Psychoncology

Dealing with female breast cancer (BC) strongly modulates the patient's self-concept, hence affecting her interpersonal network, notably with the partner. In this review, we assume that the patient-partner couple reacts as a unique dyadic system when facing the experience of BC, thus influencing the disease's adjustment and coping processes. From this point of view, BC adjustment and coping studies focused on the patient-partner couple are relevant to better understand the psychosocial dimension of this disease and plan useful dyadic support programs. The paper reviews the studies on a dyadic approach to the adjustment as well as the coping consequences of BC. The dyadic features of adjustment and coping processes over the course of illness are highlighted. The association with some specific relationship patterns as well as with the communication styles is investigated to emphasize the crucial role of conjoint psychological dynamics that define the BC dyad struggle with the illness. Finally, the literature findings on these topics are discussed together with the couple post-traumatic growth phenomena. RIASSUNTO Fare esperienza del cancro al seno femminile (BC) modula fortemente l'idea di sé della paziente, influenzando la sua rete interpersonale, in particolare con il partner. Il presupposto di questa rassegna di concetti, è che la coppia paziente-partner risponde come un sistema diadico unico di fronte all'esperienza del BC, influenzando così i processi di adattamento e coping alla malattia. In questo quadro di riferimento, gli studi di adattamento e coping al BC focalizzati sulla coppia paziente-partner sono rilevanti per comprendere meglio la dimensione psicosociale di questa malattia. Il testo passa in rassegna gli studi riguardanti un approccio diadico ai processi di adattamento e coping nel BC. La revisione di letteratura evidenzia le caratteristiche diadiche dei processi di adattamento e di coping nel corso della malattia. L'associazione con alcuni modelli specifici di relazione e con gli stili di comunicazione è studiata al fine di sottolineare il ruolo cruciale dei programmi di supporto psicologico congiunto per supportare il paziente e il suo partner. Infine, i risultati della letteratura su questi argomenti sono discussi insieme con i fenomeni di crescita post-traumatica della coppia.

People who have malignant cancer are plagued with a variety of symptoms that often severely limit their lives. In the case of carcinoid tumors, symptoms of anxiety and depression are two manifestations of- ten associated with disturbances produced by the tumor itself and the chemicals that the tumor secretes. The aim of this study was to compare the incidence of these symptoms for gastro-entero-pancreatic (GEP) tumors and non-gastro-en- tero-pancreatic (non-GEP). Methods. Patients with GEP and patients with non-GEP completed the Hospital Anxiety and Depression Scale (HADS). HADS and all of its subscales were analyzed. Results. Patients with GEP tended to have higher average total scores on the HADS-D than those with non-GEP (p<0.08), and items in which the difference between GEP and non-GEP were statistically significant were anhedonia (p<0.05), a reduced ability to laugh and have fun (p<0.05), and the feeling of hopelessness (p<0.05). No significant differences emerged, however, in HADS-T and HADS-A scores. Conclusions. On the basis of these findings, patients with GEP are affected more than patients with non-GEP with increased levels of depressive and anxiety symptoms. What is difficult to determine, however, is whether these symptoms are related to hormone overproduction, or whether they are related to tumor-related emotional distress.