Does emotional talk vary with fears of cancer recurrence trajectory? A content analysis of interactions between women with breast cancer and their therapeutic radiographers

Fears of cancer recurrence (FCR) in patients with breast cancer are hypothesised to develop over the period from diagnosis, through treatment and thereafter. A crucial point may be the contact that patients have with their therapeutic radiographer in review appointments. The study aimed to (1) describe and categorise the content of the identified emotional talk, and (2) consider the evidence for an association of content with FCR trajectory. Methods: A concurrent mixed methods approach was applied as part of a larger investigation (FORECAST) of breast cancer patients (n = 87). Patients completed a daily diary during their radiotherapy treatment. Audio recordings were collected of review appointments. The Verona Coding Definitions of Emotional Sequences (VR-CoDES) system was used to code patient emotional cues and concerns (CCs). Purposeful sampling of the daily diary ratings identified 12 patients (30 consultations) with an increasing (n=6) or decreasing (n=6) FCR trajectory. The emotional talk of these patients at their weekly reviews was content analysed. Results: Four themes were identified from 185 CCs: Physical Symptoms, Factors External to Hospital, Treatment, and Labelling Cancer. FCR decreasing trajectory group consultations were longer (p < 0.02), expressed twice as many CCs as the increasing trajectory group (p < 0.001), and were more likely to refer to cancer directly (p < 0.05). Conclusions: The emotional content expressed matched features outlined in the Lee-Jones et al (1997) FCR model, and showed evidence of avoidance in increasing FCR trajectory patients.