Fear of cancer recurrence in adult cancer survivors: a systematic review of quantitative studies

PurposeFear of cancer recurrence (FCR) is among the most commonly reported problems and one of the most prevalent areas of unmet needs for cancer survivors and their carers. This review aims to provide a comprehensive overview of current scientific knowledge on FCR and to formulate recommendations for future research.MethodsA systematic review was undertaken to identify quantitative studies associated with FCR. Relevant studies were identified via Medline, CINAHL, PsycINFO and AMED databases from 1996 through December 2011. Data from 130 eligible papers were extracted and summarized following a systematic scheme.ResultsMultiple FCR assessment methods were identified. Survivors reported low to moderate level of FCR but considered it as one of the top greatest concerns and the most frequently endorsed unmet need. FCR remains stable over the survivorship trajectory. Younger age, presence and severity of physical symptoms, psychological distress and lower quality of life were associated with higher FCR. Health behaviours, psychological reactions and functional impairments were identified as FCR consequences. Carers reported higher FCR than the patients. Limited data on interventions were available.ConclusionsFCR research has expanded somewhat haphazardly over the last 20 years. Adopted consensual definition and used well-validated measures will be necessary. Longitudinal research examining the longer-term development and impact of FCR is clearly needed. The proposal and evaluation of theoretical models of FCR is a priority.Implications for Cancer SurvivorsIdentifying the key features of FCR will stimulate the research and the development of targeted interventions for cancer survivors and their carers.

[1]  A. Stanton,et al.  The first year after breast cancer diagnosis: hope and coping strategies as predictors of adjustment , 2002, Psycho-oncology.

[2]  C. Befort,et al.  Weight control needs and experiences among rural breast cancer survivors , 2011, Psycho-oncology.

[3]  J. Gore,et al.  Correlates of bother following treatment for clinically localized prostate cancer. , 2010, The Journal of urology.

[4]  E. Reed,et al.  Spirituality, patients' worry, and follow-up health-care utilization among cancer survivors. , 2011, The journal of supportive oncology.

[5]  S. Fosså,et al.  Fear of recurrence in long‐term testicular cancer survivors , 2009, Psycho-oncology.

[6]  T. Wonghongkul,et al.  Uncertainty Appraisal Coping and Quality of Life in Breast Cancer Survivors , 2006, Cancer nursing.

[7]  M. Diefenbach,et al.  Religion and spirituality among patients with localized prostate cancer , 2006, Palliative and Supportive Care.

[8]  U. Witzsch,et al.  Quality of life after surgery for localized renal cell carcinoma: comparison between radical nephrectomy and nephron-sparing surgery. , 2003, Urology.

[9]  K. Mccaul,et al.  Coping after cancer: Risk perceptions, worry, and health behaviors among colorectal cancer survivors , 2004, Psycho-oncology.

[10]  P. Carroll,et al.  The relationship between anxiety and time to treatment for patients with prostate cancer on surveillance. , 2007, The Journal of urology.

[11]  C. Carver,et al.  Concerns about breast cancer and relations to psychosocial well-being in a multiethnic sample of early-stage patients. , 1999, Health psychology : official journal of the Division of Health Psychology, American Psychological Association.

[12]  L. Northouse,et al.  Family survivorship and quality of life following a cancer diagnosis. , 2001, Research in nursing & health.

[13]  A. Jensen,et al.  Cancer survivors' rehabilitation needs in a primary health care context. , 2009, Family practice.

[14]  C. Bungener,et al.  [Quality of life and psychological state in patients with choroidal melanoma: longitudinal study]. , 2011, Bulletin du cancer.

[15]  Matthew J. Goodman,et al.  Feasibility of a Mindfulness-Based Stress Reduction Program for Early-Stage Breast Cancer Survivors , 2011, Journal of holistic nursing : official journal of the American Holistic Nurses' Association.

[16]  J. Savard,et al.  Fear of cancer recurrence: specific profiles and nature of intrusive thoughts , 2010, Journal of cancer survivorship : research and practice.

[17]  Linda D Cameron,et al.  Changes in emotion regulation and psychological adjustment following use of a group psychosocial support program for women recently diagnosed with breast cancer , 2007, Psycho-oncology.

[18]  V. White,et al.  Understanding a ductal carcinoma in situ diagnosis: patient views and surgeon descriptions. , 2011, European journal of cancer care.

[19]  L. Stafford,et al.  Long-term quality of life in Australian women previously diagnosed with gynaecologic cancer , 2011, Supportive Care in Cancer.

