Treating fear of cancer recurrence with Eye Movement Desensitization Reprocessing: a sequential, randomized single-case experimental design

Abstract

Fear of cancer recurrence (FCR) is defined as “fear, worry, or concern relating to the possibility that cancer will come back or progress”. After cancer treatment, 20% of patients suffer from clinical fear of cancer recurrence (FCR), warranting specialized treatment. While intrusive catastrophic scenarios are clinical symptoms of FCR, they are rarely the key focus in current FCR treatments. Eye Movement Desensitization Reprocessing (EMDR) including the flash forward procedure explicitly addresses these intrusions. The present study explored whether EMDR is effective in treating clinical FCR. A sequentially replicated, randomized single-case experimental design was used among six cancer survivors with clinical levels of FCR. During an 84-day period, participants daily registered their FCR level. The Fear of Recurrence Inventory was administered at baseline, EMDR start, EMDR completion and study completion. The start of EMDR was randomized. All participants commented positively on the effect of EMDR during the semi-structured interviews: EMDR helped decrease intrusions and face death anxiety. Visual analysis of daily FCR were in line with these comments. Regression analysis showed a significant decrease of daily FCR in two participants, while the randomization test showed no effects. FCRI scores decreased below clinical levels in all participants, which was considered a reliable change in four participants. There was no drop-out. In light of these mixed findings, EMDR appears a promising treatment for FCR. Further research needs to establish its effectiveness and explore whether diminishing the emotional load of intrusions constitutes the working mechanism of EMDR in FCR.