When Do Patients with Breast Cancer Seek Help from Psycho-oncology Services? A 3-Year Retrospective Study from India

Abstract

Introduction Breast cancer is the most frequent cancer among women. In the last few decades, the outcome of breast cancer has improved significantly in terms of survivorship and quality of life. However, it is crucial that alongside managing the disease, breast cancer services address and manage associated or co-occurring psychiatric illnesses such as acute stress reactions, procedural anxieties, adjustment issues, depression, and fear of recurrence, which leads to an overall better experience of the patient. Objective There is a paucity of data on the patterns of psychiatric morbidity in patients with breast cancer who access psycho-oncology services in a naturalistic setup outside research studies from India. The current study focused on exploring this alongside reporting the common treatment methods adopted for this group of patients. Materials and Methods Real-life data from electronic patient records were retrospectively reviewed for all patients with breast cancer accessing integrated psycho-oncology services in a tertiary care hospital in India over three 3 years (2018–2020). The various psychiatric morbidities were reported, along with associated cancer demographic data, disease characteristics, and treatment details. Results Of all the breast cancer patients (n = 338) in the calendar years 2018 to 2020 reviewed by psycho-oncology services, the most common psychiatric diagnosis was depressive illness (n = 100, 29.6%), followed by adjustment disorders (n = 68, 20.1%) and anxiety (n = 66, 19.5%). There was a significant minority with serious enduring mental illnesses such as schizophrenia (n = 11, 3.3%) and bipolar disorders (n = 14, 4.1%). On the other hand, 14.2% (n = 48) of the patients with breast cancer who attended Psycho-oncology outpatient department did not have any psychiatric syndrome. Around 16.3% of patients could be managed without a prescription for any medications and almost half of the patients needed only one psychotropic medicine. Psychological interventions were used for 45.6% of patients. Conclusions Integrated psycho-oncology services in a cancer hospital catering to patients with breast cancer help in psychiatric assessment, diagnosis, and addressing the mental health needs of patients. The treatment offered needs to be nuanced and individualized and may require a combination of psychotropic medications and psychological techniques.