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Specialised psychological and psychosocial support for people with an oncological illness and their relatives — from the moment of diagnosis, through treatment and follow-up, to life after treatment, advanced illness and palliative care.
Psycho-oncology deals with the psychological and social dimensions of oncological illness – from the moment of suspicion and the establishing of the diagnosis, through active treatment and follow-up, to life after treatment, advanced illness and palliative care.
An oncological diagnosis affects not only the body. It can change one's sense of security, view of the future, relationships, professional life, sexuality and the way a person experiences themselves. Psychological reactions vary, and there is no single "correct" way for a person to experience the illness.
Psycho-oncological work does not replace medical treatment and does not imply that psychological factors are a cause of cancer. It is part of the comprehensive care for the patient and their relatives and aims to support adaptation, psychological functioning, relationships and quality of life.
Psycho-oncological consultation after diagnosis
What is it?
The establishing of an oncological diagnosis often divides life into "before" and "after". Even when a person has anticipated the result of the investigations, the final confirmation of the diagnosis can be experienced as a shock.
In the first days and weeks, fear, confusion, anger, helplessness, disbelief or a sense of unreality may appear. Other people react with apparent calm and strong mobilisation around the investigations and treatment. Both reactions can be part of the adaptation to what is happening.
The psycho-oncological consultation creates a space in which a person does not need to be "strong", to reassure their relatives or to react in a particular way. Fears, uncertainty, the forthcoming treatment, relationships with the family and the changes that the diagnosis brings into life can be discussed.
Led by: Dr Margarita Tareyn
Who is it suitable for?
For people with a recently established oncological diagnosis, as well as for patients in the process of diagnostic clarification or immediately before starting treatment.
When can it be helpful?
- immediately after the diagnosis is established;
- with strong fear and anxiety;
- with a sense of shock or unreality;
- with difficulty talking to relatives;
- with fear of the forthcoming treatment;
- with confusion and a sense of loss of control;
- when thoughts about the illness occupy almost the whole of daily life;
- when a person needs a space outside medical conversations.
What does the psychological work include?
An initial assessment of psychological distress and current needs, support in the process of adaptation and, if necessary, planning for subsequent psychological counselling or psychotherapy.
How does the first meeting proceed?
The patient has the opportunity to describe how they learned of the diagnosis, what they know about the illness and treatment, and how they are experiencing what is happening. It is not necessary to be ready to talk about all aspects of the illness at the very first meeting.
Format and frequency
Format
Individual, in person or online, when the condition allows.
Duration and frequency
From a single consultation to regular psychological support, according to individual needs.
Who conducts the consultations?
Specialists from the Institute's team with competence in the field of psycho-oncology.
Important
Psycho-oncological support complements medical care and does not replace consultations with the treating oncologist or another medical specialist.
Psychological support during oncological treatment
What is it?
Active treatment can be a lengthy period, in which medical procedures gradually begin to determine the rhythm of daily life. Surgery, systemic anti-tumour therapy, radiotherapy and other medical interventions can be associated with both physical and significant psychological strain.
A person may simultaneously be coping with side effects, uncertainty about the effect of the treatment, changes in appearance and physical abilities, absence from work and a change in family roles.
The most difficult moment is not always the beginning. With prolonged treatment, fatigue, irritability, anxiety and a sense that life has shrunk to the illness and medical procedures may gradually accumulate.
Psychological work allows these experiences to be recognised and processed, without the patient being put under pressure to be constantly positive or "fighting".
Led by: Dr Margarita Tareyn
Who is it suitable for?
For people undergoing active oncological treatment, regardless of the type and stage of therapy.
When can it be helpful?
- with fear and anxiety during treatment;
- with severe fatigue and psychological exhaustion;
- with difficulty with physical changes;
- with a sense of loss of control;
- with a change in family or professional roles;
- with social withdrawal;
- with difficulty bearing the length of the treatment;
- when the illness begins to define almost the entire sense of identity.
What does the psychological work include?
Support for adaptation to the treatment and the changes that have occurred, work with anxiety, relationships, bodily experience and personal resources. If necessary, work with a partner or family may also be included.
How does the first meeting proceed?
