Endometrial cancer is a malignancy of the endometrium that is annually affecting thousands of women and is estimated to have a predicted 66,000 new diagnoses annually in the United States in 2025. Enhanced surgical techniques, radiotherapy, and the treatment offered by targeted therapy have increased the cure rate but the process of transition from diagnosis to survivorship is rife with challenge. Apart from the physical toll of treatment, patients generally suffer psychological distress, alienation, and anxiety concerning the future. A recent article by Mandato et al., published in Frontiers in Oncology (2024), brings into perspective a crucial but inadequately acknowledged aspect of recovery: social support. By establishing care networks of support and emphasizing empathic communications, oncology nursing is an integral aspect of maximizing quality of life (QOL) in endometrial cancer survivors and a paradigm for care that is comprehensive within oncology.
The Study: Defining the Social Support Role
We longitudinally assessed 127 endometrial cancer patients, of which 98 returned questionnaires 1 month and/or 1 year following the operation. Using these reliable tools as the Short Form-36 for the emotional well-being and the Multidimensional Scale of Perceived Social Support as the tools for the family, friends and significant others’ support, the authors measured the outcomes of these variables as well as clinical variables. Clinical variables included comorbidities (hypertension and diabetes), body mass index (BMI), cancer grade, type of operation, and adjuvant treatments.
The outcome was astonishing
- Emotional Well-Being: Social support 1 month postoperative predicted improved emotional well-being both 1 month and 1 year (P < .05). It seems that early support lays the foundation for long-term emotional resilience.
- General Health and Functioning: Social support at 1 year correlated with improved general health scores (P <.05). Family support correlated with improved social functioning at 1 month and with less emotional limitation at 1 year (P <.05), and significant others’ support at 1 year improved physical functioning (P <.005), reduced pain, reduced fatigue, and improved emotional well-being (P <.05).
- Healthcare Use: Patients with stronger support networks used less healthcare throughout the postoperative year, which shows that social support is helpful in decreasing the usage of healthcare systems.
- Clinical Challenges: Greater BMI and comorbidities both correlated with worse pain and worse physical functioning 1 year after treatment. Patients with grade 3 endometrial cancer had worse social functioning compared with grade 2 patients, and the grade 2 patients’ general health scores were better than the general health scores of the grade 1 patients. Intraoperative complications such as the need for conversion of the procedure from laparoscopy to laparotomy or increased procedure times negatively influenced physical function scores.
Counterintuitively, the patients with more prolonged hospitalization had a better overall health status 1 year later, perhaps a testament to the resilience that accrues from having lived with severe illness. Similarly, patients with postoperative complications had improved energy and fatigue scores, perhaps a testament to a reservoir of vitality after recovery. These observations testify to the multifaceted nature of clinical outcome and psychosocial process and make the case for the importance of multidimensionality of care.
The Power of Communication
Physician-patient communication emerged as one of the sources of recovery. Outcomes revealed that 59.8% of patients had a family member with them when the diagnosis was communicated, 75.3% received the diagnosis in a gyn oncology clinic setting, and 85.6% of patients felt they received adequate time spent on communication. An overwhelming 82.5% of patients felt that physician communication with them was empathic and supportive, and 91.8% of respondents felt that they respected their privacy.
These statistics resonate with the importance of having a safe and supportive atmosphere for patients. Involvement of the family members, if desired, not only increases the patient’s support system but also gives them a sense of trust with the caregiving staff. To patients carrying the emotional load of a cancer diagnosis, empathic communication is able to buffer the sense of isolation and give them an active role in the process of healing.
Wider Implications in Oncology
The Mandato et al. article is consistent with advancing evidence that addresses the psychosocial component of care in cancer. For example, similar research with breast cancer and childhood brain cancer has delineated the role that social support has in QOL as well as lessening inequalities in outcomes of survival (e.g., “Racial, Ethnic Disparities Present in Pediatric Brain Cancer Survival,” May 8, 2025). For gynecologic cancer, crowdfunding against financial strain has not been sufficient with an urgent requirement for implementation of systemic support mechanisms (“Opinion: Crowdfunding Falls Short in Gynecologic Cancer,” April 15, 2025). Collectively, these articles call for a reconceptualization of cancer survivorship with the emphasis on emotional as well as social well-being as well as clinical outcomes (“Expanding Definition of Cancer Survivorship Highlights Need for New Standards,” April 12, 2025).
