Medical Oncologist
CION Cancer Clinics
When you need counselling beyond genetic counselling | CION Cancer Clinics
If worry, low mood or strain at home is still there weeks after your result was explained, or it is stopping you sleeping, working or going to screening, it is time for more than genetic counselling. A psychologist or psychiatrist treats that kind of distress. This page covers the signs, how to get a referral and the one situation that cannot wait. At CION Cancer Clinics, our team helps carriers and their families plan checks, next steps and support after a genetic result.
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Medically reviewed by Dr. Naresh GunduConsultant Medical Oncologist · MBBS, DNB (Internal Medicine), DM (Medical Oncology, AIIMS) · last reviewed September 2026, next review due September 2027
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The short answer
When is genetic counselling not enough?
When the worry, low mood or family strain is still there weeks after the result was explained, or it is stopping you from sleeping, working or looking after yourself. Genetic counselling explains a result. It is not designed to treat distress that lasts, and seeing a psychologist or psychiatrist for that is sensible, not a sign of weakness.
What a genetic counsellor does, and what they do not
A genetic counsellor helps you understand the result, what it means for your screening and who in the family might be affected. They will notice if you are struggling and should ask about it. But their sessions are few and focused on the genetics. Lasting anxiety, grief or depression needs someone whose whole job is the mind.
Why it can be harder to ask in many families
In many Indian homes, seeing a psychologist still carries stigma. Distress is often described as "tension", or shows up as headaches, poor sleep and a racing heart rather than as sadness. Relatives may say you only need to be strong. None of that makes the distress less real, and treating it early makes it easier to carry on with screening and ordinary life.
For most people the sharpest distress eases with time. Needing help when it does not ease is common and treatable.Signs to take seriously
How do I know I need more than genetic counselling?
Any one of these, lasting more than a few weeks, is a good reason to ask for a referral.
Worry that will not settle
You think about the result most of the day, check your body constantly for signs of cancer, or feel sure you are already ill even after normal scans.
Daily life is slipping
Sleep, appetite, work or care of the children have changed and are not recovering.
Often looks like
- Waking early and unable to sleep again
- Losing interest in things you used to enjoy
- Crying easily, or feeling nothing at all
Avoiding what protects you
Missing screening appointments, refusing to open reports or putting off a decision about preventive options because thinking about it is unbearable. Avoidance is one of the clearest signs that support would help.
Strain at home that keeps growing
Arguments with a spouse or parents about blame, secrecy or the children that do not calm down. A family or couples counsellor can help where a genetics appointment cannot.
Not sure whether this applies to you?
Ask an oncologist
!
One thing that cannot wait
If you are thinking about ending your life or harming yourself, or you are worried that a relative is, get help today. Go to the nearest hospital emergency department, or tell a family member or friend who can stay with you. Tele-MANAS, the Government of India's free mental health helpline, also answers in Telugu. Do not wait for your next genetics appointment.
Getting there
How do I get that kind of help?
Say it out loud to someone in your care team
Tell your genetic counsellor, oncologist or family doctor how you have been feeling. You do not need the right words. "I am not coping" is enough.
Ask for a referral
You may be referred to a clinical psychologist, a psychiatrist, or a psycho-oncology service that works only with people affected by cancer.
The first appointment
You will be asked about sleep, mood, worries and what is happening at home. It is a conversation, not a test, and it is confidential.
Agree a plan
Most people are offered talking therapy. Some are also offered medicine for anxiety or depression, which a psychiatrist will explain and monitor.
Keep your genetics care going
Carry on with screening while you get support. The two work together, and feeling steadier often makes the medical decisions easier.
Who does what
The people who can help, in plain language
- Genetic counsellor
- Explains your result, what it means for screening and who in the family may be affected. Focused on the genetics.
- Clinical psychologist
- Offers talking therapy for anxiety, low mood and grief. In India they are registered with the Rehabilitation Council of India.
- Psychiatrist
- A medical doctor who treats mental health conditions and can prescribe medicine where it is needed.
- Psycho-oncology
- Mental health care for people affected by cancer, including carriers who have never been ill.
- Family or couples counsellor
- Helps when the result has caused conflict between partners, parents and children.
- Support group
- Other carriers and families who have been through the same thing. Not a replacement for treatment, but often a comfort.
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Being straight with you
What this page cannot tell you
It cannot tell you whether what you are feeling is an illness that needs treatment. That judgement is made by a psychologist or psychiatrist who has spoken with you properly. A checklist on a website can point you towards help, not stand in for it.
