The Psychosocial Impact of Breast Cancer
The patient journey for breast cancer is often marked by anxiety and emotional distress. Chemotherapy, radiation, and surgery, exhaust patients both physically and emotionally. After these high-touch treatments are over, a low-touch at-home treatment cycle begins, during which many patients face physical sequelae and uncertainty about their prognosis.
At this time, patients often experience feelings of isolation, depression, and anxiety. Persistent fear of recurrence–driven by negative, maladaptive thought patterns–is a prominent psychosocial impact of breast cancer, which can diminish the patient quality of life.
Psychosocial Well-Being Affects Breast Cancer Outcomes
Multiple studies have identified anxiety and depression as independent risk factors for breast cancer recurrence or death, acting through both biological behavioral mechanisms. In cancer survivors, anxiety and depression have been linked to maladaptive cognitive responses and unhealthy behaviors, including poor medication adherence, healthcare avoidance or overuse, substance use, sedentary behavior, and social isolation.
Chronic stress may also contribute to dysregulated innate and adaptive immune responses that promote cancer progression. Notably, randomized clinical trial data showed that cognitive behavioral therapy (CBT) significantly increased immune function in breast cancer patients.
Connecting Clinicians and Patients: Essential but Challenging
Studies have shown that a positive clinician-patient relationship and use of digital tools to facilitate it significantly improve the quality of life of breast cancer patients. By encouraging patients’ involvement and trust in their cancer care, clinicians can help minimize patients’ stress and anxiety. The clinician-patient connection is even more essential in the era of precision oncology, as the outcomes of individualized treatment are less predictable, necessitating a continual reassessment of goals and expectations.
However, despite wanting to do so, clinicians find it challenging to provide high-quality, patient-centered care, as they struggle with rising patient volumes and the demands of increasingly complex oncology care. Unfortunately, suboptimal communication and low awareness of patients’ psychosocial needs are common in cancer care: it’s common to underestimate patients’ cancer symptoms and to fail to provide mental health referrals for cancer-related distress.
DTx–A Key Tool for Psychosocial Support in Breast Cancer Care
DTx are gaining prominence as a tool to provide much-needed psychosocial support for cancer patients. In a 2020 scientific publication, the authors note that,
Digital interventions…with easy access and use, may provide low cost, highly accessible wide reach support for cancer survivors with unmet psychosocial needs.
Unlike other digital health products, such as wellness apps, DTx are medical devices that deliver therapeutic interventions shown in clinical research to improve psychosocial outcomes in patients with breast and other cancers. In DTx, a digital algorithm–the active principal driving the therapeutic effect–generates user-responsive treatment modalities, such as CBT, which interact with patients’ thoughts, increasing awareness of dysfunctional thoughts and behaviors.
DTx-driven cognitive restructuring algorithms are disease-specific. For breast cancer, algorithms address cancer-related distress, including fear of recurrence, empowering patients to develop coping skills specific to their condition.
The power of DTx is enhanced by digital elements that increase bioavailability of treatment modalities. An appealing user-interface, gamification, and an AI-driven personalized experience are key elements that promote patient engagement and adherence with DTx interventions. DTx may also include modules that facilitate patient-clinician communication and remote symptom monitoring, providing a timely and holistic view of patients’ well-being that can influence care decisions.