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Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Rome, Italy
Interests: breast surgery; integrative oncology; microbiome in cancer (oncobiotic); supportive therapies; complementary treatments; quality of life

Dr. Antonio Franco

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Dear Colleagues,

Breast cancer is, in most cases, a curable disease and not as life-threatening as it was in the past, thanks to early diagnosis and advances in oncological treatments. As a result of the huge prevalence of this disease, together with this improvement in its prognosis, a wider and wider population of breast cancer survivors often face multiple and long-lasting side effects related to anticancer therapies, that could be prevented, alleviated, or cured if properly assessed and managed. In other terms, the outstanding advances in survival have not been matched so far by a comparable commitment to preserving the quality of life of long-term survivors. A new holistic, evidence-based approach is therefore needed, focused on providing cancer patients with the best available oncological treatments alongside person-centered support since the diagnosis of cancer, is based on behaviors (nutrition, physical activity, sleep), psychosocial aspects, and sexual and spiritual issues.

Trying to assess and manage these clinical needs, by integrating mainstream and complementary treatments, will allow breast cancer patients to achieve the goal of complete healing and rehabilitation, in order not just to survive their cancer, but to thrive beyond it.

Dr. Stefano Magno
Dr. Antonio Franco
Guest Editors

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Keywords

quality of life
integrative oncology
side effects
unmet needs
complementary treatments
nutrition in oncology
exercise oncology
sexual issues in cancer patients
oncofertility
acupuncture

Published Papers (2 papers)

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Research

Open AccessArticle

Efficacy of Tango Argentino for Cancer-Associated Fatigue and Quality of Life in Breast Cancer Survivors: A Randomized Controlled Trial

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Cancers 2023, 15(11), 2920; https://doi.org/10.3390/cancers15112920 - 26 May 2023

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Abstract

Background: Persistent impairments of quality of life—in particular, cancer-associated fatigue—are a major limitation for breast cancer survivors. As physical activity and mindfulness interventions have been shown to be effective in reducing fatigue symptoms, we investigated the efficacy of a six-week Argentine tango program. Methods: A randomized controlled trial was conducted with 60 breast cancer survivors diagnosed with stage I-III tumors 12–48 months prior to study enrollment and who had increased symptoms of fatigue. The participants were randomly assigned with a 1:1 allocation to either the tango or the waiting group. The treatment consisted of six weeks of supervised weekly one-hour tango group-sessions. Self-reported fatigue and further quality of life parameters were assessed at baseline and six weeks post-baseline. Longitudinal changes, correlations, Cohen’s D (d) effect sizes, and association factors were also calculated. Results: Superiority of the tango intervention over the waiting list control was found in terms of improvement in fatigue (d = −0.64; 95%CI, −1.2 to −0.08; p = 0.03), especially cognitive fatigue. In addition, a superiority of the tango intervention over the waiting list was found in the improvement of diarrhea (d = −0.69; 95%CI, −1.25 to −0.13; p = 0.02). A pooled pre-post analysis of the 50 participants completing the six-week tango program revealed a close to 10% improvement of fatigue (p = 0.0003), insomnia (p = 0.008) and further quality of life outcomes. Adjusted multivariate linear regression analyses revealed the greatest improvements for participants who were more active in sports. In particular, survivors who received endocrine therapies, were obese, or had no prior dance experience seemed to especially benefit from the tango program. Conclusions: This randomized controlled trial demonstrated that a six-week Argentine tango program improves fatigue in breast cancer survivors. Further trials are warranted to determine whether such improvements lead to better long-term clinical outcomes. Trial registration: trial registration number DRKS00021601. Retrospectively registered on 21 August 2020. Full article

(This article belongs to the Special Issue Breast Cancer Survivors and Supportive Therapies)

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Open AccessArticle

Breast Cancer: How Hippotherapy Bridges the Gap between Healing and Recovery—A Randomized Controlled Clinical Trial

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Cancers 2023, 15(4), 1317; https://doi.org/10.3390/cancers15041317 - 19 Feb 2023

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Abstract

Background: Breast cancer is the most diagnosed women’s cancer, and has a high survival rate. Despite great progress in detection and treatment, life reconstruction requires comprehensive cross-sectoral approaches between different disciplines and deeper consideration of the patient’s challenges. Hippotherapy is an emerging specialized rehabilitation approach, performed by accredited health professionals and equine specialists, on specially trained horses via their movement, activating major paths for physical, mental, psychic and social reinforcement, and is synergistic to rehabilitative and supportive care. Methods: We conducted a randomized open, prospective, two-armed, controlled trial on the effectiveness of hippotherapy versus conventional supportive care on adult women with a diagnosis of breast cancer, after the period of primary treatment (surgery, chemotherapy, radiotherapy). The 6-month program included, in the treated group, an initial 1-week daily hippotherapy session, followed by three short 2-day sessions with an interval of 2 months between each, where the patients received conventional supportive care. The control group received 6 months of conventional supportive care. The primary end point was quality of life. Cognitive performances, fatigue, anxiety, depression, and body image were the secondary end points. Measurements were done through self-reported questionnaires. Results: We observed statistical differences in the evolution of the measured parameters over time between the two groups. The hippotherapy group showed a much faster, favorable and continuous improvement until the end of the program for each function assessed. The most striking improvements were observed in global quality of life, and fatigue, while breast cancer-specific quality of life, cognitive performance, anxiety and depression and body image showed a less marked but still statistically significant difference at the final post-treatment evaluation. Conclusions: We demonstrate the therapeutic relevance of hippotherapy, a one-health approach, as a key initial stage after cancer diagnosis and treatment to foster recovery. Furthermore, hippotherapy has a strong impact on cancer treatments’ efficiency and reconstruction of patient’s life and ecosystem. This work reveals a layer of complexity that needs to be broadly considered. Trial registration: ClincalTrials.gov NCT04350398 accessed on 1 January 2022. Registered 17 April 2020, retrospectively registered; French Clinical Trials in Cancer Register RECF3818. Registered 18 March 2019, retrospectively registered. Full article

(This article belongs to the Special Issue Breast Cancer Survivors and Supportive Therapies)

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