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MS-N326 · Acceptance and commitment therapy · Fear of recurrence · Gastrointestinal cancer with a stoma · Human evidence · Appraised 13 November 2026

Does an eight-session acceptance and commitment therapy program reduce fear of cancer recurrence in people with gastrointestinal cancer and a stoma?

Evidence at a glance

  • Evidence label: Very small single-blind randomized trial; preliminary positive finding
  • Benefit: Fear-of-recurrence scores were lower one month after the program.
  • Certainty: Low because the trial had only 40 participants, short follow-up and incomplete effect reporting.
  • Risk: Adverse events were not reported in the full article; psychological care should include a plan for worsening distress.

What was studied

Forty adults with gastrointestinal cancer and a stoma were randomized to eight ACT-based sessions or routine care, 20 per group. Fear of recurrence was measured with the FCR-7 before treatment and one month afterward.

What the evidence found

The intervention group had a lower post-treatment FCR score than control (p<0.001). The accessible report did not provide a confidence interval or a clearly interpretable between-group absolute effect, so the magnitude and clinical importance remain uncertain.

How to interpret it

This was a single-center student-thesis project with a small sample and one-month follow-up. Blinding participants to psychotherapy is not possible, and usual care is a weak attention comparator. Stoma adaptation, quality of life, depression and clinical cancer outcomes were not established as improved.

These outcomes concern symptoms, distress, sleep or supportive care. They do not establish tumor response, delayed recurrence, progression-free survival or longer overall survival.

Practical safety context

Fear, body-image concerns, grief and stoma-related practical problems may need different forms of support. ACT should complement stoma nursing, symptom management and oncology follow-up. Severe depression, trauma symptoms or suicidal thoughts require urgent professional assessment.

Questions for the care team

  • Do I need stoma nursing, psychotherapy, peer support—or a combination?
  • How will we decide whether fear has improved enough to matter in daily life?
  • What help is available if sessions bring up overwhelming distress?

Funding and conflicts

The project was supported as a student thesis by Zahedan University of Medical Sciences. The authors declared no conflicts of interest.

Sources

Last literature search: 13 November 2026. Record appraisal: 13 November 2026. The full open report was appraised. This page is educational and does not replace individualized medical advice.