Biswas MS, Mawa MJ, Nizum SM. Unseen suffering: Addressing psychological distress in esophageal cancer with bone metastasis. World J Psychiatry 2026; 16(6): 116379 [DOI: 10.5498/wjp.v16.i6.116379]
Corresponding Author of This Article
Mohammad Shahangir Biswas, PhD, Associate Professor, Postdoc, Department of Biochemistry and Biotechnology, University of Science and Technology Chittagong, Zakir Hossain Road, Khulshi 4202, Chattogram, Bangladesh. bioshahangir@gmail.com
Research Domain of This Article
Oncology
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editorial
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Biswas MS, Mawa MJ, Nizum SM. Unseen suffering: Addressing psychological distress in esophageal cancer with bone metastasis. World J Psychiatry 2026; 16(6): 116379 [DOI: 10.5498/wjp.v16.i6.116379]
World J Psychiatry. Jun 19, 2026; 16(6): 116379 Published online Jun 19, 2026. doi: 10.5498/wjp.v16.i6.116379
Unseen suffering: Addressing psychological distress in esophageal cancer with bone metastasis
Mohammad Shahangir Biswas, Mosammat Jannatul Mawa, Sidratul Muntaha Nizum
Mohammad Shahangir Biswas, Mosammat Jannatul Mawa, Sidratul Muntaha Nizum, Department of Biochemistry and Biotechnology, University of Science and Technology Chittagong, Khulshi 4202, Chattogram, Bangladesh
Author contributions: Biswas MS conceptualized and designed the research; Biswas MS, Mawa MJ and Nizum SM performed the literature search and wrote the original manuscript; Biswas MS edited the final manuscript; all authors have read and approved the final manuscript.
Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.
Corresponding author: Mohammad Shahangir Biswas, PhD, Associate Professor, Postdoc, Department of Biochemistry and Biotechnology, University of Science and Technology Chittagong, Zakir Hossain Road, Khulshi 4202, Chattogram, Bangladesh. bioshahangir@gmail.com
Received: November 10, 2025 Revised: November 21, 2025 Accepted: January 8, 2026 Published online: June 19, 2026 Processing time: 199 Days and 15.9 Hours
Abstract
Esophageal cancer (EC) is one of the most lethal cancers of the digestive tract, characterized by rapid progression, high recurrence, and poor survival rates despite advancements in treatment. Its tendency to metastasize to bone increases the disease burden by causing severe pain, disability, and psychological distress. The psychological distress, which frequently remains unrecognized, is a dimension that extends beyond the physical complications of bone metastasis. A recent study published in the World Journal of Psychiatry by Shi et al demonstrated that among 100 patients with EC and bone metastasis, 42% cases experienced depression, where low income, poor social support, sleep disturbance, limited education, and increased high-sensitivity C-reactive protein were identified as independent risk factors. These results imply that depression in metastatic EC is an outcome of systemic inflammation and social vulnerability instead of being purely reactive. This editorial emphasizes that psychological health in cancer care needs to be monitored with the same rigor as imaging and biochemical parameters. Identifying depression as both a symptom and sign of psychological imbalance may reshape supportive oncology, making psychological health treatment an integral part of managing the cancer.
Core Tip: Esophageal cancer with bone metastases significantly affects both body and mind. Tumor growth and skeletal obstacles enhance pain and reliance, targeted therapies cause psychological and financial burden, and palliative treatments increase anticipatory anxiety. Multimodal regimens induce the greatest psychological distress, yet they also provide the best chance for rapid intervention. This article argues for culturally sensitive, system-adapted, and treatment-tailored psychological care as a significant element of cancer treatment, particularly in low- and middle-income countries, where resource constraints and structural disparities intensify patient distress.
