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FORT

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Psychosocial Oncology Laboratory

Living with cancer can be an overwhelming experience for patients and their families. Although more than half of Canadians diagnosed with cancer today will go on to live for several years with the disease, the survivorship phase is accompanied by several challenges such as fear of cancer recurrence, fatigue, and relationship changes. Our laboratory is dedicated to better understanding these challenges and to developing evidence-based interventions to address them.

We are grateful to receive research funding from the Canadian Institutes of Health Research (CIHR), the Canadian Cancer Society, the University of Ottawa Faculty of Social Sciences, and the Social Sciences and Humanities Research Council of Canada (SSHRC).

 

Research Activities

Living with Lung Cancer
Family Caregiver FORT

Dr. Lebel’s laboratory is working on adapting the FORT intervention for family caregivers and to an online format. With the help of an advisory board that included patient partners, therapists and researchers, Dr. Lebel’s team began the adaptation process of both the FORT therapist and patient manuals and is currently conducting a usability study to determine the usefulness, usability, desirability, value, accessibility, and credibility of the adapted FORT intervention (FC-FORT). Following a successful usability study, Dr. Lebel’s team will move forward with a pilot study of FC-FORT using a randomized control trial design. This project is one of the first to evaluate the feasibility of an online intervention dedicated to family caregivers living with fear of cancer recurrence. This will help bridge an important gap in bringing evidence-based care to caregivers who have never been offered help before for their fear of cancer recurrence.

 

Clinical Fear of Cancer Recurrence: Development and Validation of a Clinical Interview, Self-Report Measure, and Screening Tool

Fear of cancer recurrence (FCR) is a common experience for cancer survivors who fear their cancer may come back in the same or a different part of the body (Lebel et al., 2016). Although almost 49% of cancer survivors clinical levels of FCR (Simard et al., 2013), there currently exists no measure used by healthcare professionals to detect clinical FCR. Thus, Dr Sophie Lebel, Ph.D candidate Brittany Mutsaers, and Lauriane Giguère are currently creating and validating three measures for healthcare professional to use to detect clinical FCR. Once finalized, the Ottawa Clinical Fear of Recurrence – Interview (OCFR-I), the Ottawa Clinical Fear of Recurrence – Measure (OCFR-M), and Ottawa Clinical Fear of Recurrence – Screener (OCFR-S) will be validated in three parts. One will consist in completing the OCFR-M and OCFR-S along with six other measures. Around 230 participants will be recruited. The second stage, which will be optional (n = 50), will consist in completing the OCFR-M and OCFR-S again after a two-week period. Finally, the third stage, which will also be optional, will consist in completing the OCFR-I and three other interviews (n = 50). Recrutement is currently underway. This study will take place in Spring 2022. Should you be interested in participating or seek more information, email us at fcrstudy@toh.ca

Parent FORT
Dr. Lebel’s laboratory is currently adapting the FORT intervention for parents of child cancer survivors. With the guidance of a parent advisory, Dr. Lebel’s team is in the process of adapting both the FORT therapist and patient manuals. Upon its completion, we will conduct a usability study to determine the usefulness, usability, desirability, value, accessibility, and credibility of the adapted FORT intervention (Parent-FORT). Following a successful usability study, Dr. Lebel’s team will move forward with a pilot study of Parent-FORT using a randomized control trial design. This project is one of the first to evaluate the feasibility and acceptability of a fear of recurrence intervention for parents of childhood cancer survivors. This will help bridge an important gap in bringing evidence-based care to parents who have never been offered help before for their fear of cancer recurrence.
FORT Implementation Study
Why am I still tired? A group for cancer-related fatigue

Cancer-related fatigue (CRF) is one of the most prevalent and debilitating symptoms experienced by cancer survivors. CRF has been defined as a “distressing, persistent, subjective sense of tiredness or exhaustion related to cancer or cancer treatment that is not proportional to recent activity and interferes with usual functioning” (Berger et al, 2015). University of Ottawa researchers, Dr. Sophie Lebel and PhD Candidate Nicole Rutkowski, have partnered with the Ottawa Regional Cancer Foundation and a patient advisory board to adapt and deliver an intervention for CRF. The group is a 4-week virtual program for cancer survivors who continue to experience CRF and incorporates evidence-based treatments such as physical activity, cognitive behavioural therapy, and mindfulness. The first group launched in February 2022, the next groups will be offered in late spring and fall of 2022. The sustainability of the group was important to us; therefore, the group will continue being offered at the Ottawa Regional Cancer Foundation once the research study has been completed. If you are interested in more information on the study please contact CRFstudy@uottawa.ca.

Scoping Review on the Psychosocial Experiences of Black Canadians

Our Team

Headshot of Dr. Sophie Lebel; a woman wearing a scarf stands in front of a vine-covered wall.

Director 

Dr. Sophie Lebel, C.Psych

Ph.D. Clinical Psychology, University of Montreal, 2004

B.Sc. Psychology, McGill University, 1997

Dr. Sophie Lebel is a clinical health psychologist with a Ph.D. from Université de Montréal, Québec. She joined the Faculty in July 2007 after completing a post-doctoral fellowship at the Princess Margaret Cancer Center in Toronto, Ontario.

Her research interests focus on cancer survivors and their families, with a focus on developing and testing questionnaires, models, and interventions for fear of cancer recurrence, sexuality, fatigue, stigma, and dyadic adjustment. She is the director of the Interdisciplinary Psychosocial Oncology Research Group and Laboratory, an initiative that brings together researchers, health care providers, community partners, and trainees with an interest in helping cancer patients and their loved ones in the Greater Ottawa region. Clinically, Dr. Lebel helps cancer patients and their caregivers with adjustment difficulties throughout the disease trajectory.

Dr. Lebel is currently supervising the Doctoral dissertations of Alanna Chu, Lauriane Giguère, Nicole Rutkowski, Jani Lamarche, Ghizlène Sehabi, and Malick Outtara.