The current stage of treatment, current difficulties and the way in which the illness and therapy affect daily life and relationships are discussed.
Format and frequency
Format
Individual, in person or online, depending on the patient's condition.
Duration and frequency
It may cover a certain stage of treatment or continue throughout the whole treatment period.
Who conducts the consultations?
Specialists with competence in psycho-oncology.
Important
Psychological support is provided in parallel with medical treatment and does not replace it.
Psychological preparation and support before surgery
What is it?
The forthcoming operation can be one of the most tense moments in treatment. Fear may be related to the surgical intervention itself, the anaesthesia, pain, possible complications, the outcome or changes to the body after the operation.
For some patients, the operation is also the moment at which the diagnosis acquires a particularly concrete bodily dimension. The loss or alteration of part of the body may be associated with experiences relating to identity, sexuality, femininity or masculinity, autonomy and the future.
Psychological preparation does not aim to eliminate natural fear. It helps worries to be named, differentiated and placed in context, so that the person can go through the forthcoming event with more psychological support.
Led by: Dr Margarita Tareyn
Who is it suitable for?
For patients who are due to undergo surgical treatment in connection with an oncological illness.
When can it be helpful?
- with strong fear of the operation;
- with fear of the anaesthesia or pain;
- with anxiety about the outcome;
- with anticipated significant bodily changes;
- with fear of loss of autonomy;
- with difficulty falling asleep and constant thoughts about the operation;
- when a person finds it difficult to talk to relatives about what lies ahead.
What does the psychological work include?
Work with specific fears and expectations, psychological preparation for the period around the operation, and discussion of the possible changes afterwards.
How does the first meeting proceed?
The conversation is focused on the forthcoming operation, the information the patient has, and the aspects that cause the greatest tension.
Format and frequency
Format
Individual, in person or online.
Duration and frequency
It may be a single consultation or several meetings before and after the operation.
Who conducts the consultations?
Specialists with competence in psycho-oncology.
Important
Medical information about the operation, risks and expected outcomes is provided by the treating medical team. The psychologist does not replace the medical consultation.
Fear of recurrence or progression
What is it?
The fear that the oncological illness may return or progress is one of the most common experiences during and after treatment.
A certain degree of anxiety is understandable. A problem arises when the fear begins to be constantly present in daily life, to determine decisions and plans, or to make it almost impossible to return to a life outside the role of patient.
Ordinary bodily sensations may begin to be interpreted as a sign of illness. Forthcoming investigations may cause strong tension, and plans for the future may be avoided with the thought "I don't know if I will be well".
Psychological work does not aim to convince the person that recurrence is impossible. It helps the inevitable medical uncertainty to be borne, without it taking over the whole of life.
Led by: Dr Margarita Tareyn
Who is it suitable for?
For people during or after oncological treatment, in whom fear of the illness returning or progressing causes significant suffering.
When can it be helpful?
- with constant thoughts of recurrence;
- with strong anxiety around bodily sensations;
- with frequent seeking of reassurance;
- with avoidance of medical check-ups due to fear;
- with excessive seeking of medical investigations;
- with difficulty making plans;
- when fear disrupts sleep, relationships or daily life.
What does the psychological work include?
Exploration of the way in which uncertainty and fear are experienced, distinguishing medically justified follow-up from anxious behaviour, and work on restoring a life that is not organised solely around the risk of illness.
How does the first meeting proceed?
The specific fears, the situations that trigger them, medical follow-up and the impact of anxiety on daily life are discussed.
Format and frequency
Format
Individual, in person or online.
Duration and frequency
Determined individually.
Who conducts the consultations?
A psychologist or psychotherapist with competence in psycho-oncology.
Important
New or unexplained physical symptoms should be discussed with a medical specialist and should not automatically be assumed to be a manifestation of anxiety.
Anxiety before follow-up investigations
What is it?
Follow-up check-ups and investigations can bring the patient back to the period of diagnosis and treatment even years after its completion.
The tension often begins days or weeks in advance and may reach its highest intensity in the period between undergoing the investigation and receiving the result. Insomnia, irritability, difficulty concentrating and constant thinking about a possible unfavourable result may appear.
