Journal of Cancer Research and Immuno-Oncology
Open Access

Battling more than Cancer: The Psychological Toll of Collateral Cancer

Pilar Tops^{* *}Correspondence: Pilar Tops, Department of Medicine, University of Melbourne, Parkville, Australia, Email:

Author info »

Description

Cancer is a global health challenge, impacting millions of lives each year. The medical community has made significant progress in understanding and treating cancer, but this progress has given rise to another complex issue–collateral cancer.

Collateral cancer refers to the unintended consequences, both direct and inCollateral cancer refers to the unintended consequences, both direct and indirect, of cancer prevention, diagnosis, and treatment. This multifaceted issue impacts not only patients but society as a whole. In this essay, we will explore various aspects of collateral cancer, including overdiagnosis, overtreatment, financial toxicity, and the psychological toll on patients and their families.direct, of cancer prevention, diagnosis, and treatment. This multifaceted issue impacts not only patients but society as a whole. In this essay, we will explore various aspects of collateral cancer, including overdiagnosis, overtreatment, financial toxicity, and the psychological toll on patients and their families.

Overdiagnosis

Overdiagnosis occurs when a medical test identifies a condition that would never have caused symptoms or harm during a person's lifetime. In the context of cancer, it means diagnosing tumors that would have remained indolent, never causing symptoms or threatening a patient's life. Overdiagnosis is often a result of widespread cancer screening programs, such as mammography for breast cancer or PSA tests for prostate cancer.

Overdiagnosis can lead to overtreatment, where patients undergo unnecessary surgeries, radiation therapy, or chemotherapy, causing harm without providing any real benefits. Overdiagnosis not only puts a significant financial burden on healthcare systems but also causes physical and emotional suffering to patients. Moreover, it contributes to the overutilization of medical resources, which could be better allocated to more critical cases.

Overtreatment

Overtreatment is a direct consequence of overdiagnosis and the fear of cancer that it induces. Patients and doctors, upon receiving a cancer diagnosis, often opt for aggressive treatments even when the potential benefits are uncertain. Overtreatment leads to a range of complications, including the risk of surgical complications, the toxic side effects of chemotherapy and radiation, and long-term physical and psychological consequences.

For example, in the case of low-risk prostate cancer, studies have shown that active surveillance is a safer option than surgery or radiation for many patients. However, the fear of cancer often leads individuals to choose the more aggressive approach, subjecting themselves to unnecessary risks. Over treatment not only affects patients but also places a considerable economic burden on healthcare systems and society.

Financial toxicity

Collateral cancer is not just a medical issue; it's a socioeconomic one. The high cost of cancer care can lead to financial toxicity, which is the financial strain and distress experienced by patients and their families due to the costs associated with cancer diagnosis and treatment. The expense of cancer treatment can be overwhelming, often leading to financial ruin or bankruptcy for affected families. The cost of cancer treatment includes not only medical bills but also indirect expenses like lost income due to treatment, travel costs, and the expense of supportive care. These financial burdens can result in patients forgoing or delaying treatment, which can have severe implications for their health and survival. Moreover, it may result in patients and their families prioritizing their financial concerns over their well-being, leading to suboptimal decision-making and healthcare outcomes.

Psychological toll

The psychological impact of cancer is well-documented, but collateral cancer introduces an additional layer of distress. The fear of overdiagnosis and overtreatment can lead to anxiety, depression, and decision-making paralysis for patients and their families. The emotional burden is not only caused by the disease itself but by the uncertainty and confusion surrounding the necessity of treatments.

Patients diagnosed with cancer, whether it's overdiagnosed or not, often experience substantial psychological distress. They face the existential threat to their lives, deal with the physical and emotional toll of treatment, and wrestle with the fear of recurrence. The added complexities of overdiagnosis and overtreatment can exacerbate these existing challenges, making it difficult for patients to navigate the already treacherous path of cancer care.

Societal implications

Collateral cancer has far-reaching implications beyond individual patients. The overuse of healthcare resources for overdiagnosis and overtreatment diverts valuable funding from other essential health services. This financial strain on healthcare systems can limit access to care for those with genuine medical needs, contributing to healthcare inequalities and disparities.

Furthermore, the psychological toll of collateral cancer on patients and their families can strain social support systems, impacting relationships and the quality of life. Caregivers often experience significant stress and burden, leading to their own health problems. The ripple effect of collateral cancer thus extends to social and familial domains, affecting not only the patient but their entire support network.

Addressing collateral cancer requires a multi-faceted approach. Healthcare providers must improve communication with patients, ensuring they understand the risks, benefits, and alternatives to treatment. Shared decision-making, where patients are actively involved in their care, can help mitigate overdiagnosis and overtreatment. Additionally, rigorous evaluation of cancer screening programs is necessary to ensure that they do not contribute to overdiagnosis. Research should focus on better distinguishing between indolent and aggressive cancers, enabling more accurate and personalized treatment plans.