The link between psychological distress and survival in solid tumor patients: A systematic review

Abstract

Purpose Research has demonstrated that solid tumor patients experience high levels of psychological distress at the time of diagnosis. While distress has been associated with many adverse clinical outcomes, little is known about how this symptom may influence the disease trajectory for cancer patients, affecting outcomes such as progression, recurrence, and survival. The purpose of this systematic review was to explore the literature linking distress with survival in solid tumor patients, which may guide future work exploring clinical outcomes as a function of distress. Methods A systematic search of PubMed, Embase, and Web of Science was performed using PRISMA (Preferred Reporting Items for Systematic Reviews and Meta‐Analyses) guidelines with predefined eligibility criteria. Thirteen studies met the inclusion criteria and were selected for review. Results Findings from this review demonstrated a weak‐to‐moderate relationship between cancer patients' experience of distress and overall survival, with most included studies (11/13) finding at least one predictive analysis to be significant when controlling for confounders. However, significant heterogeneity in the literature, particularly with study sample characteristics and varying methodologies, made direct comparisons across studies challenging. Conclusion Findings from this review suggest that psychological distress may have an impact on disease‐related outcomes, including (but not limited to) survival. Future work should consider performing disease‐specific analyses controlling for key prognostic factors to better understand the nuanced relationship between distress and clinical outcomes, which may allow further understanding of the biological underpinnings of this relationship and enable the development of targeted interventions for improving distress.

Colorectal Cancer Surgery: Influence of Psychosocial Factors

“…Our results show not only that the well-being of these individuals is compromised, but also, given the existing literature, that they are exposed to cellular changes that facilitate the proliferation of cancer cells and thus influence the prevalence of the disease. Furthermore, these stress levels influence the course of the disease, leading to physical deterioration, and are associated with lower survival rates and a poorer response to treatment [ 19 , 20 , 21 , 22 ]. It should be noted that in our study, patients who perceived high and very high levels of stress were more likely to develop paralytic ileus ( p = 0.002).…”

“…Our results show that active coping styles predominate. These contribute to a greater adjustment to the illness and lower stress levels in the patients, due to the beneficial effects of active coping styles on stress [ 10 , 46 ] and hence they improve their psychological situation, the non-proliferation of cancer cells, and enable better management of the disease and its circumstances [ 19 , 20 , 21 , 22 ].…”

“…Thus, the targeted mobilization of resources or their potential depletion incapacitates the organism to some extent to fight effectively against cancer cells. Given the relationship between the neurochemical, hormonal and immune systems, a perturbation in any of these processes could ostensibly increase the proliferation of cancer cells [ 20 ]. On the other hand, it should be emphasised that stress favours the development of neoplasia, not only by disrupting immune regulation, but also by damaging DNA and altering repair mechanisms [ 21 ].…”

Preparing for and Not Waiting for Surgery

“…Pooled data from 16 prospective studies, reporting 4353 cancer related deaths, revealed that higher levels of distress were associated with a 32% greater mortality risk [70]. A 2023 systematic review reported that presence of psychological distress was predictive of reduced survival across 11 of the 13 reviewed studies [71].…”

Common and distinct risk factors that influence more severe and distressing shortness of breath profiles in oncology outpatients

“…In our recent study, 29 patients with the highest occurrence rates for shortness of breath reported higher levels of global, cancer‐related, and cumulative life stress. Given that a cancer diagnosis and its associated treatments are extremely stressful experiences, 30 , 31 and albeit limited information on positive associations between the occurrence and severity of shortness of breath and stress, an examination of its associations with both severity and distress is warranted. Equally important, evidence suggests that resilience facilitates a positive cognitive appraisal of perceived stress.…”