This anxiety is not unusual and does not necessarily indicate the presence of an anxiety disorder. However, when every follow-up period becomes a significant psychological ordeal, professional support can be helpful.
Led by: Dr Margarita Tareyn
Who is it suitable for?
For people undergoing oncological follow-up who experience significant anxiety around check-ups and examinations.
When can it be helpful?
In cases of intense anticipatory anxiety, sleep disturbances, panic experiences, persistent thoughts about the result, or significant disruption of daily functioning around medical follow-up.
What does the psychological work involve?
Working with anxiety, uncertainty and the experience of medical follow-up, as well as with the way in which previous experience of the diagnosis and treatment is reactivated by check-up examinations.
How does the first meeting proceed?
It explores when the anxiety began, how it manifests, and what the check-up examinations mean for the particular person.
Format and frequency
Format
Individual, in person or online.
Duration and frequency
This may be short-term work around a specific follow-up period or part of longer-term psychotherapy.
Who conducts the consultations?
A specialist with competence in psycho-oncology.
Important
Psychological support does not replace the necessary medical follow-up.
Changes in the body and body image after oncological treatment
What is it?
Oncological disease and its treatment can leave visible and invisible changes in the body – surgical scars, loss of an organ or part of it, changes in hair, skin, weight, physical capacity or sexual functioning.
The changed body may be experienced as foreign, damaged or unpredictable. Sometimes those around the person perceive the treatment as having been successfully completed, while the person themselves continues to encounter its consequences in their own body every day.
Working with body image does not aim to convince the person that they must like every change that has occurred. It creates a space for loss, anger, shame, fear and the gradual building of a new relationship with one's own body.
Led by: Dr Margarita Tareyn
Who is it suitable for?
For people in whom the disease or treatment has led to changes in appearance, bodily functioning or the way they experience their own body.
When can it be helpful?
- after surgical intervention;
- with visible scars or bodily changes;
- with changes in weight or hair;
- with loss of an organ or function;
- when avoiding mirrors, social situations or intimacy;
- with shame and estrangement from one's own body;
- when bodily changes affect identity and self-esteem.
What does the psychological work involve?
Exploration of the experience of the changed body, losses, identity, self-esteem, relationships and intimacy.
How does the first meeting proceed?
The person themselves decides to what extent and in what way they wish to talk about the bodily changes. There is no requirement to show or discuss aspects for which the patient is not ready.
Format and frequency
Format
Individual, in person or online.
Duration and frequency
Determined individually.
Who conducts the consultations?
A psychologist or psychotherapist with competence in psycho-oncology.
Important
In the case of physical symptoms and functional disturbances, appropriate medical follow-up is necessary.
Sexuality and intimacy in oncological disease
What is it?
Sexuality often remains in the background in conversations about oncological treatment, although the disease can substantially change desire, bodily sensation, sexual functioning and the relationship between partners.
The causes may be physical, hormonal, psychological and interpersonal. Fatigue, pain, fear, bodily changes, or the feeling that the body now belongs mainly to medical procedures, can change the way a person experiences intimacy.
Sometimes both partners avoid the topic in an attempt to protect the other. In this way, silence can gradually create distance.
Psychological work provides a space in which sexuality can be discussed as a normal part of life and of quality of life after the diagnosis.
Led by: Dr Margarita Tareyn
Who is it suitable for?
For patients and partners in whom oncological disease or treatment has affected sexuality, body confidence or intimate relationships.
When can it be helpful?
With changes in sexual desire, avoidance of intimacy, shame about the body, fear of the partner's reaction, changes in sexual functioning, or difficulty discussing the topic within the couple.
What does the psychological work involve?
Work with body image, intimacy, communication between partners, fears, and the psychological consequences of the disease and treatment.
How does the first meeting proceed?
The topic is discussed with respect for the person's personal boundaries and pace. An individual or couple's consultation may be conducted.
Format and frequency
Format
Individual or with a partner; in person or online, when appropriate.
Duration and frequency
Determined individually.
Who conducts the consultations?
A specialist from the team with the appropriate competence.
Important
In the case of physical changes in sexual functioning, a consultation with an appropriate medical specialist may be necessary.