Office: 4016

Email: slebel@uottawa.ca

Graduate Students

Alanna Chu

b8982ccc-74be-4e4a-9b69-9d9d46966442

Ph.D Candidate

Alanna Chu, MPH

Ph.D., Clinical Psychology, University of Ottawa, 2020-

Microprogram in Evaluation Sciences

Master of Public Health in Epidemiology, University of Toronto, 2019

Collaborative Specialization in Addiction Studies 

B.A. Psychology, Queen’s University, 2016

Alanna Chu is a doctoral candidate in the Clinical Psychology program at the University of Ottawa. Her research interests are in the experiences of fear of cancer progression and supportive care needs of patients with advanced and metastatic lung cancer receiving an immunotherapy or targeted therapy. Her clinical interests are in clinical, health and rehabilitation psychology. She received her Master of Public Health in Epidemiology with a collaborative specialization in addictions from the University of Toronto in 2019 and her Bachelor of Arts in Psychology from Queen’s University in 2016.

Dissertation: Living in Limbo: The psychological experiences and unmet needs of patients with advanced and metastatic lung cancer receiving immunotherapy and targeted therapy (defended proposal December 2022) 

Publications: https://www.researchgate.net/profile/Alanna-Chu

Lauriane Giguère
 

 

IMG_8927[71]

Ph.D Candidate

Lauriane Giguère, B.A

Ph.D., Clinical Psychology, University of Ottawa, 2021-

B.A., Psychology, University of Ottawa, 2021

Lauriane Giguère is a doctoral candidate in the Clinical Psychology program at the University of Ottawa. Her research interests focus on clinical fear of cancer recurrence, including the development of measures and interventions for fear of cancer recurrence as well as the impact of fear of cancer recurrence on caregivers of cancer patients or survivors.

Dissertation: Clinical Fear of Cancer Recurrence: Validation of a Clinical Interview, Self-Report Measure, and Screening Tool

Publications: https://www.researchgate.net/profile/Lauriane-Giguere

Jani Lamarche
jani_headshot25

Ph.D. Candidate

Jani Lamarche, BA

Ph.D., Clinical Psychology, University of Ottawa, 2019-

B.A., Psychology, University of Ottawa

Jani Lamarche is a doctoral candidate in the Clinical Psychology program at the University of Ottawa. Her research interests include fear of cancer recurrence, cancer patients and family caregivers, and the development of E-health interventions. She is currently working on adapting the Fear Of Recurrence Therapy (FORT) intervention for family caregivers of cancer patients and to an online format.

Dissertation: It’s Time to Address Fear of Cancer Recurrence in Family Caregivers: Adaptation, Feasibility, and Acceptability Study of an Online Version of the Fear of Recurrence Therapy (FORT) 

Publications: https://www.researchgate.net/profile/Jani-Lamarche

Nicole Anna Rutkowski
nicole

Ph.D Candidate

Nicole Anna Rutkowski, BA

Ph.D., Clinical Psychology, University of Ottawa, 2017-

B.A. Psychology, University of Ottawa, 2016

Minor in Social Sciences of Health

Nicole is a doctoral candidate in the Clinical Psychology program at the University of Ottawa. Nicole’s personal research interests include cancer-related and post-stroke fatigue, social support and rehabilitation in advanced cancer patients, sexuality, and chronic pain. She received her Bachelor of Arts in Psychology (with a minor in Social Sciences of Health) from the University of Ottawa in 2016.

 

Dissertation: Why am I Still Tired? Adaptation, Implementation and Evaluation of an Intervention for Cancer-Related Fatigue

Ghizlène Sehabi

Ph.D Student

Ghizlène Saida Sehabi, BA

B.A. Psychology, University of Ottawa, 2023

Minor in Health Sciences

 

Ghizlène Sehabi is a Ph.D. doctoral student in the Clinical Psychology program at the University of Ottawa.

Malick Outtara

Research Staff

Celeste Holy

One morning, when Gregor Samsa woke from troubled dreams, he found himself transformed bed a horrible vermin pitifully compared.

Emma Kearns

IMG_1853 3

Research Coordinator

Emma Kearns, BA

Emma is a full-time research coordinator in the PSO Lab through the Ottawa Hospital Research Institute. She is involved in the Clinical Fear of Cancer Recurrence measures study and the Family Caregiver FORT implementation study, and is involved in general laboratory coordination activities. 

 

Anne Leslie

AnneLPhoto

Research Coordinator

Anne Leslie, BSc, MRT(R)

Advanced Diploma, Medical Radiation Technology, Algonquin 

B.Sc., Interdisciplinary Health Sciences, University of Ottawa

Anne holds an Honours Interdisciplinary Health Sciences undergraduate degree from the University of Ottawa, as well as an Advanced Diploma in Medical Radiation Technology from Algonquin College. In addition to working as a research assistant on the Living With Lung Cancer study, Anne works in mammography as a diagnostic imaging technologist at The Ottawa Hospital. Anne has a keen interest in interdisciplinary approaches to healthcare, and how facilitating continuity of care can lead to improved patient experiences. 

Undergraduate Honours Students

Suchithra Shenthil

Suchithra is in the process of completing her B.A. Honours Thesis under the supervision of Laurianne Giguère.

Past Members

Brittany Mutsaers
brittany

Brittany is a Graduate Student in Clinical Psychology, University of Ottawa. Brittany’s research interests focus on cancer survivorship issues, namely fear of cancer recurrence. She is interested in investigating the characteristics that differentiate clinical from non-clinical levels of fear of cancer recurrence, and intervention approaches to help cancer survivors cope with FCR at various levels of severity.

Brittany also has an interest in program evaluation, particularly in the context of programs developed for cancer survivors that address psycho-social aspects of cancer survivorship, self-management, empowerment, and living well after a cancer diagnosis.

