Self-identification and relief of psychological pain in patients with gynecological tumors

Gynecological cancer refers to tumors involving the female reproductive tract. According to statistics from the World Health Organization, cervical cancer, uterine cancer, and ovarian cancer are ranked third, sixth, and eighth in the world in terms of incidence among women, respectively. In China, the number of cases of gynecological cancer is increasing due to the growth and aging of the population. Receiving a cancer diagnosis is a stressful experience, as cancer means facing a huge threat to one's life and requiring a series of treatments that may have various side effects.

This diagnosis is a huge blow not only to the patient but also to their family members, as it can have a significant impact on their immediate and long-term mental health. During this process, the patient may face psychological distress at any time, which further affects the patient's quality of life. It is very important for patients to learn to self-identify psychological distress early and seek help from medical staff in a timely manner.

1. What is psychological pain?

Distress is an unpleasant experience that involves mental, physical, and social aspects, affecting how you feel, think, and behave. Distress is a continuum of emotion, ranging from common, normal emotional states (such as vulnerability, sadness, and fear) to severe problems that can lead to impairment (such as depression, anxiety, panic, social isolation, existential and spiritual crises, etc.).

Psychological pain occurs at different stages in almost every cancer patient's life. It is normal and expected to feel sad, afraid, and helpless.

Psychological pain often manifests as: sadness; fear, worry, and helplessness; anger and feeling out of control; extreme concern about the illness and treatment; worry about paying bills and making a living; questioning the purpose of life; avoiding crowded places; poor sleep quality, loss of appetite, and decreased concentration; depression, anxiety, panic; and frequent thoughts about illness and death.

2. The Generation and Self-evaluation of Psychological Pain

Psychological distress often has many reasons, and it varies from person to person. Some people suffer from psychological distress due to serious side effects of treatment, while others suffer from psychological distress due to the extra expenses caused by illness. Anyone can suffer from psychological distress, but in some cases, such as when the patient's symptoms are uncontrollable, when they suffer from other serious diseases besides cancer, when they have cognitive impairment, or when they face financial problems, family conflicts, and lack of social support, they are more likely to fall into psychological distress.

The Distress Thermometer (DT) recommended by the National Comprehensive Cancer Network (NCCN) is a single-item self-assessment tool for pain. The thermometer can be used to assess the patient's pain level in the past week, with 0 points = no pain and 10 points = extreme pain; a score of ≥ 4 points indicates that moderate to severe pain may exist and further specialist evaluation is required.

Image source: Interpretation of the 2018.V1 version of the NCCN Cancer Clinical Guidelines: Management of Psychological Distress

3. How to relieve psychological pain by confirming gynecological tumors

1. Understand the type of disease you have and have more control over your situation

When you first learn you have cancer, your daily life may feel disrupted. Learning more about your disease and its treatment can help you feel more confident. Understanding your disease can help you talk to your doctor about which treatment is right for you. You can learn about your cancer type and treatment by asking your doctor or nurse, taking notes during doctor visits, asking other people for advice, and researching your cancer type online, in public libraries, or in hospital informational materials for patients and families.

2. Share your feelings about cancer

It's hard to cope with cancer alone. Although it can be hard to talk about your cancer for the first time, most people find that sharing their thoughts and feelings helps them cope. Choose a good listener at this time. You may not need advice or someone to tell you what to do, but you just want someone to listen and try to understand your current life situation. You may need to find someone outside your family to talk to.

Also, you should choose a time that is appropriate. Sometimes people will give you some signs that they want to let you know that they are willing to talk about cancer with you. Sometimes you can ask others about their thoughts and feelings. Don't avoid some negative feelings - share them with others and try to understand them. Don't pretend to be happy. You may not want to let people around you know that you have strong negative feelings, but pretending to be happy is not only unhelpful for you to express your true feelings, but also makes it more difficult for others to understand your true thoughts and feelings. Sometimes, seeking help from community resources is also a way. Support groups composed of social workers may be able to provide more support.

3. Recognize the main triggers of your negative emotions

Analyzing the causes of repressed emotions can help you improve your self-awareness and bring about more positive changes. For example, rational analysis can help you recognize the vicious cycle of negative emotions and get out of it in time. Once you clearly understand the specific causes of negative emotions, you can prevent them from developing further into more serious consequences that may affect your behavior.

Also, try to avoid making a mountain out of a molehill or jumping to negative conclusions too quickly. Sometimes we are faced with situations that have no solution, and it is sensible and necessary to accept the reality of the situation. It may be helpful to talk to a psychiatrist who can help you with self-discovery and help you transform your self-defeating, negative thoughts into positive thoughts that value life.

4. Reach out to someone you know who is also experiencing pain

Some cancer patients find comfort and strength in sharing their stories and experiences with other patients, which can be motivating. Sometimes, learning about the anxiety and pain that others are experiencing can make you more forgiving of yourself and more compassionate toward others. However, you may want to consider waiting until you are emotionally and mentally ready before reaching out to others.

5. Seek professional help

There is no shame in seeking help when you need it. If you feel overwhelmed and it affects your work, school, family order, or even your relationship with your partner, consider seeking counseling and help from a psychiatrist.

In 2020, the theme of the "World Cancer Day" of the International Union Against Cancer (UICC) is "Caring for Patients, Fighting Cancer Together (I am and I will)". Let us work together to alleviate psychological pain and improve the quality of life during illness.

References:

1.National Cancer Institute Dictionary. Gynecologic Cancer. National Institutes of Health Web site

2.World Health Organization. The global burden of disease: 2004 update. World Health Organization Web site

3.NCCN guidelines for patients: Distress During Cancer Care

4. Qi WJ, Hu J, Li LY. 2018. Interpretation of the V1 version of the NCCN Cancer Clinical Guidelines: Management of Psychological Distress[J]. Chinese Journal of General Practice, 2018, 21(15): 1765-1768.

Author: Wang Yun and Wang Yang from Shanghai Jiao Tong University School of Medicine Mental Health Center

Funded by Shanghai Science and Technology Commission's Science Popularization Project

(Project No.: 20DZ2311100)