Understanding the Multifaceted Challenges Faced by Patients Receiving Radiation Therapy: A Focus on Emotional, Social, and Physical Health Problems

INTRODUCTION

In recent years, remarkable progress has been made toward understanding cancer development, diagnosis, and treatment.^[1,2] Radiation therapy remains an essential element of cancer treatment, and more than half of all cancer patients receive radiation therapy during their course of illness.^[3,4] In recent years, radiotherapy has been considered a vital specialty in cancer management.^[5–7] Complications of radiotherapy are well-known and very common among patients.^[8] Previous research has shown that approximately 50–70% of patients receive radiation therapy and experience emotional and physical health problems during treatment. Many studies have shown that patients will experience side effects, and these vary from patient to patient and depend on the area where the radiation is delivered.^[9,10]

Cancer treatment modalities can have a substantial impact on the physical and emotional health and well-being of patients. The studies have explored patients' pain, emotional status, and overall health during radiation therapy.^[11,12] Another study identified the factors for the development of psychological issues among cancer patients. These factors include diagnosis experience, treatment modalities, treatment burden, and cost of treatment.^[13] Depression and anxiety are the most critical psychological comorbidities that are common among cancer patients. These conditions may lead to severe problems in patients who are receiving radiation therapy.^[14] Current challenges and needs of patients undergoing radiation therapy need to be identified to develop preventive strategies for short and long-term complications related to radiation therapy. Hence, the present study was conducted to identify the emotional, social, and physical difficulties experienced by the patients receiving radiation therapy in a South Indian context.

MATERIAL AND METHODS

RESULTS

The burden of illness: Patient perspectives

The description of perceived emotional problems experienced by the patients is shown in Table 3. The majority (79.3%) of participants reported that things have been feeling down in their lives. The perceived social problems experienced by the patients revealed that most (72.0%) patients felt burdened by others [Table 4]. The perceived physical problems experienced by the patients showed that the majority (86.6%) reported tiredness all the time and soon ran out of energy [Figure 1]. Most patients reported that the present state of illness affected their family (97.6%) and social (78%) lives [Table 5].

Table 3: Assessment of perceived emotional problems experienced by the patients

(n = 82)
Emotional problems	Yes		No
	Frequency	%	Frequency	%
Things are getting me down	65	79.3	17	20.7
Forgotten to enjoy	49	59.8	33	40.2
Feeling on edge	36	43.9	46	56.1
The days seem to drag	53	64.6	29	35.4
Lose my temper easily	55	67.1	27	32.9
Losing control	41	50.0	41	50.0
Worry is keeping me awake at night	55	67.1	27	32.9
Life is not worth living	57	69.5	25	30.5
Wake up feeling depressed	56	68.3	26	31.7

Table 4: Assessment of perceived social problems experienced by the patients

(n = 82)
Social problems	Yes		No
	Frequency	%	Frequency	%
Feeling lonely	32	39.0	50	61.0
Finding it hard to make contact with people	42	51.2	40	48.8
Feel a burden on other people	59	72.0	23	28.0
Feel there is nobody that I am close to	49	59.8	33	40.2
I find it hard to get along with people	58	70.7	24	29.3

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Figure 1:

Assessment of physical problems experienced by the patients.

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Table 5: Description of the present state of health causing problems among patients

(n = 82)
The present state of health is causing problems with:	Yes		No
	N	%	n	%
Work	46	56.1	36	43.9
Looking after the home	59	72.0	23	28.0
Social life	64	78.0	18	22.0
Home life	80	97.6	2	2.40
Sex life	38	46.3	44	53.7
Interests and hobbies	35	42.7	47	57.3
Vacations	11	13.4	71	86.6

DISCUSSION

This study on the South Indian population explored several aspects of health problems, such as physical, emotional, and social, as experienced by patients undergoing radiation therapy. Similar results were reported by studies that studied patients with head and neck cancer, reporting health issues due to chronic pain that had a significant impact on their treatment, well-being, and recovery.^[15] In the present study, the mean age of study participants was 43.67 ± 8.3 years. The demographic profile of participants showed that an equal proportion (37.8%) of study participants belonged to the age groups of 31–40 years and 41–50 years, and the majority (62.2%) were males. In another study, participants under 55 years reported almost all physical symptoms.^[16] In the present study, most patients had a low socioeconomic status. A study reported that participants with low income experienced significant issues with their health and signs of financial distress.^[17]

Participants reported feeling tired and running out of energy. Similarly, another study reported that many cancer survivors identify fatigue as one of the most frequent and distressing cancer-related symptoms.^[18] Fatigue can be a distressing symptom for every patient, interfering with daily life. Most of the study participants revealed that they felt burdened by other people. These patients thought they were causing inconvenience or additional work for others around them. A previous study reported that physical and psychological disturbances can lead to substantial social problems, such as the inability to work and accept social roles.^[19]

In the present study, most participants reported that things are getting them down in life. These patients are experiencing a significant amount of negativity, stress, or challenges in their lives that are affecting their overall well-being, leading to feelings of sadness, frustration, or hopelessness. A previous research study reported higher levels of psychological distress among the patients, such as uncertainty about the future, concerns about cancer spreading to other parts of the body, feelings of sadness, and fear about death and dying.^[20] It reported that the challenges faced by cancer patients can vary significantly across different cultural contexts.^[20]

This study is limited to a smaller sample size. Hence, it is recommended that extensive sample studies be conducted in different settings, comparing the various types of cancer patients and stages of cancer. Interventional studies can be performed to evaluate the effectiveness of evidence-based nursing interventions on patients' physical, social, spiritual, and emotional problems. Multidimensional approaches, including physical, psychological, spiritual, and social factors and individualised interventions to address these issues, are also needed to improve cancer patients' QoL.^[21,22] Future studies can be aimed at understanding the need for collaboration with interdisciplinary healthcare teams to help patients face the challenge of managing health problems. Further research could explore specific interventions to mitigate these challenges and improve quality of life. These studies can help to design effective protocols in hospitals and healthcare settings.

CONCLUSION

The present study findings showed that most patients undergoing radiation therapy reported emotional distress, felt like a burden to others, and were consistently tired all the time. The patients reported that the present state of illness demonstrated a negative impact on their home and social lives. The findings of the study underscore the importance of addressing patients' holistic well-being during radiation therapy.