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Cancer

Psychosocial Impacts of Prophylactic Total Gastrectomy for Hereditary Diffuse Gastric Cancer: A Narrative Review

Strategic Insights

— 1 min read

Prophylactic total gastrectomy (PTG) is a recommended intervention for patients with hereditary diffuse gastric cancer (HDGC), a condition caused by pathogenic or likely pathogenic (P/LP) CDH1 germline genetic variants. However, PTG significantly impacts a patient's quality of life (QOL) and psychological well-being. A recent review of published literature on the psychosocial sequelae and quality of life reported post-PTG in germline (P/LP) CDH1 variant carriers reveals a pressing need for evidence-based recommendations to address their psychosocial needs.

Key Takeaways:

  • 37 articles met the inclusion criteria for the review, with 7 of the most frequently mentioned psychosocial domains including quality of life (n = 22), social relationships (n = 12), depression and anxiety (n = 8), decision-making (n = 7), employment and finances (n = 4), body image (n = 5), and substance abuse (n = 3).
  • Prophylactic total gastrectomy (PTG) presents a psychosocial vulnerability for CDH1 (P/LP) variant carriers, considering the known psychological impact of a genetic cancer predisposition diagnosis and the significant postoperative lifestyle adjustment.
  • Standardized integration of mental health care along the PTG surgical continuum is recommended to address the psychosocial needs of PTG patients.
  • The combination of the diagnosis of a hereditary cancer syndrome and the life-altering nature of PTG places patients at risk for psychosocial distress.

Statistics:

  • 22 articles mentioned quality of life as a significant psychosocial domain post-PTG.
  • 12 articles mentioned social relationships as a key concern for patients post-PGT.
  • 8 articles mentioned depression and anxiety as significant psychosocial impacts of PTG.

Sources:

  • Psychosocial Impacts of Prophylactic Total Gastrectomy for Hereditary Diffuse Gastric Cancer: A Narrative Review. Psycho-Oncology, 2025;34(10).
  • National Institutes of Health, Intramural Research Program, Bethesda, Maryland, USA.
  • Wiley, 111 River St, Hoboken 07030-5774, NJ, USA.
  • Psycho-Oncology, 10.1002/(ISSN)1099-1611.
  • Olivia Kearns, Jeremy Davis, Amber F. Gallanis, Rachael Lopez, Michael Liu, Haniya Raza.

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