Objectives: Body image adjustment is a crucial issue for patients with facial cancer, but body image–specific interventions are scarce. We report results of a novel psychotherapeutic intervention to address body image concerns during acute postoperative recovery following facial reconstructive surgery. Our primary aims were to evaluate the intervention’s feasibility, acceptability, and efficacy on body image concerns, psychological distress, and quality of life (QOL).Methods: Adults with facial cancers who endorsed body image concerns were recruited to participate in a randomized controlled trial. The intervention group participated in 4 in-person counseling sessions. The control group received an educational booklet and a brief phone call. Participants completed measures of body image, distress, and QOL at baseline and at the 4-week follow-up to assess the impact of the intervention. Intervention outcomes were assessed with 2 sample t-tests or Mann–Whitney U tests as appropriate.Results: Twenty-nine participants completed both the baseline and follow-up assessments. The intervention demonstrated good feasibility with a high retention rate (79%), visit completion rate (81%), and high satisfaction scores (75% reported mean satisfaction score of >3). Intervention did not result in an observed statistically significant difference in reduction in body image dissatisfaction and disturbance, psychological distress, or improvement in QOL compared with the control group. However, intervention resulted in statistically significant difference in perceived social impact (−1 vs. −8.3, p = 0.033) compared to control group.Significance of results: Our study highlights the potential clinical benefits of a novel psychotherapeutic intervention that targets body image concerns and suggests the need for further evaluation.

Objective: Body image is a vital and complex issue in cancer patients, but not well recognized. In the ambulatory psychiatric-oncology clinic, we assessed what portion of cancer patients endorsed appearance problems and if they differed in terms of depression, anxiety, or distress scores when compared with those who did not endorse appearance problems.Method: All adult patients with active cancer diagnosis seen in the outpatient psychiatry oncology clinic (June 2014–January 2016) who provided informed consent were included (N = 1,939) in the cross-sectional study design. “Appearance problems” were assessed as a categorical, binomial variable (yes/no) using the National Comprehensive Cancer Network Distress Thermometer checklist. Other assessments included the Patient Health Questionnaire-9, Patient Health Questionnaire-2, Generalized Anxiety Disorder-7, Distress Thermometer, and Edmonton Symptom Assessment Scale.Result: The overall prevalence rate of individuals who endorsed appearance problems was approximately 36%; they were more likely to be younger, female, Black or Hispanic, and not in a committed relationship (all results for demographic variables were statistically significant; all p < .001). Importantly, those patients who endorsed appearance problems exhibited higher scores for depression (p < .0001), anxiety (p < .0001), and distress (p < .0001), and these differences were of medium effect size (Cohen's d = 0.5−0.6).Significance of results: The current results underscore the need to identify patients with body image problems early given that they are likely to exhibit higher magnitude of anxiety, depression and distress symptoms while undergoing cancer care. The results highlight the importance of body image issues and the need to evaluate them in cancer patients.

Background: Medical mistrust is a barrier to optimal cancer care. Analyzing social media posts where patients voice mistrust provides an opportunity to understand its variations and derive potential ways to address medical mistrust.Aims: To (1) identify the frequency of mistrust expression in cancer‐related Reddit posts, (2) characterize mistrusted entities and reasons for mistrust, and (3) identify emotional tone associated with mistrust.Methods: 101,963 posts from 10 entity‐specific cancer communities on the social media platform Reddit made before September 30, 2024, were analyzed using a Large Language Model (LLM, “gpt‐4o‐mini”) in this cross‐sectional study. Performance of the LLM was compared to human raters. Categories for mistrusted entities and reasons for mistrust were developed inductively by human evaluators. Subsequently, posts were assigned to these different categories by the LLM.Results: Of n = 101,963 posts analyzed, 19,159 posts (18.8%) were categorized as expressing mistrust, predominantly directed at healthcare professionals (n = 14,221, 74.2%). Most common reasons for mistrust were “disregard for patient concerns” (n = 8176, 42.7%), “perceived incompetence of medical management” (n = 4871, 25.4%), and problems in “communication” (n = 4060, 21.2%). Mistrust posts commonly contained “worried” (n = 5933, 31.0%), “concerned” (n = 3623, 18.9%) and “frustrated” (n = 3046, 15.9%) tones.Conclusions: Expression of medical mistrust is prevalent in social media and is predominantly directed at healthcare professionals. Mistrust is frequently associated with dismissal of patients' symptoms or concerns, a perceived lack of thoroughness in clinical management and communication difficulties, suggesting these as key actionable areas to address medical mistrust in clinical practice.