Bengaluru: A patient in her 50s, diagnosed with colon cancer that spread across her body, was told by doctors that her time was limited. The news was delivered to her along with her husband and two daughters. Unable to bear the pain, she said she did not want to live anymore and began asking for medication that could help her die peacefully. At that moment, a psycho-oncologist stepped in to support her — helping her find hope and emotional strength for as long as she lived.“After that, we continued to work with the family to deal with their grief. These are sensitive and critical times for the families,” said Shilpi Saraswat, clinical psychologist, Sakra World Hospital.Beyond the physical toll, cancer places an enormous burden on the mental health of patients. To address this, cancer treatment centres are increasingly bringing psycho-oncologists on board to support both patients and their families through the journey.Globally, evidence suggests 3 out of 5 patients experience significant emotional distress that requires professional support, said Brindha Sitaram, group director, Psycho-oncology Services, HCG Cancer Centre, KR Road. She added, “Emotional well-being varies across different phases — during diagnosis, treatment, while awaiting reports, and even in survivorship. The mind is dynamic, and each phase brings its own challenges. Our internal study of around 2,500 patients showed 92% experienced emotional difficulties, with 52% facing moderate to severe distress.”In some cases, psychological distress can even interfere with treatment. Anuvinda Sadanandan, consultant psycho-oncologist, Apollo Hospitals, shared the case of a young woman diagnosed with breast cancer. “During the initial phase of her treatment, she struggled with severe anxiety, which led her to refuse further treatment. On evaluation, the primary reason for her refusal was fear — fear related to the diagnosis and concerns about her prognosis,” she said.She added with structured psychological support, including guided therapy, coping strategies, and cognitive behavioural therapy, the patient gradually regained emotional stability. She also became more resilient and actively engaged in her recovery process.“As we know, a cancer diagnosis often brings a wide range of psychological distress, including anxiety, fear, depression, uncertainty, body image concerns, and loss of identity. Addressing these aspects is crucial because mental well-being directly influences treatment adherence, recovery, and overall quality of life,” Anuvinda said.In terminal cases, however, the nature of conversations shifts significantly. Shilpi Saraswat said, “In terminal patients, a psycho-oncologist helps manage fear of death and existential stress, such as concerns about family and what will happen after they are gone. The focus shifts towards comfort, acceptance, and emotional closure. We support patients in expressing their wishes, while also facilitating family conversations, which can be difficult as family members are often in denial or at different stages of grief.““Currently, the biggest barrier in India is financial — psycho-oncology services are often not covered by insurance, making them an out-of-pocket expense. Even modest costs can be burdensome for patients already dealing with high treatment expenses. Institutional constraints, such as return on investment and manpower costs, also play a role, although awareness and acceptance are gradually improving,” Brindha said.
