Psycho-Oncology Introduction Psycho-Oncology Service Services Offered Frequently Asked Questions
When you first heard your doctor say “It’s Cancer”, surely your world came crashing down and questions such as “Why me?”,
“What next?”, “Is there life after this?”, “What will happen to my family?”, “Will there be pain & suffering?”, “Will I become
dependent or a burden?!”, “Is it worth it?!” and more flooded you. You felt angry! You were anxious. There was fear, deep sadness,
guilt and shame. There was an endless surge of emotions, leading to helplessness, hopelessness and feelings of isolation and loneliness.
We want you to know that all these reactions are normal and a lot of people in your situation react similarly.
The intensity and nature of their distress may vary but most individuals touched by the disease do experience these
overwhelming emotions! So, you are not emotionally weak; it’s just your reaction to a situation and therefore, there is
nothing right or wrong about it!
However, while it is normal to experience these overwhelming emotions, these emotions can be debilitating and
therefore need to be handled. But how? Where? And, with whom? Often, when you feel like sharing your innermost
thoughts, fears and emotions with your near and dear ones, you may hold back either because you feel you are burdening
your family and friends with more problems, or you may find your loved ones telling you not to worry, to be brave, happy
and positive and assuring that everything would be okay. And this may leave you even more frustrated, lonely and lost.
You get the feeling that no one understands you, and you are completely ALONE!!
No, you are not alone. We are with you! HCG is very sensitive to your emotional needs and extends its helping
hand through COPER: Centre of Psycho-oncology for Education and Research.
Psycho-oncology is a subspecialty of oncology that addresses the emotional issues and concerns
of individuals and their families touched by cancer. The psycho-oncology team is a group of mental
health specialists (psycho-oncologists & psychiatrists who specialise in cancer care) who are highly
qualified, trained and empathetic. The team caters to the needs of adults, children, adolescents and
young adults touched by cancer.
It is these compassionate and committed team members who will guide and navigate you
through the cancer journey. You can share your thoughts, feelings and emotions in the ambience
of complete privacy and confidentiality. These specialists will not only listen to you but will
help you cope with your overwhelming situation.
The psycho-oncology service extends its help, by meeting your various psychological and emotional needs
through well designed, scientific techniques, which are tailor-made to suit your emotional needs.
The emotional changes with cancer are due to various reasons and very often people going through cancer are
unable to manage or control the changes caused by the disease, treatment, side-effects, altered roles,
home situation etc.
Oftentimes, various myths and misconceptions about the disease and its treatment are a major source of emotional
distress. For example, people believe that cancer is incurable or a deadly disease and this obviously causes fear,
dread, anxiety, depression etc., in people. But once they are made to understand that cancer, like any other disease,
it is treatable, it brings a lot of psychological relief to them and they approach the treatment differently and
in a more positive way.
In addition, emotional changes may be caused by:
Various chemicals released by the tumour.
Disease or lesion in specific areas of the brain.
Physical or Biochemical reasons: Electrolyte imbalance, infection, fatigue, poor sleep etc.
Drug-induced: Steroids, some chemo agents etc.
Withdrawal of tobacco, alcohol, and other substances (abused drugs)
Pre-existing (previous) psychological or psychiatric problems
Therefore, it is important to understand the exact cause of emotional distress to plan timely and
appropriate intervention or treatment to restore emotional well-being of the individual, which only
a qualified psycho-oncologist is competent to do.
Very often, people going through the cancer journey may experience some of the
issues highlighted below, and if you are troubled by one or more of the following, it’s a good idea to
seek psycho-oncology services @ HCG:
Fear of future
Feeling helpless or hopeless
Feelings of panic (racing heartbeat, dryness of mouth etc.)
Difficulties dealing with symptoms such as pain, fatigue, nausea & vomiting etc.
Difficulties dealing with medical procedures: MRI, surgery, chemotherapy, radiation etc.
