Silent Distress: The role of emotional loneliness in treatment compliance in elderly cancer patients

Emotional loneliness is increasingly recognized as a significant barrier to optimal cancer care in elderly population. As populations are aging worldwide, and particularly in India, a parallel transformation in society structures i.e. from extended joint families to nuclear ones, has left many elderly people emotionally unsupported during times of critical illness. Loneliness contributes to psychological distress, impaired cognition, reduced motivation, and lack of hope, which eventually reduces treatment compliance in the elderly people.This review synthesizes evidence on the epidemiology of aging, the shift in social dynamics, cancer burden in elderly population and ways through which emotional loneliness eventually affects adherence to oncological treatment. We outline practical assessment tools, culturally contextual mechanisms, and multidomain interventions to address silent distress in geriatric oncology. Finally, we highlight gaps in knowledge and propose practical recommendations that can transform how clinicians understand and respond to emotional vulnerability in older adults with cancer.