Evaluation of psychosocial changes in cancer patients during the diagnosis and treatment process

Introduction: Cancer is a chronic disease that significantly impacts human life and health. According to the World Health Organization's 2018 data, 9.7 million deaths were attributed to cancer. In Turkey, cardiovascular diseases rank first in morbidity, followed by cancer in second place. Every year, 300,000 individuals in the country are diagnosed with cancer. Cancer is a disease that is increasingly prevalent, causing not only physical difficulties but also severe problems in patients' social lives and psychological well-being. These mental health issues can adversely affect the progression of the disease and the response to treatment. Since the treatment process often involves a challenging and prolonged period, providing psycho-social support to patients is critical in preserving their mental health and enhancing their ability to cope with the disease. Objective: The objective of this thesis is to thoroughly examine the psychosocial problems experienced by cancer patients and reveal the effects of these problems on patients' quality of life, treatment adherence, and treatment efficacy. This study aims to shed light on stress, psychological issues, lack of family and social support, and similar challenges faced by cancer patients to guide future research. In this context, data will be collected through in-depth interviews and surveys conducted with patients and their families, alongside a review of existing literature. Methodology: This study was conducted between November 1, 2024, and December 1, 2024, involving 308 cancer patients (primarily breast, colon, and lung cancer patients) who visited the medical oncology department and outpatient clinics of Dicle University Hospital. The research utilized a face-to-face survey consisting of 32 questions assessing patients' demographic characteristics, diagnosis, treatment, treatment adherence, social issues, psychological problems, and spiritual processes. Findings: Among the participants, 17.5% were aged 18–40, 66.9% were aged 40–65, and 15.6% were over 65 years old. Of the patients, 38% were male, and 62% were female. Marital status analysis revealed that 10.7% were single, 82.8% were married, and 6.5% were divorced or widowed. Regarding educational status, 39.3% were illiterate, 34.1% were primary school graduates, 8.4% were secondary school graduates, 12.3% were high school graduates, and 5.8% were university graduates. Income levels showed that 24% earned below the minimum wage, 53.6% earned the minimum wage, and 22.4% earned above the minimum wage. The study determined that 41.6% of patients were diagnosed with breast cancer, 16.9% with lung cancer, 14.3% with colon cancer, and 27.3% with other types of cancer. Regarding disease stages, 1.6% were at stage 1, 17.9% at stage 2, 31.2% at stage 3, and 49% at stage 4. Psychological aspects of the patients were evaluated in the study. It was found that 6.2% of the patients had pre-existing psychiatric illnesses, with 31.5% diagnosed with anxiety disorders and 68.5% with depression. During the disease process, 63.3% exhibited anxiety symptoms, and 44.5% exhibited depressive symptoms. Anxiety symptoms were more prevalent among patients aged 18–40, females, those with detailed knowledge about their illness, and those diagnosed with breast cancer. No significant relationship was found between patients' psychological conditions and parameters such as monthly income, place of residence, disease stage, health insurance, and the most challenging complaints during treatment. However, patients who were dissatisfied with how they learned about their illness, female patients, those considering divorce due to spousal problems, those requiring psychological/psychiatric support during the illness, those receiving insufficient support from caregivers, and those experiencing a decline in family interest after diagnosis were more likely to feel hopeless and consider self-harm. Furthermore, patients contemplating self-harm were more likely to interrupt treatment and show depressive symptoms. Patients cared for by spouses or children, married individuals, actively working individuals, and those without family or marital problems had a lower need for psychological/psychiatric support. Female patients, singles, illiterates, retirees, those experiencing financial loss during treatment, and those relying on prayer were more likely to require spiritual support. Conclusion: This study has outlined the scope of psychosocial problems experienced by cancer patients and the factors associated with these challenges. The findings indicate that psychological symptoms such as hopelessness, depression, and anxiety are prevalent among cancer patients, increasing their need for psychological support. Additionally, individuals with a psychiatric history demonstrated a greater need for support, and the absence of spiritual support further complicated their process. The results of this study serve as a critical guide for the development of multidisciplinary approaches and individualized support programs.