Psycho-Oncology: Role of Mental Health Professionals in Cancer Care

  •   Tue, Oct 14 2025
  •   By Jestalaxmi B

October 14, 2025

Psycho oncology is a vital branch of psychology which addresses the psychological, social and behavioural aspects of cancer patients, families and caregivers across their cancer journey. Social workers, counsellors and psychiatrists play their respective roles in this field to ensure that cancer patients are helped to accept and face challenges - physical, psychological & spiritual in their fight against cancer. Psycho-oncology as a discipline of study and therapy to patients was founded by Dr. Jimmie Holland in New York Cancer Centre in 1977. Since then, the field has grown into a recognised component of quality cancer care, integrating mental health support with medical treatment to improve overall quality of life of the patients.

Major psychological challenges faced by the cancer patients are discussed below:

  1. Mental shock - when the patient & family gets the news of ‘cancer’ as the diagnosis, they experience a sudden thunderbolt. Different people may respond differently to this situation. The fear associated with the name ‘cancer’ is a major cause for this. Counsellors can help in this situation by expressing empathy, to accept reality & to deal with the fear. Discussing various modern treatments available can help in reducing fear and to be hopeful. Examples of previous recovery can motivate patients to take up treatment. 
  1. Fear about side effects – Cancer treatment involves different kinds of therapies like radio therapy, chemo therapy, immumo therapy etc and each therapy may have certain side effects like hair loss, fatigue, weight loss, change in physical appearance after surgery etc. which may lower the confidence of patients. Counsellors help the patients to deal with their psychological struggle and suggest coping mechanisms during such tough phase. 
  1. Dealing with negative thought process – Cancer can bring about multiple emotional & psychological trauma to a patient & patient may start thinking like ‘Why this has come to me?’ ‘Why I only got this?’‘What sin have I committed?’ ‘What is the reason that I got this disease?’ Patient may also worry & get anxious about his & his family's future. Questions like ‘Whether it will be fully cured?’‘What if my children get this?’‘Whether this treatment is effective?’‘What will happen to my future?’‘What if it relapses?’ Patient may even get depressed by these thoughts . Counsellor can help a patient in this situation by clearing the doubts and filling hope & courage in the patient. 
  1. Sleep issues - Patient may experience insomnia / disturbed sleep, nightmares etc. during the treatment. Professionals can help the patients by teaching sleep techniques. Progressive muscle relaxation, visualisation, breathing techniques are useful tools to deal with sleep issues. 
  1. Financial stress – Cancer treatment is long term & expensive. In case of patients with financial difficulties and BPL (Below Poverty Line) patients, social workers can help them in utilising government schemes likeAyushman Bharath & help them avail the benefits of such schemes. Patients can also be educated about various health insurance plans, ESI, some social organisations, NGOS & Trusts like Indian Cancer Society. Social workers help the patients to get financial support from such organisations. They help patients to contact them, complete the procedure & avail benefit. Social media also can help patients in raising funds for treatment. 
  1. Family issues – If the patients have issues in family like elderly dependents, disabled children, conflicts, financial stress etc. diagnosis & treatment of cancer becomes an additional stressor. Accompanying the patient for treatment, taking leave from job, additional responsibilities at home, managing financial stressors like job loss etc can aggravate the stress. Age and domestic role of the patient is crucial in determining the stress level. Sometimes patient is living alone and unavailability of a care taker cause a problem. There are examples of domestic violence, emotional abuse, social isolation etc. to the patients. Proper counselling of patients & family members may improve the situation in such cases. 
  1. Mental & physical comorbidities – Cancer patients might be having other diseases or health conditions like diabetes, hyper tension, depression, anxiety etc. the patient may get panic at the news of a new disease. Counsellors can help the patient in accepting, support the patient by connecting them with dieticians who will help them to have suitable diet plan, to inculcate healthy habits like yoga, exercise etc. Caregivers can also be guided to look after the patient in a structured manner. History of addiction, substance abuse may bring up withdrawal symptoms which needs to be taken care with proper motivation, guidance and medication. 
  1. Palliative care – when it comes to final stage of cancer & patient is given only supportive care to manage the pain & other physical challenges, it becomes crucial to understand the emotional struggle of patients & caregivers & to offer them support. Preparing them for future possibilities also becomes important at this point of time. Family must be informed of patient condition & they should be helped to prepare socially, financially, personally & emotionally. It also involves keeping the patient happy & relaxed. Plan of action has to be customised according to patient condition. 
  1. Suicidal thoughts/attempts – The apprehension & stigma associated with cancer may stress a patient to a level which stimulate the patient to think of ending his / her life. Many patients tend to commit suicide due to shock, anxiety, fear about treatment & side effects, financial problems etc. It is vital to identify certain hints, to give proper counselling & social support to the patient to prevent suicide. Assurance of proper treatment will help in reducing the fear. 

  2. Life style changes – Cancer may bring in many life style changes in the life of patient & family members. Food & routine activities may change. House & school shifts may take place for reducing expenses & for convenience. This may lead to resentment, irritation, restless behaviour, anger outbursts etc. Patient may feel that they are ‘burden’ to the family. Patient & family members may lose jobs. Income may get affected. Savings might drain away. There are examples of people selling property for treatment too. In such situation, counselling can help in increasing faith & confidence and help them to find practical solutions to their concerns. 

  3. Anger issues – Patient may show his helplessness in the form of anger behaviour like shouting, screaming, non-cooperative behaviour, not taking medicine regularly, refusing treatment etc. This behaviour may be due to pain or any other discomfort or family conflicts. Counselling can help by teaching pain management techniques & guide the patient & caregiver in this regard.

  4. Fear of Hospital & treatment (nosocomephobia) – Some patients have health anxiety-fear of hospital & treatment process in particular. Sometimes they may get panic attacks. Some patients cannot sleep / consume food due to such fears. Fear even to step in to the hospital, to have scan & blood tests etc. are seen in some patients. Excessive interest search about the disease may increase anxiety. If counselling is not able to solve the issue,patient may require psychiatry medication to bring the fear under control.

Other than the concerns mentioned above, patients may experience different kinds of fear, anxiety- death anxiety, worry-because of uncertainty about the future of self & family, indecisiveness, social, economic & family issues, pain, dependency etc. Family members of patients & care givers also may experience different kinds of emotional traumas. Patient may be non-cooperative or refuse treatment at times. Travelling for treatment, hiding the disease from patient, preparing special diet to patient, managing additional responsibilities are some major reasons for caregiver stress. If the patient is under treatment for stage III & IV Cancer, possibility of patient death, preparing to face it mentally financially & socially can be challenging to family members. Caregiver counselling & family counselling can support the family in such critical situations.    

 

 

 
By Jestalaxmi B
Jestalaxmi B is a practicing psychological counsellor and psycho-oncologist at Mangalore Institute of Oncology, Pumpwell, Mangaluru.
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Title: Psycho-Oncology: Role of Mental Health Professionals in Cancer Care



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