Psychotherapy in oncological disease
What is it?
Sometimes an oncological diagnosis does not give rise merely to a temporary crisis, but confronts the person with deeper questions about the body, dependency, relationships, loss, death and the way they have lived up to that point.
In such cases, short-term counselling may not be sufficient, and longer-term psychotherapeutic work may be appropriate.
Psychotherapy is not directed towards "positive thinking" and does not place upon the patient the responsibility to influence the development of the cancer through their psychological state. It works with the person's subjective experience and with the way in which the disease fits into their personal history.
In psychotherapy there may also be room for experiences that are not directly related to the diagnosis but have become more visible or more difficult since it.
Led by: Dr Margarita Tareyn
Who is it suitable for?
For people with oncological disease who have a need for deeper and longer-term psychological work.
When can it be helpful?
In cases of persistent psychological distress, recurring difficulties, depressive or anxious experiences, changes in identity and relationships, or when the diagnosis activates earlier traumatic experiences and conflicts.
What does the psychological work involve?
Regular psychotherapeutic sessions, tailored to the individual's condition, treatment and the specialist's psychotherapeutic approach.
How does the first meeting proceed?
The initial sessions focus on the reason for seeking psychotherapy, current functioning, personal history and the possibilities for subsequent work.
Format and frequency
Format
Individual, in person or online, when appropriate.
Duration and frequency
Psychotherapy presupposes regularity. Duration is determined individually.
Who conducts the psychotherapy?
Psychotherapists from the team with competence in the field of psycho-oncology.
Important
Psychotherapy complements medical treatment and does not affect the need to carry out the prescribed antitumour therapy.
Support after completion of active treatment
What is it?
The end of active treatment is often anticipated as the moment after which life will return to normal. For many people, however, this is precisely when a different, and sometimes unexpectedly difficult, period begins.
During treatment, daily life is organised around specific tasks and medical procedures. After they end, contact with the medical team decreases, and the patient is often expected simply to move forward.
Physical fatigue, bodily changes, fear of recurrence, difficulties with sexuality, problems with concentration and uncertainty about returning to work may remain. Sometimes those close to the person expect that "everything should now be fine", while the person themselves is still trying to understand what has happened.
Psychological work supports the transition from active treatment to life afterwards – not necessarily a return to how things were before, but the building of a way of life that incorporates what has been experienced.
Led by: Dr Margarita Tareyn
Who is it suitable for?
For people who have completed active oncological treatment and have moved into a period of follow-up.
When can it be helpful?
With fear of recurrence, difficulty returning to work, a sense of loss of direction, bodily changes, relationship problems, or a feeling that those around them do not understand the ongoing impact of the disease.
What does the psychological work involve?
Work on adaptation after treatment, fear of recurrence, relationships, identity, bodily experience, and the return to professional and social life.
How does the first meeting proceed?
The treatment experienced, current difficulties and the areas of life in which the person encounters the greatest difficulties are discussed.
Format and frequency
Format
Individual, in person or online.
Duration and frequency
Determined individually.
Who conducts the consultations?
Specialists with competence in psycho-oncology.
Important
Psychological support after treatment does not replace medical follow-up.
Support in advanced oncological disease
What is it?
In advanced oncological disease, a person may be confronted with a different type of uncertainty – related to the progression of the disease, treatment options, physical limitations and the future.
Psychological work is not based on the assumption that the patient must necessarily talk about death or "accept" a particular outlook. At the centre remains the specific person and what is important to them at the present moment.
There may be room for fear, hope, anger, relationships with loved ones, dependency on others' help, bodily changes, meaning, unfinished conversations, and decisions the person wishes to make.
Psychological support may be part of palliative care and is aimed at preserving dignity, autonomy and the best possible quality of life.
Led by: Dr Margarita Tareyn
Who is it suitable for?
For people with advanced oncological disease and, where necessary, for their loved ones.
When can it be helpful?
With fear and uncertainty, changes in prognosis, physical deterioration, dependency on others' help, difficult family conversations, existential questions, or the need for support in making important personal decisions.
What does the psychological work involve?
Individual support for the patient, work with loved ones and, where necessary, family sessions, tailored to the patient's condition, wishes and capabilities.
