Psycho oncology is a specialty providing psychosocial services (individual, family, group counseling, education, advocacy, discharge planning, case management, and program development) to patients and families through all phases of the cancer continuum including prevention, diagnosis through survivorship, terminal care and bereavement.
The initial years of psycho-oncology
Psycho-oncology found footing in the mid1970s, when it was realized that the stigma – “cancer means death” – needs to be addressed. It covers two major dimensions of cancer care:
● Firstly, the psychological response of patients and their caregivers to the disease at all the stages.
● Secondly, psychological, behavioural, social, and ethical factors that may influence the disease process.
Importance of Psycho-oncology
Psycho-oncology plays an important role in aiding patients and their caregivers in the process of coping with the diagnosis and the progress of the illness. Its importance is recognized on account of the following factors:
● Psychological morbidity among cancer patients tends to be high due to the stigma attached to the disease.
● Regardless of the prognosis, cancer causes some level of emotional distress, depression and anxiety. In certain types of cancer diagnosis (lung cancer and head & neck cancer) guilt is seen to be an associated factor due to tobacco and alcohol use which adds to the patients’ distress.
● Cancer is a disease which affects all aspects of an individual, with questions and concerns around “why me”, adjustment issues, altered body image (hair loss, skin discoloration, mastectomy), interpersonal problems and sexuality arising at various points during the treatment process.
Who is a psycho oncologist?
Psycho-oncology is an inter-disciplinary field lying at the intersection of psychology and oncology. This field emits a lot of scope and potential for young practitioner all over the world. In India, psycho-oncology is an emerging and upcoming field. To be a psycho oncologist an individual needs to have a diploma/M.Phil/P.hd in psycho-oncology with mandatory training under the supervision of a psycho-oncologist in a cancer care setup.
There are various institutes which offer psycho-oncology programs across the country. These include:
● The Department of Psycho-oncology and Resource Center for Tobacco Control Cancer Institute (WIA), Chennai provides M.Phil and Ph.D programs in psycho-oncology.
● Centre of Psycho-oncology for Education and Research, Bangalore provides a one year diploma in psycho-oncology.
● Tata Cancer Hospital, Kolkata has a one year fellowship program in psycho-oncology.
● Tata Memorial Center, Mumbai provides diploma programs in psycho-oncology.
The role of a psycho-oncologist
Psycho-oncologists wear many hats and pursue varied roles in their work with patients having cancer and their families. These include:
➢ Psycho Education: Psycho-oncologists educate about the treatment and its possible side effects, help patient as well as caregivers cope with the stress of the treatment process, along with reducing the rate of patients not adhering to the treatment due to side effects.
➢ Supportive Counseling: Counseling is imperative with cancer patients as they face the risk of substantial physical impairment, the inability to perform routine activities and reduced psychological and social levels resulting from the disease trajectory. By providing required help to patients and their caregivers coping is facilitated, restoring normalcy in their day to day life which helps them cope better emotionally and psychologically.
➢ Psychological Support: At the time of the diagnosis, psychological support from the psycho-oncologist helps reduce stress and anxiety, gives patients a greater sense of control and informs them of their probable experience during the course of illness and treatment. It may significantly improve the quality of life and the patients’ ability to cope with the treatment.
➢ Emotional Support: The physically demanding nature of the treatment process as well as the short and long term side effects often result in emotional distress and psychological problems among individuals affected by cancer which eventually impacts their daily life. Psycho-oncologist aids throughout the treatment, survivorship or end of life care, by providing emotional support to the patients and their caregivers, helping them cope with the stress and the worries of the diagnosis.
➢ Support Group: Psycho-oncologists facilitate group sessions with cancer survivors to hold discussions and exchange experiences.
Psycho-oncology is a holistic end-to-end care program which begins at the level of prevention (primary prevention) where people are helped by spreading awareness regarding cancer prevention and lifestyle changes. Every stage of cancer diagnosis comes up with psychological issues which vary in intensity and degree. In the initial stages the diagnosis is a shock. Gradually when patients cope with this shock they learn to cope with the side effects of the treatment and the treatment itself. The consolidation of the treatment leaves behind issues of survivorship and constant fear of relapse, making the role of a psycho-oncologist even more crucial in assisting with greater quality of psychological wellbeing.
Fortis Memorial Research Institute, Gurgaon is one such center that has introduced comprehensive Psycho-oncological services, aimed at improving the quality of care for cancer patients.