{"slug":"psychosocial","tag":"psychosocial","variants":["psychosocial"],"description":"The mind and the life around it after cancer: mood, fear of recurrence, body image, relationships, work and money.","count":24,"kinds":{"technology":24},"related":[{"slug":"rejuvenation","tag":"rejuvenation","shared":24},{"slug":"survivorship","tag":"survivorship","shared":24},{"slug":"policy","tag":"policy","shared":3},{"slug":"equity","tag":"equity","shared":1},{"slug":"quality-of-life","tag":"quality-of-life","shared":1},{"slug":"transplant","tag":"transplant","shared":1}],"records":[{"id":"rejuv-mind-fear-of-recurrence","kind":"technology","name":"Fear that the cancer will come back: how common it is, and when it stops being ordinary worry","route":"/technologies/rejuv-mind-fear-of-recurrence/","status":"established","tldr":"Almost everyone who finishes cancer treatment thinks about it coming back, and for about one in five the thought is severe enough to be worth treating. Pooling 9,311 people from 46 studies in 13 countries, 58.8 per cent scored 13 or more on a 36-point questionnaire, 45.1 per cent scored 16 or more and 19.2 per cent reached 22, the clinical threshold."},{"id":"rejuv-mind-fear-of-recurrence-treatment","kind":"technology","name":"Treating fear of recurrence: the randomised trials, their effect sizes, and where the treatment is available","route":"/technologies/rejuv-mind-fear-of-recurrence-treatment/","status":"emerging","tldr":"Treatment aimed specifically at fear of recurrence works, and the effect is small: across 23 controlled trials the pooled difference was 0.33 of a standard deviation afterwards and 0.28 at follow-up. The two largest randomised trials, ConquerFear with 222 people and SWORD with 88, each beat their comparator, and SWORD cost 466 euros a person."},{"id":"rejuv-mind-scan-anxiety","kind":"technology","name":"Anxiety around scans, and what the evidence says about how often to scan","route":"/technologies/rejuv-mind-scan-anxiety/","status":"established","tldr":"Anxiety around a scan has been measured in 57 studies using 81 different instruments, which is why reported rates run from 13 to 83 per cent; moderate to severe anxiety was reported by 4 to 28 per cent. Scanning more often does not lengthen life in breast cancer or in one common lymphoma, and in bowel cancer it found more curable recurrences but no fewer deaths."},{"id":"rejuv-mind-depression-after-cancer","kind":"technology","name":"Depression during and after cancer: the interview-based prevalence, and the care model that works","route":"/technologies/rejuv-mind-depression-after-cancer/","status":"standard-of-care","tldr":"Diagnosed by psychiatric interview rather than questionnaire, depression affects about one in six people being treated for cancer: 16.3 per cent across 70 studies and 10,071 people. Years later the rate is no higher than in people who have not had cancer. The treatment with the largest trial behind it is nurse-delivered collaborative care, which tripled the response rate."},{"id":"rejuv-mind-anxiety-after-cancer","kind":"technology","name":"Anxiety after cancer, in survivors and in their partners","route":"/technologies/rejuv-mind-anxiety-after-cancer/","status":"established","tldr":"Two or more years after diagnosis, anxiety is the mood problem that stays raised: 17.9 per cent of 48,964 people against 13.9 per cent of 226,467 who had not had cancer, a relative risk of 1.27. Depression at that distance is not raised. Where both members of a couple were measured, spouses reported anxiety at 40.1 per cent against 28.0 per cent."},{"id":"rejuv-mind-traumatic-stress-after-cancer","kind":"technology","name":"Post-traumatic stress after cancer: what is measured, and how much of it is measurement","route":"/technologies/rejuv-mind-traumatic-stress-after-cancer/","status":"emerging","tldr":"Post-traumatic stress disorder is commoner after cancer than in matched controls, with a pooled odds ratio of 1.66 across 11 studies, and the meta-analysis authors say some of that may come from publication bias. How much is reported depends on whether a clinician interviewed the person, and on whether the paper's own title mentions post-traumatic stress."},{"id":"rejuv-mind-distress-screening","kind":"technology","name":"Screening for distress: what the thermometer can and cannot do","route":"/technologies/rejuv-mind-distress-screening/","status":"established","tldr":"The one-question distress thermometer is good at ruling depression out and poor at ruling it in: pooled across 38 analyses of 6,414 patients, sensitivity 78.4 per cent, specificity 66.8 per cent, and only 34.2 per cent who screened positive were depressed. Tested as a way of improving outcomes rather than finding cases, the one randomised trial found no improvement."