Psychological Distress in End-Stage Oral Cancer: A Case Study of Palliative Care Challenges

End-stage oral cancer is associated with profound psychological distress, particularly among patients from rural areas where access to healthcare and psychosocial support is limited. This case report describes a 67-year-old male farmer from rural Chennai diagnosed with Stage IV oral cancer who experienced severe emotional distress during end-of-life care. He had a long history of snuff use spanning 39 years, which he discontinued three years before diagnosis. Clinically, the patient presented with advanced disease, marked functional impairment, and nutritional dependence on a Ryle’s tube. Psychological assessment revealed high distress using the National Comprehensive Cancer Network (NCCN) Distress Thermometer score of 8/10, characterized by depressed mood, anxiety regarding death, and concerns about his family’s financial and social well-being. A brief psychoeducational intervention was provided, focusing on acceptance of prognosis, emotional support, stress management, and enhancing meaningful family interactions, alongside limited palliative chemotherapy. This case highlights the challenges of delivering holistic palliative care in resource-constrained rural settings and emphasizes the crucial role of integrated psychological support in improving the quality of end-stage cancer care.