1. The Role of the Psychooncology in
The Multimodality Treatment Team in Oncology
Adina Moraru BSc, MSc., Chiricuta I. C. MD PhD
Amethyst Radiology Therapeutic Center, Bucharest- Otopeni
Omul care moare inainte de a muri
nu moare cand moare
(Abraham Sancta Clara, calugar german din sec XII)
The Multimodality Treatment Team
The place of Psychotherapy in
The Radiotherapy Treatment Chain
Psychologic Concept
Amethyst is the first radiotherapy clinic in Romania to include ­ free of charge ­ the initial session of psychotherapy and therapeutic activities in the support groups for patients and their families. The mission of Amethyst Centre is to ensure that each patient has access to the highest quality medical and psychological services. The Amethyst vision focuses on multidisciplinary activity that integrates the holistic approach to neoplastic patients, providing them with medical oncology, radiotherapy, CT- scan medical imaging, psychotherapy and nutrition services. The start of psychotherapeutic activity consists of enticing the patients' desire to live and engaging them in the act of healing, by making them aware of the need for collaboration.
The progress achieved in oncology and radiotherapy made possible the delivery of an individualized treatment. The therapeutic indication is based on the tumor board decision. At our center we introduced the tumor board from the beginning of our activity in The tumor board evaluates all factors involved in the diagnosis and treatment delivery to cancer patients. Generally the treatment indications are based on the NCCN recommendations. Special attention should be given for advanced stage patients to insure the compliance capacity. The monitoring of the psychological and nutritional status is an important additional measure to make possible the optimal treatment delivery and the improvement of the patients´ compliance.
Psychological care
This paper aims at highlighting how the provision of individual and group psychotherapeutic support and seamless integration of psychology in the concept of multidisciplinarity can help neoplastic patients. Psychotherapy plays an important role in awakening the patients’ hope by making them aware of their own resources and (re)connecting them with these resources, as well as strengthening their will to fight the adversities of life.
Patients´ investigations
The study was conducted on a total of 70 young and adult oncology patients, tracking their progress every week for a year. The breakdown of the first five diagnostics / ICD standard localization is the following:
Lip, oral cavity, pharynx %
Breast %
Respiratory and intrathoracic organs %
Female genitalia %
Eye, brain and other parts of the CNS 8.87%
Laughing Therapy
Psychologic Methods
The mind-body-soul holistic approach, understanding that the human being operates as a single unit and the social context plays a non-negligible role, clinical interview, tests and clinical scales, clinical observation, support groups, breathing exercises, and emotion and pain management exercises, Ericksonian hypnosis and relaxation, forgiveness techniques, neurolinguistics techniques, graphic productions (drawings, diaries, etc.), Frankl’s narrative method (2010), role playing, occupational therapy.
Imaging for Target Delineation
Tumor Board
Support Groups
Self evaluation
Conclusions
Results
Psychological counselling for neoplastic patients is an integral part of the multidisciplinary care team concept. Within this relationship, mutual respect, trust reflected in both poles of the relationship and the psychologist’s empathy are the path towards building a successful collaboration. The patients' own beliefs about the idea of psychotherapy, their attitude, feelings, lifestyle and diet play an important role in the treatment stage. Through a synergistic effect of medical and psychological activities, neoplastic patients discover a new meaning of life and rebuild their lives through a realistic adaptation.
Awakening hope, optimism, interest in life, reconciliation with oneself and with others, finding/retrieving love for themselves and for others, gaining patience, developing a positive self-image, reconciliation with the fear of death, spiritual growth, self-knowledge and communication, developing deeper relationships with oneself and with others, discovering and resolving emotional disturbances that predated the illness.