Psychological support important from the start

Patients who begin treatment for metastatic cancer with more pronounced depression, anxiety or stress are at greater risk of facing the same psychological burden even after three months of therapy, according to a study by researchers from the Faculty of Medicine of the University of Montenegro (UCG) and the Clinical Center of Montenegro (KCCG), published in the journal "Healthcare".

The study "Psychological Adjustment to Metastatic Cancer: A Comparative Longitudinal Analysis of Patients with Breast and Lung Cancer" analyzed how the psychological state of patients changes in the first months of treatment, especially when comparing different types of cancer.

The work is signed by researchers from the Faculty of Medicine of the University of Montenegro and the University of Montenegro - Mitar Saveljic, Ph.D Milovan Roganović and others Emir Muzurović - in cooperation with colleagues from health and academic institutions from Bosnia and Herzegovina and Croatia.

The research, according to the UCG announcement, was conducted at the Institute of Oncology and Radiotherapy of the KCCG, where patients with metastatic breast cancer were monitored, and at the Special Hospital for Pulmonary Diseases "Dr Jovan Bulajić", where patients with metastatic lung cancer were monitored.

The study included 121 patients - 66 with metastatic breast cancer and 55 with metastatic lung cancer. Their psychological state was assessed at the beginning of treatment and after three months, or after three cycles of chemotherapy.

The paper states that psychological symptoms were assessed using standardized scales for depression, anxiety, and stress, as well as for anxiety sensitivity.

According to the results of the study, the University of Montenegro states that at the beginning of the measurements, no statistically significant differences were observed between the two groups of patients in the levels of depression, anxiety and stress. However, after three months of treatment, differences in psychological adjustment emerged.

The study reported that patients with metastatic breast cancer experienced an increase in anxiety and stress, while depressive symptoms did not change significantly. Patients with metastatic lung cancer experienced a decrease in depression and stress.

"At follow-up, anxiety was significantly higher in patients with metastatic breast cancer than in patients with metastatic lung cancer," the study states.

The authors of the paper indicate that in patients with metastatic breast cancer, anxiety may be exacerbated by concerns about body image, femininity, and the prolonged emotional burden associated with a metastatic diagnosis, even during active treatment.

The study findings indicate that psychological adjustment does not occur equally in all patients and that the type of illness may be important for understanding their needs.

"Depression, anxiety, and stress are not viewed as side effects of the disease, but rather as part of the overall picture of treatment and the patient's quality of life," the paper states.

The most important finding of the study was that initial symptom severity was the strongest predictor of psychological state after three months. This means that patients who entered treatment with more severe depression, anxiety, or stress were at greater risk of having these symptoms persist during the early phase of treatment.

Patients with metastatic lung cancer, the study found, were significantly older, and 93 percent of them were current smokers, compared to 33 percent of patients with metastatic breast cancer.

The paper also found that younger age was strongly associated with higher initial psychological distress in lung cancer patients. The study included factors such as age, cancer type, smoking status and the importance of religion, but the authors found that the patients' initial psychological state was the most important predictor of their later state.

The authors also pointed out that standardized psychological support was not available during the study, which emphasizes the importance of early identification of patients who are under the greatest psychological burden.

The study emphasizes that the importance of the research is particularly pronounced in the Montenegrin context, as the treatment of oncology patients in Montenegro is centralized, while psychological support is limited. The authors also state that such research has not been conducted in Montenegro so far.