[20]  Y. Brandberg,et al.  The EORTC Ophthalmic Oncology Quality of Life Questionnaire Module (EORTC QLQ-OPT30). Development and Pre-Testing (Phase I-III) , 2004, Eye.

[21]  M. Noguchi,et al.  Psychologic and cosmetic self‐assessments of breast conserving therapy compared with mastectomy and immediate breast reconstruction , 1993, Journal of surgical oncology.

[22]  A. Dinkel,et al.  Evaluation of two group therapies to reduce fear of progression in cancer patients , 2010, Supportive Care in Cancer.

[23]  T. Kershaw,et al.  A family‐based model to predict fear of recurrence for cancer survivors and their caregivers , 2007, Psycho-oncology.

[24]  Jim C Hu,et al.  Determinants of treatment regret in low-income, uninsured men with prostate cancer. , 2008, Urology.

[25]  Matthew J. Goodman,et al.  Randomized controlled trial of mindfulness‐based stress reduction (MBSR) for survivors of breast cancer , 2009, Psycho-oncology.

[26]  S. Rogers,et al.  Fear of recurrence following head and neck cancer in the outpatient clinic , 2010, European Archives of Oto-Rhino-Laryngology.

[27]  H. Leventhal,et al.  Contribution of concrete cognition to emotion: neutral symptoms as elicitors of worry about cancer. , 1989, The Journal of applied psychology.

[28]  S. Goldenberg,et al.  Patient acceptance of active surveillance as a treatment option for low‐risk prostate cancer , 2011, BJU international.

[29]  R. Gray,et al.  Perspectives on living with ovarian cancer: older women's views. , 2001, Oncology nursing forum.

[30]  Peter A Ubel,et al.  Effect of esthetic outcome after breast-conserving surgery on psychosocial functioning and quality of life. , 2008, Journal of clinical oncology : official journal of the American Society of Clinical Oncology.

[31]  M. Sprangers,et al.  Quality of life and fear of cancer recurrence after endoscopic and surgical treatment for early neoplasia in Barrett’s esophagus , 2010, Endoscopy.

[32]  G. Krekels,et al.  Determinants of satisfaction with the health state of the facial skin in patients undergoing surgery for facial basal cell carcinoma. , 2006, Patient education and counseling.

[33]  Kimberly M. Kelly,et al.  Cancer Recurrence Worry, Risk Perception, and Informational-Coping Styles Among Appalachian Cancer Survivors , 2010, Journal of psychosocial oncology.

[34]  B. Ferrell,et al.  Going With the Flow: Quality‐of‐Life Outcomes of Cancer Survivors With Urinary Diversion , 2010, Journal of wound, ostomy, and continence nursing : official publication of The Wound, Ostomy and Continence Nurses Society.

[35]  D. Lubeck,et al.  Fear of cancer recurrence in patients undergoing definitive treatment for prostate cancer: results from CaPSURE. , 2003, The Journal of urology.

[36]  A. Novick,et al.  Quality of life and psychological adaptation after surgical treatment for localized renal cell carcinoma: impact of the amount of remaining renal tissue. , 2001, Urology.

[37]  M. McGurk,et al.  Can we predict which head and neck cancer survivors develop fears of recurrence? , 2008, Journal of psychosomatic research.

[38]  Phyllis Butow,et al.  Long-term survival from gynecologic cancer: psychosocial outcomes, supportive care needs and positive outcomes. , 2007, Gynecologic oncology.

[39]  J. Holland,et al.  The Memorial Anxiety Scale for Prostate Cancer , 2003, Cancer.

[40]  G. Humphris,et al.  Fear of Cancer Recurrence — A Literature Review and Proposed Cognitive Formulation to Explain Exacerbation of Recurrence Fears , 1997, Psycho-oncology.

[41]  Louis J. Wagner,et al.  Coping among older‐adult, long‐term cancer survivors , 2006, Psycho-oncology.

[42]  M. van Kleef,et al.  Concerns of former breast cancer patients about disease recurrence: a validation and prevalence study , 2008, Psycho-oncology.

[43]  A. Dinkel,et al.  [Fear of progression in chronic diseases]. , 2011, Psychotherapie, Psychosomatik, medizinische Psychologie.

[44]  N. Heinrichs,et al.  [Fear of progression in partners of chronically ill patients]. , 2012, Psychotherapie, Psychosomatik, medizinische Psychologie.