Survivors of endometrial cancer experience some issues, i.e., gyn oncological cancer stigma and physical consequences of treatment such as hysterectomy or radiation. In AYA patients, these are added to issues of fertility, body image, and reintegration into society (“Opinion: Increasing Support and Awareness for AYAs With Cancer,” April 28, 2025). The emphasis that the Mandato study placed on social support offers a template for dealing with these in a range of patient groups with the focus on the universal nature of the need for understanding and connection.
Nursing Interventions: Implementing Research into Practice
Oncology nurses occupy the front line of patient care and have the opportunity to integrate the clinical and psychosocial needs. Mandato’s study offers practical answers for the enhancement of survivorship care:
- Building Support Networks: Patients should be urged by the nurse to spend time with relatives and friends. Patients should be referred by the nurse to such resources as the support services of the American Cancer Society or the local survivor support groups. For patients with few social networks, the nursing staff should collaborate with the social workers in building up other support networks like peer mentoring programs.
- Enhancing Communication: Take the time to conduct empathic, patient-focused conversations around diagnosis, treatment, and survivorship. Use active listening and open-ended questioning that is responsive to patients’ fears and hopes. Invite family members as necessary for reinforcement of support and assurance of congruence with patient preference.
- Care Individualization According to Clinical Needs: A high BMI, comorbidities, and a history of complex surgical treatment require more monitoring and teaching. An example is education provided by the nurse in the control of conditions such as diabetes in an effort to eliminate pain and improve body functioning. Patients recovering from an invasive procedure require physical therapy referrals for long-term recovery.
- The Development of Resilience: Identify potential development in patients surviving complications or extended in-patient stays. Promote such setbacks as opportunities for resilience using motivational interviewing to facilitate patients’ coping mechanisms and strengths.
- Fostering Systemic Change: Advocate for institutional policies that put psychosocial care as a priority with social workers as members of oncology teams or survivorshipclinics. These programs enable the delivery of unmet needs such as financial counseling or mental health care that play a critical role in long-term QOL.
Case Scenario: Social Support in Action
Let’s assume a hypothetical patient, Maria, a 55-year-old woman with stage II endometrial cancer. Following hysterectomy, Maria is fatigued, distressed emotionally, and lonely due to a lack of family support. Her oncology nurse is influenced by the Mandato study and does the following:
- Evaluation: The nurse employs a series of questions in an effort to establish Maria’s emotional status and sense of social support, isolation being of particular concern.
- Intervention: The nurse makes an appointment with Maria for a local endometrial cancer support group and counseling with an oncology specialist. The nurse extends a warm invitation for Maria’s close friend to accompany her for follow-up.
- Communication: The nurse spends more time on visitations discussing Maria’s problems using empathic communication to validate her emotions. She ensures Maria understands her survivorship care plan, such as ways of reducing fatigue.
- Follow-Up: 1-year postoperative, Maria is reporting improved emotional status and reduced doctor visits that she attributes to the support group and the nurse’s encouragement.
The case illustrates how evidence-based targeted interventions have the potential to alter the survivor experience in accordance with the Mandato study’s recommendations.
Challenges and Future Directions
Although social support is promising, its execution is not straightforward. Time constraints within hectic oncology practices constrain the opportunity for a high level of discussion, and unequal access across the support services worsens inequalities. Rural residents or marginalized patients might have restricted access to support groups or psychological services, emphasizing the need for telehealth and population-level interventions.
Future research is required to explore the potential of digital tools as an adjunct to social support. Some examples of such potential include mobile cognitive evaluation and survivorship care planning interventions (“Mobile App Appears Feasible for Cancer Survivor Cognitive Assessment Function,” April 17, 2025). Using such tools within oncology practice is one way of providing accessible and scalable support for patients with limited in-person access. In addition, the oncology practice must address the more universal social determinants of health such as socioeconomic status and culture that affect access. Systems-level improvement is possible through the combined actions of healthcare providers, policymakers, and patient advocacy organizations that ensure all survivors of endometrial cancer enjoy the advantages of robust care networks.
Conclusion
A New Survivorship Paradigm The Mandato et al. report further stipulates that empathic communication and social support are not secondary but integral components of endometrial cancer care. By establishing a sense of relationship, clinical problem-solving capacity, and resiliency enhancement, oncology nurses can empower survivors with the optimism and self-efficacy necessary for a successful transition into survivorship. As oncology progresses, the incorporation of psychosocial care into standard practice will become necessary. Nurses as advocates and caregivers will be responsible for taking survivorship way beyond the physical aspect of how long one lives and into that of emotional and social flourishing. Backed by empathic care, the power of a supportive network of people can be the difference in the lives of endometrial cancer survivors. No.
