International Journal of Clinical Case Reports, 2026, Vol.16, No.1, 53-65 http://medscipublisher.com/index.php/ijccr 57 gradually worsen during the treatment process, and only a little improvement can be seen by the end of the treatment. A study on bladder cancer patients found that the most obvious emotional changes occurred within 1 to 3 months after chemotherapy, and then the emotions would gradually stabilize. Additionally, emotional distress and the patient's subjective well-being are inversely proportional. These research results indicate that at different stages of chemotherapy, patients face different psychological risks, so psychological care cannot remain the same and should provide more targeted support based on the emotional changes at each stage (Figure 1). Figure 1 The change in emotion levels and wellbeing levels at different chemotherapy stages (Adopted from Yang et al., 2023) 4 Main Influencing Factors of Psychological Problems 4.1 Factors related to the disease and treatment The severity of the patient's condition directly determines their psychological state. The development of the disease, the size of the tumor, and the doctor's assessment of the recovery situation all affect the patient's mood. Relevant studies show that patients in the advanced stage, with recurrence, or in stage IV are more likely to experience anxiety and depression compared to those in the early stage (Li et al., 2025). Taking breast cancer patients as an example, those with metastasis, newly diagnosed, or undergoing chemotherapy usually have to endure greater psychological pressure. This indicates that the more severe the disease and the more complex the treatment process, the heavier the psychological burden on the patients (Tang et al., 2024). If patients lack confidence in the treatment and believe that the disease is difficult to cure, they are more likely to feel helpless and worried, which also affects their enthusiasm for cooperating with the treatment. Among these influencing factors, the treatment method itself, especially chemotherapy, has a more obvious impact on the patient's psychological state. Research has found that patients undergoing chemotherapy have much greater psychological stress than those who have completed treatment (Tang et al., 2024). Compared to other treatment methods, chemotherapy is more likely to cause anxiety and depression in patients (Li et al., 2025). Some studies also mention that knowing whether the patient is undergoing chemotherapy can roughly predict their risk of developing psychological problems (Velasco-Durantez et al., 2024). This indicates that the pressure brought by the disease itself, combined with various physical discomforts during the treatment process, makes patients undergoing chemotherapy more prone to psychological problems. 4.2 Social and family support factors For patients undergoing chemotherapy, the support from family and friends is particularly important. This support can help patients reduce stress and enable them to better cope with the disease. Studies show that if patients are
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