Psycho-oncology · 2026
Beyond Physical Toxicities: Identifying Psychosocial Domains Requiring Integrated Support in Breast Cancer Pharmacotherapy.
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Sutanto Henry, Ashariati Ami, Savitri Merlyna, Hendarsih Een
Аннотация
BACKGROUND: Cancer pharmacotherapy imposes substantial physical and psychosocial burdens that affect patients' quality of life (QoL). While oncologic outcomes are well studied, the psychological dimensions-particularly future perspective, emotional resilience, and body image-remain underintegrated into routine care. The growing recognition of psycho-oncology highlights the need for synergistic collaboration between oncology and clinical psychology.
AIM: To evaluate changes in QoL before and after pharmacotherapy among women with breast cancer and identify domains most vulnerable to psychological distress, thereby informing the need for integrated psycho-oncologic care.
METHODS: This prospective study included 106 women with breast cancer undergoing pharmacotherapy. Sociodemographic and clinical characteristics were collected, including cancer stage, treatment modalities, and baseline cardiometabolic parameters. QoL was assessed pre- and post-treatment using EORTC QLQ-C30 and BR23 instruments. Paired comparisons were performed using Wilcoxon signed-rank tests, and correlations with age were analyzed using Spearman or Pearson methods as appropriate.
RESULTS: Global health status declined significantly after pharmacotherapy (83.3 to 66.7; p = 0.002). Functional domains-including physical, role, and social functioning-also worsened, while emotional functioning improved modestly. Symptom burden increased across fatigue, nausea, pain, appetite loss, and systemic side effects (all p < 0.001). Breast-cancer-specific domains such as body image and future perspective showed minimal change but remained highly variable, indicating psychosocial vulnerability. Distress related to hair loss demonstrated a modest inverse correlation with age (r = -0.296; p = 0.003).
CONCLUSION: Pharmacotherapy substantially reduces multiple QoL domains, highlighting symptom-function trade-offs and persistent psychological concerns. The patterns in emotional functioning and future perspective indicate unmet psychosocial needs. These findings underscore the imperative for integrated psycho-oncology models to enhance holistic survivorship care.
AIM: To evaluate changes in QoL before and after pharmacotherapy among women with breast cancer and identify domains most vulnerable to psychological distress, thereby informing the need for integrated psycho-oncologic care.
METHODS: This prospective study included 106 women with breast cancer undergoing pharmacotherapy. Sociodemographic and clinical characteristics were collected, including cancer stage, treatment modalities, and baseline cardiometabolic parameters. QoL was assessed pre- and post-treatment using EORTC QLQ-C30 and BR23 instruments. Paired comparisons were performed using Wilcoxon signed-rank tests, and correlations with age were analyzed using Spearman or Pearson methods as appropriate.
RESULTS: Global health status declined significantly after pharmacotherapy (83.3 to 66.7; p = 0.002). Functional domains-including physical, role, and social functioning-also worsened, while emotional functioning improved modestly. Symptom burden increased across fatigue, nausea, pain, appetite loss, and systemic side effects (all p < 0.001). Breast-cancer-specific domains such as body image and future perspective showed minimal change but remained highly variable, indicating psychosocial vulnerability. Distress related to hair loss demonstrated a modest inverse correlation with age (r = -0.296; p = 0.003).
CONCLUSION: Pharmacotherapy substantially reduces multiple QoL domains, highlighting symptom-function trade-offs and persistent psychological concerns. The patterns in emotional functioning and future perspective indicate unmet psychosocial needs. These findings underscore the imperative for integrated psycho-oncology models to enhance holistic survivorship care.