Well-being Of Breast Cancer Patients Research Articles

The role of resilience and coping strategies as predictors of well-being in breast cancer patients

PurposeThis study investigated the role of resilience and coping strategies on breast cancer patients´ well-being using a structural equation model. To achieve this objective, a model previously developed by Mayordomo´s group was partially replicated using a longitudinal study design in an oncological sample. MethodPatients with breast cancer were recruited (N=166). Resilience was measured with the Mexican Resilience Measurement Scale, coping strategies with the Forms of Coping and Dimensions Scale and perception of the psychological well-being with a short-form of Ryff’s Scales of Psychological Well-Being at the start and end of adjuvant chemotherapy (T1 and T2 respectively). ResultsThe results showed stability in the variables over time and revealed differences with respect to Mayordomo´s model. The best predictor of well-being at T2 was well-being at T1. In addition, the model indicated that resilience had a direct impact on well-being through problem-focused coping. Indeed, resilience and problem-focused coping best explained well-being at T2. ConclusionsBoth at the start and end of adjuvant chemotherapy for breast cancer, problem-focused coping positively predicted resilience, which in turn was a positive predictor of well-being. On the other hand, emotion-focused coping showed no association with resilience or well-being. As part of the multidisciplinary cancer team, oncology nurses have a key role to play in promoting resilience and problem-focused coping as an important goal of psychosocial interventions in breast cancer patients.

Factors Affecting Fatigue in Breast Cancer Patients Undergoing Radiotherapy

Purpose: The aim of this study was to investigate the effects of nutrition risk, physical activity, insomnia, anxiety, and depression on fatigue among breast cancer patients undergoing radiotherapy.Methods: The participants of this study were 160 breast cancer patients at Yeungnam University Medical Center in South Korea. The data were collected from September to November 2022 and analyzed using descriptive statistics, the t-test, analysis of variance, the Mann-Whitney test, the Kruskal-Wallis test, the Bonferroni correction, Pearson correlation coefficients, and multiple regression with SPSS version 28.0.Results: The mean fatigue score was 18.44±7.30 points, while the scores for nutrition risk, insomnia, anxiety, and depression were 2.03±1.52, 5.43±4.79, 6.79±2.81, and 8.17±3.36 points, respectively. Physical activity was measured at 1366.49±1617.87 METs. The general characteristics of the participants showed significant differences in fatigue concerning pain (F=13.97, <i>p</i>=.001), duration of illness (t=-2.37, <i>p</i>=.019), and total radiation dose (t=-2.13, <i>p</i>=.035). Fatigue exhibited significant positive correlations with nutrition risk (r=.35, <i>p</i><.001), insomnia (r=.35, <i>p</i><.001), and anxiety (r=.35, <i>p</i><.001), and a significant negative correlation with physical activity (r=-.20, <i>p</i>=.012). In multiple regression analysis, the factors influencing fatigue were identified as nutrition risk (β=.28, <i>p</i><.001), duration of illness (β=.19, <i>p</i>=.005), depression (β=.23, <i>p</i>=.006), total radiation dose (β=.19, <i>p</i>=.005), and physical activity (β=-.14, <i>p</i>=.036).Conclusion: This study highlights the importance of addressing nutrition risk and depression in breast cancer patients undergoing radiotherapy. Encouraging physical activity may also play a crucial role in managing fatigue in these patients. These findings could guide the development of targeted interventions to improve the well-being of breast cancer patients during radiotherapy.

An Integrated Care Approach to Improve Well-Being in Breast Cancer Patients.

Breast cancer (BC) treatment has recently been revolutionized by the introduction of newer targeted agents, that helped tailoring therapies around the single patient. Along with increased survival rates, a careful evaluation of diet, lifestyle habits, physical activity, emotional and psychological experiences linked to the treatment journey, is now mandatory. However, a true proposal for an omnicomprehensive and "integrative" approach is still lacking in literature. A scientific board of internationally recognized specialists throughout different disciplines designed a shared proposal of holistic approach for BC patients. A narrative review, containing information on BC treatment, endocrinological and diet aspects, physical activity, rehabilitation, integrative medicine, and digital narrative medicine, was developed. In the context of a patient-centered care, BC treatment cannot be separated from a patient's long-term follow-up and care, and an organized interdisciplinary collaboration is the future in this disease's cure, to make sure that our patients will live longer and better. NCT05893368: New Model for Integrating Person-based Care (PbC) in the Treatment of Advanced HER2-negative Breast Cancer (PERGIQUAL). Registration date: 29th May 2023.

Tele-Health Psychological Interventions in Breast Cancer at the Time of Coronavirus: A Narrative Review

Introduction: During the recent pandemic-related health emergency of COVID-19, the health system care has undergone several substantial and sudden changes to benefit the populations of patients affected by COVID-19 delaying the diagnosis and treatment of all other patients. One of the most vulnerable populations during this period was the oncological population. The use of telemedicine has become necessary to compensate for all this by forging medical and psychological support at a distance.
 Objectives: The purpose of this narrative review is to offer an overview of the literature on present scientific papers regarding tele-health psychological interventions aimed at breast cancer patients during the pandemic period of COVID-19 and discussing the reported effects.
 Methods: This narrative review has been realized through a revision of the scientific literature conducted from August to October 2023 using the following electronic databases: “PubMed”, “Science Direct” and “Google Scholar” typing keywords related to the pandemic period, breast cancer population and telehealth psychological interventions. For the evaluation of the effects of the interventions, the statistical indices of p-value and effect size measures were considered.
 Results: Online mindfulness-based interventions have been found to be significant in reducing anxiety, depression and sleep problems, and in improving self-perception of body image, quality of life, and self-efficacy. No significant results are detected in the reduction of depression symptoms and stress levels between groups.
 Discussions: Very limited studies investigated the topic. Further research is needed to better understand the efficacy of telepsychology during the pandemic period and deepen research in terms of other therapeutic approaches and other methods of treatment delivery. In addition, interventions based on a systemic approach, that involve both health care workers and caregivers, can be more effective for the overall well-being of breast cancer patients.

