Psychological Distress May Contribute to Cancer Treatment Delays

Get Permission

Researchers have found that psychological distress may contribute to delayed cancer treatment, according to a recent study published by Frosch et al in Supportive Care in Cancer.


Prior research has shown that delays in initiating cancer therapy may be increasing, and these delays can lead to not only poorer patient outcomes, but also increased psychological distress.

Study Methods and Results

In the recent qualitative study, the researchers conducted one-on-one interviews with 22 patients with cancer and 12 health-care providers in which they asked questions designed to gain insight into the patients’ and providers’ experiences with treatment delays, opinions on how quickly treatment should commence, and ideas for preventing delays.

The researchers discovered that the patients felt a strong urgency to initiate their cancer treatment immediately following their diagnosis, whereas the providers’ opinions on the goal time frame varied. Both groups recognized the anxiety that a new cancer diagnosis provokes as well as the logistical factors that go into planning treatment.

However, the providers were slightly more focused on risk stratification and capacity when deciding when to initiate treatment, whereas the patients felt more urgency to begin as soon as possible. Part of what drove this urgency in the patient group was fear. Nonetheless, both the patients and providers shared that this same fear could discourage patients from taking the necessary steps to move their cancer treatment along as well as cause the patients to act in ways that delayed care. The patients expressed fear not only of cancer progression while awaiting care, but also of the potential side effects, poor outcomes, and financial consequences of their care—which could lead them to delay their own treatment.

The researchers reported other sources of delays, including logistics (insurance authorization and a lack of transportation) as well as social barriers (insufficient health literacy and a desire to participate in upcoming social events prior to initiating cancer treatment).

The study participants further shared suggestions for overcoming the barriers and causes of cancer treatment delays. In particular, they expressed a desire for education and anticipatory guidance, especially from peers, to help them process their diagnosis and understand their proposed treatment plan.


“We were struck by how fear came into so many aspects of cancer care. Patients talked about how they or [patients] they know have many different reactions to that fear. Some [of them] really tried to accelerate things, while other patients or providers talked about patients either not returning phone calls or presenting other issues that delayed care,” stressed lead study author Zachary Frosch, MD, MSHP, Assistant Professor in the Department of Hematology/Oncology and a member of the Cancer Prevention and Control Research Program at the Fox Chase Cancer Center. “One of the exciting things is that addressing some of these psychological barriers has been more of a challenge, and I think it’s going to be a good challenge to see if we can move the needle on those,” concluded Dr. Frosch.

Disclosure: For full disclosures of the study authors, visit

The content in this post has not been reviewed by the American Society of Clinical Oncology, Inc. (ASCO®) and does not necessarily reflect the ideas and opinions of ASCO®.