“Wult Doud”, a Kashmiri term meaning a lethal disease which is considered equivalent to death was the response I often heard when I asked patients and caregivers about their understanding of cancer. This deeply rooted perception reflects not only fear but also a sense of hopelessness that often occurs after hearing the diagnosis. As we know that cancer cases are rising In Kashmir at an alarming rate, it’s really unfortunate that the emotional impact of the disease is over shadowed and often ignored by the utmost focus on only physical treatments, whilst it’s imperative, widely accepted and a known fact that the psychological burden which is marked by anxiety, depression, and emotional exhaustion can be as debilitating as the severe illness itself.
The given data explains the devastating situation of increasing cancer cases in the union territory of Jammu and Kashmir. As reported by Union Health Ministry, there were 51,577 cancer cases in Jammu and Kashmir from 2019 to 2022, with annual cases rising from 12,396 in 2019 to 13,395 in 2022. The previous year alone, SKIMS Soura had registered over 5,200 new cases, and 8700 cases registered in GMC Srinagar since 2017 which indicates the average of 32 new diagnoses each day. Despite the troubling and severe statistics, the mental distress and emotional pain experienced by patients and care-givers goes unnoticed.
According to the Centres for Disease Control and Prevention (CDC)out of four, three people with cancer report symptoms of psychological distress which is a concerning ratio, and if left unnoticed it will ultimately create an adverse effect on the overall quality of life, recovery and adherence to treatment. The prominent Cancer care societies worldwide highlights that emotional distress should be regarded as the sixth vital sign, alongside, temperature, pulse, respiratory rate, blood pressure, and pain. But the question is, are we truly acknowledging its seriousness or even thinking about incorporating it into our healthcare practices?
The Science of Stress and Cancer: A Decade-Old Breakthrough Ignored
More than a decade ago, groundbreaking research at UCLA’s Jonsson Comprehensive Cancer Centre revealed in a very interesting experiment that chronic stress can accelerate cancer progression. Studies on mice demonstrated that stress reprogrammed immune cells from protectors into enablers of the disease, resulting in a 30-fold increase in cancer spread among group of stressed mice compared to their unstressed group. This finding confirmed what many oncologists had long suspected, stress contributes to cancer growth. Yet, in cancer care, emotional distress continues to be pushed aside. If we had focused upon such researches and worked upon it rigorously, we could have woven stress management into standard treatment protocols, potentially enhancing both survival rates and quality of life.
Psycho-Oncology: A Crucial Missing Element in Cancer Care
During my data collection for my research thesis in the oncology department at GMC Srinagar, I have eye-witnessed the turmoil of cancer stretching far beyond the individual patient, affecting the entire family, especially the primary caregivers. I remember a 9-year-old girl diagnosed with a third-stage brain tumour, her mother almost found it impossible to articulate her experience and share with me, it felt like her throat was chocked seeing the devastating condition of her daughter, her silence spoke volumes, representing not just grief but a heavy burden of emotional turmoil, and after comforting her, she spoke while tears were falling as if she needed to burst out since eternity. This very small incident highlights an urgent need to address the emotional aspects of cancer care. Only then can we hope to provide holistic support for those fighting this disease, ensuring they and their families can navigate through this unimaginable journey with resilience and hope.
Another heart wrenching moment for me involved an 11-year-old boy battling ameloblastic carcinoma. Amidst his extremely difficult treatment phase, his most innocent and simple request for a bowl of noodles explained how this illness can strip away not only the essence but also the normalcy of everyday life. Experiences like these underlines the pressing need to consider not only the medical aspects but also the emotional challenges faced by patients and their caregivers. This is precisely where psycho-oncology, a field dedicated to the emotional, social, and psychological dimensions of cancer care becomes vital. Studies indicate that integrating psychological support can lead to better treatment outcomes, less emotional turmoil, and improved overall wellness. Yet, in Kashmir, such services are most often ignored and nearly non-existent. Organizations like the Rajiv Gandhi Cancer Institute have shown that incorporating psycho-oncology can significantly bolster patient resilience and adherence to treatment.
Unfortunately, in Kashmir, several hurdles impede this integration, including unawareness regarding the importance of psycho-oncology, lack of trained professionals, insufficient resources, and societal stigma surrounding mental health which is quite pervasive. As a result, patients, caregivers and doctors including all the health care staff for that matter often find themselves struggling through this emotional pain which could otherwise have been alleviated if holistic and multi-disciplinary health care system was taken into consideration.
Prioritizing Emotional Support in Cancer Care
To address this gap, it is essential to weave psycho-oncology into the fabric of standard cancer care practices. The integration is vital, and if taken appropriately and on right time, It can improve the overall health care system, the health care authorities should start incorporating the following measures:
- The most vital step as of now is to increase awareness about the importance of mental health in cancer treatment to dismantle societal stigma and empower patients to seek help.
- Incorporating emotional distress as the sixth vital sign, and taking it into consideration while routine cancer assessments.
- Advocating for the changes in healthcare policies focusing on psychological assistance alongside medical treatment.
- Funding for training programs for healthcare professionals, doctors, nurses, and counsellors, particularly psycho-oncologists to ensure that they possess skills that encompasses compassionate communication to deliver psychological first aid.
The World Health Organization also addresses that emotional distress is indispensable and imperative and neglecting psychological health can hinder physical recovery. Given the rising incident rate of cancers in Kashmir, it’s high time to incorporate these baby steps in order to ensure a more holistic approach which is extremely essential so that we are not only just focusing on the physical disease, but also considering mental health challenges of patient, associated family members and health care professionals.
By integrating psycho-oncology into cancer treatment, everyone will work as a team and it will ultimately ensure the all-encompassing support that this extremely dreadful disease demands. Remember, ‘it’s not just about battling cancer, it’s about standing with resilience by upholding dignity, renewing hope, and ensuring that no one faces this journey alone’.
(The author is a Doctorate Research Scholar in the Department of Psychology. Feedback: [email protected])
