Oncology Internal

PSYCHO ONCOLOGY
Psycho-oncology is a multidisciplinary field that focuses on the psychological,

emotional, social, and behavioral aspects of cancer. It addresses the
psychological responses of patients, their families, and caregivers to the
diagnosis, treatment, and long-term effects of cancer. Additionally, it
examines how psychological, social, and behavioral factors can influence
cancer risk, progression, and outcomes.
Psycho-oncology integrates knowledge from psychology, psychiatry,

oncology, social work, and other related fields to provide comprehensive
care. This can include counseling, support groups, stress management
techniques, and interventions to improve the quality of life and emotional
well-being of patients throughout their cancer journey.
Cancer is a group of diseases characterized by the uncontrolled growth and

spread of abnormal cells in the body. Normally, cells grow, divide, and die in
a regulated way. However, in cancer, the process becomes disrupted, leading
to the formation of a mass of tissue called a tumor. Tumors can be benign
(non-cancerous) or malignant (cancerous). Malignant tumors can invade
nearby tissues and spread to other parts of the body through the blood and
lymphatic systems, a process known as metastasis.
Cancer can develop in almost any part of the body and is often named after
the organ or type of cell where it originates, such as lung cancer, breast
cancer, or leukemia (cancer of the blood). The causes of cancer are complex
and can include genetic mutations, lifestyle factors (such as smoking, diet,
and exposure to carcinogens), environmental influences, and infections.
Treatment for cancer can vary depending on the type, location, and stage of
the disease. Common treatments include surgery, radiation therapy,
chemotherapy, immunotherapy, targeted therapy, and hormonal therapy.
Early detection and treatment can improve outcomes, but the prognosis
depends on the specific type of cancer, how advanced it is, and various
individual factors.
The biology of cancer involves the transformation of normal cells into

cancerous cells due to genetic mutations and alterations. These changes
lead to uncontrolled cell growth, resistance to cell death, and the ability to
invade surrounding tissues. Unlike normal cells, cancer cells can bypass
regulatory mechanisms that control cell division, allowing them to proliferate
indefinitely.
1. Sustained Cell Proliferation – Cancer cells continuously divide and grow.

2. Evading Cell Death – They resist programmed cell death (apoptosis).
3. Angiogenesis – They can form new blood vessels to supply nutrients to
tumors.
4. Invasion And Metastasis – Cancer cells spread to other parts of the
body.
5. Avoiding Growth Suppressors – They ignore signals that would normally
stop cell growth.
6. Genetic Instability – Increased mutation rates help cancer cells adapt
and survive.
Cancer results from the accumulation of genetic changes over time, which
can be influenced by factors like inherited mutations, environmental
exposures (e.g., smoking, radiation), and lifestyle. These alterations lead to
the disruption of normal cellular processes, resulting in the development and
progression of cancer.
Breaking bad news, especially in the context of psycho-oncology, is a

challenging but crucial part of cancer care. It involves delivering information
about a serious diagnosis, disease progression, or poor prognosis to patients
and their families in a sensitive, compassionate, and clear manner. Effective
communication can help reduce anxiety, build trust, and support informed
decision-making.
Key Principles of Breaking Bad News in Psycho-Oncology:-
1. Prepare for the Conversation:
Ensure privacy and a quiet setting to minimize interruptions.
Allocate enough time for the conversation, allowing the patient to ask
questions.
Review the patient’s medical information and have a plan for the discussion.
Consider the cultural background, preferences, and readiness of the patient
to receive the information.
2. Assess the Patient’s Understanding and Preferences:-
Start by asking open-ended questions to gauge how much the patient knows
about their condition (e.g., “What have the doctors told you about your
diagnosis so far?”).
Understand how much detail the patient wants to know, as some may prefer
a full explanation while others may choose to receive only basic information.
3. Deliver the News Clearly and Directly:
Use straightforward, non-technical language to convey the diagnosis or

prognosis.
Be honest but compassionate, avoiding euphemisms or vague terms that

could lead to misunderstandings.
Deliver the news in small, digestible pieces, allowing the patient to absorb
the information.
4. Acknowledge Emotions and Provide Support:
Give patients and families time to process the information, as initial reactions
may include shock, disbelief, anger, or sadness.
Validate their emotions by acknowledging the difficulty of the situation (e.g.,

“I can see this is very difficult news to hear, and it’s understandable to feel
overwhelmed”).
Offer support, including immediate comfort and the availability of mental

health professionals, social workers, or support groups.
5. Encourage Questions and Explore Concerns:
Allow patients and families to ask questions and clarify their concerns. This
can help ensure they understand the situation and can make informed
decisions about treatment options.
Be prepared to answer questions about treatment, prognosis, and what to
expect in the future, but also be honest if there are uncertainties.
6. Provide a Plan and Next Steps:
After delivering the news, outline the available treatment options, next steps,
and resources for support.
Reinforce that the patient is not alone, and the healthcare team will provide
ongoing care and guidance throughout the process.
SPIKES Protocol for Breaking Bad News:-
The SPIKES protocol is a widely used framework for delivering bad news
effectively. It stands for:
S – Setting: Arrange for a comfortable, private environment.
P – Perception: Assess the patient’s perception of their condition.
I – Invitation: Invite the patient to express how much information they want.
K – Knowledge: Provide the information clearly and sensitively.
E – Emotions: Address and validate the patient’s emotions.
S – Strategy and Summary: Develop a plan and summarize the next steps.
By following these principles and protocols, healthcare professionals can

approach the difficult task of breaking bad news with empathy and clarity,
helping patients navigate their cancer journey with support and
understanding.

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PSYCHO ONCOLOGY

Psycho-oncology is a multidisciplinary field that focuses on the psychological,

Psycho-oncology integrates knowledge from psychology, psychiatry,

Cancer is a group of diseases characterized by the uncontrolled growth and

The biology of cancer involves the transformation of normal cells into

1. Sustained Cell Proliferation – Cancer cells continuously divide and grow.

Breaking bad news, especially in the context of psycho-oncology, is a

Key Principles of Breaking Bad News in Psycho-Oncology:-

1. Prepare for the Conversation:

Ensure privacy and a quiet setting to minimize interruptions.

2. Assess the Patient’s Understanding and Preferences:-

3. Deliver the News Clearly and Directly:

Use straightforward, non-technical language to convey the diagnosis or

Be honest but compassionate, avoiding euphemisms or vague terms that

4. Acknowledge Emotions and Provide Support:

Validate their emotions by acknowledging the difficulty of the situation (e.g.,

Offer support, including immediate comfort and the availability of mental

5. Encourage Questions and Explore Concerns:

6. Provide a Plan and Next Steps:

SPIKES Protocol for Breaking Bad News:-

S – Setting: Arrange for a comfortable, private environment.

P – Perception: Assess the patient’s perception of their condition.

K – Knowledge: Provide the information clearly and sensitively.

E – Emotions: Address and validate the patient’s emotions.

By following these principles and protocols, healthcare professionals can

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