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Neuropathological Diseases

ISSN Print: 2160-2468
ISSN Online: 2160-2476

Archives: Volume 1, 2012 to Volume 2, 2013

Neuropathological Diseases

DOI: 10.1615/NeuropatholDiseases.v1.i1.50
pages 71-93

Psycho-Oncology in Childhood and Adolescence: The Italian Experience

Marina Bertolotti
Psycho-oncology, Pediatric Onco-hematology Unit, Regina Margherita Children's Hospital, Turin, Italy
Pia Massaglia
Child Neuropsychiatry Section, Pediatric Department, University of Turin, Turin, Italy

ABSTRACT

In childhood and adolescence, cancer has a 100 times lower incidence rate than in adulthood and higher probabilities of cure (approximately 80%). These results are achieved through intensive treatments delivered in qualified medical centers in which identical protocols are applied. For a number of years, treatment has included structured care, provided by expert multidisciplinary teams, for the developmental needs of children and adolescents and for their and their families' quality of life. Nevertheless, the lengthy uncertainty about the outcome, apart from implying relevant psychological costs, can cause emotional reactions that prevent patients from getting over the experience if they are cured, and from preserving quality of life if the disease worsens. The main issues of a child's or an adolescent's cancer experience, concerning objective aspects (e.g., hospitalization and therapy) and subjective ones (e.g., self-image, fears, anxieties, hopes), are reviewed here. The need for and ways to establish a direct therapeutic relationship with the child or adolescent from diagnosis are outlined. The psycho-oncologist cooperates in the comprehensive care, based on open and honest communication, and performs specific interventions at different levels: prevention, support, and psychotherapy. Settings are flexible according to each patient's needs, as they arise in the care-giving experience, and individual and family resources and fragilities are fully respected.