Missing moments and being a burden: the lived experience of fear of cancer recurrence among older rural Australian women.

Fear of cancer recurrence is a common experience in cancer survivorship and can impact both physical and mental well-being. Some evidence exists on the manifestation of fear of cancer recurrence and its treatment. The purpose of this qualitative study was to fill a gap in the understanding of rural older women's lived experience of fear of cancer recurrence. A sample of ten women aged ≥ 65 years living in rural Australia who were in remission from gynaecological cancers participated in semi-structured interviews about their lived experience of fear of cancer recurrence. Inductive thematic analysis generated four overarching themes that were subsequently mapped onto the Lee-Jones Model of fear of cancer recurrence, which provided a largely congruent interpretative framework for the affective, behavioural and cognitive aspects of older women's experiences in this sample. However, themes relating to coping mechanisms and help-seeking behaviour extended beyond the model's constructs, particularly around participants' strong self-reliance values and aversion to seeking support. Across interviews, a prominent concern was the fearof being a burden to family if cancer were to return, or concern for family members if they were to die. Further, they expressed an aversion to seeking professional help when worries about recurrence emerged, preferring to distract themselves or avoid thoughts of fear. The aversion to help-seeking highlighted in this sample suggested that traditional forms of support offered for fear of cancer recurrence may not be appropriate for older women. Further work is needed to establish targeted support for this cohort.