Tori Langmuir
Danielle Figueiredo

Danielle's research is currently analyzing fear of cancer recurrence and the meditational role of coping in gynecological and breast cancer survivors.

Fatima Imsirovic
Georden Jones
georden_5

Dr. Jones provides bilingual individual psychotherapy for adults and couples' therapy. Her areas of practice include anxiety, obsessive compulsive disorder, depression, chronic illness, adjustment to illness, pain management, fatigue, and sleeping difficulties. Georden’s primary research interests are in psychosocial oncology: cancer-related fatigue, fear of cancer recurrence, health anxiety, and stigma. In a broader sense, she is also intrigued by the impact of chronic illnesses on patients’ mental health, the ability to adjust and cope with health concerns, and couples' and caregivers' adjustment to a family member living with chronic illnesses.

Julia Parrott
Julia's research interests include existential issues of youth coping with long-term illness', and she is currently researching intolerance of uncertainty as it relates to breast and gynecological cancer survivors.
Danielle Petricone-Westwood
danielle

Danielle's dissertation research focuses on caregivers of patients with ovarian cancer, with a particular interest in attachment theory and the caregiver's relationship with the healthcare provider. She additionally is interested in distress among patients and their families with advanced cancer, psychosocial concerns at the end of life, and psychotherapeutic interventions to help individuals and couples adapt to chronic illness.

Caroline Séguin Leclair
caroline

Caroline’s primary research interests are in psychosocial oncology:  fear of cancer recurrence, health behaviours, coping and adjustment throughout the cancer trajectory. In a broader sense, she is also intrigued by the impact of chronic illnesses on patients’ mental health and the ability to adjust and cope with health concerns.

Previous Projects

Partnership project with Lung Cancer Canada

Lung cancer is currently the leading cause of cancer-related deaths in Canada. The recent development of immunotherapy and targeted therapy drugs offer a new hope for prolonging survival and improving quality of life in patients with advanced lung cancer. However, treatment response to these drugs is variable and unpredictable. Thus, early research indicates that patients are “living in limbo”, oscillating between periods of hopeful engagement in valued life activities, and periods of uncertainty about treatment, the future, and end-of-life. This situation presents unique challenges to this population which must be better understood. The study design and interview guide were developed in partnership with Lung Cancer Canada (LCC) and a patient advisory board. A diverse group of patients with advanced or metastatic lung cancer receiving immunotherapy or targeted therapy were recruited from across Canada. Qualitative interviews (n = 30) explored their unmet needs using the Supportive Care Framework in Cancer Care (Fitch, 2008) as well as the preferred self-designations of this group (e.g., survivor, cancer patient.

Why am I still tired? A group for cancer-related fatigue

Cancer-related fatigue (CRF) is one of the most prevalent and debilitating symptoms experienced by cancer survivors. CRF has been defined as a “distressing, persistent, subjective sense of tiredness or exhaustion related to cancer or cancer treatment that is not proportional to recent activity and interferes with usual functioning” (Berger et al, 2015). University of Ottawa researchers, Dr. Sophie Lebel and PhD Candidate Nicole Rutkowski, have partnered with the Ottawa Regional Cancer Foundation and a patient advisory board to adapt and deliver an intervention for CRF. The group was a 4-week virtual program for cancer survivors who continue to experience CRF and incorporates evidence-based treatments such as physical activity, cognitive behavioural therapy, and mindfulness. The sustainability of the group is important to us; therefore, the group will continue being offered at the Ottawa Regional Cancer Foundation now that the research study has concluded.

The Use of Survivorship Care Plans as a Transition Tool from the Cancer Center to Follow-Up in Primary Care Settings

FORT Materials

Fear of Cancer Recurrence Therapy (FORT) Materials can be requested here.

 