How does the first meeting proceed?
The patient determines the pace and topics of the conversation. Conversations about prognosis, death or other topics the person does not wish to discuss are not imposed.
Format and frequency
Format
Individual or with the family; in person or online, depending on condition and circumstances.
Duration and frequency
Flexible and tailored to the patient's condition and needs.
Who conducts the consultations?
Specialists with competence in psycho-oncology and work with serious illness.
Important
Psychological support is part of comprehensive care and does not replace oncological, symptomatic or palliative medical treatment.
Support for relatives of a person with a cancer diagnosis
What is it?
An oncological diagnosis affects not only the patient. Partners, parents, children and other relatives often take on the organisation of treatment and daily life, accompany the patient and, at the same time, try to cope with their own fears.
A relative can easily become nothing more than “the person who cares for them”. One's own fatigue, anxiety, anger and need for rest can be experienced with guilt.
Sometimes the patient and their relatives try to protect each other by not speaking about what they fear. In this way, everyone can be left alone with the same worries.
Psychological support provides a space in which the relative, too, has the right to be a person with their own experiences and needs.
Led by: Dr Margarita Tareyn
Who is it suitable for?
For partners, parents, adult children and other relatives of a person with a cancer diagnosis.
When can it be helpful?
In cases of anxiety, exhaustion, guilt, helplessness, difficult relations with the patient, fear of loss, excessive caregiving burden or difficulty talking about the illness.
What does the psychological work involve?
Individual counselling or psychotherapy, working with the burden of caregiving, relationships, boundaries, fears and the relative's own needs.
How does the first meeting proceed?
The focus is on the relative's experience, not on the assessment or treatment of the patient.
Format and frequency
Format
Individual, couple-based or family-based, depending on the specific situation.
Duration and frequency
Determined individually.
Who conducts the consultations?
Specialists from the team with competence in psycho-oncology and family support.
Important
Information about the patient is not provided or discussed outside the framework of professional confidentiality and the applicable rules on consent.
How to talk to a child when a parent has cancer?
What is it?
When a parent or other very close person has a cancer diagnosis, adults often wonder whether they should tell the child and how much information is appropriate.
The wish to protect the child is natural. At the same time, children usually notice the changes – absences, medical visits, fatigue, worry and conversations between adults. When there is no explanation, the child may create their own, sometimes more frightening than reality.
The aim is not for the child to be burdened with medical information, but to receive an honest explanation appropriate to their age, together with the opportunity to ask questions.
Led by: Dr Margarita Tareyn
Who is it suitable for?
For parents and other significant adults who need to talk to a child about a cancer diagnosis in the family.
When can it be helpful?
At the time of diagnosis, before an upcoming operation or treatment, with visible changes in the parent's condition, prolonged hospitalisation, disease progression, or when the child begins to ask questions.
What does the psychological work involve?
Counselling the parent on how to adapt information to the child's age and development, how to respond to the child's reactions, and how the conversation can continue over time.
How does the first meeting proceed?
Initially, work is usually done with the parent or other adult. If necessary and after assessment, the child may also be included.
Format and frequency
Format
Parental consultation, family meeting or individual work with the child, depending on the situation.
Duration and frequency
From a single consultation to ongoing support of the family.
Who conducts the consultations?
Specialists with competence in psycho-oncology and work with children and families.
Important
The content and manner of the conversation must always be adapted to the child's age, development and the specific family situation.
Family and couple support in cancer diagnosis
What is it?
A cancer diagnosis enters an existing system of relationships and can change roles, responsibilities, closeness and the way family members communicate.
The partner may become the main caregiver, the children may take on new responsibilities, and the patient may feel guilty about having become dependent on others. At the same time, old conflicts do not automatically disappear because of the illness.
Family or couple work creates a space in which these changes can be discussed, without seeking to assign blame and without assuming that all family members must experience the illness in the same way.
Led by: Dr Margarita Tareyn
Who is it suitable for?
For couples and families in which a cancer diagnosis has led to significant changes, tension or difficulties in communication.
When can it be helpful?
In cases of difficult conversations, changes in roles, conflicts around caregiving, distance between partners, changes in intimacy, different ways of coping, or difficulties in relationships with children.