},{"id":"rejuv-mind-post-traumatic-growth","kind":"technology","name":"Post-traumatic growth: what people report, and what the measurement actually captures","route":"/technologies/rejuv-mind-post-traumatic-growth/","status":"established","tldr":"Many people say cancer changed them for the better, and that report is real. What the standard questionnaire measures is less clear: when researchers compared what people said had changed with what had actually changed on the same measures taken before and after the event, the two were largely unrelated, and perceived growth went with more distress while measured growth went with less."},{"id":"rejuv-mind-access-to-psychological-care","kind":"technology","name":"Getting psychological help after cancer: the stepped-care model, and what is actually commissioned","route":"/technologies/rejuv-mind-access-to-psychological-care/","status":"established","tldr":"The guideline answer is stepped care: education for everyone, named talking therapies for moderate symptoms, more intensive therapy for severe ones, and medication after those rather than before. The English four-level model that cancer services were built around, published by NICE in 2004, has been retired and nothing has replaced it in the same form."},{"id":"rejuv-mind-body-image-after-cancer","kind":"technology","name":"Body image after cancer treatment: how it is measured, what drives it, and what helps","route":"/technologies/rejuv-mind-body-image-after-cancer/","status":"established","tldr":"Body image has a validated ten-item questionnaire built for cancer trials and tested in 682 women with breast cancer. It discriminates reliably between people who had a mastectomy and those who had breast-conserving surgery, and the scores do not track age or time since diagnosis, which is the finding most at odds with what people are told."},{"id":"rejuv-mind-visible-difference-head-and-neck","kind":"technology","name":"A changed face and voice: body image after head and neck cancer treatment","route":"/technologies/rejuv-mind-visible-difference-head-and-neck/","status":"emerging","tldr":"Head and neck cancer treatment changes the part of the body a person cannot cover, and the functions, speech and eating, that social life is built on. There is no pooled prevalence figure for body image distress in this group: the first systematic review of the factors behind it was still a published protocol in 2025, which makes this the clearest measurement gap in this part of the corpus."},{"id":"rejuv-mind-body-after-stoma-and-limb-loss","kind":"technology","name":"Living with a stoma, and living after an amputation","route":"/technologies/rejuv-mind-body-after-stoma-and-limb-loss/","status":"established","tldr":"A stoma changes how the body works in public, and the comparisons of quality of life after a stoma against a restored bowel are small and mixed. After bone sarcoma of an arm or leg the finding is the one people least expect: most studies comparing amputation with limb-saving surgery reported no significant difference in quality of life."},{"id":"rejuv-mind-the-word-survivor","kind":"technology","name":"The word survivor, and why the vocabulary is not a detail","route":"/technologies/rejuv-mind-the-word-survivor/","status":"established","tldr":"In the one in-depth British study to ask, most of 40 people interviewed at least five years after a diagnosis of breast, bowel or prostate cancer rejected the word survivor, and the authors recommended descriptive terms instead. A wider review of eight cancer studies found the opposite in five of them, which is the point: there is no single right word."},{"id":"rejuv-life-partners-and-intimacy","kind":"technology","name":"Partners and relationships after cancer: what the divorce data actually show","route":"/technologies/rejuv-life-partners-and-intimacy/","status":"established","tldr":"The widely repeated claim that a marriage is six times more likely to end when the woman is the patient comes from one prospective cohort of 515 people. The largest study of the question, 134,435 married Finnish women followed for a median of 17 married years, found no increase in marital breakdown after early breast cancer, with a hazard ratio of 0.96."},{"id":"rejuv-life-carers","kind":"technology","name":"The carer's own recovery: what is known about the person who is not the patient","route":"/technologies/rejuv-life-carers/","status":"established","tldr":"In studies that measured both halves of a couple, anxiety was reported by 40.1 per cent of spouses against 28.0 per cent of the people they cared for, and the review of fear of recurrence found carers reported more fear than patients. Across 29 randomised trials, interventions aimed at carers reduced burden and improved coping, with small to medium effects."},{"id":"rejuv-life-children-of-a-parent-with-cancer","kind":"technology","name":"Children of a parent treated for cancer","route":"/technologies/rejuv-life-children-of-a-parent-with-cancer/","status":"established","tldr":"An estimated 1.58 million people in the United States living after a cancer diagnosis have a child under 18 at home, about 2.85 million children, and roughly 562,000 of them live with a parent in early treatment. The systematic review found no general excess of serious difficulty against reference groups, a slightly raised risk of internalising problems, and adolescent daughters most affected."