Adolescents' Health Awareness and Understanding of Cancer and Tumor Prevention: When and Why an Adolescent Decides to Consult a Physician.

BACKGROUND: A feature often seen in adolescent patients with cancer is a lengthy symptom interval, especially in comparison with children. It has been suggested that inadequate awareness of cancer risk among adolescents may play an important role in this study. METHODS: The Società Italiana Adolescenti con Malattie Onco-ematologiche and the Fondazione Umberto Veronesi conducted a survey to investigate health awareness among healthy adolescents and their understanding of cancer and its signs and symptoms by commissioning a specialized agency (AstraRicerche). A questionnaire was administered to 500 Italian adolescents from the age group of 15 to 19 years using the computer-aided web interviewing method. RESULTS: Approximately 80% of the adolescents interviewed claimed to be well informed about their own health, 85% said they were aware that some lifestyle habits could influence their health, and 80% reported that they know that cancer can develop in adolescence too. It was also noted that, while some adolescents were worried about a given symptom, 22% of them reportedly preferred a wait-and-see approach (either to avoid alarming their parents, or they hoped that the symptom would be temporary). CONCLUSIONS: This study showed that a majority of adolescents are concerned about their own health, but sometimes prefer not to report their symptoms to anyone. Hence, it is important to develop information campaigns tailored to raise awareness among this age group and help them interpret their symptoms.

[Italian version of the Defense Mechanisms Rating Scales for Clinicians: a tool for the assessment of defense mechanisms in medical oncology]. / Versione italiana della Defence Mechanisms Rating Scales for Clinicians: uno strumento per la valutazione dei meccanismi di difesa del medico in oncologia.

INTRODUCTION: Facing distress situations arising from the interaction with the patient in oncology, eg breaking bad news, clinicians also, such as patients, protect themselves using unconscious defense mechanisms. Clinicians' psychic defenses topic is related to the clinicians training on communication with patients and to clinicians' individual characteristics issues. For clinicians the defensive functioning can be adaptive when mature defenses are activated or maladaptive if the defensive mode is immature, with implications on medical care effectiveness. It is therefore important to identify, assess and intervene on clinicians' defense mechanisms. The Defense Mechanisms Rating Scales for Clinicians (DMRS-C) is a tool developed as an addendum to the DMRS (originally created by Perry), for the assessment of clinician defenses. It is an assessment tool based on the observer, which can be applied to audio or video recordings, interviews transcripts or medical - psychotherapy sessions. This tool is currently available in French language only. AIM: The aim of this work is to translate and adapt DMRS-C in Italian. METHOD: The DMRS-C has been translated into Italian and back-translated into French in order to verify the correspondence with the original language. Psychometric properties of the scale has been investigated, in terms of face validity and reliability among judges, by calculating the intraclass coefficients Correlation, based on videotaped interviews of oncology visits from the Milan San Paolo Hospital video recordings Archive. RESULTS: The assessment tool has had positive findings for the purposes of intra-judges reliability (ICC=4.73; sd mean=80,33) and face validity. CONCLUSIONS: The consistency of the italian version with the original makes it suitable to highlight the frequency and variety of clinician defenses. This is the first study on medical oncologists defenses in real interviews. This tool will be useful to the fields of training and research on defenses in clinical care settings treating severe conditions such as oncology.

[Adolescents with cancer: the "Youth Project" at the Istituto Nazionale Tumori in Milan]. / Gli adolescenti ammalati di tumore: il "Progetto Giovani" dell'Istituto Nazionale dei Tumori di Milano.

Adolescents with cancer are a particular group of patients who are less likely to gain access to optimal cancer services at comprehensive cancer Centers: many studies suggest adolescents fare less well than children with the same disease. The paper describes the key issues of the "Youth Project" of the Pediatric Oncology Unit IRCCS Fondazione Istituto Nazionale Tumori in Milan, dedicated to adolescents (over 15 years old) and young adults (up to 25 years old) with solid tumors. This project is a possible clinical and organizational model to address the unique needs of patients in this age group and for bridge the gap in access to care and in recruitment in clinical trials, in clinical and psycho-social management and in curves of healing. The paper also describes the activity of the Adolescent Commission established by the Italian Pediatric Hematology Oncology (AIEOP).

The Youth Project at the Istituto Nazionale Tumori in Milan.

The paper describes the key issues of the Youth Project launched in 2011 at the pediatric oncology unit of the Istituto Nazionale Tumori in Milan dedicated to adolescents (over 15 years old) and young adults (up to 25 years old) with solid tumors. The Youth Project was developed within the pediatric oncology unit in the conviction that adolescent patients may benefit from the multidisciplinary team typical of the pediatric oncology setting, as well as the expertise in treating pediatric-type malignancies and enrolling patients in clinical trials. The project was an offshoot of existing activities, making no major changes to the hospital's organization and posing no major demands on the institution's administration and board. Patients are managed by the pediatric oncology staff, but they have access to particular services (e.g., regarding their psychosocial support, fertility preserving measures, access to care after completing therapy); dedicated, adequately equipped multifunctional rooms have been provided. The location of the pediatric unit within a cancer referral center and the cooperation with divisions dedicated to adults have played an important role in the project's creation.

Psychological assessment of women on an early breast screening program after radiotherapy to the chest wall for childhood cancer.

AIMS AND BACKGROUND: This study investigates the psychological status in a population of female patients who received chest irradiation for a childhood cancer and were screened for second primary breast cancer. METHODS: Sixty-eight consecutive such young women were included. Compilation of the Crown-Crisp Index questionnaire was requested and 49/68 patients accepted to fill it in; 14 women in the sample had children (28%). RESULTS: Twenty-seven of 49 patients achieved a normal score, whereas in 22 the score was slightly above the normal range in at least one scale. Pathological scores were more frequent among the women without children. CONCLUSION: Quality of life in this series of long-term survivors does not seem to be severely affected by previous treatment for cancer nor by the concern for the onset of a second primary malignancy.