Psycho-oncology

Cancer diagnosis is often seen as a physical illness only. We may not realise the mental health challenges it may be causing to our daily routines and relationships. We often tend to ignore the consequences of surgical, medical, radiation and hormonal treatments on a person's mental health.

Psycho-oncology is a branch of health psychology which combines psychology with cancer care and creates a bridge between the physical and mental aspects of the illness. Psycho-oncology provides specialised interventions from the time of diagnosis through treatment, focusing on the psychosocial aspects of patients and their caregivers through psychotherapy and specialised counselling sessions.

The need for psycho-oncology is undeniable, especially in addressing the psychological responses to cancer and other manifestations during the varying stages of illness and survivorship. People diagnosed with cancer or in stages of recovery all require support from a psycho-oncologist, a support service that benefits patients and caregivers in their journey towards healing.

Symptoms

A Psycho-oncologist is a specialist who identifies and manages a broad range of mental health problems faced by patients diagnosed with cancer, along with their family members and caregivers. The mental health challenges that can occur include initial trauma, denial, anxiety, depression, fear, anger outburst, lack of compliance, grief and so on.

Other symptoms include:

• Helplessness
• Loss of hope
• Anxiety and panic
• Sadness
• Mood swings
• Anger outbursts
• Fears and worry
• Insecurity and body-image concerns
• Conflicts in relationships
• Death ideation and negative thinking
• Feelings of loss and grief
• Guilt and embarrassment
• Reduced sexual desirability
• Feelings of shock and trauma
• Concentration and memory concerns

Role of Psycho-oncology Support

Psycho-oncology helps people with cancer and their families deal with the stress of the illness. Counselling therapy is useful for both acute and chronic cases. It focuses on understanding and treating cancer-related impact on one's mental health and well-being by evaluating the social, psychological, spiritual, emotional and functional aspects of cancer on the individual.

In addition, psycho-oncologists aim to:

• Strengthen the mind to help cope with the experience of cancer
• Help both patients and families from the time of diagnosis through treatment
• Focus on improving psychological and social well-being, including:
  • acceptance of diagnosis and treatment,
  • ways of coping with the treatment,
  • rebuilding inner strength to resume functionality,
  • pre- and post-operative counselling and
  • encouraging lifestyle changes

When to see a Psycho-oncologist?

The diagnosis of cancer itself may cause shock, anxiety and depressiveness in many patients. In addition, it puts a lot of stress on the family, finances, and day-to-day living in general.

A Psycho-oncologist helps and supports patients learn to address and cope with the pressures of medical treatment, insomnia, relationship conflicts, emotional needs, coping with pain and side effects, caregiving, and other issues that patients and their families may experience during and after the diagnosis of cancer and its treatment.

A Psycho-oncologist should be consulted when an individual has been diagnosed with cancer or is already in treatment for the same. If they are experiencing any distress at a psychosocial level, they are advised to seek counselling support with a Psycho-oncologist.

They help with the following:

• Regulating Emotions: Constantly feeling sad, upset, frustrated, depressed or hopeless and not being able to deal with such emotional outbursts requires professional assistance. An imbalance of emotions can be detrimental to mental as well as physical health. Psycho-oncologists can help regulate these emotions and prevent triggers.
• Disturbed Sleeping Patterns: Poor sleep quality greatly affects one's mental health. Often, people struggling with mental health issues have trouble sleeping due to anxiety, worries, and preoccupations; and either wakes up too early or repeatedly at night. Inadequate or disturbed sleep has a major impact on routine, performance, functionality and emotional health. Hence, consulting a Psycho-oncologist may help address these issues.
• Unhealthy Patterns: People with mental health issues as a result of cancer may resort to addictions to alcohol or other substances to help cope with the stress of the disease. Psycho-oncologists can help reduce and eventually eliminate these addictive behavioural patterns as an unhealthy coping mechanism.
• Isolation and Social Withdrawal: It is common for people with cancer to experience depressiveness or anxiety due to their changed appearance and side effects of the treatment. This further and often leads to avoidance of social gatherings and support circles. This could be due to their inability to control emotions, fear of judgement of their appearance, or lack of confidence to face others.
• Excessive Anxiety: A Psycho-oncologist can help deal with emotions such as anxiety, stress, sorrow or worries in patients with cancer. In addition, it is imperative to speak to a Psycho-oncologist if one feels extreme bouts of dullness and sadness, along with death ideations leading to thoughts of self-harm or dysfunctionality.

Process of Therapy with a Psycho-oncologist

Psycho-oncologists conduct counselling sessions wherein the patient and the therapist speak in a judgement-free environment, where the patient can talk about their emotions, thoughts and feelings in the here and now.

Each practitioner's methods and techniques may vary from practice to practice. However, Psycho-oncologists primarily focus on assessing the patient's mental health through psychological interviewing and assessment tools. In addition, they may provide appropriate interventions, when needed, that are tailor-made to the specific individual's concerns and problems. Psycho-oncologists are also involved in research, training and support group planning and implementation.

Here is how they formulate an individual patient-related case:

Initial Assessment: Initial interviewing requires building rapport and having an in-depth conversation with the patient about their mood, thoughts and present feelings. They further ask relevant questions and allow the client or the patient to feel comfortable and emotionally safe to further discuss their problems while keeping confidentiality in mind. During the conversation, they assess how the client thinks, interprets, and infers.

Intervention Planning: Based on the initial assessment, the treatment plan is formulated and discussed with the patient, their families and the treating team to ensure a holistic approach to each patient. There are various psychological approaches and therapeutic models that are implemented for one or multiple difficulties. Psycho-oncologists choose one or an eclectic approach suited to their assessment and practice.

As opposed to psychiatrists, Psycho-oncologists are trained counsellors and therapists with a background and training in Psychology and a specialisation in Psycho-oncology.

However, psychologists or Psycho-oncologists do not have the authority to prescribe medications. Hence, if a chemical imbalance leads to a clinical mental health issue in a patient diagnosed with cancer, it is imperative to consult a psychiatrist or the treating oncologist. And the Psycho-oncologist can make a cross-referral for pharmacotherapeutic intervention alongside ongoing counselling support.

Last Update

Reviewed by Hiba Siddiqui, Senior Psycho-Oncologist, Psycho-oncology on 31-Oct-2022