},{"id":"rejuv-life-return-to-work","kind":"technology","name":"Going back to work after cancer: the rates, and the programmes that change them","route":"/technologies/rejuv-life-return-to-work/","status":"established","tldr":"Pooled across 36 studies, 20,366 people who had had cancer and 157,603 controls, 33.8 per cent of those who had had cancer were unemployed against 15.2 per cent, a relative risk of 1.37. Of four kinds of return-to-work programme tested in trials, exercise and multidisciplinary ones each raised the proportion returning by about a quarter; education alone did not."},{"id":"rejuv-life-employment-rights-uk","kind":"technology","name":"Employment rights with cancer in the United Kingdom","route":"/technologies/rejuv-life-employment-rights-uk/","status":"standard-of-care","tldr":"Schedule 1 of the Equality Act 2010 says in one sentence that \"Cancer, HIV infection and multiple sclerosis are each a disability\", so protection applies from the moment of diagnosis rather than when the illness starts to limit anything. That brings the employer's duty to make reasonable adjustments, and Statutory Sick Pay of £123.25 a week for up to 28 weeks."},{"id":"rejuv-life-employment-rights-us","kind":"technology","name":"Employment rights with cancer in the United States","route":"/technologies/rejuv-life-employment-rights-us/","status":"standard-of-care","tldr":"Federal regulation states that \"cancer substantially limits normal cell growth\", and the statute counts an impairment in remission if it would substantially limit a major life activity when active. The Americans with Disabilities Act reaches employers with 15 or more employees; unpaid job-protected leave under the Family and Medical Leave Act is 12 workweeks a year."},{"id":"rejuv-life-insurance-loans-and-the-right-to-be-forgotten","kind":"technology","name":"Insurance, mortgages and the right to be forgotten","route":"/technologies/rejuv-life-insurance-loans-and-the-right-to-be-forgotten/","status":"emerging","tldr":"Nine European Union countries have passed laws giving people who have had cancer the right not to declare it when applying for a loan or insurance after a set period, commonly five to ten years for adults and five for a cancer diagnosed young. Where the laws have been in force longest, acceptance rates are high and the strain on insurers is reported as minimal."},{"id":"rejuv-life-money-after-treatment","kind":"technology","name":"Money after treatment: what the cost of cancer does once the treatment has finished","route":"/technologies/rejuv-life-money-after-treatment/","status":"established","tldr":"In a United States cohort covering 231,596 people diagnosed between 1995 and 2009, those who filed for bankruptcy after a cancer diagnosis had a mortality hazard ratio of 1.79 against propensity-matched people who did not. In a national survey of people over 50, 42.4 per cent had depleted their entire assets two years after diagnosis, losing an average of 92,098 dollars."},{"id":"rejuv-mind-sleep-after-cancer","kind":"technology","name":"Sleep after cancer: how common insomnia is, how long it lasts, and the treatment that works","route":"/technologies/rejuv-mind-sleep-after-cancer/","status":"standard-of-care","tldr":"In 962 people interviewed six times over 18 months after surgery for a first non-metastatic cancer, 59 per cent had insomnia symptoms at the start, 28 per cent met criteria for an insomnia syndrome, and 36 per cent still had symptoms at 18 months. A short course of talking therapy for insomnia improved sleep efficiency by 15.5 per cent against 6.1 per cent in controls."},{"id":"rejuv-mind-sleeping-tablets-after-cancer","kind":"technology","name":"Sleeping tablets after cancer: what they do and what they do not","route":"/technologies/rejuv-mind-sleeping-tablets-after-cancer/","status":"established","tldr":"The American Academy of Sleep Medicine's guideline on drugs for chronic insomnia rates every one of its recommendations as weak, suggests eight drugs and suggests against six more, including melatonin, trazodone, diphenhydramine and valerian. In cancer specifically, the only placebo-controlled trial of temazepam and prolonged-release melatonin randomised 21 people."},{"id":"rejuv-tx-quality-of-life","kind":"technology","name":"Quality of life after transplant and cell therapy","route":"/technologies/rejuv-tx-quality-of-life/","status":"established","tldr":"Most people who come through a transplant or CAR-T report, years later, a quality of life close to that of people who never had one. Underneath that, a substantial minority live with fatigue, anxiety, low mood or trouble concentrating, and the strongest predictor is having had anxiety or depression before treatment, which is treatable."}]}