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Elizabeth Cheung

In the fifth instalment of a six-part Health Matters wellness series on cancer in Hong Kong, Elizabeth Cheung looks at the hidden psychological burden patients face and how support programmes are reshaping treatment.
The battle with multiple cancers since the summer of 2024 has taken a mental toll far beyond what Sasa Hui Yuen-sim felt she could manage.
The 67-year-old retiree was first diagnosed with breast cancer in June 2024, followed by lung cancer the following year.
Between the two diagnoses, she also suffered from the painful viral rash of shingles and underwent surgery to remove extra thyroid nodules that affected her swallowing and breathing.
In October last year, she was found to have two non-cancerous nodules in her liver that required further follow-up.
“I have fear and wonder when all these diseases will stop,” Hui said. “The physical pain and mental stress are really overwhelming.”
Experts say mental well-being and quality of life are crucial in a cancer patient’s journey, but are often given less priority than treatment.
Previous studies have shown that improvements in patients’ overall well-being can extend survival and strengthen treatment tolerance.
Hui said she felt less anxious after joining a patient support programme run by the Hong Kong Anti-Cancer Society, where she took part in activities such as flower arranging, mooncake making and drawing classes.
The activities, along with counselling support, helped boost her mental resilience.
“Originally I was in a dark hole … suddenly there was a ray of light shining upon me,” she said. “I see hope when I see light.
“It was as if someone had untied my knot so I could breathe.”
A 2024 narrative review found that a substantial proportion of cancer patients worldwide experience psychological distress, including anxiety and depression.
The research, involving scholars from eight countries, including one from the University of Hong Kong (HKU), found that patients undergoing multiple simultaneous treatments face the highest psychosocial burden.
Being younger, female or having a higher level of education was associated with a greater self-reported need for psychosocial support.
Suicide rates among cancer patients are nearly double those of the general population, prompting calls for routine distress screening and efforts to address stigma around mental health needs.

Dr Jerry Ho Chun-wing, chairman of the Hong Kong Society of Palliative Medicine, called for greater attention to patients’ overall quality of life, rather than focusing solely on treatment.
“We talk about the quantity of life, how much longer we can live, but little has been discussed about the quality of life,” Ho said.
“We strongly believe that a person is more than a body … there are also psychosocial and spiritual aspects that are equally important.”
Lai Kit-man, chairwoman of the Hong Kong Palliative Nursing Association, said that while managing physical symptoms improved comfort, psychological and social support could help patients cope better and improve their living conditions.
“If a patient’s quality of life improves, their physical health will also improve,” she said, noting that this had been demonstrated in previous studies.
Ho suggested introducing additional support when a disease reached a stage where a cure was no longer possible and treatment focused on slowing deterioration, rather than waiting until the final weeks of life.




A local study published in 2021 found that public hospital cancer patients receiving palliative care had a median overall survival of 5.1 months, compared with 1.96 months for those who did not.
Under the Anti-Cancer Society’s support programme, newly diagnosed patients receive a comprehensive guide covering treatment, side effects, nutrition and financial arrangements.
Each patient is also assigned a case manager to help coordinate care and provide emotional support.
A range of activities, including art therapy, singing bowl sessions, aromatherapy and acupressure, are available to help patients manage their emotions.
Speaking after an art therapy session, Hui said drawing had helped her cope.
“I released my negative energy from my hands into the paintings and I felt more comfortable,” she said.
Meanwhile, the Hospital Authority has partnered with the Hong Kong Cancer Fund to set up patient resource centres in oncology units, offering information libraries, counselling services, rehabilitation workshops and peer support activities.
It also employs more than 45 case managers for those with breast, colorectal, gynaecological, blood, urological and lung cancers, as well as musculoskeletal tumours, to coordinate care between patients and doctors.
In the 2024-25 financial year, more than 11,400 patients used the service, averaging one manager for every 250.
Amid growing awareness of quality-of-life issues for terminally ill patients, lawmakers passed legislation in November 2024 to give legal status to advance directives, expected to take effect on July 31.
The law will allow patients to refuse certain medical treatments near the end of life, providing greater certainty in the event of family disputes. Do-not-attempt cardiopulmonary resuscitation orders will also be legally recognised for out-of-hospital settings.
Yet, both Ho and Lai said more needed to be done.
“The modes of promotion should change, with more focus on social media,” Lai said, noting that more people now consumed information on those platforms than on television.
She added that life and death education should begin in primary school.
Reflecting on her experience, Hui said maintaining a positive mindset had been key.
“Surgery can remove a tumour … but the state of mind is even more important. With a positive mindset, you can stay cheerful,” she said. “Otherwise, even medication will not help.”
Additional reporting by Emily Hung


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From art therapy to counselling, psychological support and palliative care improve quality of life and treatment outcomes, experts say


From art therapy to counselling, psychological support and palliative care improve quality of life and treatment outcomes, experts say.


‘I see hope’: how mindset shifts help Hong Kong cancer patients cope with diagnosis

.css-1c6uqr6{color:inherit;font-weight:inherit;font-size:inherit;font-family:inherit;line-height:inherit;overflow-wrap:break-word;}From art therapy to counselling, psychological support and palliative care improve quality of life and treatment outcomes, experts say

From art therapy to counselling, psychological support and palliative care improve quality of life and treatment outcomes, experts say