Living with cancer is not just physically demanding - it is emotionally overwhelming. From the moment of diagnosis, patients often live with persistent fear, uncertainty, and psychological stress, all of which can intensify during the long and exhausting course of treatment. This unaddressed emotional burden can directly affect treatment tolerance, recovery, and outcomes.
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Yet, despite its profound impact, psychological support remains largely informal and reactive within cancer care in India. Experts argue that for outcomes to truly improve, this gap must be addressed - and mental health support needs to become a structured, integral part of cancer treatment rather than an afterthought.
HT Lifestyle spoke to Dr Mehezabin Dordi, a clinical psychologist at Sir HN Reliance Foundation Hospital, for her expert insights on the subject. She specialises in working with patients managing complex physical conditions - including cardiac, pulmonary, oncological, renal, neurological, and musculoskeletal disorders - as well as individuals undergoing various organ transplants, bringing a deeply integrated mind-body perspective to survivorship and long-term care.
She highlights, “In most Indian oncology settings, psychological distress is managed in a fragmented and informal manner. Oncologists and nurses often become the first line of emotional support, offering reassurance during brief consultations. Psychiatrists are typically involved only when distress escalates into severe depression, anxiety, delirium, or insomnia.”
How does delayed psychological support affect patients?
According to Dr Dordi, delaying formal psychological support until a patient reaches severe emotional distress can negatively impact treatment outcomes. She emphasises that cancer itself is a profoundly stressful condition to live with, and when that stress becomes chronic, persistently elevated stress hormones can exacerbate symptoms, strain the body, and ultimately interfere with both recovery and overall wellbeing.
She explains, “From a physiological lens, this delayed response allows chronic stress to persist, leading to sustained activation of stress hormones that can worsen fatigue, pain, sleep disturbances, immune functioning, and treatment tolerance. Without structured screening tools or time, subclinical distress, adjustment disorders, caregiver burnout, and existential concerns often go unaddressed.”
Furthermore, the psychologist adds that other cultural factors like stigma around mental health, family-centric decision-making, and the tendency to ‘normalise suffering’ further result in emotional distress being under-reported and under-treated. Consequently, care often remains reactive rather than preventive.
Changes needed in the structure of cancer treatment
Dr Dordi strongly advocates for a multi-level, systemic shift in the way cancer care is structured in India. She highlights the need to embed formal training in psycho-oncology within medical and nursing curricula.
She stresses, “India needs a multi-level systemic shift. Medical and nursing education must include structured training in psycho-oncology, basic distress screening, and the physiological impact of stress on cancer outcomes.”
In addition, the psychologist calls for the integration of qualified psychologists - specifically trained to work with oncology patients - as core members of multidisciplinary cancer care teams, rather than as optional or peripheral support.
“At the hospital level, qualified psychologists equipped to deal with oncology patients should be embedded within oncology teams and tumor boards, not used only as referral options. Routine psychological screening should be as standard as monitoring blood counts,” states Dr Dordi.
“At a policy level, national cancer programs must formally recognise psychological care as essential, not optional, with proper workforce planning, and insurance coverage. In the Indian context, integrating psychological care is critical not only for emotional well-being, but also for improving treatment adherence, recovery and overall quality of life.”
As part of the broader systemic reforms, the psychologist emphasises the need for the formal recognition of psychological care as an essential component of cancer treatment in India under national cancer programmes. This recognition must be backed by robust workforce planning and comprehensive insurance coverage, ensuring that psychological support is not a privilege, but a standard, accessible part of cancer care for every patient.
Note to readers: This article is for informational purposes only and not a substitute for professional medical advice. Always seek the advice of your doctor with any questions about a medical condition.