For fear of a cancer return, a team of researchers led by UNSW Sydney is looking into methods to use e-health to improve access to critical therapy.

A national team of clinicians created the digital intervention, researchers, and cancer survivors under the direction of Dr. Adeola Bamgboje-Ayodele at the Ingham Institute for Applied Medical Research and Dr. Ben Smith, Cancer Institute NSW Career Development Fellow and Senior Research Fellow at South West Sydney Clinical School, UNSW Medicine & Health.

One of the most frequent concerns cancer survivors have after treatment ends is that their cancer will return. This fear can be crippling for many people and significantly impact their well-being and ability to enjoy life. UNSW reports that the “self-guided digital intervention” is showing promise for helping cancer survivors manage their post-treatment uncertainty.

A self-directed online tool called iConquerFear was created to help people manage their fear of cancer recurrence. It is a modified version of ConquerFear, a therapist-delivered treatment for fear of recurrence created by the Psycho-Oncology Co-operative Research Group, a national cancer clinical trials group. It has been proven to be successful in lowering psychological distress.

According to UNSW, conquering fear is to equip survivors with strategies and techniques to manage their fear of recurrence and develop behaviors consistent with their values. Participants complete interactive exercises about goal setting, attention training, and mindfulness throughout five bite-sized modules, providing them with various practical tools to help reduce unhelpful thoughts about recurrence.

Dr. Smith asserts that concerns regarding recurrence are reasonable and common and that it’s crucial to realize they can’t simply be dispelled.

The goal of the conquerer technique is to alter how people interact with their thoughts regarding repetition. It’s about assisting people in resisting beliefs that are detrimental to their welfare.

More than 50 million individuals are coping with cancer and its aftereffects, according to UNSW, and around half of the cancer survivors have clinically significant recurrence worry, which is linked to psychological distress, lower quality of life, and increased healthcare use.

The biggest unmet need for a cancer survivor, above pain, exhaustion, and other bodily symptoms, according to Dr. Smith, is assistance coping with a fear of cancer recurrence.

“This fear disrupts their capacity to engage with day-to-day activities, loved ones, and future planning, causing great distress and impacting quality of life.”

Dr. Smith points out that therapist-delivered therapies for fear of recurrence have successfully assisted survivors in managing their fears. However, access to these programs can be difficult due to distance and resource availability.

According to Dr. Smith, many Australian cancer survivors, particularly those in rural and remote locations, lack access to existing interventions, despite their success. The health system is working extremely hard while having insufficient resources to handle the mental health load.

Additionally, not all patients prefer or can participate in face-to-face therapy, according to Dr. Bamgboje-Ayodele. Therefore, there is a rising demand for more scalable digital interventions to close this substantial gap.

Dr. Smith asserts that self-guided digital therapies have great promise for addressing unmet needs related to fear of recurrence and providing timely, accessible treatment that is not confined by patient location. But many of the current digital treatments have recently shown modest engagement and effectiveness.

Current digital interventions for fear of recurrence, he says, “either don’t use the cognitive behavioural tactics that we know are particularly effective in reducing anxieties, or haven’t been built with as much involvement or feedback from cancer survivors.” He notes that this is a young field.

With its emphasis on user experience, interactive activities, and personalized feedback, conquer fear, according to Dr. Bamgboje-Ayodele, can meet demands related to fear of recurrence while being more accessible and scalable than current treatments.

According to Dr. Smith, participants feel they are controlling their concerns and are encouraged to do so as they engage in these activities and receive personalized feedback.

The program is made to engage users while encouraging actions like self-examination and follow-up that may help reduce the likelihood of their disease recurring.

Recently, a study was carried out by the UNSW team to determine the effectiveness of the conquerer intervention. About a quarter of the participants also reported clinically significant improvements in their reduction of fear of recurrence. The study found that most of the 54 breast cancer survivors who participated in the program showed a decrease in fear of recurrence immediately after participating in the program and three months post-intervention.

According to Dr. Smith, the initial uptake and engagement with iConquerFear revealed its promise as an efficient intervention tool for fear of recurrence, even though participation in later program modules slightly decreased.

“We showed significant initial uptake and engagement and promising decreases in fear recurrence,” adds Dr. Smith. “These reductions were equivalent in size to what we saw face-to-face.” It implies that digital interventions may increase survivors’ access to psychosocial assistance and enable self-management.

According to UNSW, their next project will involve collaborating with Ovarian Cancer Australia to conduct a randomized pilot control trial to assess iConquerFear’s efficacy before launching a large-scale deployment.

In addition, Blue Note Pharmaceuticals, a US-based digital therapeutics provider, recently obtained a license to use the iConquerFear and ConquerFear programs to create a product for the North American market, according to UNSW.

In conclusion, Dr. Smith said, “We are open to discussing business models with partners that will maximize iConquerFear’s accessibility and effect in Australia and beyond.

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