Mind over malignancy: Why psycho-oncology can no longer be afterthought

While cancer has long been recognised as a life-threatening illness, mental health support for patients continues to receive limited attention.

The psychological toll — from diagnosis through treatment and survivorship — remains overlooked.

Psycho-oncology, meant to address this gap, is yet to become part of mainstream healthcare.

Lack of focus on mental health and a shortage of trained professionals have made services scarce, doctors said.

Dr Brindha Sitaram, Group Director at a city cancer hospital, said: "In my experience, almost 100 per cent of cancer patients go through some level of fear, anxiety or depression. Globally, evidence suggests that three out of five patients experience significant emotional distress that requires professional support.

"Our internal study of around 2,500 patients showed that 92 per cent experienced emotional difficulties, with 52 per cent facing moderate to severe distress. Even those in the remaining 8 per cent may have been assessed during a relatively stable or positive phase."

On the systemic gap, she said: "The stigma and lack of awareness among doctors have significantly reduced, but the biggest barrier is financial burden. Psycho-oncologist service is not covered by insurance, and many healthcare establishments see it as a low return on investment."

Doctors said psycho-oncology improves treatment adherence and reduces dropouts.

Clinical psychologist Shilpi Saraswat said: "When distress decreases, adherence improves, leading to better treatment outcomes. Quality of life improves, which enhances patient engagement, reduces symptoms, and supports better patient well-being. While dropouts happen for many reasons, those because of fear and anxiety have reduced."

On support for children, Consultant Paediatric Oncology Dr Rasmi Palassery said: "Trained psycho-oncologists assess each patient and address their specific needs, but such targeted psychological support is very limited in most parts of the country. When compared to adults, the survival rate in children is 80 per cent, so there is a need to address anxiety and treatment-induced depression."

Building a workforce

Dr Yaduraj Gowda, Professor and Head of the Department of Palliative Medicine at Bengaluru’s Kidwai Memorial Institute of Oncology, said: "The branch of psycho-oncology needs to thrive. The lack of workforce has impacted the field. We have recently started offering internships to students to train them as psycho-oncologists. We have tied up with private colleges offering a master's degree in psycho-oncology and take on students independently as well."