'Living beneath the sword of damocles': perceptions of risk and fears of cancer recurrence amongst Australian melanoma survivors at high or moderate risk of developing new primary disease

Nadine A. Kasparian, Jordana K. McLoone, Bettina Meiser, Phyllis N. Butow, Margaret Charles, Kristine Barlow-Stewart, Graham J. Mann, Scott W. Menzies

Research output: Contribution to journalMeeting abstractpeer-review


Background: Despite continued progress in the clinical management of
melanoma, patients continue to live at increased risk of developing new
primary disease. This study examined risk perceptions, fears of cancer recurrence,
melanoma-related behaviours, and satisfaction with clinical care
amongst melanoma survivors at high or moderate risk of new primary
Methods: Participants were recruited via the High Risk Clinic at the Sydney
Melanoma Diagnostic Centre (high risk group) or the Melanoma Institute
Australia (moderate risk group). Individuals at high risk (i.e. multiple
melanoma diagnoses, or one primary melanoma and dysplastic naevus
syndrome, DNS), or moderate risk (one melanoma and no DNS) completed
a questionnaire assessing: psychological factors (e.g. fear of melanoma
recurrence, risk perceptions, anxiety, depression); sun protection and skin
cancer screening behaviours; satisfaction with clinical care; and demographic
and clinical characteristics.
Results: 310 participants completed the survey (high risk n = 165; moderate
risk n = 145; response rate: 79%; 56% male; mean age: 59.5 years;
SD = 12.8). Clinically-relevant levels of anxiety and depression, as measured
by the HADS, were reported by 25% and 9% of participants, respectively.
Seventy-three percent of participants reported clinically-relevant levels of
fear of cancer recurrence, with mean scores similar between groups (t = −1.2,
p = 0.2). Participants reported high levels of satisfaction with melanoma
care. Path analysis is currently underway and will be presented at the
Conclusion: Melanoma patients experience a range of practical, emotional,
physical, and social challenges as a result of their diagnosis and treatment.
For some people, these challenges may continue to have an impact long after
initial diagnosis. Although many patients exhibit healthy psychological
adjustment, this study found that 73% of moderate- to high-risk patients
report levels of fear of cancer recurrence indicative of the need for clinical
intervention. To be effi cacious, psychological support must be offered to
patients in a timely manner, and should be tailored to the individual’s needs
and resources.
Original languageEnglish
Article number450
Pages (from-to)236-236
Number of pages1
JournalAsia-Pacific Journal of Clinical Oncology
Issue numberSupplement S3
Publication statusPublished - Nov 2012
Externally publishedYes
EventJoint Meeting of the COSA 39 Annual Scientific Meeting and IPOS 14 World Congress of Psycho–Oncology - Brisbane, Australia
Duration: 13 Nov 201215 Nov 2012

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