"The worst thing for me was not the actual diagnosis, but that I recently learned that doctors still found cancer cells in my body," Kurt Schröder said [name changed by the editors for privacy reasons]. "That's not great news when it comes to pancreatic cancer. They took the cancer out in surgery, there are only residual cells left. I would prefer, of course, that there was nothing left at all. But I'm a boundless optimist."

Schröder is 61 years old, has always been healthy, and is passionate about his hobbies, natural history and photography. After receiving his cancerdiagnosis in August 2022, his first surgery followed in October. The so-called "head" of the pancreas and the duodenum (the first part of the small intestine) were removed. Chemotherapywas next, with corresponding side effects such as nausea, vomiting and changes in taste.

"Bread tasted like sandpaper," Schröder said. "Bananas were flaming sweet, I couldn't eat them at all."

Early on, he turned to Gudrun Bruns, the head of a cancer counseling center in Münster.

Cancer counseling offers more than first aid

Bruns has decades of experience in the field of psycho-oncology, a scientific discipline that developed in the 1970s.

"Psycho-oncology deals with the psychological and social changes that result from cancer," Bruns said.

Studies have shown that around 25 to 30% of all people who receive a cancer diagnosis develop psychological disorders or psychosocial impairments over the course of the disease.

Psycho-oncology counselors provide guidance to patients in order to accompany them on their difficult path back into everyday life. They also provide practical help and information about the next possible steps.

"Mrs. Bruns knows an enormous number of people and institutions. She has connections that you didn't even think of yourself," says Schröder. "Of course, that's immediately a tremendous psychological help, too, when you know that you can turn to different places for support."

Psycho-oncology must be given higher priority worldwide

Paying more attention to the emotional and psychological aspects of cancer, integrating them into cancer treatment and improving conditions worldwide are some of the goals of IPOS, the International Psycho-Oncology Society.

Founded in 1984 and based in Toronto and New York, the organization works to make psycho-oncology an integral part of cancer therapies worldwide. To reach that goal, IPOS works with international partners and various interest groups and is pushing for more intensive research.

In 2020, more than 19 million people were newly diagnosed with cancer worldwide, according to the International Agency for Research on Cancer, IARC. And the number will grow. IARC estimates that cancer deaths will nearly double from 9.96 million worldwide in 2020 to about 16.3 million worldwide by 2040.

This makes it all the more important to offer psycho-oncological counseling and therapy. The worries and fears that cancer patients have to contend with are similar, regardless of whether they are getting treatment in Africa, Asiaor Europe, and regardless of the type of cancer involved.

Relatives also need help

A cancer diagnosis not only turns the life of the patient upside down, but also the lives of family members. Studies show that they, too, are exposed to severe psychological stress.

"Relatives often have the feeling that they have to support the sick person to the maximum, and then they lose track of their own life. If they give in to their own wishes and needs, they often have moral misgivings and a guilty conscience, even if it's simply a visit to the cinema or other leisure activities," Bruns said.

Such behavior, however, helps no one, she said.

 "It is absolutely necessary that relatives find ways for themselves to recharge their own energy."

Schröder has experienced himself what overly selfless commitment can do to relatives of cancer patients. His partner, Simone Burmann [name changed by editor for privacy reasons], was diagnosed with cervical cancer in 2010.

"When I accompanied my partner back then, I noticed how tremendously exhausting it was," Schröder said. "Then when I got my own cancer diagnosis, I kept admonishing her not to come to the hospital every day. In my opinion, she visited me far too often. At some point, she reached her limits and broke down emotionally."

Burmann struggled with her cancer diagnosis. "It was a fast-growing tumor, and I had three operations," she said. "My uterus was removed and parts of my vagina."

Since then, the now 55-year-old has been cancer-free. She experienced her hospital stay very differently from her partner. "For me, it was very important to have frequent visits, to have support and just to know there was someone there."

Cancer remains a scary diagnosis

For most, the full spectrum of emotions shows up shortly after diagnosis. It's not just anxiety, anger and irritability, Bruns said.

"It's also the grief of losing the health people had before they got sick."

Before their diagnosis, Bruns said, most people took their health for granted. Today, cancers are much more treatable, and many cancers are curable.

"But what remains is the associations with infirmity and dying. And of course, many patients are afraid that their disease cannot be cured, that it may come back, and that it will lead to death," Bruns said.

That's why, she said, giving cancer patients constant encouragement is one of the most important tasks in psycho-oncology: "It's often simply about not leaving people alone, and just listening to them."

There is no set routine for this, says Schröder. "The conversations just happened from day to day. They've started, for example, with Mrs. Bruns asking, 'How are you today? What's up?' And then you just start talking."

This article was originally published in German.