (T3) and 6 months (T4) following treatment. The study’s primary outcome was the change in total score on the 42-item FCRI scale, on which higher scores suggest worse FCR, and various secondary outcomes concerned FCRI subscales.

For this study, 80 survivors received the FORT intervention and 84 participated in the LWWC control group. Reductions in FCRI total scores were larger between T1 and T2 for survivors in the group receiving FORT, compared with the LWWC group. The between-group difference for this comparison was −9.48 points (P =.0393). The effect, compared with T1, appeared to be maintained at T3 (P =.0330), but there appeared not to be a difference sustained between groups at T4 (P =.2302).

Evaluations of various secondary outcomes suggested benefits with FORT. Between T1 and T2, these involved the need for physician reassurance (P =.0117), quality of life (in terms of mental health, P =.0147), cognitive avoidance (P =.0155), FCRI triggers (P =.0208), and FCRI coping scores (P =.0351). Between-group differences at T4 suggested FORT showed favorable results for FCRI psychological distress (P =.0026), cognitive avoidance (P =.0399), and quality of life (in terms of physical health, P =.0316).

“This RCT demonstrated that FORT, in comparison to an attention placebo control group, resulted in a greater reduction in FCR posttreatment and at 3 months posttreatment in women with breast and gynecological cancer, indicating its promise as a new treatment approach,” the study investigators concluded in their report.


Maheu C, Lebel S, Bernstein LJ, et al. Fear of cancer recurrence therapy (FORT): a randomized controlled trial. Health Psychol. 2023;42(3):182-194. doi:10.1037/hea0001253

This article originally appeared on Oncology Nurse Advisor