FEAR OF CANCER RECURRENCE IN RURAL AUSTRALIAN WOMEN WITH A DIAGNOSIS OF BREAST CANCER - A META-NARRATIVE REVIEW

ABSTRACT Introduction Fear of cancer recurrence (FCR) has emerged as a significant concern for breast cancer survivors, regardless of geographical location.  There are acknowledged links between FCR and anxiety and/or depressive states, however there is currently a paucity of literature on those links and efforts to reduce FCR are limited. This meta-narrative review examines the potential link between a pre-existing anxiety and/or depressive state, FCR and geographical isolation. Method A small, but highly targeted, selection of literature from a diverse range of sources, both scientific and grey, was examined using a meta-narrative style. Results The search process revealed fourteen pieces of literature. Ten published studies, two FCR dissertations and two pieces of grey literature were included in the study. Five emergent themes were identified: completion of treatment; pre-existing mental health status; family and community support structures; distance from primary treating centre and fear of cancer recurrence. Within the FCR component, there were emergent sub-themes, including knowledge of someone with a recurrence of cancer and either trait or state anxiety and/or depression. Discussion There was evidence of poorer mental health outcomes amongst rural survivors, however no significant links between geographical isolation and levels of FCR were identified. Although the presence or absence of family and community support structures was a significant theme within the literature, no clear link could be made to FCR. Conclusion Further research examining the relationship between FCR in rural breast cancer survivors and pre-existing anxiety and/or depression is needed. It is important to better understand the mental health impacts of breast cancer in order to improve health care and health outcomes for rural living breast cancer survivors.