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Table of Contents
LETTER TO EDITOR
Year : 2019  |  Volume : 2  |  Issue : 2  |  Page : 244-245

Mental health care as part of cancer care: A call for action


1 Medical Officer, National Urban Health Mission, Ernakulam, Kerala, India
2 Malabar Cancer Centre, Thalassery, Kerala, India
3 Medical Oncologist, MOSC Medical College, Kolenchery, Kerala, India

Date of Web Publication20-Dec-2019

Correspondence Address:
Aju Mathew
MOSC Medical College, Kolenchery, Kerala
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/CRST.CRST_59_19

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How to cite this article:
Jagan SM, Abraham J, Mathew A. Mental health care as part of cancer care: A call for action. Cancer Res Stat Treat 2019;2:244-5

How to cite this URL:
Jagan SM, Abraham J, Mathew A. Mental health care as part of cancer care: A call for action. Cancer Res Stat Treat [serial online] 2019 [cited 2020 Feb 22];2:244-5. Available from: http://www.crstonline.com/text.asp?2019/2/2/244/273677



A news report from a metropolitan city in India headlined with the phrase “better than cancer.” It was a shocking report of a man who killed himself after murdering his wife. He left a note. He wrote that taking one's life was better than the “dangerous disease.” While we have made tremendous progress in treating cancer, we still have a long way to go in creating resources that will help people cope with the disease.[1]

Patients with cancer go through a wide range of psychological problems from shock, distress, or life stress to major anxiety disorders, depressive episodes, and suicidal thoughts and attempts. A Swedish study involving data from six million individuals observed that a patient with cancer is at twelve-fold risk for suicide in the first week of diagnosis when compared to a person who is cancer-free.[2] In the first year, there is a three-fold raised risk, an incidence rate of six suicide deaths per 10,000 patients with cancer per year.[2] A study from the USA of 4.6 million individuals with cancer also showed similar statistics, 2.5-fold greater risk compared to general population within a year of diagnosis of cancer.[3]

There are scant data from India though. To our knowledge, the only study on this issue is a retrospective study based on data from the Indian National Crime Bureau Record. The study used indirect estimation using projections to report an average of 750 suicides due to cancer per year. However, these findings are unreliable and susceptible to various biases including underreporting.[4] As per the National Institute of Cancer Prevention and Research (NICPR), we currently have around 20 lakh people living with cancer in our country, and approximately 12 lakh new cases are registered every year.[5] With cancer being the second most common disease in our country, greater focus needs to be given to the overall welfare of our patients. A recent National Mental Health survey found that more than three-fourths of patients with mental health conditions fail to get appropriate care.[6] In patients living with cancer, these statistics may be even more depressing.

How can we tackle this problem?First, we need to measure it. To paraphrase a management guru, “If you can't measure it, you can't manage it.” Unfortunately, we have very limited data from India regarding mental health issues of patients with cancer.[7],[8],[9] We suggest collaborative studies done in a prospective manner. Second, we need more support groups that actually do what they are intended to do – support patients with cancer, and their families. Third, more awareness needs to be created regarding this disease so that people understand that this diagnosis is not a death sentence in all cases. Fourth, we need more trained personnel, specialized training programs, and job opportunities.

Psycho-oncologists can fill a huge lacuna in a multidisciplinary cancer center. The major role of a psycho-oncologist is to manage the psychological, emotional, cognitive, and social aspects of oncology care of a person from prevention to survivorship and palliation. Greater understanding and management of psychological problems will help both the patient and their oncologist during the cancer treatment. However, mental health professionals face some challenges. Visiting a psychologist is sometimes perceived as a sign of weakness and often stigmatized. There is considerable delay in referral to a mental health professional. The success of a psycho-oncologist is heavily dependent on the primary oncologist involved in the care of the patient.

Mental health goes hand-in-hand with physical health. As we make great strides in the field of cancer care, it is equally important to shed light on the emotional stress that patients go through during this period. We should never have to wake up to a news headline where, not an illness, but rather a diagnosis takes a life.

Financial support and sponsorship

Nil.

Conflicts of interest

There are no conflicts of interest.



 
  References Top

1.
Kumar G. Better than Cancer, Says Bengaluru man Before Killing Wife, Dog, and Leaping to Death. India Today; 2019. Available from: https://www.indiatoday.in/crime/story/bengaluru-man-kills- wife-dog-suicide-cancer-1492894-2019-04-03. [Last accessed on 2019 Aug 20].  Back to cited text no. 1
    
2.
Fang F, Fall K, Mittleman MA, Sparén P, Ye W, Adami HO. Suicide and cardiovascular death after a cancer diagnosis. N Engl J Med 2012;366:1310-8.  Back to cited text no. 2
    
3.
Zaorsky NG, Chinchilli VM, Zhang Y, Tuanquin L, Bluethmann SM, Park HS. Suicide among cancer patients. Nat Commun 2019;10:207. [Doi: 10.1038/s41467-018-08170-1].  Back to cited text no. 3
    
4.
Mohandoss AA, Thavarajah R. A study on suicide among Indians living with cancer during 2001-2014. Indian J Cancer 2016;53:435-40.  Back to cited text no. 4
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5.
National Institute of Cancer Prevention and Research. Cancer Statistics. National Institute of Cancer Prevention and Research; 2019. Available from: http://cancerindia.org.in/cancer-statistics/. [Last accessed on 2019 Aug 20].  Back to cited text no. 5
    
6.
Murthy RS. National mental health survey of India 2015-2016. Indian J Psychiatry 2017;59:21-6.  Back to cited text no. 6
[PUBMED]  [Full text]  
7.
Asthana S, Bhatia S, Dhoundiyal R, Labani PS, Garg R, Bhatnagar S. Quality of life and needs of the Indian advanced cancer patients receiving palliative care. Cancer Res Stat Treat 2019;2:138-44.  Back to cited text no. 7
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8.
Salins N. Health related quality of life: Is it a missing feature in the Indian cancer setting? Cancer Res Stat Treat 2019;2:213-4.  Back to cited text no. 8
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9.
Raghavan V, Manuprasad A, Sajeev Kumar PB, Raj Z, Shenoy PK, Nair CK. Health-related quality of life in patients with multiple myeloma on novel agents: Report from a tertiary cancer center in rural India. Cancer Res Stat Treat 2018;1:92-5.  Back to cited text no. 9
  [Full text]  




 

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