Individual Abstract within a Delegate Designed Symposium 2025 Joint Meeting of the COSA ASM and IPOS Congress

Background:
Nepal faces a growing cancer burden, with an age-adjusted incidence of 65.6 per 100,000 and mortality of 29 per 100,000. Despite this, psychosocial care was virtually nonexistent until 2016. This abstract outlines Nepal’s pioneering psycho-oncology program, its achievements, and a SWOT analysis to guide future scaling.

Objectives:

To describe Nepal’s first psycho-oncology program (2016–present), validate context-specific tools, and identify strategic priorities via SWOT analysis to scale services. The triangulated data assessed service gaps, workforce capacity and policy adaptation barriers.

Methods:

 Using the policy and systems based SWOT framework, data from National policies, clinical observation, current publications were used to assess Nepal’s psycho-oncology service system and need.

Results:

• Key Accomplishments:Screened/trained >1,000 patients; launched Nepal’s first psycho-oncology nurse fellowship (2024).
• DT Validation:High distress prevalence (55.6%); emotional (OR=28.00) and practical (OR=12.15) problems were primary drivers.
• Suicide Risk:DT cutoff ≥4 predicted suicidal ideation (sensitivity=92.9%; prevalence=17.3%).
• SWOT Synthesis:
  • Strengths:Culturally adapted DT, trained nurses, high patient acceptance.
  • Weaknesses:Low oncologist referrals, stigma, fragmented follow-up.
  • Opportunities:high patient/family demand post-education; growing MH professional interest.
  • Threats:No government funding; high unmet needs in advanced cancer.

Impact:

Government acknowledging the need of psycho-social services and willing to establish psycho-oncology unit in Bhaktapur Cancer Hospital if support of human resources available.

Conclusion & Call to Action:
Nepal’s model demonstrates feasibility in low-resource settings but requires global collaboration to:

1. Fund government-backed units (e.g., Bhaktapur Cancer Hospital).
2. Scale mentorship .
3. Develop training curricula for nurses and psychiatrists.

Key Message:
"Echoing IPOS, Sustainable psychosocial care cannot exist in isolation—it demands collective investment in cancer’s invisible wounds."