Post-Diagnosis Stress Can Cause or Result in Cancer Treatment Delays

The days after a cancer diagnosis can be a distressing time for patients, with many people reporting that they want to begin treatment right away in fear of their cancer spreading. However, sometimes more information or testing is needed before the most appropriate therapy is decided, which can be even more anxiety-inducing, according to research.

Now, a recent study showed that fear — which can come from a “huge mental shift” during this time — can be a contributing factor to delayed treatment as well as a result of the wait times between diagnosis and treatment.

“I would encourage patients to be open with their care team about how much and what information they would find most helpful [during this time],” Dr. Zachary Frosch, assistant professor in the Department of Hematology/Oncology and a member of the Cancer Prevention and Control Research Program at Fox Chase Cancer Center in Philadelphia said in an interview with CURE®.

READ MORE: Psychological Distress in Patients with Cancer Leads to Slower Time Until Treatment

Frosch and colleagues recently published a study in the journal Supportive Cancer Care that looked at the relationships between psychological distress and treatment delays in 22 patients with solid cancers. After the study’s publication, CURE® interviewed Frosch about what patients need to know.

CURE®: Can you explain why it was important to look at how psychosocial distress can delay cancer care?

Frosch: Being diagnosed with cancer is obviously a very difficult time. There is a lot occurring both medically and psychologically between this point and the time when people start treatment. It can be very busy with treatment planning appointments and testing, along with an incredible amount of information to absorb about the diagnosis, treatment plan and its effect on quality of life and prognosis. It’s often a huge mental shift for patients to make relatively quickly.

Different people have different techniques and methods for dealing with this type of situation, so understanding the range of these reactions and how they affect the start of cancer care is important. Medical and logistical factors are no doubt incredibly important, but to understand the whole picture of a patient’s experience during this time we also have to understand the psychosocial component.

What were the main findings that patients and their loved ones should know about?

Our study had three main findings. First, patients often felt a real urgency to start their cancer treatment and suffered psychological distress while waiting for it to begin.

Second, our participants identified different sources of delays in care — one of which was psychosocial distress. They frequently identified fear as a barrier to beginning therapy. This meant that fear could either be a consequence of delays in care or a driver of them.

Third, participants suggested that a better understanding of what was to come could help alleviate these fears.

Frosch explained to CURE what patients should do if they experience psychological stress before receiving treatment.

If patients are experiencing psychological distress before starting treatment — and especially if it may lead to treatment being delayed — what should they do?

I would encourage patients to discuss how they are dealing with their diagnosis and treatment planning with their care team. This is especially true if they are feeling so distressed and overwhelmed that it's impacting their care. Of course, not all information may be available right away and further work-up and planning are often needed. However, participants in our study often told us about how better understanding what they should expect, what we call anticipatory guidance, can help them cope better.

Everyone has different desires and needs during this time. Some people may want more information about what’s to come, others only a little bit at a time.

Why did some patients feel the need to start cancer treatment so soon after being diagnosed? What is your message for this patient population?

Many people told us about their fears that the cancer would spread if treatment was not started right away. Each situation is different, and sometimes more information is needed to design the best treatment plan. So, there is a balance between avoiding unnecessary delays and getting the treatment plan right.

What more do you hope to see done in this field in the coming years

Better understanding what patients are experiencing during this time is just the first step. The true goal is easing that distress and facilitating the start of their therapy, which is where I hope to see this headed.

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