Psycho-Oncology: The Relationship of Cancer and Psychiatric Care

Michelle Riba, MD, discussed the intersection of psychiatry and oncology and the evolving challenges of psychiatric workforce capacity.

Riba described 2 distinct patient populations at the interface of cancer and mental illness. The first comprises patients who develop psychiatric disorders following a cancer diagnosis—a phenomenon affecting approximately 30% to 40% of oncology patients across the cancer care continuum, from initial diagnosis through treatment and end of life.¹ The second, she argued, is equally important but less commonly addressed: patients with preexisting severe mental illness, including schizophrenia and bipolar disorder, who subsequently develop cancer. Riba noted that this population faces significant disparities in cancer screening and access to care, and that their underlying psychiatric illness frequently worsens during the cancer treatment course. She emphasized that patients with severe mental illness die 10 to 20 years earlier than those without, with cancer contributing substantially to this mortality gap.²

Riba called for closer collaboration between psychiatry, oncology, and primary care to ensure that patients with severe mental illness are not disadvantaged in accessing cancer screenings and navigating treatment, stating that "we have to work with clinicians in oncology and primary care to make sure that doesn't happen to our patients."

On workforce, Riba identified the scale of unmet psychiatric need as the field's defining challenge, noting that this area of psychiatry has shifted substantially from an inpatient to an outpatient specialty and that meeting demand requires reimagined training models, proactive consultative approaches, and deeper interdisciplinary collaboration.

Dr Riba is deputy editor emeritus of Psychiatric Times; a professor at the University of Michigan Department of Psychiatry in Ann Arbor, MI; and director of the PsychOncology Program at the University of Michigan Rogel Cancer Center in Ann Arbor, MI.

References

1. Venkataramu VN, Ghotra HK, Chaturvedi SK. Management of psychiatric disorders in patients with cancer. Indian J Psychiatry. 2022;64(Suppl 2):S458-S472.

2. de Mooij LD, Kikkert M, Theunissen J, et al. Dying too soon: excess mortality in severe mental illness. Front Psychiatry. 2019;10:855.