Psychological counseling for patients with bone tumors

   Relevance. Psychological difficulties are extremely common among patients with bone tumors. Patients often underestimate the severity of their condition, leading to unrealistic treatment expectations and the formation of a passive stance in the treatment process. This underscores the importance of studying the psychological status of patients with bone tumor lesions and exploring the possibilities of psychological assistance for this patient group. One of the main targets of clinical-psychological interventions in an oncological orthopedic clinic is the quality of life (QoL) of patients, encompassing experiences and relationships oriented towards understanding one’s existence, valuing health, and the individual’s ability to establish connections with the external world according to their needs and capabilities, even in the context of illness.

   The purpose of the work is to formulate the main directions of psychological counseling for patients at oncology orthopedic clinic in accordance with the data on characteristics of their quality of life and emotional and personal sphere.

   Methodology consists of analysis of data from the previous studies and review of modern scientific literature on this topic.

   Results of the study indicate that each nosological group of patients, due to the specific parameters of QoL determined by the clinical picture of a particular form of bone tumor lesion, requires an individual approach within the framework of psychological counseling.

   The important aspect of psychological counseling in an orthopedic oncology clinic is working with the patient to see the possibility of influencing their QoL in a situation of illness and extensive surgical treatment.

   Psychological counseling for amputation of the lower limb is indicated for patients at all stages of treatment: in the preoperative period, in the early postoperative period and at the rehabilitation stage. Psychological assistance in the preoperative period includes work with acute reactions caused by the need for amputation. The early postoperative stage confronts the patient with the task of changing the body scheme and working with phantom sensations. It is advisable to consult patients with spine tumors in preoperative period to discuss the actual clinical situation and formulate correct expectations from surgical treatment, including the prognosis of the disease, the possible level of physical and social activity, expected limitations, the expected intensity and prevalence of pain in the postoperative period and the duration of rehabilitation process.

   Conclusion. The article presents the main directions of work with patients of an oncology orthopedic clinic, formulated on the basis of previously conducted studies of QoL and emotional and personal characteristics of persons with bone tumors.

1. Musaev Je.R., Shshelkova O.Yu., Usmanova E.B. [et al.]. Kachestvo zhizni pacientov s opuholjami kostej [Quality of life in patients with bone tumors]. Moscow, 2022. 118 p. (In Russ.)

2. Tarabrina N.V., Vorona O.A., Kurchakova M.S. [et al.]. Onkopsihologija [Oncopsychology]. Moscow, 2010. 186 p. (In Russ.)

3. Chow E., Andersson L., Wong R. [et al.]. Patients with advanced cancer: a survey of the understanding of their illness and expectations from palliative radiotherapy for symptomatic metastases. Clin Oncol (R Coll Radiol). 2001; 13(3): 204–208.

4. Gal R., Oostinga D., Wessels H. [et al.]. Pre-treatment expectations of patients with spinal metastases: what do we know and what can we learn from other disciplines? A systematic review of qualitative studies. BMC Cancer. 2020; (20): 1212.

5. Jehan M., Azam S., Taimuri M.A. [et al.]. Care for breast cancer survivors in Asian countries : A review of sexual dysfunction. Womens Health (Lond). 2024. 20:17455057241237687 [Preprint].

6. Lattig F., Fekete T.F., O’Riordan D. [et al.]. A comparison of patient and surgeon preoperative expectations of spinal surgery. Spine. 2013; (38(12)): 1040–1048.

7. Mannion A.F., Junge A., Elfering A. [et al.]. Great expectations: really the novel predictor of outcome after spinal surgery? Spine. 2009; (34(15)): 1590–1599.

8. Rehman Y., Syed M., Wiercioch W. [et al.]. Discrepancies between patient and surgeon expectations of surgery for sciatica: a challenge for informed decision making? Spine. 2019; (44(10)): 740–746.

9. Saban KL, Penckofer SM. Patient expectations of quality of life following lumbar spinal surgery. J. Neurosci Nurs. 2007; (39(3)): 180–189.

10. Solomons L., Farrar C. Psychological support for chronic conditions. Curr Opin Support Palliat Care. 2023; (17(3)): 240–246.

11. Sze J., Marisette S., Williams D. [et al.]. Decision making in palliative radiation therapy: reframing hope in caregivers and patients with brain metastases. Support Care Cancer. 2006; (14(10)): 1055–63.

12. Twitchell D. Twitchell D.K., Wittmann D.A., Hotaling J.M. [et al.]. Psychological Impacts of Male Sexual Dysfunction in Pelvic Cancer Survivorship. Sex Med Rev. 2019; (7(4)): 614–626.

13. van Wulfften Palthe O., Houdek M.T., Rose P.S. [et al.]. How Does the Level of Nerve Root Resection in En Bloc Sacrectomy Influence Patient-Reported Outcomes? Clin Orthop Relat Res. 2017; (475): 607–616. DOI 10.1007/s11999-016-4794-3.

14. Yoo S.H., Kang J., Kim H.J. [et al.]. Opioid use and subsequent delirium risk in patients with advanced cancer in palliative care: a multicenter registry study. Sci Rep. 2024; (14(1)): 5990-6004. DOI: 10.1038/s41598-024-56675-1.

15. Zhang Y., He Y., Pang Y. [et al.]. Suicidal ideation in Chinese patients with advanced breast cancer: a multi-center mediation model study. BMC Psychol. 2024; (12(1)): 130–139. DOI: 10.1186/s40359-024-01607-x.