(Un)certainties in psycho-oncology

Objective. This article discusses the role of uncertainty in psycho-oncology from the perspective of the patient and the treating physician as well as the discipline itself. Method. A case report illustrates in which way patients are affected by uncertainty, how psycho-oncological support can help to provide a sense of certainty or to cope with a certain degree of remaining uncertainty. Results. Patients with cancer are often confronted with a variety of uncertainties regarding the disease itself, the course and outcome as well as the effect on the physical and psychological well-being. Within the psycho-oncological community there is certainty about the nature and extent of psychosocial distress, the supportive care needs of both patients and relatives and the efficacy of evidence-based psychooncological interventions; however, there is still uncertainty regarding insufficient evidence on specific psychosocial aspects in the various patient groups, on delayed and long-term consequences of multimodal treatment, on interventions for specific syndromes, such as fatigue or cognitive impairments or on permanent lifestyle changes. Finally, uncertainties also relate to the prerequisites for providing effective psycho-oncological care in the clinical setting including services and treatment pathways, quality assurance and financing. Discussion. Psycho-oncological care can help patients to regain security and to find a way to cope with finiteness of human life and thus to tolerate an inevitable level of remaining uncertainty. In doing so, psycho-oncological care contributes to high-quality patientcentered cancer care. Scientific research is still needed in questions on cancer survivorship, in symptom-specific interventions, effective prevention and healthcare.