[45]  J. Lange,et al.  [Who has more anxiety concerning a shortened life span: terminal cancer patients or those in curative therapy?]. , 2010, Psychotherapie, Psychosomatik, medizinische Psychologie.

[46]  D. Moher,et al.  Preferred reporting items for systematic reviews and meta-analyses: the PRISMA statement , 2009, BMJ.

[47]  N. Aaronson,et al.  The health-related quality of life of long-term survivors of melanoma treated with isolated limb perfusion. , 2007, European journal of surgical oncology : the journal of the European Society of Surgical Oncology and the British Association of Surgical Oncology.

[48]  S. Lutgendorf,et al.  Adjusting to life after treatment: distress and quality of life following treatment for breast cancer , 2007, British Journal of Cancer.

[49]  Ali Montazeri,et al.  Factors predicting the use of complementary and alternative therapies among cancer patients in Iran. , 2007, European journal of cancer care.

[50]  B. Ferrell,et al.  An evaluation of the quality of life among long-term survivors of breast cancer , 2005, Breast Cancer Research and Treatment.

[51]  C. Befort,et al.  Sequelae of breast cancer and the influence of menopausal status at diagnosis among rural breast cancer survivors. , 2011, Journal of women's health.

[52]  C. Carver,et al.  Assessing Quality of Life in Adult Cancer Survivors (QLACS) , 2005, Quality of Life Research.

[53]  Nikki A. Hawkins,et al.  Health-related behavior change after cancer: results of the American Cancer Society’s studies of cancer survivors (SCS) , 2010, Journal of cancer survivorship : research and practice.

[54]  M. Keller,et al.  Progredienzangst (PA) bei chronischen Erkrankungen (rheumatischen Erkrankungen, Krebserkrankungen und Diabetes mellitus) , 2004 .

[55]  P. Ganz,et al.  Breast cancer in younger women: reproductive and late health effects of treatment. , 2003, Journal of clinical oncology : official journal of the American Society of Clinical Oncology.

[56]  H. Sommer,et al.  Impact of medical and demographic factors on long-term quality of life and body image of breast cancer patients. , 2003, Annals of oncology : official journal of the European Society for Medical Oncology.

[57]  T. Gansler,et al.  A population‐based study of prevalence of complementary methods use by cancer survivors , 2008, Cancer.

[58]  Y. Shin,et al.  Increased fear of progression in cancer patients with recurrence. , 2010, General hospital psychiatry.

[59]  W. Söllner,et al.  Need for supportive counselling--the professionals' versus the patients' perspective. A survey in a representative sample of 236 melanoma patients. , 1998, Psychotherapy and psychosomatics.

[60]  Tasha M Burwinkle,et al.  How young can children reliably and validly self-report their health-related quality of life?: An analysis of 8,591 children across age subgroups with the PedsQL™ 4.0 Generic Core Scales , 2007, Health and quality of life outcomes.

[61]  Frank Baker,et al.  Adult cancer survivors: How are they faring? , 2005, Cancer.

[62]  J. Gore,et al.  Partnership and outcomes in men with prostate cancer , 2009, Cancer.

[63]  E. Guadagnoli,et al.  Use of alternative medicine by women with early-stage breast cancer. , 1999, The New England journal of medicine.

[64]  I. Asvadi,et al.  A Comparison of Nurse and Patient Perceptions of Chemotherapy Treatment Stressors , 2000, Cancer nursing.

[65]  Y. Shin,et al.  Psychological impact of thyroid surgery on patients with well-differentiated papillary thyroid cancer , 2011, Quality of Life Research.

[66]  G. Sledge,et al.  An Intervention to Improve Communication Between Breast Cancer Survivors and Their Physicians , 2010, Journal of psychosocial oncology.

[67]  Huey-Shyan Lin,et al.  Correlates of Death Anxiety Among Taiwanese Cancer Patients , 2011, Cancer nursing.

[68]  D. Forman,et al.  Primary health and supportive care needs of long-term cancer survivors: a questionnaire survey. , 2011, Journal of clinical oncology : official journal of the American Society of Clinical Oncology.

[69]  G. Humphris,et al.  Fear of recurrence and psychological distress in head and neck cancer patients and their carers , 2009, Psycho-oncology.

[70]  C. Gotay,et al.  Fear of cancer recurrence: a systematic literature review of self‐report measures , 2012, Psycho-oncology.

[71]  Deborah A. Bowen,et al.  The physician-patient relationship and quality of life: lessons from chronic lymphocytic leukemia. , 2009, Leukemia research.