It cannot interpret your genetic result
Sometimes distress comes from misunderstanding what a result means. What your specific variant means for you is a question for the counsellor who ordered the test, and a second conversation with them can ease a great deal of fear on its own.
Who this does not apply to
Feeling shaken, tearful or angry in the days after a result is a normal response to hard news. If those feelings are easing and you are managing daily life, you probably do not need more than the support of family and your genetics team. Studies so far suggest most people adjust over time, though the research on Indian families is small.
If you are unsure whether you need more help, call the helpline and ask to speak to someone about a referral.Commonly believed
Four things people say about getting more help
"Seeing a psychologist means I am going mad."
It means you are carrying something heavy and want help with it. Most people who see a psychologist after a genetic result are dealing with worry, grief or strain at home.
"I have not even got cancer, so I have no right to struggle."
Living with a raised risk is hard in its own way. Carriers who have never been ill are as entitled to support as patients.
"Mental health medicine will make me dependent."
Medicines for anxiety and depression are prescribed and reviewed by a psychiatrist, and many are not habit forming. Many people need only talking therapy.
"My family will find out and judge me."
Mental health consultations are confidential. You choose who, if anyone, in the family is told.
Questions we are asked
Common questions about getting more support
How long is it normal to feel upset after a result?
There is no fixed timetable. Most people feel the shock most sharply at first and find it eases over the following weeks and months. If it is not easing, or it is getting worse, that is the time to ask for more support rather than waiting.
Can my genetic counsellor refer me to a psychologist?
Yes. Tell them how you have been feeling and ask directly. Your oncologist or family doctor can also refer you. You do not need to have a diagnosis of anxiety or depression before you ask for help.
What is the difference between a psychologist and a psychiatrist?
A clinical psychologist offers talking therapy. A psychiatrist is a medical doctor who can also prescribe medicine. Many people see a psychologist first, and are referred to a psychiatrist only if medicine might help.
Can I get counselling in Telugu?
Often, yes. Ask for it when you are referred. Talking about feelings is much easier in the language you think in, and a good counsellor will understand how family and community shape what you are going through.
Does counselling cost a lot?
Costs vary between hospitals and private practices, and government hospitals often charge very little. Ask about fees before the first appointment. Tele-MANAS, the government's mental health helpline, is free and a reasonable first step.
Should my spouse or parents come with me?
That is your choice. Some people want to speak alone first. If the result has caused conflict at home, joint sessions with a family counsellor can help everyone hear each other, rather than arguing in circles.
Will seeking help affect my insurance or job?
Mental health consultations are confidential. If you are worried about disclosure on an insurance form, ask the insurer or an adviser before you apply, and read the question carefully. Your counsellor will not share your notes with your employer.
Where do I start if I feel I am not coping?
Tell someone today, whether that is a relative, your doctor or your genetic counsellor. Call the CION helpline if you are not sure who to approach, and someone will help you find the right support. If you feel unsafe, go to an emergency department first.
Your Specialists
Meet CION's oncologists. Bring your family history or genetic report to them.
Our medical oncologists see people with a strong family history of cancer, arrange genetic counselling and testing where it fits, and plan the checks that follow.
Medical Oncologist
Dr. C. Raghavendra Reddy
MBBS(Gold Medal), DNB(General Medicine), DM(Medical Oncology)(Gold Medal)
Medical Oncologist
Dr. Bharati Devi Gorantla
MBBS, MD(General Medicine), DM(Medical Oncology)(Adyar,Chennai), ECMO, MRCP SCE(UK)
Medical Oncologist
Dr. Owais Mohammed
MBBS, MD (General Medicine), DrNB (Medical Oncology), ECMO, MRCP SCE (Medical Oncology) (UK)
Medical Oncologist
Medical Oncologist
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Sources
- National Cancer Institute — Cancer Genetics Risk Assessment and Counseling (PDQ)
- National Cancer Institute — Adjustment to Cancer: Anxiety and Distress (PDQ)
- Ministry of Health and Family Welfare, Government of India — Tele-MANAS: National Tele Mental Health Programme
- NHS — Predictive genetic tests for cancer risk genes
This page is general information, not a prescription. Do not change or stop any treatment based on what you read here. If anything is worrying you, contact your own treating team — or call our helpline and we will help you reach the right specialist.
Keep reading
Related pages
Talk to us
Not sure whether you need more support?
Tell us how you have been feeling since the result and we will help you find the right person to talk to, in Telugu if you prefer. One helpline serves every CION centre.