Acceptance and Commitment Therapy May Reduce Fear of Recurrence in Cancer Survivors

Recent research has found that acceptance and commitment therapy (ACT) can reduce the fear of cancer recurrence in breast cancer survivors. This study, conducted by researchers from Regenstrief Institute, Butler University, and West Virginia University School of Medicine found that cancer survivors who underwent ACT showed significantly greater improvements in their fear of recurrence when compared to women who received other therapies. This work was published on September 20 in the journal Cancer.

For those who have survived cancer, fear of recurrence is a common and disruptive issue. This fear is particularly common in those who have survived breast cancer, with 70% claiming that their fear of developing cancer again impacts their daily life. This persistent fear can lead to issues such as depression, anxiety, and an overall lower quality of life.

What is Acceptance and Commitment Therapy?

ACT helps individuals cope with unwanted or difficult feelings, circumstances, and thoughts, such as fear of cancer recurrence. In this therapy, specialists work with the survivors to bring their attention to the present moment and reduce their fears of the future that are diminishing their quality of life.

“We conducted this study because evidence supporting group-based ACT for cancer survivors with fear of recurrence is extremely limited,” explained Shelley Johns, PsyD, Regenstrief Institute scientist and first author on the paper. “There are nearly 17 million cancer survivors in the U.S., but there are not enough healthcare providers who specialize in fear of recurrence to treat them. Many community therapists practice ACT, so providing evidence that the therapy works, particularly in a group format, offers both survivors and therapists more options for treatment.”

Background of the ACT Research

In their randomized controlled trial, the researchers recruited 91 breast cancer survivors and assigned them to three different groups. The first received ACT for six weeks, the second survivor education for the same time, and the third received enhanced usual care. The latter therapy involved standard care from physicians, a survivorship booklet and lists of supplemental resources alongside a 30-minute group coaching session.

The participants had their fear of recurrence evaluated at the beginning of the study, immediately after intervention, one month after, and six months after. Each of these groups showed reductions in their fear of recurrence, but the ACT group was the only one that showed significant improvements at each evaluation, with this effect growing as time went on.

“There is no way to erase the understandable concern that one’s cancer may recur, yet ACT allows cancer survivors to focus more on living their lives as meaningfully as possible and less on the fear they feel,” said Dr. Johns. “We want them to be the driver of their own lives, not be driven by the fear. In my clinical practice, I found that ACT really resonated with my patients. It teaches them skills they can use throughout their life.”

The researchers concluded that the success of recruitment and retention rates in the study show that ACT treatment is feasible.

Author Affiliations and Funding

In addition to her role at Regenstrief, Dr. Johns is an assistant professor at Indiana University School of Medicine and a clinical health psychologist in the Eskenazi Health Palliative Care Program. She is a member of the Indiana University Melvin and Bren Simon Cancer Center.

Other authors on the paper are: Patrick V. Stutz, B.A. from IU School of Medicine; Tasneem L. Talib, PhD, formerly of Regenstrief Institute; Andrea A. Cohee, PhD from Indiana University School of Nursing; Kathleen A. Beck-Coon, M.D. from IU School of Medicine and IU School of Nursing; Linda F. Brown, PhD from IU School of Medicine; Laura R. Wilhelm, PhD from West Virginia University School of Medicine; Patrick O. Monahan, PhD from IU School of Medicine; Michelle L. LaPradd, M.S. from IU School of Medicine; Victoria L. Champion, PhD from IU School of Nursing; Kathy D. Miller, M.D. from IU School of Medicine and Indiana University Simon Cancer Center; and R. Brian Giesler, PhD from Butler University.

This study was funded by Indiana University Health Values Grant (grant 0952) and the Walther Cancer Foundation (0175.01).