A qualitative analysis of fear of cancer recurrence among Chinese nasopharyngeal cancer patients who are undergoing active treatment

Abstract

Purpose: Nasopharyngeal cancer (NPC) is one of the most prevalent head and neck cancers. Fear of cancer recurrence (FCR) is a psychological state experienced by cancer patients, characterized by concern and worry about the possibility of cancer recurrence. Long-term and persistently high-level FCR is associated with emotional distress, sleep disorders, and decreased treatment compliance in patients, seriously affecting their quality of life and increasing medical costs. This study employed a phenomenological approach to explore the perceptions of fear of cancer recurrence (FCR) and its impacts on Chinese patients with nasopharyngeal cancer (NPC) who have received radiotherapy. Methods: We conducted semi-structured interviews, guided by the theoretical model of FCR, with 18 patients diagnosed with NPC at a tertiary hospital in Shanghai, China, between August 2023 and January 2024. All data were transcribed verbatim and then analyzed by two researchers using Colaizzi’s descriptive phenomenological method. Results: Five themes were identified, including (1) internal triggers of FCR, (2) external triggers of FCR, (3) illness perceptions, (4) challenges and changes due to FCR, and (5) adaptations and responses to FCR. Conclusion: FCR in patients with NPC is a complex, multidimensional phenomenon involving physiological, psychological, and social dimensions. Our study provides a unique and in-depth understanding of the triggers, challenges, and changes associated with FCR, as well as the adaptations and responses of patients with NPC. We suggest that future research focus on developing appropriate measures and interventions to address FCR in this patient population.