Cancer Beyond the Physical Illness: Structural Barriers to Psychological Care – A Narrative Review

Abstract

The Cancer is a life-threatening chronic illness that affects individuals not only physically but also psychologically, emotionally, socially, and financially. Cancer patients frequently experience anxiety, depression, fear of recurrence, emotional exhaustion, uncertainty regarding treatment outcomes, and reduced quality of life. Despite increasing recognition of psycho-oncology, access to psychological care among cancer patients remains inadequate, particularly in low- and middle-income countries such as India. This narrative review synthesizes existing literature on the structural barriers that prevent cancer patients from accessing psychological care. The review highlights major barriers including financial burden, inadequate healthcare infrastructure, shortage of trained mental health professionals, geographic inaccessibility, social stigma, lack of awareness, and caregiver burden. Existing evidence indicates that these barriers significantly contribute to untreated psychological distress, poor treatment adherence, emotional suffering, and impaired psychosocial adjustment among cancer patients. Particular emphasis is placed on the Indian healthcare context, where economic inequalities, delayed diagnosis, and limited psycho-oncology services further intensify emotional and psychological burden. The review further discusses the importance of integrating psychological support into routine oncology care and emphasizes the need for multidisciplinary, accessible, and culturally sensitive psycho-oncology services. Findings suggest that structural barriers continue to remain a major obstacle in achieving holistic cancer care.