What does the psychological work involve?
Joint meetings focused on relationships, communication, differing needs and the family's adaptation to the illness.
How does the first meeting proceed?
It is discussed how each participant is experiencing the situation and how the illness has changed relationships and daily life.
Format and frequency
Format
Couple or family meetings.
Duration and frequency
Determined according to the specific situation.
Who conducts the consultations?
A specialist with appropriate competence in working with families and cancer diagnosis.
Important
The aim is not to determine which family member is “right”, but to understand the relationships and support communication.
Psychosocial support and patient navigation
What is it?
A cancer diagnosis can create difficulties that extend far beyond medical treatment. A person may simultaneously need to organise tests and treatment, take time off work, navigate administrative procedures, seek social support and arrange care at home.
During a period of physical and psychological strain, the healthcare and social systems can seem particularly complex. The patient and family do not always know which institution to turn to, what rights they have, or what forms of support are available.
Patient navigation and clinical social work help the person to find their way through these processes and to connect the medical, social and practical aspects of care.
This does not mean that decisions are made instead of the patient. The aim is for the patient and their family to have sufficient information and support to make an informed choice.
Led by: Dr Margarita Tareyn
Who is it suitable for?
For people with a cancer diagnosis and their families who have social, administrative, professional or practical difficulties related to the diagnosis and treatment.
When can it be helpful?
- when there is a need to navigate the healthcare and social systems;
- for questions regarding ТЕЛК and НЕЛК;
- in cases of temporary or permanent incapacity for work;
- for questions regarding social and insurance rights;
- when social services are needed;
- for organising care in the home environment;
- when returning to work;
- when the patient and family do not know which institution or specialist to turn to.
What does the psychosocial work involve?
Assessment of psychosocial needs, provision of information, referral to appropriate institutions and resources, support in planning care and, where necessary, coordination with other professionals.
How does the first meeting proceed?
The specific situation, current needs, available resources and the issues for which the patient or family need assistance are clarified.
Format and frequency
Format
Individual or family consultation; in person or online, depending on the nature of the issue.
Duration and frequency
May be a single consultation on a specific issue or ongoing work in a more complex situation.
Who conducts the consultations?
A clinical social worker or another specialist from the team, depending on the nature of the need.
Important
Psychosocial counselling does not replace legal, medical or administrative expertise where such is required. Decisions of the ТЕЛК, НЕЛК, НОИ, НЗОК and other competent institutions are made solely by the respective bodies.
Support in the loss of a relative as a result of cancer
What is it?
When a person has accompanied a relative through a cancer diagnosis, the loss is often preceded by a prolonged period of treatment, hope, anxiety, caregiving and gradual physical exhaustion.
After the death, sadness, emptiness, guilt, anger, relief, exhaustion may all be present at once, together with difficulty understanding how to continue one's life after a period in which much of it had been organised around caring for the other person.
Conflicting feelings do not mean an absence of love. They may be part of the complex process of grieving after a prolonged illness.
Psychological work provides a space for the experience of the loss, the relationship with the person who has been lost, and gradual adjustment to life afterwards.
Led by: Dr Margarita Tareyn
Who is it suitable for?
For relatives of a person who has died as a result of a cancer diagnosis.
When can it be helpful?
In cases of intense or prolonged grief, guilt, anger, emptiness, social withdrawal, difficulty returning to daily life, or the need to talk about the period of illness and death.
What does the psychological work involve?
Individual counselling or psychotherapy focused on the experience of the loss and adaptation to the change that has occurred.
How does the first meeting proceed?
The person decides what and how much they are ready to share about the illness, the death and the relationship with the relative who has been lost.
Format and frequency
Format
Individual, in person or online. Where a suitable programme is available, group support may also be offered.
Duration and frequency
Determined individually. No predetermined time limit is set by which a person “must” complete the grieving process.
Who conducts the consultations?
A psychologist or psychotherapist with competence in working with loss, grief and cancer diagnosis.
Important
Grief is a natural human response to loss and does not in itself constitute a mental illness. In cases of severe impairment of functioning or risk to safety, additional specialised help may be necessary.