It’s easy to talk about cancer. There are many types, however capable of affecting the same organ or system. The more science advances with knowledge of the invisible, analyzing cellular, metabolic and genetic characteristics of each neoplastic unit, the more we realize that even with the same pathological condition, the picture that develops and the ways in which the individual patient deals with it can vary. It is not for nothing that we talk about tailor-made treatments.
But the research tries to go beyond the biological characterizations of the neoplasm. As? Trying to study and analyze every history of every patient with cancer, to implement those support tools that go beyond treatment but involve sectors such as the psyche, nutrition, rehabilitation. This is the proposal that emerges from the PRISMA project, a research program promoted by the Foundation for Personalized Medicine (FMP).
Tailor-made treatments
Every day in Italy more than 1,000 people fall ill with cancer. However, two people with the same tumor, the same staging and the same therapy can deal with the disease in completely different ways. PRISMA is based on an already approved study on over 100 patients with solid tumors to try to reconstruct the particular way in which each patient interprets what is happening to him through a “personal code”. This subsequently guides the choice of support tools to propose: psychological, rehabilitative, nutritional or behavioral.
“In recent years, oncology has learned to choose treatments based on the molecular characteristics of the individual tumor”
underlines the professor. Paolo Marchetti, President of the FMP and Scientific Director of the IDI-IRCCS.
“So the question to ask is: if the therapy is built on the biological profile of that person, why should everything that accompanies the treatment remain the same for everyone? For years we have been repeating that the patient must be placed at the center of a treatment path with a direction to be built by walking alongside the person. Now we also need to “personalise” the assistance and therefore we have decided to support and promote the new PRISMA programme”.
From psycho-oncology to a practical example
“Each patient experiences the disease in different ways. We need to understand how the person reads what is happening to them, to offer them support that really has a chance of working instead of advising everyone on the same path”
explains Stefania Alfani, Psychologist and Creator of PRISMA.
The observational study will enroll over 100 patients over twelve months. For each participant, clinical data collection, a semi-structured interview and the Brief Illness Perception Questionnaire are foreseen, a validated tool that measures how the person perceives their illness.
The same reasoning must apply to prevention. Knowing what would be useful to do is not enough. The same indication is accepted and translated into everyday life in very different ways depending on who receives it. Understanding how each person perceives and accepts this guidance makes the advice more actionable.
A concrete example comes from secondary lymphedema, the chronic swelling that appears when surgery and radiotherapy damage the lymphatic system. Depending on the type of tumor, the diagnostic criteria and the duration of follow-up, it can affect up to 60% of cancer patients.
“It is a chronic condition that does not heal and must be managed for years, with a daily impact on work, movement and social life”
concludes Roberto Bartoletti, physiotherapist at IDI-IRCCS.
“Lymphedema cannot be resolved with a simple cycle of sessions. It accompanies the person for a long time and must be followed as if it were a chronic disease and therefore with scheduled checks and adjustments along the way. When treatment is interrupted, the arm or leg swells again and the patient finds himself back to square one. This will be one of the complications, induced by cancer, that we will address in the PRISMA project”.
