DISCUSSION
anxiety, fatigue, toxicity, cancer, aggressiveness, nausea and vomiting, pain, cervical cancer, psychiatric, depressive symptoms, depression, genitourinary sequelae, depressions, trait-state anxiety
BREAST CANCER, CANCER, DISEASE, CERVICAL CANCER, EFFECTS OF CHEMOTHERAPY
Women with cervical cancer suffer from the aggressiveness of radiochemotherapy, changes in daily life activities, and live with anxiety throughout the therapeutic course. Therefore, the healthcare team should be attentive to these modifications and offer interventions that minimize anxiety and provide overall well-being.Our findings corroborate with the profile of women from other continents affected by CC: age between 40 and 49 years old and in the workforce. The socioeconomic impact generates negative feelings of stress, anxiety, and delay in diagnosisRadiochemotherapy in advanced disease (IIB-IVA) presents a worse prognosis, with improved survival in 5 years, prevalence of genitourinary sequelae, higher toxicity in elderly individuals, lower treatment adherence, limitations for surgical treatment indication, and decline in QoL. The presence of comorbidities and sedentary lifestyle results in a higher incidence of psychiatric symptoms and risk of mortalityWe emphasize the importance of identifying risk factors for anxiety in these women, understanding that they are a vulnerable group for developing psychological distress, and implementing screening measures for anxious and depressive symptoms in the care process. Therefore, multidisciplinary actions associated with qualified care are fundamental in empowering women to access services, promote therapeutic adherence, and improve overall health conditionsOur initial findings showed traces of anxiety (i.e., a stable variable indicating a greater disposition to feel anxious) prior to the inclusion of participants in the research, possibly related to the sociodemographic, clinical, and therapeutic factors of CC. It is worth noting that depression and anxiety are associated with a lower probability of screeningDuring RGI sessions, the reduction of anxiety state (moment or particular situation related to the procedures, for example) can be explained by the neurophysiological effect of the intervention. Some of the sessions occurred during the period of greatest discomfort, fear, and anxiety due to brachytherapy (intracavitary application of ionizing radiation). Our data are corroborated by a systematic review that analyzed the outcome of RGI in women with breast cancer, showing a reduction in anxiety and depression, improved mood, body discomfort, and long-term improvement of HRQoL. However, regarding the effects of chemotherapy, such as nausea and vomiting, pain, and fatigue, better evidence is neededThe RGI intervention is psychologically favorable and increases comfort in cancer treatment. It is effective in mental state, reducing average scores of depressions, anxiety, and biomarker effects (heart rate, blood pressure, cortisol, amylase, and immunity)Different practices can be used concurrently with guided imagery. Music therapy was applied in heterogeneous populations of cancer patients, showing a significant reduction in trait-state anxiety levelsConfirming our hypothesis, women with anxiety, either state or trait, presented a reduction during RGI sessions, concomitant with radiochemotherapy. We believe that the immersive potential of the intervention, made possible by VRWe noticed curiosity, acceptability, and adherence (not evaluated in this research) to the use of VR for RGI application. We reflect that, for future issues in different care environments, they could even be self-applied by patients when well-guided. It is an immersion mediated by electronic devices with the aid of smartphones, which are already widely used in society, and VR has been a growing object of study for different variables, clinical contexts, and heterogeneous populationsGiven the results of this and other related research, the use of the technique is recommended as a complementary means to minimize anxiety, as this suffering can present itself before, during, and extend after treatment. To do so, it would be necessary to expand the network of care with a psychosocial focus and train professionals in the implementation of cognitive-behavioral skills. It is a simple and low-cost intervention