Psychological distress, physical symptoms, financial toxicity, and unmet supportive care needs in breast and gynecological cancer patients

Abstract Purpose This study aimed to identify psychological distress, physical symptoms, financial toxicity, and unmet supportive care needs in women with breast and gynecological cancers, and to examine the relationships among these variables. Methods This prospective, descriptive, cross-sectional study was conducted with 234 patients receiving treatment in oncology clinics and outpatient units in Turkey between January and October 2025. Data were collected using the Participant Information Form, Financial Toxicity Scale (COST), Short-Form Supportive Care Needs Survey (SCNS-SF 29), Edmonton Symptom Assessment Scale (ESAS), and Distress Thermometer. Results Patients reported high levels of fatigue, anxiety, and pain, and the mean distress level was high (7.16 ± 1.88). Psychological distress was moderately positively correlated with overall supportive care needs ( r = 0.593, p < 0.001), as well as with the Health Care Services and Information ( r = 0.458, p < 0.001), Daily Life ( r = 0.676, p < 0.001), and Psychology ( r = 0.617, p < 0.001) subscales, and weakly positively correlated with Sexuality needs ( r = 0.211, p = 0.001). Overall, lower COST scores were associated with greater psychological distress and higher unmet supportive care needs. Conclusions Psychological distress, financial toxicity, symptom burden, and unmet supportive care needs were significantly associated with one another in women with breast and gynecological cancers. Cancer should be addressed as a multidimensional condition involving not only physical but also psychological and economic challenges. Nurses play a critical role in early identification of distress, symptom burden, and financial difficulties. Routine screening and holistic assessment should be integrated into clinical practice. Multidisciplinary and patient-centered care approaches, including psychosocial support and financial counseling, are essential to improve patient outcomes and quality of life.