Psycho-oncology services within the Italian Breast Units must be strengthened as soon as possible. In 2019, only 20% of women who would have needed them actually benefited from these services, also due to the lack of dedicated and qualified personnel to manage this delicate aspect of the diagnostic-therapeutic process: 60% of psycho-oncologists involved in the Breast Units it is in fact made up of consultants and staff with fixed-term contracts, who obviously have difficulty in developing the necessary skills and integration with the oncology team, and guaranteeing therapeutic assistance. A critical aspect, therefore, made even more complex today by the Covid 19 pandemic. This is what emerges from a survey on the state of the art of psycho-oncology services in 44 Breast Units of three different Regions – Emilia-Romagna, Piedmont and Lazio – which involved psycho-oncologists, center coordinators and voluntary associations.
Strongly, the survey in Emilia Romagna, Piedmont and Lazio
This is the second edition of the ForteMente project promoted by Europa Donna Italia and the Italian Society of Psycho-Oncology (SIPO). The initiative, which enjoys the patronage of AIOM (Italian Association of Medical Oncology), A.Ge.Na.S. (National Agency for Regional Health Services) and Senonetwork Italia Onlus, the network of Italian breast care centers, was presented today during a virtual press conference. “After the success of the first edition of the project, aimed at detecting the need for psychological support in particular in women with metastatic breast cancer, we wanted to continue and verify how much this support is actually available to the patients of the Breast Units”, explained Rosanna. D’Antona, President of Europa Donna Italia, during the presentation of the results of the second edition of ForteMente. “The picture that emerged from the survey, which will soon be extended to other Regions, reveals an imbalance between need and supply that is the mirror of a widespread tendency to underestimate psycho-oncological support as part of the treatment process, despite being provided for by the guidelines national and international “.
One fifth of the services financed by the associations
According to the findings of the ForteMente project, for example, only 78% of psycho-oncology services in the regions examined are entirely borne by the National Health Service, while 22% are assisted by funding from patient associations, which in some cases arrive to cover even 100% of the costs. “The results of ForteMente only reinforce our request to the institutions, that is to guarantee the presence of psycho-oncology in all the Breast Units of Italy, as already established by a document approved in 2019 in the State Regions Conference”, commented Marco Bellani, President of the Italian Society of Psycho-Oncology (Sipo). “It is known that one in three patients suffer from anxiety or depression, and 30-70% of patients with breast cancer will need psychological support during their treatment, and it must not be forgotten that these problems can also affect relatives or caregiver. In order to guarantee adequate psycho-oncology services, it is necessary not only to strengthen resources, but also to recognize the role of the psycho-oncologist within the multidisciplinary team and the need for his close collaboration with all specialists. Last but not least, patients must be informed more and better about the opportunity to benefit from these services ”.
The remote psychologist
In addition to the recognition of the in the three regions, the ForteMente project has also created a focus on the use of remote psychological support to ensure the continuity of patient care during the pandemic. In Piedmont (at the Breast Unit of the AOU Città della Salute e della Scienza in Turin) and in Lazio (at the Breast Unit of the Tumori-Regina Elena Institute in Rome) a pilot project was launched on the digital platform PsyDit (PsychoTherapy Digital Tools) with the aim of evaluating the functionality of the tool, the satisfaction of patients and psychologists and the overall effectiveness of the service. “Thanks to new digital tools it is possible to guarantee continuity of care to patients also in psycho-oncological support – underlined Cristina Cenci, CEO of DNM-Digital Narrative Medicine – the path is not yet completed but the first feedbacks are positive. The availability of a specific and non-general structure for online meetings with patients is appreciated. It is important that awareness of the potential of these tools increases and that innovative digital paths are shared that do not limit themselves to reproducing what happens in presence “.
The next investigation
Finally, once the second edition is over, it is already time to think about the third. This time the three regions involved will be Veneto, Tuscany and Abruzzo, and the focus – announce the promoters of the project – will be to collect not only quantitative but also qualitative data, with the use of focus groups in which psychologists, referents of the Breast Units and representatives of patient organizations will express needs and advice on how to improve the state of affairs. Because, Rossana D’Antona recalls: “As Professor Veronesi said, breast cancer must be removed not only from the body but also from the mind, and here the psychological factor is fundamental”.
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