Publications

Articles published in peer-reviewed journals (past 5 years)
  • Mah, K., Lebel, S., Irish, J., Bezjak, A., Payne, A.Y.M., & Devins, G.M. "A two-dimensional model of disrupted body integrity: Initial evaluation in head and neck cancer". Supportive Care in Cancer, in press. 
  • Tomei, C., Lebel, S., Maheu, C., Lefebvre, M. & Harris, C. "Examining the Efficacy of an Intervention for Fear of Cancer Recurrence: A Randomized Controlled Clinical Trial Pilot Study". Supportive Care in Cancer, in press.
  • Wan, C., Arès, I., Gareau, A., Collins, K. A., Lebel, S., & Bielajew, C. "Motherhood and well-being in young breast cancer survivors". Breast Cancer Management, in press.       
  • Fardell, J., Jones, G., Smith, A., Lebel, S., Thewes, B., Costa, D., Tiller, K, Simard, S., Feldstain, A., Beattie, S., McCallum, M, on behalf of the Conquer Fear authorship group, & Butow, P. “Exploring the screening capacity of the Fear of Cancer Recurrence Inventory-Short form for clinical levels of fear of cancer recurrence”. Psycho-Oncology, 27(2), pp 492-499, 2018. 
  • Wan, C., Couture-Lalande, M.-E., Lebel, S., & Bielajew, C. “The role of stressful life events on the cortisol secretion patterns of breast cancer survivors”, Psychology & Health, 32(12), pp 1485-1501, 2017. Author
  • McCallum, M., Jolicoeur, L., Lefebvre, M., Babchishin, L. K., Le, T., &  Lebel, S. “Filling in the Gaps: Sociodemographic and Medical Predictors of Sexual Health and Other Supportive Care Needs and Desire for Help in Gynecological Cancer Survivors”. Canadian Oncology Nursing Journal, 27(3), pp 251-258, 2017.
  • Jones, G., Séguin Leclair, C., Petrione-Westwood, D., Lefebvre, M., Morash, R., Liska, C. Jolicoeur, L., Lebel, S., “An Implementation Evaluation of the Wellness Beyond Cancer Survivorship Class: Who is attending?”, Canadian Oncology Nursing Journal, 27(3), pp 268-274, 2017.
  • Feldstain, A., Lebel, S., & Chasen, M., “The longitudinal course of depression symptomatology following a palliative rehabilitation program”, Quality of Life Research. 26(7), pp 1809-1818, 2017.    
  • Lebel, S., Ozakinci, G., Humphris, G., Thewes, B., Prins, J., Dinkel, A., & Butow, P. “Current State and Future Prospects of Research on Fear of Cancer Recurrence”, Psycho-Oncology, 26(4), pp 424-427, 2017.
  • Moran, C., Tomei, C., Lefebvre, M., Harris, C., Maheu, C., & Lebel, S. “An exploratory study of the worst-case scenario exercise as an exposure treatment for fear of cancer recurrence”. Supportive Care in Cancer, 25(5), pp 1373-1375, 2017.
  • Beattie, S., Lebel, S., Petricone-Westwood, D., Wilson, K.G., Harris, C., Devins, G., Huebsch, L., & Tay, J., “Balancing Give and Take in Hematopoietic Stem Cell Transplantation”. Psycho-Oncology, 26(12), pp 2224-2231, 2017. doi: 10.1002/pon.4340.
  • Petricone-Westwood, D. & Lebel, S. “Being a caregiver to patients with ovarian cancer: A scoping review of the literature”. Gynecologic Oncology, 143(1), pp184-192, 2016. 
  • Jones, G., Perez, S., Huta, V., Rosberger, Z., & Lebel, S. “The role of HPV-related stigma on HPV vaccine decision-making among college males”. Journal of American College Health, 64(7), pp 545-554, 2016.
  • Lebel, S., Ozakinci, G., Humphris, G., Mutsaers, B., Thewes, B., Prins, J., Dinkel, A., & Butow, P. “From normal response to clinical problem: Definition and clinical features of fear of cancer recurrence”. Supportive Care in Cancer, 24(8), pp 3265-3268, 2016.
  • Mutsaers, B., Jones, G., Rutkowski, N., Tomei, C., Séguin Leclair, C., Petricone-Westwood, D.,   Simard, S., & Lebel, S. “When Fear of Cancer Recurrence Becomes a Clinical Issue: A Qualitative Analysis”, Supportive Care in Cancer, 24(10), pp 4207-4218, 2016.
  • Maheu, C., Lebel, S., Courbasson C., Lefebvre, M.,  Singh, M., Bernstein, L., Muraca, L., Benea, A., Jolicoeur, L., Harris, C., Ramanakumar, A.V., Ferguson, S., Sidani, S., “Protocol of a randomized controlled trial of the Fear of Recurrence Therapy (FORT) Intervention to address fear of cancer recurrence in women with breast or gynecological cancer”. BMC Cancer, 16, 291, 2016 doi: 10.1186/s12885-016-2326-x.
  • Wan, C., Couture-Lalande, M.-È., Narain, T. A., Lebel, S., & Bielajew, C. “Salivary alpha-amylase reactivity in breast cancer survivors”. International Journal of Environmental Research and Public Health, 13(4), pp 353, 2016.
  • Tomei, C., Lebel, S., Maheu, C., & Mutsaers, B., “Addressing fear of recurrence: improving psychological care in cancer survivors”, Supportive Care in Cancer, 24(7), pp 2815-2818, 2016.
  • Lebel, S., Payne, A.Y.M, Mah, K., Irish, J., Rodin, G., & Devins, G.M. “Do stigma and its psychosocial impact differ between Asian-born Chinese immigrants and Western-born Caucasians with head and neck cancer?”, Psychology, Health & Medicine, 21(5), pp 583-92, 2016.
  • Thewes, B., Lebel, S. Seguin Leclair, C., Butow P., “A qualitative exploration of coping techniques and most feared aspects of FCR amongst Australian and Canadian Young breast cancer survivors”, Supportive Care in Cancer, 24, pp 2269–2276, 2016.
  • Lebel, S., Simard, S., Harris, C., Feldstain, A., Beattie, S., McCallum, M., Lefebvre, M., Savard, J., Devins, G., “Empirical validation of the English version of the Fear of Cancer Recurrence Inventory”, Quality of Life Research, 25(2), pp 311-321, 2016.
  • Feldstain, A., Lebel, S., & Chasen, M., “Self-efficacy: A theoretical basis for interdisciplinary interventions for patients with advanced cancer and depressive symptomatology”, Supportive Care in Cancer, 24(1), pp 109-117, 2016.
  • Devins, G.M., Payne, A.W.Y., Mah, K., Lebel, S., Lee, R.N., Wong, J. Irish, J., & Rodin, G., "Disease-Specific Self-Concept, Distancing, and Subjective Well-Being in Head and Neck Cancer", Psycho-Oncology, 24, pp 1506-1513, 2015.
  • Maheu, C., Lebel, S., Tomei, C., & Singh, M., “A qualitative assessment of women’s experience in participating in a cognitive-existential group intervention for fear of cancer recurrence”, European Journal of Oncology Nursing, 19(4), pp 433-440, 2014.
  • Couture-Lalande, M.-E., Lebel, S., & Bielajew, C., “Analysis of the Cortisol Diurnal Rhythmicity and Cortisol Reactivity in Long-Term Breast Cancer Survivors”, Breast Cancer Management, 3(6), 465-476, 2014.
  • Lebel, S., Maheu, C., Lefebvre, M., Secord, S., Courbasson, C., Singh, M., Jolicoeur, L., Benea, A., Harris, C., Fung Kee Fung, M. Rosberger, Z., & Catton, P., “Addressing Fear of Cancer Recurrence Among Women with Cancer: A Pilot Study of A 6-Week Group Cognitive-Existential Intervention”, Journal of Cancer Survivorship, 8(3), pp 485-96, 2014.
  • Ares, Isabelle, Collins. K. A., Lebel, S., & Bielajew, C., “The Impact of Motherhood on Perceived Stress, Illness Intrusiveness, and Fear of Cancer Recurrence in Young Breast Cancer Survivors over Time”, Psychology & Health, 29(6), pp 651-70, 2014.
  • McCallum, M., Jolicoeur, L., Lefebvre, M., Babchishin, L., Robert-Chaurest, S., Le, T., & Lebel, S., “Supportive care needs after gynecological cancer: Where does sexual health fit in? Evaluating unmet needs and desire for help”, Oncology Nursing Forum, 41(3), pp 297-306, 2014.
  • Feldstain A., Bélanger, M., Tomei, C., & Lebel, S., Screening for distress in patients with cancer: Methodological considerations, Current Oncology, 21(2), pp 330-33, 2014.
  • Lebel, S., Beattie, S., Ares, I., & Bielajew, C., "Young and worried: age and fear of recurrence among breast cancer survivors", Health Psychology, 32(6), pp 695-705, 2013.
