Tumori Journal Abstract Book - October 2020 - 174

174	

Tumori Journal 106(2S)

1

ASL 5 Spezzino S.C. Oncologia, La Spezia; 2Asl 5 Spezzino S.P.D.C., La
Spezia; 3Tutto รจ vita onlus, Firenze; 4ASL 5 Spezzino SC Oncologia, La
Spezia; 5Asl 5 Spezzino S.S.D. Cure Palliative, La Spezia

Backgroud: Mammographic screening is a periodic secondary prevention for asymptomatic women. Several studies highlight the reduction of breast cancer mortality, both
for mammographic screening and for more innovative
cancer treatments. Only 5% of breast cancers are metastatic de novo. The communication of tumor disease
changes the way of "being in the world"of the person: how
the patient handles this emotional crisis determines his
entire adaptive structure and the same prognosis. We have
developed an integrated multidisciplinary simultaneous
approach in patients with de novo metastatic breast cancer,
with denial of the disease.
Material (patients) and methods: We have analyzed using
a HAM-D/HAM-A scale and PPI, 9 patients (median age 50
years, range 46-73 years) admitted to the Oncology Unit of
ASL 5 Spezzino, from July 2016 to October 2018, after the
access to the Emergency Room for an internistic complication and a simultaneous diagnosis of metastatic breast cancer (Tab.1). In all patients a personalized management has
been developed by performing periodic check-ups, in the
presence of the oncologist, palliativist, psychologist and
psychiatrist in simultaneous care. A pharmacological and
psychotherapeutic approach was performed in order to control the deepest anxieties of separation, abandonment, death
with a systemic chemotherapy.
Results: The assessment of the patients' mental state revealed
some common traits, in particular "anosognosia", sometimes
"anosodiaforia", up to indifference. The psychopathological
evaluation of the patients highlights a dynamic adaptations
such as the euphoric negation or a strong regressive negation. In some patients a more regressive defense mechanisms
have been established such as denial. All 9 patients have followed active care pathways, despite late diagnosis, sometimes with a surprising median overall survival .
Conclusions: Despite the broad affirmation of mammographic screening, denial prevents the adherence to diagnostic-therapeutic procedures. In the metastatic breast
cancer, which is less managed in simultaneous care, our
study shows that an integrated approach allows a greater
elaboration of the disease optimizing the adherence to the
pathways of care.
Nb pt

Clinical and socio-cultural characteristics

9/9
3/9
2/9
1/9
9/9
9/9
9/9

De novo metastatic breast cancer
CNS metastasis
Pulmonary thromboembolism
Dorsal medullary compression
No mammography screening
Upper-secondary education
Integration in an appropriate socio-family context

S14
Providing nutritional care to
cancer patients during the
COVID-19 pandemic: an Italian
perspective
Caccialanza R.1, Lobascio F.1, Cereda E.1, Crotti S.1, Masi S.1,
Brugnatelli S.1, Secondino S.1, Monaco T.1, Inglardi M.1, Pozzi E.1,
Pedrazzoli P.1
1

Fondazione IRCCS Policlinico San Matteo Pavia, Pavia

Background: The emergence of 2019 novel coronavirus
disease (COVID-19) has caused a global public health emergency. Italy was the first European country where the disease
widespread and Lombardy is the principal cluster. In the
most affected areas, a rapid and thorough reorganization of
hospital clinical procedures has taken place: all non-essential
clinical activity has been suspended, while the ordinary
activity continues for whom diagnostic procedures and treatments cannot be delayed. It is the case of cancer patients
undergoing treatments with curative intent; in this situation
of deep distress for the health care system, the inability to
satisfy cancer patients' needs is an additional concern.
In the light of the above, during the current COVID-19 pandemic it is likely to see a dramatic worsening of cancer
patients' nutritional status, due to possible delayed clinical
assistance and difficulties in procuring nutritionally adequate quality food as lock-down's repercussion. The consequences are reasonably foreseeable and will have a severe
negative impact after the emergency. Hence, it is essential
to carry on, as far as possible, the activity of clinical nutrition in oncology, which can be safely provided only by a
thorough setting and approach to patients rearrangement.
Methods: For this purpose, the Clinical Nutrition and
Dietetics Unit and the Medical Oncology Unit of our hospital have reorganized the clinical routine activity in strict
collaboration, to better face up to the challenge, while preserving cancer patients' needs.
Results: Several general actions have been taken to protect
both patients and healthcare professionals; remote capabilities have been implemented to minimize interactions, efforts
are being done to secure medical resources and supplies.
This allowed the regular provision of nutritional counseling
and nutritional support in both inpatients and outpatients, in
line with the recommended hygienic measures to protect
both patients and healthcare professionals. Nutritional follow-up has been planned by regular telephone counseling
and laboratory exams have been checked by email.
Conclusions: Implementing appropriate nutritional care
in oncology during this unprecedented emergency is a
hard challenge. However, any effort should be done to
guarantee, along with active treatment, adequate nutritional support to cancer patients, in order to prevent the
deleterious consequences of malnutrition on clinical outcomes and quality of life.



Tumori Journal Abstract Book - October 2020

Table of Contents for the Digital Edition of Tumori Journal Abstract Book - October 2020

Contents
Tumori Journal Abstract Book - October 2020 - Cover1
Tumori Journal Abstract Book - October 2020 - Cover2
Tumori Journal Abstract Book - October 2020 - I
Tumori Journal Abstract Book - October 2020 - II
Tumori Journal Abstract Book - October 2020 - Contents
Tumori Journal Abstract Book - October 2020 - IV
Tumori Journal Abstract Book - October 2020 - V
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Tumori Journal Abstract Book - October 2020 - Cover3
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