Fear of cancer and emotional regulation among patients with pulmonary tuberculosis: A psycho-oncological perspective
Abstract
Pulmonary tuberculosis (TB) imposes a substantial psychological burden. Prolonged treatment, social stigma, and uncertainty can precipitate anxiety and depressive symptoms. Psycho-oncology offers transferable constructs—especially fear of cancer (including fear of recurrence) and emotion regulation—that may illuminate analogous mechanisms in TB. To synthesize evidence on (i) psychological distress, stigma, and emotion regulation among people with TB; (ii) conceptual overlaps between fear of cancer and chronic-illness anxiety; and (iii) implications for psycho-oncology–informed care pathways in TB. Narrative review guided by SANRA quality principles and informed by PRISMA-ScR transparency standards. Searches of PubMed, Scopus, Web of Science, and Google Scholar (2015–2025) combined terms for tuberculosis, fear of cancer/recurrence, emotion regulation, stigma, self-esteem, and coping. Inclusion criteria: peer-reviewed, open-access, English-language studies addressing psychosocial constructs in TB, cancer, or closely related chronic conditions. Ten eligible studies were thematically synthesized. Four convergent themes emerged. (1) Psychological distress and stigma in TB: Internalized/anticipated stigma are consistently associated with anxiety, depression, and poorer quality of life; higher self-esteem buffers these effects. (2) Fear of cancer and emotion-regulation mechanisms: Adaptive strategies (e.g., cognitive reappraisal, acceptance) reduce fear-related distress; maladaptive strategies (rumination, avoidance, self-blame) amplify it. (3) Cross-disease psychosocial parallels: Trans-diagnostic patterns link fear, control beliefs, and interpersonal regulation to resilience and adherence across TB and oncology. (4) Intervention implications: Multilevel approaches—counselling, peer/family support, stigma-reduction toolkits, and culturally attuned mind–body practices—target shared mechanisms and may improve well-being and treatment engagement. Fear-related processes and emotion regulation constitute a common psychological architecture across TB and cancer. A psycho-oncological lens clarifies how stigma, self-concept, and regulatory strategies shape distress, resilience, and adherence in TB. Integrating routine psychological screening, brief emotion-regulation interventions, interpersonal supports, and culturally sensitive practices into TB services could strengthen outcomes and advance a biopsychosocial standard of care. This review expands the psycho-oncological paradigm to infectious disease contexts.
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