Mind‐body interventions for fear of cancer recurrence: A systematic review and meta‐analysis
Open accessAbstract
Objective: Fear of cancer recurrence (FCR) is a common existential concern and source of distress among adults with a cancer history. Multiple randomized controlled trials (RCTs) have examined mind‐body approaches to mitigating FCR. We summarized characteristics of these trials and calculated their pooled effects on decreasing FCR. Methods: Six electronic databases were systematically searched from inception to May 2017, using a strategy that included multiple terms for RCTs, cancer, mind‐body medicine, and FCR. Data extraction and reporting followed Cochrane and Preferred Reporting Items for Systematic Reviews and Meta‐Analyses (PRISMA) guidelines. Pooled effect sizes on self‐report measures of FCR were computed by using random‐effects models. Results: Nineteen RCTs (pooled N = 2806) were included. Most studies (53%) were published since 2015 and targeted a single cancer type (84%; mostly breast). Intervention sessions (median = 6, mode = 4) tended to last 120 minutes and occur across 1.5 months. Delivery was predominantly in‐person (63%) to either groups (42%) or individuals (42%). Most interventions incorporated multiple mind‐body components (53%), commonly cognitive‐behavioral skills (58%), or meditative practices (53%). Small‐to‐medium pooled effect sizes were observed postintervention (Hedges' g = −0.36, 95% CI = −0.49, −0.23, P < .001) and at follow‐up assessments (median = 8 months, P < .001). Potential modifiers (control group design, group/individual delivery, use of cognitive‐behavioral or mindfulness skills, number of mind‐body components, cancer treatment status, and number of sessions) did not reach statistical significance. Conclusions: Mind‐body interventions are efficacious for reducing FCR, with small‐to‐medium effect sizes that persist after intervention delivery ends. Recommendations include testing effects among survivors of various cancers and exploring the optimal integration of mind‐body practices for managing fundamental uncertainties and fears during cancer survivorship.
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Clinical FCR can be decreased in cancer survivors by group or individual therapy with small to moderate effect sizes and sustained improvements at follow-up (on average 8 months post-therapy).
“According to two meta-analyses published to date [11, 12], clinical FCR can be decreased in cancer survivors by either group or individual therapy with small to moderate effect sizes and evidence of sustained improvements at follow-up (on average 8 months post-therapy).”
From It is time to address fear of cancer recurrence in family caregivers: protocol for the feasibility and acceptability of a randomized pilot study of the online version of the Family Caregiver–Fear Of Recurrence Therapy (FC-FORT) (2024) · cites this paper as [11]
The Conclusions report small-to-medium reductions in fear of cancer recurrence (FCR) that persisted at follow-up, and the subgroup analysis includes both group and individual delivery. However, the Study limitations say the review could not ascertain clinically significant FCR reductions. The Results give a median of eight months from baseline to the last assessment, not an average of eight months after therapy. (LLM, conf=0.90)
Experimental — accuracy not yet measuredDifferent psychological interventions are available for people presenting with significant FCR-related distress, the most common being cognitive behavioural approaches.
“Different psychological interventions are available for people presenting with significant FCR- related distress, the most common being cognitive behavioural approaches, either in traditional or contemporary versions (see Hall et al.,2018; Tauber et al.,2019 for systematic reviews and meta- analyses).”
From Developing an emotion‐focused therapy model for fear of cancer recurrence: A case‐level task analysis. (2024) · cites this paper as Hall et al.,2018
The Results (Mind-body components; page not provided) describe a range of interventions targeting fear of cancer recurrence and identify cognitive-behavioral skills as the most common component (11 of 19 interventions). The paper does not classify those approaches into traditional and contemporary versions, so that part of the attributed claim is not established by this source. (LLM, conf=0.84)
Experimental — accuracy not yet measuredSeveral psychological interventions have been developed to reduce FCR with varying levels of effectiveness.
“Several psychological interventions have been developed to reduce FCR with varying levels of effectiveness [10, 19].”
There are existing systematic and metareviews on web-based interventions for cancer care/aftercare and on fear of cancer recurrence interventions more generally.
“There are a number of existing systematic and metareviews on web-based interventions for cancer care/aftercare [9–17] and on fear of cancer recurrence interventions more generally [18–21].”
Longer duration of intervention would be more beneficial to patients with higher levels of FCR.
“It had been suggested that longer duration of intervention would be more beneficial to patients with higher levels of FCR [10] however there was no consensus on the optimal duration and frequency of web-based interventions.”