  • Lebel, S., Feldstain A., McCallum, M., Beattie, S., Irish, J., Bezjak, A., & Devins, G., "Predicting positive health changes in survivors of head and neck or lung cancer", Psychology & Health, 28(9), pp 1066-1081, 2013.
  • Beattie, S., Lebel, S, & Tay, J., "The Influence of Social Support on Hematopoietic Stem cell Transplantation Survival: A Systematic Review of literature", PLOS One, 8(4), pp 1-5, 2013.
  • Lebel, S., Tomei, C., Feldstain, A., Beattie, S., & McCallum, M., "Does Fear of Cancer Recurrence Predict Cancer Survivors’ Health Care Use?", Supportive Care in Cancer, 21(3), pp. 901-906, 2013.
  • Devins, G., Payne, A.Y.M., Lebel, S. Mah, K., Lee, R.N.F., Irish, J., Wong, J. & Rodin, G., "The Burden of Stress in Head and Neck Cancer", Psycho-Oncology, 22, pp. 668-676, 2013.
  • Wong, J., Payne, A.Y.M., Mah, K., Lebel, S., Lee, R.N.F., Irish, J., Rodin, G., & Devins, G., "Negative Cancer-Stereotypes and Disease-Specific Self-Concept in Head and Neck Cancer", Psycho-Oncology, 22, pp. 1055-1063, 2013.
  • Lebel, S., Castonguay, M., Mackness, G., Bezjak, A., Irish, J., & Devins, G., "The psychosocial impact of stigma in lung and head and neck cancer", Psycho-Oncology, 22, pp. 668-676, 2013.
  • Author Contribution: 65%
Conference presentations (past 2 years)
  • Petricone-Westwood, D., Jones, G., Mutsaers, B., Séguin Leclair, C., Rutkowski, N., Tomei, C., Imsirovic, F., Dinkel, A., & Lebel, S. A systematic review on interventions for health anxiety in the context of chronic illness: An update from 2014 to 2017. Paper submitted for poster presentation at the 39th Annual Meeting of the Society for Behavioral Medicine, New Orleans, USA.
  • Maheu, C., Lebel, S., Courbasson, C., Lefebvre, M., Singh, M., Bernstein, L. J., Muraca, L., Harris, C., Jolicoeur, L., Ramanakuar, A. V., Ferguson, S. (2017). Randomized Controlled Trial of the Fear of Recurrence Therapy (FORT) Intervention for Women with Breast or Gynecological Cancer. Randomized Controlled Trial of the Fear of Recurrence Therapy (FORT) Intervention for Women with Breast or Gynecological Cancer. Paper presented at the 29th Canadian Association of Nurses in Oncology/Association canadienne des infirmières en oncologie (CANO-ACIO) October 27-30, 2017.
  • Petricone-Westwood, D., Ta, V., Jones, G., Séguin Leclair, C., Tomei, C., Mutsaers, B., Dinkel, A., & Lebel, S. Can we apply Salkovskis and Warwick’s cognitive-behavioural model of health anxiety to people with chronic illness? Toronto, ON, Poster presented at the Canadian Psychological Association's 78th Annual Convention, (2017, June).
  • Laflamme, S., Petricone-Westwood, D., Séguin Leclair, C., Tomei, C., Jones, G., Mutsaers, B., Dinkel, A., & Lebel, S. Systematic review of the relationship between health anxiety and sociodemographic variables in individuals with chronic illness. Toronto, ON, Poster presented at the Canadian Psychological Association's 78th Annual Convention, (2017, June).
  • Parrott, J., Mutsaers, B., Lebel, S., Maheu, C. Fear of cancer recurrence, intolerance of uncertainty, and quality of life. Vancouver, BC, Paper presented at the Canadian Association for Psychosocial Oncology, (2017, May).
  • Lamarche, J., Grenier, J., Lafontaine, M-F., Greenman, P., Gosselin, J., Joanisse, M., Chomienne, M-H., Maheu, C., Lebel S. Teletherapy: Relieving Fear of Cancer Recurrence among Ontario Francophones. Vancouver, BC, Poster presented at the Canadian Association for Psychosocial Oncology, (2017, May).
  • Gollish, M., Jones, G., Brunet, J., Lebel, S. From Guidelines To (non) Practice: Do our recommendations match the opinions of stakeholders in cancer-related fatigue? Vancouver, BC, Paper presented at the Canadian Association for Psychosocial Oncology, (2017, May).
  • Petricone-Westwood, D., Lebel, S., & Brunet, J. The Interdisciplinary Psychosocial Oncology Study and Research Laboratory: A progress report. Vancouver, BC, Poster presented at the annual meeting of the Canadian Association of Psychosocial Oncology, (2017, May).
  • Lebel, S., Rutkowski, N., Mutsaers, B., Tomei, C., Petricone-Westwood, D., Seguin Leclair, C., & Jones, G. How is health anxiety defined among individuals with a chronic illness? ", Annual Meeting and Scientific Sessions of the Society of Behavioural Medicine, San Diego, USA, 2017, March.
  • Jones, G., Ta, V., Tomei, C., Seguin Leclair, C., Petricone-Westwood, D., Mutsaers, B., & Lebel, S. "Psychological Outcomes of Health Anxiety in Chronic Illnesses: A systematic review of the literature", Annual Meeting and Scientific Sessions of the Society of Behavioural Medicine, San Diego, USA, 2017, March.
  • Lamarche, J., Grenier, J., Lafontaine, M-F., Greenman, P., Gosselin, J., Joanisse, M., Chomienne, M-H., Maheu, C., Lebel S. Téléthérapie : Soulager la peur de la récidive du cancer chez les francophones de l’Ontario. Ottawa, ON, Papier présenté au Colloque scientifique sur la santé des communautés de langue officielle du Canada, (2017, February).
  • Tomei, C., Lebel, S., Maheu, C., Lefebvre, M., & Harris, C. "Examining Fear of Recurrence in Cancer Survivors: A Randomized Controlled Clinical Trial Pilot Study", 18th World Congress of the International Psycho-Oncology Society, Dublin, Ireland, 2016, October.
  • Jones, G., Lavigne, A., Seguin Leclair, C., Petricone-Westwood, D., Tomei, C., Dinkel, A., Lebel, S. Examining Interventions for Health Anxiety Among Chronically Ill Patients: A Systematic Review. Victoria, BC, Poster presented at the Canadian Psychological Association's 77th Annual Convention, (2016, June).
  • Petricone-Westwood, D., Jones, G., Seguin Leclair, C., Lefebvre, M.,  Morash, R., Jolicoeur, L., Liska, C., Larocque, G., Lebel, S. Predictors of attendance to the Wellness Beyond Cancer Survivorship class for low-risk endometrial and breast cancer survivors in transition to primary care. Halifax, NS, Paper presented at the Canadian Association of Psychosocial Oncology Conference, (2016, May).
  • Petricone-Westwood, D, Lebel, S., & Brunet, J. Promoting psychosocial oncology collaboration in Ottawa: The Interdisciplinary Psychosocial Oncology Study and Research Laboratory. Halifax, NS, Poster session presented at the Canadian Association of Psychosocial Oncology Conference, (2016, May).
  • Séguin Leclair, C., Drexler, E., Lebel, S., & Simard, S. The use of complementary and alternative medicine and fear of cancer recurrence in survivorship. Halifax, NS, Paper presented at the Canadian Association of Psychosocial Oncology Conference, (2016, May).
  • Lebel, S., Mutsaers, B., Jones, G., Rutkowski, N., Tomei, C., Séguin Leclair, C., Petricone-Westwood, D., & Simard, S. From normal response to clinical problem: Definition and clinical features of fear of cancer recurrence. Halifax, NS, Paper presented at the Canadian Association of Psychosocial Oncology Conference, ( 2016, May).
  • Moran, C., Lebel, S., Tomei, C., Lefebvre, M., & Maheu, C. An exploratory study of the worst-case scenario exercise in a cognitive-existential intervention for fear of cancer recurrence. Halifax, NS, Poster session presented at the Canadian Association of Psychosocial Oncology Conference, (2016, May).
  • Beattie, S., Lebel, S., Labelle, L., Petricone-Westwood, D.,  Harris, C., Wilson, K., Devins, G., Huebsch, L., & Tay, J. Patient Self-Perceived Burden and Caregiver Burden in Recipients of Hematopoietic Stem cell Transplantation: A Longitudinal study examining gender differences. Honolulu, Hawaii, Paper submitted for presentation at the BMT Tandem meetings, (2016, February).

