Does Alexithymia Affect Patients with Hidradenitis Suppurativa?

Cancer, as the second leading cause of death globally, poses a severe public health challenge. According to GLOBOCAN data, there were nearly 20 million new cancer cases worldwide in 2022., With advancements in diagnostic and therapeutic technologies, alongside improved early screening strategies, cancer survival rates have significantly increased, leading many types of cancer to be managed as chronic diseases. Despite this prolonged survival, patients continue to face persistent health challenges, among which pain is one of the most prevalent and distressing symptoms. Chronic cancer-related pain (CCRP) refers to pain caused by the primary tumor, metastases, or cancer treatments (eg, surgery, chemotherapy, radiotherapy) that typically persists or recurs for more than three months. A meta-analysis indicated that the prevalence of cancer pain is 55.0% during anti-tumor treatment, 39.3% after curative treatment, and up to 66.4% in advanced, metastatic, or terminal stages, with 38.0% of patients reporting moderate to severe pain. CCRP entails not only persistent physical discomfort but also severe psychological distress, significantly impairing patients’ social functioning and frequently precipitating social alienation., Social alienation refers to the weakening or detachment of a patient’s interpersonal relationships. Subjectively, it manifests as negative emotional experiences, such as loneliness and helplessness; objectively, it presents through behavioral characteristics, including social avoidance and a diminished social network. Due to physical limitations, patients with CCRP often struggle to participate in social activities. Beyond physical suffering, CCRP also triggers negative emotions such as anxiety and depression. These psychological factors, along with cognitive burdens including stigma and low self-worth, further undermine patients’ motivation for social interaction. Moreover, pain-related communication difficulties, combined with potential societal misconceptions about cancer, contribute to a reduction in actual social support received by patients. The synergistic effect of these risk factors predisposes patients with CCRP to social alienation. Once established, social alienation diminishes social support, reinforces negative emotions and cognitions, and in turn exacerbates pain perception. This process may ultimately heighten barriers to pain management and reduce motivation for recovery, perpetuating a vicious cycle. Several quantitative studies have documented a strong link between chronic pain and social alienation, suggesting a complex and reciprocal relationship between the two., Yet social alienation does not occur immediately at pain onset; instead, it develops through a gradual and dynamic process. Although existing qualitative research has extensively explored social alienation in the context of specific cancer types or treatments,, it remains limited in fully explaining the psychological distress and interpersonal struggles patients with CCRP experience during prolonged pain, prior to eventually becoming socially alienated. Therefore, this study adopts a phenomenological design to investigate the lived experiences of patients with CCRP. By clarifying the developmental process and real-life experiences underlying social alienation, it seeks to identify unmet multidimensional needs and offer evidence to support clinicians in designing tailored psychosocial interventions.