Breast cancer, psychological support and sport complement therapies

Finding out you have breast cancer: a woman's fears, escape reactions involving even those closest to her, the upheaval of life, changes in body and soul. After talking about prevention, therapies and research in the last Sole 24 Ore video forum dedicated to breast cancer prevention month, we talked about what it means for a woman to discover she has breast cancer. Of the importance of onco-psychological therapy, which intervenes on the emotional and mental mechanisms that trigger the disorder and the dysfunctional behaviour that fuels it. Guests of the videoforum were Gabriella Pravettoni, director of the Division of Psycho-oncology at the European Institute of Oncology, Katia Flacco, vice-president of RosaRemo, a non-profit sports association that through rowing helps women regain possession of their lives, Angela Piattelli, national president of the Italian Society of Psycho-oncology, and Simonetta De Fermo, who took part in the 50 km walk 'Metadynamics paths of well-being' reserved for women with metastatic cancer. A project organised by Komen Italia with the support of the Fondazione Policlinico Gemelli and the Onconauti association of Bologna

Faced with a cancer diagnosis, women suddenly feel vulnerable and have to deal with many fragilities. From the first investigations through to diagnosis, surgery and treatment, a woman who discovers she has breast cancer is catapulted into a whirlwind of strong and conflicting emotions that accompany the different stages of the treatment process. There are many losses to process, starting with self-image and ending with plans for the future. There are five stages, as pointed out in the pioneering studies on psycho-oncology by Elisabeth Kübler-Ross, which is the branch of psychology that deals with the psychological aspects of people with cancer: one goes from shock and denial to anger, from bargaining to depression, and finally to acceptance.

"Psycho-oncology means working so that our patients can live well, not only in terms of a life that with the chronicity of the disease due to therapeutic innovation is lengthening, but also in terms of the quality of their existence. It is crucial that we continue to work alongside them to remove the tumour from their heads and minds'. Thus Gabriella Pravettoni, director of the Ieo psycho-oncology division. 'It is crucial that a psycho-oncologist is always present in the treatment team, as is also the case for the Breast Unit,' Pravettoni further warns. This is necessary for all cancer patients, after all, as well as for their caregivers'.

'The diagnosis of a breast cancer disease has profound repercussions on the patient's psychological and social-relational sphere. And if this discomfort is not carefully treated in the acute phase, it can become chronic, and the patient can find herself experiencing anxious-depressive symptoms, sleep disorders, and more, even in the survival phase,' continues Angela Piattelli, president of Sipo, the Italian Society of Psycho-Oncology. 'It is important for women to undergo these interventions, which must necessarily be provided to patients, but this must be done systematically. Instead, the last Favo report showed a deterioration in the provision of this type of support throughout the country'.

The diagnosis of an oncological disease inevitably involves the whole system of significant relationships around the patient, so, in the case of a woman with breast cancer, the partner, children and family of origin. 'Several studies,' Piattelli continues, 'show how the caregiver's distress can become clinically significant and must therefore be adequately treated. Therefore, psychological intervention must absolutely be extended to the family system as well, and this contributes to our patient's psychological well-being and quality of life'.