Resources

Kym’s story – Fear of cancer recurrence (YouTube, 10:09 minutes)

A woman talks about her experience with FCR and how she copes with it.

Breast Cancer Network Australia (Producer). (2017, March 8). Kym’s story – Fear of cancer recurrence. 

Living with uncertainty: discussing the fear of cancer recurrence (Webcast, 58:18 minutes)

https://cancerconnection.ca/webcasts

Dr. Christine Maheu leads a discussion on FCR and gives definitions. There is a question period at the end.

Maheu, C. (2015, December 14). Living with uncertainty: discussing the fear of cancer recurrence. Canadian Connection. – Canadian Cancer Society. 

Fear of cancer recurrence (YouTube, 7:22 minutes)

Dr. Carrie Lethborg talks about the definition of FCR and who could be affected by it.

Breast Cancer Network Australia (Producer). (2017, March 8). Fear of recurrence with Dr Carrie Lethborg [Video file]. 

Tips and strategies (YouTube, 4:18 minutes)

Dr. Carrie Lethborg discusses practical tips on how to manage FCR.

Breast Cancer Network Australia (Producer). (2017, March 8). Tips and strategies with Dr Carrie Lethborg [Video file]. 

Where to go for help (YouTube, 1:53 minutes)

Dr. Carrie Lethborg mentions some available resources for people affected by FCR.

Breast Cancer Network Australia (Producer). (2017, March 8). Where to go for help with Dr Carrie Lethborg [Video file]. 

Fear of recurrence (YouTube, 2:38 minutes)

Professor Bruce Mann discusses FCR among women diagnosed with breast cancer.

Breast Cancer Network Australia (Producer). (2017, March 8). Fear of recurrence with Professor Bruce Mann [Video file]. 

Managing anxiety – Odette Cancer Centre (YouTube, 4:43 minutes)

Cancer survivors discuss their cancer-related anxiety and give strategies on how to manage it.