From Web-based interventions for fear of cancer recurrence: A scoping review with a focus on suggestions for the development and evaluation of future interventions (2024) · cites this paper as [10]
The Results (Duration; page unavailable) describe how long the interventions lasted, but do not link duration to benefit among patients with higher FCR. The Conclusions report no significant difference by number of sessions and call for further research on optimal dosing; they do not suggest that longer interventions would benefit that subgroup more. (LLM, conf=0.76)
Experimental — accuracy not yet measured
In the prior meta-analysis, only 13 of the 19 studies included an FCR-specific measure, with the remaining studies assessing more general cancer-related uncertainty.
“Second, only 13 of the 19 studies included an FCR-specific measure, with the remaining studies assessing more general cancer-related uncertainty.”
From Effect of Psychological Intervention on Fear of Cancer Recurrence: A Systematic Review and Meta-Analysis. (2019) · cites this paper as [19]
Only one meta-analytical evaluation of the effect of mind-body interventions on FCR and cancer-related uncertainty in 19 RCTs has been published, which reported a small effect both at postintervention (Hedges's g = −0.36; P < .001) and at follow-up (g = −0.31; P < .001).
“Thus far, only one meta-analytical evaluation of the effect of mind–body interventions on FCR and cancer-related uncertainty in 19 RCTs has been published,19 which reported a small effect both at postintervention (Hedges’s g = −0.36; P < .001) and at follow-up (g = −0.31; P < .001).”
From Effect of Psychological Intervention on Fear of Cancer Recurrence: A Systematic Review and Meta-Analysis. (2019) · cites this paper as [19]
Potentially important between-study differences remained unexplored in the former review, including the type of psychotherapeutic framework and whether the intervention specifically targeted FCR.
“Third, potentially important between-study differences remained unexplored in the former review,19 including the type of psychotherapeutic framework and whether the intervention specifically targeted FCR.”
From Effect of Psychological Intervention on Fear of Cancer Recurrence: A Systematic Review and Meta-Analysis. (2019) · cites this paper as [19]
This prior meta-analysis included not only psychological interventions, but also physical interventions-for example, yoga or dance.
“However, this study included not only psychological interventions, but also physical interventions—for example, yoga or dance.”
From Effect of Psychological Intervention on Fear of Cancer Recurrence: A Systematic Review and Meta-Analysis. (2019) · cites this paper as [19]
Previous meta-analyses on MBIs for cancer patients and survivors have been restricted in scope, being either relatively narrow or very broad.
“First, previous meta‐analyses have been restricted in their scope by being either relatively narrow, eg, focusing only on effects of mindfulness‐based stress reduction (MBSR) in breast cancer survivors,13 or very broad, eg, focusing on “mind‐body approaches.”14”
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- Authors
- Hall, D. L., Luberto, C. M., Philpotts, L. L., Song, R., Park, E. R., & Yeh, G. Y.
- Affiliations
- Beth Israel Deaconess Medical Center (US)
- Harvard University (US)
- Massachusetts General Hospital (US)
- Chungnam National University (KR)
- Corresponding author
- Hall, Daniel L.
- Venue
- Psycho-Oncology
- Publisher
- Wiley
- Published
- 2018-06-05
- Volume
- 27
- Issue
- 11
- Pages
- 2546-2558
- ISSN
- 1057-9249 (ISSN-L)
- 1099-1611
- PMC
- PMC6488231
- OpenAlex
- W2800776882
- Cited by
- 159
- References
- 92
- Citations by year
- 2026: 9 · 2025: 20 · 2024: 24 · 2023: 22 · 2022: 34 · 2021: 23 · 2020: 11 · 2019: 12 · 2018: 4
- FWCI
- 1.30
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- Psycho-Oncology (publishedVersion)
- PubMed (publishedVersion)
- PubMed Central (acceptedVersion)
- Funders
- National Center for Complementary and Integrative Health (K24AT009465, T32AT000051)
- National Cancer Institute (K24CA197382)
- Topics
- Health Sciences › Medicine › Oncology › Cancer survivorship and care
- Social Sciences › Psychology › Clinical Psychology › Mindfulness and Compassion Interventions
- Health Sciences › Medicine › Complementary and alternative medicine › Complementary and Alternative Medicine Studies
- Keywords
- fear of cancer recurrence, mind-body interventions, cancer survivors, breast cancer, cognitive-behavioral techniques, mindfulness, meditation, psychological distress, cancer survivorship, intervention efficacy
- MeSH terms
- Cancer Survivors, Adult, Fear, Humans, Neoplasm Recurrence, Local, Neoplasms, Phobic Disorders, Mind-Body Therapies
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