When your body betrays you: interoceptive mechanisms of anxiety after cancer

There is unequivocal evidence that cancer causes anxiety. For some, anxiety resolves following successful cancer treatment. For others, anxiety persists. As cancer survival rates have just surpassed 50%, the mental health consequences of cancer survival are now a public health concern. Cancer disrupts a person’s relationship with their body and the sensing of internal bodily sensations – termed interoception. Yet, intact interoception is important for detecting, interpreting, and regulating emotion. Using experimental medicine methods, we will uncover how interoceptive mechanisms can be repaired to help resolve anxiety in cancer survivors. In WP1 we will target neurophysiological interoceptive mechanisms, training interoceptive precision to reduce anxiety. In WP2 we will probe psychological interoceptive mechanisms, investigating how changing interoceptive beliefs can ameliorate post-cancer anxiety. In WP3 we will examine socio-structural interoceptive mechanisms, defining how clinician-patient communication about interoception can lessen anxiety. Experiments will take place in the UK and US, integrating lived experience through partnerships with three diverse groups: breast cancer, adolescent and young adult cancers, and rare inherited cancers. Uncovering interoceptive mechanisms of anxiety resolution across different levels of explanation (neurobiological, psychological, socio-structural) in cancer survivors could transform clinical and digital health treatment options in this growing population.