Sunnybrook Hospital (Producer). (2017, Feb 16). Managing anxiety – Odette Cancer Centre [Video file].

Fear of Recurrence (YouTube, 6:58 minutes)

Young adult cancer survivors talk about their personal experience with FCR.

Livestrong (Producer). (2013, April 26). Fear of Recurrence. [Video file]. 

Just Breathe: Dealing with Fear and Anxiety after Cancer (YouTube, 2:22 minutes)

Dr. Mary Elliott gives advice (S.T.O.P.) on how to manage stress and FCR after cancer.

Rethink Breast Cancer (Producer). (2015, Aug 15). Just Breathe: Dealing with Fear and Anxiety After Cancer. [Video file]. 

5 Tips for Coping with the Fear of Cancer Recurrence (YouTube, 4:09 minutes)

5 strategies to manage FCR.

Breast Cancer Answers (Producer). (2016, April 11). 5 Tips for Coping with the Fear of Cancer Recurrence. [Video file]. 

Fear of Recurrence and Late Effects: Living with Uncertainty (Podcast, 58:44 minutes)

https://www.cancercare.org/connect_workshops/2-cancer_fear_recurrence_2011-07-12

Richard Dickens, Merle Mishel and David Spiegel discuss FCR and give some coping strategies.

Dickens, R., Mishel, M. & Spiegel, D. (2011). Fear of Recurrence and Late Effects: Living with Uncertainty. Part IV of The Ninth Annual Cancer Survivorship Series: Living With, Through and Beyond Cancer. Cancer Care. [Podcast]. 

 

Coping with The Fear of Recurrence (Podcast, 5:34 minutes)

https://www.cancer.net/blog/podcasts/coping-fear-recurrence

Discussion on how to manage FCR after completion of treatment (6 strategies).

Cancer.Net. (2013). Coping with the Fear of Recurrence. Coping With the Fear of Recurrence. [Podcast]. 

Managing Fear of Recurrence among Breast Cancer Survivors (Webcast, 35:20 minutes)

https://www.broadcastmed.com/cancer/4919/videos/managing-fear-of-recurrence-among-breast-cancer-survivors

Lynne Wagner presents of FCR.

Wagner, L. (2016, November 18). Managing Fear of Recurrence Among Breast Cancer Survivors. Oncology. Broadcast Med. [Video file]. 
Coping with the Fear of Recurrence (Webinar, 57:05 minutes)

Susan Stollings presents on FCR.

Stollings, S. (2017, Nov 8). Coping with the Fear of Recurrence. National Ovarian Cancer Coalition (Publisher). [Video file].

Fear of Cancer Recurrence “What if my cancer comes back?” – Anna Hrynko (Webinar, 10:02 minutes)

Anna Hrynko, a cancer survivor, talks about how she lives with FCR.

Hrynko, A., (2014, Aug 18). Fear of Cancer Recurrence “What if my cancer comes back?” – Anna Hrynko webinar excerpt. Cancer Council NSW. [Video file]. 

Comment réduire la peur de la récidive du cancer? In French (Podcast, 15:30 minutes)

https://ici.radio-canada.ca/premiere/emissions/style-libre/segments/entrevue/57461/comment-reduire-la-peur-de-recidive-du-cancer

Josée Savard talks about FCR and how to manage it.

Coping with Fear of Recurrence

https://www.cancer.net/survivorship/life-after-cancer/coping-with-fear-recurrence

Tips for coping with the fear of recurrence and when to determine that you might be in need of more help.

Fear of recurrence – living beyond breast cancer (pdf)

https://www.lbbc.org/sites/default/files/GUFR2017_FINAL.pdf

Understanding FCR, Common fear triggers, life after treatment, getting support – mainly for breast cancer

Fear of cancer recurrence: A practical guide for clinicians

http://www.cancernetwork.com/oncology-journal/fear-cancer-recurrence-practical-guide-clinicians

How to assess and screen for FCR, how to provide adequate information about prognosis, and how to prevent FCR.

Butow, F., Sharpe, L,. Thewes, B,. Turner,. Gilchrist, J, & Beith, J. (2018). Fear of Cancer Recurrence: A Practical Guide for Clinicians. 

Coping with the fear of recurrence

https://www.cancercare.org/publications/253-coping_with_the_fear_of_recurrence

Tips on managing FCR

Fear of cancer recurrence – fact sheet (pdf)

https://www.bcna.org.au/media/4167/bcna-fact-sheet-fear-of-cancer-recurrence-jan-2017.pdf

Definition, signs and symptoms, why does it occur, how to manage

  
Fear of cancer coming back

https://www.cancercouncil.com.au/15291/b1000/living-well-after-cancer-45/living-well-after-cancer-fear-of-recurrence/

Ways to manage the fear of recurrence, fear of getting a different cancer

Coping with the fear of breast cancer recurrence

https://rethinkbreastcancer.com/coping-with-the-fear-of-breast-cancer-recurrence/

Personal experience with FCR

Prospective Students

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Graduate Students

I am not currently accepting graduate students.

UROP Students

I am interested in having a UROP student for the 2022-2023 year. If you are interested in applying for the UROP with me, please contact me and send me a copy of your CV and transcripts. Learn more about the Undergraduate Research Opportunity Program (UROP) on the Office of Undergraduate Research website. 

Volunteers

Volunteers will be considered on a rolling basis. If you are interested in volunteering with the lab, please complete the following form. We will contact you with any future opportunities. 

https://forms.gle/E46vRKHiYBQimuqZ7 

Honours Students

I am currently looking for one or two Honours thesis candidates for 2024-2025. If you are interested in completing your Honours thesis with the PSO lab, please send me a copy of your transcript and your CV.

