Parental Psychological Distress in Pediatric Cancer Care: A Narrative Review with Focus on the Indian Context

Abstract

Pediatric cancer is a severe and life-altering condition that affects not only the child but also the psychological functioning of parents who provide continuous care throughout the treatment process. Although advances in medical care have improved survival outcomes, the psychological distress experienced by parents remains highly prevalent and is often under-recognized, particularly in low- and middle-income countries such as India. This narrative review critically synthesizes existing literature on parental psychological distress in pediatric oncology, emphasizing its multidimensional nature, which includes emotional, financial, social, cognitive, and systemic dimensions. Common psychological manifestations such as anxiety, depression, post-traumatic stress symptoms, and chronic stress-related reactions are examined. The review also highlights structural and systemic barriers that limit access to psychological care, including inadequate psychosocial services, financial strain, stigma, and healthcare accessibility challenges. Special attention is given to the Indian context, where these barriers are more pronounced. Additionally, emerging evidence related to step-parent caregiving is briefly discussed as an underexplored area within pediatric psycho-oncology. Overall findings suggest that parental distress is most intense during diagnosis and early treatment stages, although psychological burden often persists long after treatment completion. The review emphasizes the importance of integrating structured, culturally sensitive, and family-centered psychosocial care within pediatric oncology services.