[72]  P. Carroll,et al.  Impact of radical prostatectomy positive surgical margins on fear of cancer recurrence: results from CaPSURE. , 2010, Urologic oncology.

[73]  Sanne J Franssen,et al.  Psychological factors and preferences for communicating prognosis in esophageal cancer patients , 2009, Psycho-oncology.

[74]  U. Koch,et al.  Verlauf der psychosozialen Belastung und gesundheitsbezogenen Lebensqualität bei Patienten verschiedener Altersgruppen in der onkologischen Rehabilitation , 2009 .

[75]  S. Stewart,et al.  Then and now: quality of life of young breast cancer survivors , 2004, Psycho-oncology.

[76]  Walker Bl.  Adjustment of husbands and wives to breast cancer. , 1997 .

[77]  Louis J. Wagner,et al.  Cancer‐related health worries and psychological distress among older adult, long‐term cancer survivors , 2006, Psycho-oncology.

[78]  J. Dunn,et al.  Predictors of change in unmet supportive care needs in cancer , 2010, Psycho-oncology.

[79]  U. Matulonis,et al.  Long-term adjustment of early-stage ovarian cancer survivors , 2007, International Journal of Gynecologic Cancer.

[80]  H. Bartelink,et al.  Psychological effects of breast conserving therapy in comparison with radical mastectomy. , 1985, International journal of radiation oncology, biology, physics.

[81]  L. Gurrin,et al.  Quality of life in patients attending a low‐risk gynaecological oncology follow‐up clinic , 2001, Psycho-oncology.

[82]  D. Stewart,et al.  The views of ovarian cancer survivors on its cause, prevention, and recurrence. , 2001, Medscape women's health.

[83]  L. Northouse.  Mastectomy patients and the fear of cancer recurrence , 1981, Cancer nursing.

[84]  C. Moy,et al.  Development and validation of disease-specific measures for choroidal melanoma: COMS-QOLS report No. 2. , 2003, Archives of ophthalmology.

[85]  D. Jeffe,et al.  Correlates of fear of cancer recurrence in women with ductal carcinoma in situ and early invasive breast cancer , 2011, Breast Cancer Research and Treatment.

[86]  S. Vickberg.  Locating Breast Cancer in the Context of Women's Lives , 2003 .

[87]  S. Rogers,et al.  Fear of recurrence and possible cases of anxiety and depression in orofacial cancer patients. , 2003, International journal of oral and maxillofacial surgery.

[88]  B. Matthews,et al.  Role and gender differences in cancer-related distress: a comparison of survivor and caregiver self-reports. , 2003, Oncology nursing forum.

[89]  L. Carey,et al.  Women's experiences with genomic testing for breast cancer recurrence risk , 2010, Cancer.

[90]  A. Brédart,et al.  Qualité de vie et état psychologique de patients atteints d’un mélanome de la choroïde : étude longitudinale , 2011 .

[91]  M. Dempster,et al.  Psychological distress among family carers of oesophageal cancer survivors: the role of illness cognitions and coping , 2011, Psycho-oncology.

[92]  M. Diefenbach,et al.  Longitudinal associations among quality of life and its predictors in patients treated for prostate cancer: The moderating role of age , 2008, Psychology, health & medicine.

[93]  G. Stucki,et al.  Cost-effectiveness of cognitive-behavioral group therapy for dysfunctional fear of progression in cancer patients , 2011, The European Journal of Health Economics.

[94]  Suzanne M. Johnson Vickberg,et al.  The concerns about recurrence scale (CARS): A systematic measure of women’s fears about the possibility of breast cancer recurrence , 2003, Annals of behavioral medicine : a publication of the Society of Behavioral Medicine.

[95]  J. Holland,et al.  Quality of life for adult leukemia survivors treated on clinical trials of cancer and leukemia group B during the period 1971‐1988 , 1997, Cancer.

[96]  Carolyn Rabin,et al.  Conceptualization of disease timeline predicts posttreatment distress in breast cancer patients. , 2004, Health psychology : official journal of the Division of Health Psychology, American Psychological Association.

[97]  J. Holland,et al.  Assessing anxiety in men with prostate cancer: further data on the reliability and validity of the Memorial Anxiety Scale for Prostate Cancer (MAX-PC). , 2006, Psychosomatics.

[98]  C. Shapiro,et al.  Are rural Ohio Appalachia cancer survivors needs different than urban cancer survivors? , 2009, Journal of cancer survivorship : research and practice.