Lab Photos

FORT

About the FORT Intervention

Fear of Recurrence Therapy (FORT) is a manualized and standardized therapist led group intervention. It consists of 6 weekly sessions of 90-120 minutes each and includes take-home assignments. The FORT program is based on 6 major goals:

  1. Distinguish worrisome symptoms from benign ones
  2. Identify triggers and inappropriate coping strategies
  3. Facilitate the learning and use of new coping strategies such as relaxation techniques and cognitive restructuring 
  4. Increase tolerance for uncertainty
  5. Promote the emotional expression of the specific fears that underlie fear of cancer recurrence
  6. Re-examine life priorities and set realistic goals for the future

FORT is based on a blended theoretical model of fear of cancer recurrence (Lebel & al., 2014; 2018) that aims at addressing key vulnerability factors such as internal and external triggers, exaggerated perceived risk of recurrence, hyper-focus on ambiguous physical sensations, maladaptive coping, uncertainty around cancer and its treatments or care, intolerance of uncertainty as well as beliefs the benefits of worrying about one’s health. It combines elements of group therapy, cognitive behavioral therapy and existential therapy.

FORT Resources

The resources listed below are available to all by request. Please fill out the following request form (see sidebar) to let us know which resources you would like to access and we will email them to you.

Fear Of Recurrence Therapy (FORT) Intervention

Therapist Intervention Manual

Complete Patient Workbook

Fear Of Recurrence Therapy (FORT) Additional Materials

Training Capsule Videos of the FORT Sessions

Recorded Training Webinars (February 17th and 24th 2022)

FORT Published Articles

FORT Intervention

Session 1: Introduction of participants, ABC model, FCR model, cognitive reframing, progressive muscular relaxation.

Session 2: Prepare questions for visit from health care professional, discuss living with uncertainty, gaining control, calming self-talk. 

Session 3: Visit from health care professional, discuss faulty benefits of worry, maladaptive coping strategies, teach guided imagery.

Session 4: Explain reason to exposure to worse scenario, promote emotion expression, confront fear underlying FCR, write down worst fear scenario, teach mindfulness exercise

Session 5: Review exposure to worst case scenario exercise, discuss ways of coping, promote expression of demoralization, encourage re-engagement with life/activities/people; discuss meaningful future, mindfulness exercise.

Session 6: Review all content covered, discuss future goals, set new priorities. Promote the expression of saying good-bye to the group and provide closure.

Published Articles

Lebel, Maheu, C., Lefebvre, M., Secord, S., Courbasson, C., Singh, M., Jolicoeur, L., Benea, A., Harris, C., Fung, M. F. K., Rosberger, Z., & Catton, P. (2014). Addressing fear of cancer recurrence among women with cancer: a feasibility and preliminary outcome study. Journal of Cancer Survivorship, 8(3), 485–496. https://doi.org/10.1007/s11764-014-0357-3

Maheu, Lebel, S., Courbasson, C., Lefebvre, M., Singh, M., Bernstein, L. J., Muraca, L., Benea, A., Jolicoeur, L., Harris, C., Ramanakumar, A. V., Ferguson, S., & Sidani, S. (2016). Protocol of a randomized controlled trial of the fear of recurrence therapy (FORT) intervention for women with breast or gynecological cancer. BMC Cancer, 16(289), 291–291. https://doi.org/10.1186/s12885-016-2326-x

Moran, Tomei, C., Lefebvre, M., Harris, C., Maheu, C., & Lebel, S. (2017). An exploratory study of the worst-case scenario exercise as an exposure treatment for fear of cancer recurrence. Supportive Care in Cancer, 25(5), 1373–1375. https://doi.org/10.1007/s00520-017-3600-4

Maheu, Lebel, S., Tomei, C., Singh, M., & Esplen, M. J. (2014). Breast and ovarian cancer survivors’ experience of participating in a cognitive-existential group intervention addressing fear of cancer recurrence. European Journal of Oncology Nursing : the Official Journal of European Oncology Nursing Society, 19(4), 433–440. https://doi.org/10.1016/j.ejon.2014.12.003

Lebel, Maheu, C., Tomei, C., Bernstein, L. J., Courbasson, C., Ferguson, S., Harris, C., Jolicoeur, L., Lefebvre, M., Muraca, L., Ramanakumar, A. V., Singh, M., Parrott, J., & Figueiredo, D. (2018). Towards the validation of a new, blended theoretical model of fear of cancer recurrence. Psycho-Oncology (Chichester, England), 27(11), 2594–2601. https://doi.org/10.1002/pon.4880

Tomei, Lebel, S., Maheu, C., & Mutsaers, B. (2016). Addressing fear of recurrence: improving psychological care in cancer survivors. Supportive Care in Cancer, 24(7), 2815–2818. https://doi.org/10.1007/s00520-016-3103-8

Tomei, & Lebel, S. (2017). Addressing Fear of Cancer Recurrence : A Cognitive-Existential Psychosocial Intervention for Cancer Survivors. Université d’Ottawa / University of Ottawa.

Rudy, Maheu, C., Körner, A., Lebel, S., & Gélinas, C. (2020). The FCR‐1: Initial validation of a single‐item measure of fear of cancer recurrence. Psycho-Oncology (Chichester, England), 29(4), 788–795. https://doi.org/10.1002/pon.5350

Tomei, Lebel, S., Maheu, C., Lefebvre, M., & Harris, C. (2018). Examining the preliminary efficacy of an intervention for fear of cancer recurrence in female cancer survivors: a randomized controlled clinical trial pilot study. Supportive Care in Cancer, 26(8), 2751–2762. https://doi.org/10.1007/s00520-018-4097-1

Upcoming Research in FORT

Dr. Lebel’s laboratory is currently working on adapting the FORT intervention for family caregivers and to an online setting. Updates about this research are to come.

Funding

We would like to thank the Canadian Cancer Society for financial support in the development of the Fear Of Recurrence Therapy (FORT) intervention.

Quality of Life Research Grant #702985 (2013-2019)