From doctor to patient: this is the journey of Roberto Laudati, hematologist at the Hematology Unit AOU Città della Salute e della Scienza in Turin, who in December 2021 received the diagnosis of non-Hodgkin’s lymphoma. On Saturday 29 April, Roberto will leave Turin, his city, for Rome, riding his bicycle to demonstrate how therapeutic physical activity can be in oncology as well. The initiative takes the name of ‘Pedalata Arcobaleno della Speranza’ (Rainbow Ride of Hope) and includes a journey in 5 stages and over 700 kilometres.
The doctor becomes the patient
Roberto is 69 years old and lives in Trofarello, in the province of Turin. He has three children and is also the grandfather of five grandchildren. What was it like, as a hematologist, to receive the diagnosis of non-Hodgkin’s lymphoma, neoplasms originating from lymphocytes (B e T), cells of the immune system present in the blood, lymphatic tissue of lymph nodes, spleen, thymus and bone marrow. As often happens with this type of tumour, Roberto discovered the disease following the enlargement of the lymph nodes in his neck. What did he feel as a hematologist when she was diagnosed with blood cancer? “I have always worked in the same hospital for 46 years and have been criticized several times for the relationship I had with the patients: I called them familiar and they did the same with me, there has always been a very familiar relationship with the patients”, replies Roberto who adds: “Clearly it’s very different when you experience the diagnosis firsthand, however I must say that being a doctor helped me because when I received the diagnosis it’s not that I experienced it as if it were I had already experienced it for better or worse for another person”.
The bewilderment and chaos of disease
Even the doctor Roberto feels feelings of fear and bewilderment when he becomes a patient: “I faced the situation like any other person, in the sense that when they give you news like that, the first feeling is disorientation,” he recalls. “You go in the shower and start thinking a bit about what it will be like, above all because you have 3 children, 5 grandchildren, your wife, what immediately strikes you is the idea of having to say goodbye to them”. Then, however, the disease imposes itself with all its practical needs because you have to organize yourself to go and get the therapies and, moreover, for Roberto all this happened in the Covid era with all the additional difficulties of the case.
Diagnoses of haematological cancer
In short, in the face of the disease we are all the same: “When a patient is told that the therapies have greatly improved and that therefore the possibility of recovery is about 80%, the patient always thinks of the 20% non-healing. It’s the same thing that I experienced for a while”, continues the doctor-patient. Diagnoses of haematological cancer are on the rise due to the general aging of the population but life expectancy is higher and 40-50% of patients can even aspire to recovery. Furthermore, the remarkable advances in medicine have meant that many of the diseases considered fatal have turned into chronic.
Research on the therapeutic value of physical activity
But the doctor’s imprinting pushes Roberto to search the literature for everything that could be new for therapy and it was in this way that he found very interesting, recent studies validated by a very large sampling that demonstrated the therapeutic value of sports for oncological diseases. “Following the indications of the most recent studies – says Roberto – I started a program of physical activity which has greatly helped me in counteracting the side effects of the therapy and, I hope, the disease itself. Hence the idea of the Turin-Rome ride, with the intention of ideally uniting all the Italian Oncohaematological Centers and to raise awareness of the importance of physical exercise even during therapy to fight against tumours”.
A targeted exercise program
After these searches, Roberto contacts Maria Christina Coxhaematologist at the Tor Vergata University Hospital in Rome and professor of adapted physical exercise in cancer patients. “She was the first to have devised a program of physical exercise during therapy for oncological diseases and has a gym next to the oncohematology department of Tor Vergata just for patients”, explains Roberto. We developed an exercise program with her. I also bought trainers because as it was winter, you couldn’t cycle outside so I put the bike on trainers and continued pedaling. Clearly when you have chemotherapy you lose your hair, you are weak, you sweat a lot, but I must say that both cycling and bodyweight exercises have helped me a lot. I sweated a lot and maybe that also helps in eliminating some therapy.
The benefits of movement
Numerous studies have shown that people who have had cancer and have remained physically active show greater adherence to therapies, have a lower risk of recurrence and an increase in survival compared to inactive people. “Motor activity, even for those undergoing chemotherapy, is essential not only to improve the quality of life of patients but also to prevent the side effects of long-term oncological therapies. A personalized physical activity on the patient’s characteristics, which in the first 8-12 weeks must be followed by an expert coach, is able to restore a good part of the loss of physical, psychological and mental efficiency, as well as lay the foundations for the prevention of other complications – declares Maria Christina Cox, hematologist at the Tor Vergata University Hospital in Rome and professor of adapted physical exercise in cancer patients.
The passion for two wheels
Roberto has always been a bicycle enthusiast and you haven’t actually stopped exercising. “When I was diagnosed – he recalls – I had just returned from a trip that I had organized and that we had called ‘the diagonal’, from Tarvisio to Trapani by bicycle, almost 2,000 km. I returned in mid-October and at the beginning of November I began to have the first symptoms, the diagnosis required some time for the histological examination and I started chemotherapy on December 29, 2021, but I resumed as early as January 1 physical activity”. Since it was his passion, Roberto above all continued to ride a bicycle: “The therapy, in addition to chemotherapy, also includes cortisone which, in addition to giving stomach ailments and various things, causes an increase in appetite, so you gain weight so I tried to counter this too; nevertheless I gained 6-8 kg, now I’m starting to lose them but it’s very difficult especially at my age”.
Two wheels for research
How did the idea of social commitment come about? “Years ago some friends and I founded a group called ‘Two wheels for research’ thanks to which we set up at least 4 or 5 scholarships for young biologists for research in the pediatric hematology field and we bought two pieces of equipment for a total of around €50,000”, says Roberto. And now comes the ‘Rainbow of Hope Ride‘ which starts from the Piedmontese Oncohematological Center of Turin and ends at the Hematology Department of the Tor Vergata Polyclinic, on May 4th. “Cycling has a dual purpose – he says Maria Stella Marchetti, president of The Rainbow of Hope Odv. Raise awareness among doctors, healthcare professionals and patients on the importance of physical activity in all its forms to improve the quality of life of onco-haematological patients and raise funds to finance two scholarships for motor science experts in order to carry out the physical exercise project adapted to both pediatric and adult onco-haematological patients”. Two assisted pedal bicycles will be used for pedaling, also suitable for those who start doing sport during illness; one of the two bicycles will be used by Roberto while some of Roberto’s sporting friends will take turns on the other as well as some personalities from the world of sport who want to join this adventure. It will be possible to follow the event on the Association’s social channels.