[99]  A. Stanton,et al.  Form or function? Part 2. Objective cosmetic and functional correlates of quality of life in women treated with breast‐conserving surgical procedures and radiotherapy , 2001, Cancer.

[100]  B. Pollock,et al.  A comparison of races and leukemia subtypes among patients in different cancer survivorship phases. , 2011, Clinical lymphoma, myeloma & leukemia.

[101]  E. Grunfeld,et al.  Factors reported to influence fear of recurrence in cancer patients: a systematic review , 2013, Psycho-oncology.

[102]  W. Yeo,et al.  Psychosocial impact of breast cancer surgeries in chinese patients and their spouses , 2004, Psycho-oncology.

[103]  H. Brenner,et al.  Fear of recurrence and disease progression in long‐term (≥5 years) cancer survivors—a systematic review of quantitative studies , 2013, Psycho-oncology.

[104]  D. Brockopp,et al.  Quality of life one year following bone marrow transplantation: psychometric evaluation of the quality of life in bone marrow transplant survivors tool. , 2001, Oncology nursing forum.

[105]  S. Lutgendorf,et al.  Cancer fear and mood disturbance after radical prostatectomy: consequences of biochemical evidence of recurrence. , 2003, The Journal of urology.

[106]  J. Griggs,et al.  Correlates of worry about recurrence in a multiethnic population‐based sample of women with breast cancer , 2011, Cancer.

[107]  M. Mackean,et al.  Carcinoembryonic antigen (CEA) testing in colorectal cancer follow up: what do patients think? , 2007, Postgraduate Medical Journal.

[108]  P. Salovey,et al.  Patient participation in treatment decision making and the psychological consequences of breast cancer surgery. , 1998, Women's health.

[109]  B. Trock,et al.  Psychological side effects of breast cancer screening. , 1991, Health psychology : official journal of the Division of Health Psychology, American Psychological Association.

[110]  C. White,et al.  The prevalence and moderators of fatigue in people who have been successfully treated for cancer. , 2006, Journal of psychosomatic research.

[111]  P. Sismondi,et al.  Menopause after breast cancer: a survey on breast cancer survivors. , 2003, Maturitas.

[112]  G. Devins,et al.  Emotional distress impacts fear of the future among breast cancer survivors not the reverse , 2009, Journal of cancer survivorship : research and practice.

[113]  Erika A. Waters,et al.  Perceived Risk, Trust and Health-related Quality of Life Among Cancer Survivors , 2010, Annals of behavioral medicine : a publication of the Society of Behavioral Medicine.

[114]  Patricia A. Ganz,et al.  From cancer patient to cancer survivor : lost in transition , 2006 .

[115]  C. Sheppard,et al.  Breast cancer follow up: a randomised controlled trial comparing point of need access versus routine 6-monthly clinical review. , 2009, European journal of oncology nursing : the official journal of European Oncology Nursing Society.

[116]  Liying Zhang,et al.  Patients' and health care professionals' evaluation of health-related quality of life issues in bone metastases. , 2009, European journal of cancer.

[117]  S. Rogers,et al.  The association of cigarette smoking and anxiety, depression and fears of recurrence in patients following treatment of oral and oropharyngeal malignancy. , 2004, European journal of cancer care.

[118]  J. Schreiber.  Image of God: effect on coping and psychospiritual outcomes in early breast cancer survivors. , 2011, Oncology nursing forum.

[119]  A. Mehnert,et al.  Fear of cancer progression and cancer‐related intrusive cognitions in breast cancer survivors , 2009, Psycho-oncology.

[120]  L. Bernstein,et al.  Complementary and alternative therapies among very long-term breast cancer survivors , 2009, Breast Cancer Research and Treatment.

[121]  Zeev Rosberger,et al.  Comparison of four common stressors across the breast cancer trajectory. , 2007, Journal of psychosomatic research.

[122]  Howard Balshem,et al.  GRADE guidelines: 3. Rating the quality of evidence. , 2011, Journal of clinical epidemiology.

[123]  Trevor Murrells,et al.  Patients' supportive care needs beyond the end of cancer treatment: a prospective, longitudinal survey. , 2007, Journal of clinical oncology : official journal of the American Society of Clinical Oncology.

[124]  D. Bowen,et al.  Psychometric Evaluation of the Brief Cancer Impact Assessment among Breast Cancer Survivors , 2006, Oncology.

