From Hidden Burden to Visible Care: Integrating Psycho-Oncology into Breast Cancer Control in Tajikistan through Indian and African Models

• Muqaddam Shohzodaeva

  Department of Oncology, Radiology and Radiotherapy, Avicenna Tajik State Medical University / Lead for Psycho-Oncology Initiatives, Tajikistan

• Uldoshev Ravshan Zohidovich

  Department of Oncology, Radiology and Radiotherapy, Avicenna Tajik State Medical University / Lead for Psycho-Oncology Initiatives, Tajikistan

• Rachel Kansiime

  Department of Paediatrics and Child Health, Mulago Hospital / Joint Clinical Research Centre, Kampala, Uganda

• Joyeeta Talukdar

  Department of Action Institute for Blood Diseases, Transplantation and Cellular Therapy (AIBTraCT) (Adult & Pediatric Units), Action Cancer Hospital, New Delhi, India

Breast cancer is among the most common cancer in women worldwide. It is accompanied by significant psychosocial, cultural, and spiritual challenges that have a substantial impact on treatment adherence, care-seeking behavior, and perceptions of the disease. These psychosocial aspects of cancer are still largely unexplored in Tajikistan, where stigma, cultural norms, and the dearth of organized psycho-oncology services all contribute to increased distress, delayed diagnosis, and low patient engagement. In order to direct the methodical integration of psychosocial care into breast cancer control, this perspective paper suggests a hybrid psycho-oncology framework for Tajikistan based on transferable and contextually relevant models from Africa and India. Instead of serving as a supplemental mental health intervention, it seeks to understand how culturally sensitive psycho-oncology can serve as a fundamental part of oncology services in a setting with limited resources and high stigma. The study explores culturally mediated barriers that influence screening behaviour, diagnostic engagement, and treatment adherence among Tajik women, including fear of social exposure, body image disruption, gendered distress, and privacy-related anxieties. It does this by combining clinical insights and established psycho-oncology practices from similar low- and middle-income contexts. The analysis demonstrates how structured interventions can enhance early detection, continuity of care, and quality of life. These interventions include regular distress screening, counselling, community engagement, family-inclusive care, and palliative psychosocial support. Instead of offering empirical results, this viewpoint promotes a translational framework for cooperatively integrating psycho-oncology into Tajikistan's cancer care system. As a scalable approach for workforce development, capacity building, and long-term integration of psycho-oncology into cancer care systems throughout Central Asia, it suggests a tripartite collaborative model involving Tajikistan, India, and Uganda.

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