Loss of appetite
Lack or loss of interest in work, daily functioning and life in general
Communication issues with family, friends etc.
Challenges balancing the demands of the illness, treatment and other adjustment issues
Altered body image and functioning (hair loss, loss of body part, etc)
Difficulties in decision making
Difficulty in concentration, memory and learning
Altered family roles and relationships
Feeling short-tempered and grouchy
Not being able to get certain thoughts out of your mind
Crying for long periods or many times every day
Thinking about hurting or harming yourself
Sleep problems: not being able to sleep, having nightmares, or sleeping too much.
Difficulties with sexuality or intimacy
It is quite possible that what you are experiencing is not reflected here, as this list
provided is not all comprehensive.
Generally, when you come into a hospital before your doctor sees you, the nurse notes
your heart rate, blood pressure, pulse, temperature and pain. These are called the 5 vital signs.
International bodies have now recommended that emotional well-being should be considered the 6th
vital sign in cancer care. It is precisely for this reason, we, at HCG, screen all patients for
emotional well-being. Our nurse at HCG (who is qualified and trained in psychosocial screening)
will be using the distress thermometer to determine your emotional well-being. This will also give
you an opportunity to share your concerns with her. She will then talk to your treating doctor and
facilitate a meeting with the psycho-oncology team.
From the time you discover your symptoms to the time your diagnosis is confirmed you are faced with
series of emotional challenges. After cancer diagnosis new issues and concerns emerge: How to cope
with cancer treatments, their side-effects and post treatment (Life after cancer) …what next?!
Throughout the cancer journey things may seem overwhelming and out of control. Therefore, from
day one if you seek assistance of the Psycho-oncology service they will hand-hold you and navigate
you throughout this journey. They will enable you to deal with various emotional and adjustment
issues and empower with coping skills and restore your emotional well-being.
It is also possible that you may be feeling you are coping well and in control… absolutely!! We all have the
resilience to deal with various situations. Yes, even if you feel you are in control, it helps to know from
a professional, (the psycho-oncologist) that you are Strong and Coping fine and strengthen the power of your
With our motto - “Adding life to years…”, we are enhancing your quality of life. Quality of life
is never complete without addressing the emotional elements of patients and their families.
Oftentimes we say “he or she had the will- to- live and made it happen”. Now, how does willpower
translate into well-being?! Researchers in the field of Psychoneuroimmunology (PNI) are trying
to seek answers to this question by exploring the possible link between the mind and body. While
the results are preliminary, there is growing evidence to indicate that your emotions could, indeed,
impact your physical well-being by altering your neural and immune systems.
There is evidence to suggest that emotionally-distressed patients tend to tolerate treatment poorly,
report more side-effects, have compromised quality of life and compromised immune functions. Some
studies have even shown that patients who are emotionally down have limited survival time as well.
Conversely, patients who cope better with their illness, who are in a positive state of mind
and who seek professional psychological assistance are known to tolerate the treatment better,
have improved quality of life, a buoyant (enhanced) immune functioning and have also shown better
treatment outcomes. Therefore, psychological well-being undoubtedly contributes to improved physical recovery.
You are right! Good family support and understanding doctors are very important in your recovery.
Psycho-oncology service is not a substitute for family, friends and medical support. It only complements
and augments the emotional or psychological support you require to sail through this journey smoothly. Also,
in support groups, while the support you receive from other members who have gone through a similar experience
undoubtedly contributes to your confidence, please be warned that all the experiences they may have gone through,
need not ring true for you as an individual, because each person’s experience is unique. Therefore, support groups are not a substitute for professional assistance.
Oftentimes, your family and doctors may not be well-equipped to handle the various family, social, sexual,
marital and neuro-cognitive issues you may be going through.
Just as your treating oncologist is a specialist in his area of medicine
(which is important for your physical recovery), your psycho-oncologists are mental health specialists
in cancer care who foster your emotional well-being. As you now know, the cause of your emotional distress
could be due to many reasons (as cited in question 1). Therefore, you need a mental health specialist
in the area of cancer care to facilitate your emotional recovery.