[125]  K. Ashing-Giwa,et al.  Examining emotional outcomes among a multiethnic cohort of breast cancer survivors. , 2011, Oncology nursing forum.

[126]  G. Taylor,et al.  Need for Supportive Counselling – the Professionals’ versus the Patients’ Perspective , 1998, Psychotherapy and Psychosomatics.

[127]  R. Gray,et al.  Canadian women's perspectives on ovarian cancer. , 1999, Cancer prevention & control : CPC = Prevention & controle en cancerologie : PCC.

[128]  S. Rachman.  Contributions to medical psychology , 1980 .

[129]  G. Humphris,et al.  The AFTER intervention: a structured psychological approach to reduce fears of recurrence in patients with head and neck cancer. , 2008, British journal of health psychology.

[130]  P. Carroll,et al.  Fear of recurrence, symptom burden, and health-related quality of life in men with prostate cancer. , 2008, Urology.

[131]  J. Savard,et al.  Screening and comorbidity of clinical levels of fear of cancer recurrence , 2015, Journal of Cancer Survivorship.

[132]  K. Portier,et al.  Exploratory factor analysis of the Cancer Problems in Living Scale: a report from the American Cancer Society's Studies of Cancer Survivors. , 2009, Journal of pain and symptom management.

[133]  U. Matulonis,et al.  Comparison of the quality of life of early and advanced stage ovarian cancer survivors , 2008 .

[134]  M. Köhler,et al.  Wer hat größere Furcht vor einer Verkürzung der Lebensspanne: palliativ oder kurativ behandelte Krebspatienten? , 2010 .

[135]  L. Weiss,et al.  A Population-Based Study of the Quality of Life of Cancer Survivors and Their Family Caregivers , 2006, Cancer nursing.

[136]  B. Ferrell,et al.  Quality of life in breast cancer survivors: implications for developing support services. , 1998, Oncology nursing forum.

[137]  M. Schlairet.  Needs of older cancer survivors in a community cancer care setting. , 2011, Journal of gerontological nursing.

[138]  J. Savard,et al.  Fear of Cancer Recurrence Inventory: development and initial validation of a multidimensional measure of fear of cancer recurrence , 2009, Supportive Care in Cancer.

[139]  Mast Me.  SURVIVORS OF BREAST CANCER : ILLNESS UNCERTAINTY, POSITIVE REAPPRAISAL, AND EMOTIONAL DISTRESS , 1998 .

[140]  I. Fentiman,et al.  Quality of life in breast cancer patients aged over 70 years, participating in the EORTC 10850 randomised clinical trial. , 2003, European journal of cancer.

[141]  P. Carroll,et al.  Fear of recurrence, treatment satisfaction, and quality of life after radical prostatectomy for prostate cancer , 2008, Supportive Care in Cancer.

[142]  C. Gotay,et al.  Assessment of Survivor Concerns (ASC): A newly proposed brief questionnaire , 2007, Health and quality of life outcomes.

[143]  M. Schlairet,et al.  Piloting a needs assessment to guide development of a survivorship program for a community cancer center. , 2010, Oncology nursing forum.

[144]  M. Keller,et al.  Fear of progression in chronic diseases: psychometric properties of the Fear of Progression Questionnaire. , 2005, Journal of psychosomatic research.

[145]  E. Winer,et al.  Long‐term psychosocial adjustment of older vs younger survivors of breast and endometrial cancer , 2007, Psycho-oncology.

[146]  T. Gansler,et al.  The role of psychological functioning in the use of complementary and alternative methods among disease‐free colorectal cancer survivors , 2009, Cancer.

[147]  J. Earle,et al.  Quality of life after iodine 125 brachytherapy vs enucleation for choroidal melanoma: 5-year results from the Collaborative Ocular Melanoma Study: COMS QOLS Report No. 3. , 2006, Archives of ophthalmology.

[148]  S. Rogers,et al.  The development of a Patients Concerns Inventory (PCI) to help reveal patients concerns in the head and neck clinic. , 2009, Oral oncology.

[149]  N K Aaronson,et al.  Quality of life of early-stage breast cancer patients treated with radical mastectomy or breast-conserving procedures: results of EORTC Trial 10801. The European Organization for Research and Treatment of Cancer (EORTC), Breast Cancer Co-operative Group (BCCG). , 1998, European journal of cancer.

[150]  P. Butow,et al.  When the safety net of treatment has been removed: patients' unmet needs at the completion of treatment for haematological malignancies. , 2009, Patient education and counseling.