Psycho-oncology is not just counselling. There is a range of scientifically proven Psychological Intervention
techniques used to restore the Psychological and emotional well-being of individuals who are brushed with
Psycho-oncologists are psychologists and psychiatrists who are highly trained and specialised in the area
of cancer care. As already stated, the expertise in the area of cancer is important to unravel the complex
nature of the emotional and other psychological issues of patients, which only a trained and qualified
psycho-oncologist can do.
Equally important, psycho-oncologists are an integral part of a multidisciplinary cancer care team.
They work in close association with your treating doctor for a better understanding of your medical situation.
Proper psychological intervention planning and feedback or inputs from the Psycho-oncologists also enables
your treating oncologists to understand you better and accordingly plan the medical intervention as well.
C.A.R.E.S stands for Cognitive Assessment and Remediation Enabling Strategies. C.A.R.E.S addresses the
Neurocognitive issues such as attention, concentration, memory, learning difficulties etc.
These difficulties could arise due to disease or sometimes due to the treatment
(Surgery, Chemotherapy [Chemo brain/ Chemo fog] Radiation to the whole brain etc.) or
due to various emotional factors as well (anxiety, depression etc). After thorough and proper
assessment using standardized neurocognitive assessment tools, C.A.R.E.S provides customized remediation,
retraining and rehabilitation services to individuals facing these difficulties.
Yes. Because your loved ones enjoy a close bonding with you, they will be affected by your illness.
They feel helpless and find it difficult to express themselves, as they often feel that they do not
want to burden you as you already are going through enough. To meet the emotional needs of your family,
we have special sessions designed for family, spouse or partner and children.
The Marital Therapy session is designed to address various concerns and issues of the spouse as
well as the couple with regard to communication, altered roles, physical intimacy etc.
Therapy sessions for children touched by the disease are designed to help them to deal with: hospital anxiety,
fear of needles or injections, pill swallowing difficulty, treatment-related distress etc. The therapies are
planned to enable children to resume normal life and functioning.
A child whose parent is touched by cancer often feels neglected and lost in the adult distressed world.
They appear to be struggling with their emotions which often manifests as behavioural problems, temper
tantrums etc. Such special needs are also met by the psycho-oncology service through specially designed
therapy sessions to enable children cope and return to normal.
Due to the Covid-19 pandemic to ensure your safety, HCG has initiated the Tele-Psycho-oncology service.
The Tele-Psycho-oncology service is facilitated via video conferencing and the service is extended to
patients and their families across the country. This service is offered only after the Psycho-oncologist
has assessed you and finds you suitability for tele-psycho-oncology service.
We Work Monday through Saturday (11:00 am to 4 pm)
Dr Brindha Sitaram
Dr. Brindha Sitaram is the Group Head of Pyscho Oncology at HCG Cancer Centre, Bangalore.
She has completed her M Phil and Ph D from NIMHANS and is the Founder-Director of Centre of Psycho-Oncology
for Education & Research (COPER), Bangalore.
Dr. Brindha’s primary area of interest is Adult & Pediatric psychology and secondary area of interest
in Preventive Psycho-Oncology. She is the recipient of multiple fellowships from prestigious institutions
such as the National Cancer Institute, USA and the UICC, Memorial Sloan-Kettering Cancer Centre and St. Jude
Children’s Cancer Hospital & Research Centre.
Dr. Brindha has authored Not Out: Winning the Game of Cancer, for which she received the Shresta
Vidyakeya Lekhana Prashasthi by Dr. P.S.Shankar Prathishtana, Gulbarga. She has also the received
“Vocational Excellence Award for outstanding contribution and singular efforts in the field of Psycho-oncology”
by Rotary Dist 3190 and Rotary Bangalore East, Bangalore.