Memory Impairments and Wellbeing in Breast Cancer Patients: A Systematic Review.

Breast cancer is one of the most diagnosed cancers among women. Its effects on the cognitive and wellbeing domains have been widely reported in the literature, although with inconsistent results. The central goal of this review was to identify, in women with breast cancer, the main memory impairments, as measured by objective and subjective tools and their relationship with wellbeing outcomes. The systematic literature search was conducted in the PubMed, Scopus, and ProQuest databases. The selected studies included 9 longitudinal and 10 cross-sectional studies. Although some studies included participants undergoing multimodal cancer therapies, most focused on chemotherapy's effects (57.89%; n = 11). The pattern of results was mixed. However, studies suggested more consistently working memory deficits in breast cancer patients undergoing chemotherapy. In addition, some associations have been identified between objective memory outcomes (verbal memory) and wellbeing indicators, particularly depression and anxiety. The inconsistencies in the results could be justified by the heterogeneity of the research designs, objective and subjective measures, and sample characteristics. This review confirms that more empirical evidence is needed to understand memory impairments in women with breast cancer. An effort to increase the homogeneity of study methods should be made in future studies.

Predicting Role of Social Support and Coping in Physical Well-Being of Breast Cancer Patients in Punjab, Pakistan

Predicting Role of Social Support and Coping in Physical Well-Being of Breast Cancer Patients in Punjab, Pakistan

Empowerment-Based Palliative Care to Improve Psychological Well Being and Quality of Life in Women with Breast Cancer

Patients with breast cancer at the terminal stage often experience a decrease in quality of life and problems in psychological well-being. Management of patients with terminal illnesses requires end-of-life care, which is comprehensive care for chronic diseases that are nearing death, which involves multidisciplinary collaboration of health workers with the main focus of care being a peaceful death. The aim of this research is to develop empowerment-based palliative care to improve psychological wellbeing and quality of life of breast cancer patients. Explanatory research with a cross sectional approach to develop a model. The sample of this study were 125 breast cancer patients. The variables in this study consisted of self- management, delivery systems, decision support, clinical information, community resources, palliative care, empowerment, quality of life and spiritual wellbeing which were measured using a modified questionnaire whose validity and reliability were measured. The data were then analyzed using Smart PLS and used in formulating strategic issues for focus group discussions and expert consultations. The output of this study was an empowerment-based palliative care module on the quality of life and psychological well-being of breast cancer patients as well as scientific publications in the Scopus International journal, a module that already prepared will be arranged in the ISBN and Intellectual Property Rights

P2E1-12 To support Well-being of Breast Cancer Patients

P2E1-12 To support Well-being of Breast Cancer Patients

Avatar-Based Strategies for Breast Cancer Patients: A Systematic Review.

There is a lack of studies to determine if avatar-based protocols could be considered an efficient and accurate strategy to improve psychological well-being in oncology patients, even though it represents a growing field of research. To the best of our knowledge, this is the first systematic review addressing the effectiveness of avatar-based treatments to enhance quality of life (QoL) and psychological well-being in breast cancer patients. The purpose of this study was to review the scientific literature of those studies involving avatar-based technology and breast cancer patients in order to answer the following questions. (1) Are avatar-based strategies useful to im-prove QoL and psychological well-being (anxiety and depression symptoms) in breast cancer patients? (2) Which is the best way to develop avatar-based protocols for breast cancer patients? We conducted a systematic review of the peer-reviewed literature from EBSCO, Ovid, PubMed, Scopus, and Web of Science (WOS), following the PRISMA statements and using "avatar + breast cancer" or "avatar + cancer" as keywords. Studies which were published in either English or Spanish and which addressed QoL and psychological well-being in breast cancer patients were reviewed. The results will contribute to developing innovative avatar-based strategies focused on breast cancer patients.

Evaluating the ability of an artificial-intelligence cloud-based platform designed to provide information prior to locoregional therapy for breast cancer in improving patient's satisfaction with therapy: The CINDERELLA trial.

Breast cancer therapy improved significantly, allowing for different surgical approaches for the same disease stage, therefore offering patients different aesthetic outcomes with similar locoregional control. The purpose of the CINDERELLA trial is to evaluate an artificial-intelligence (AI) cloud-based platform (CINDERELLA platform) vs the standard approach for patient education prior to therapy. A prospective randomized international multicentre trial comparing two methods for patient education prior to therapy. After institutional ethics approval and a written informed consent, patients planned for locoregional treatment will be randomized to the intervention (CINDERELLA platform) or controls. The patients in the intervention arm will use the newly designed web-application (CINDERELLA platform, CINDERELLA APProach) to access the information related to surgery and/or radiotherapy. Using an AI system, the platform will provide the patient with a picture of her own aesthetic outcome resulting from the surgical procedure she chooses, and an objective evaluation of this aesthetic outcome (e.g., good/fair). The control group will have access to the standard approach. The primary objectives of the trial will be i) to examine the differences between the treatment arms with regards to patients' pre-treatment expectations and the final aesthetic outcomes and ii) in the experimental arm only, the agreement of the pre-treatment AI-evaluation (output) and patient's post-therapy self-evaluation. The project aims to develop an easy-to-use cost-effective AI-powered tool that improves shared decision-making processes. We assume that the CINDERELLA APProach will lead to higher satisfaction, better psychosocial status, and wellbeing of breast cancer patients, and reduce the need for additional surgeries to improve aesthetic outcome.

Effect of mindfulness-based therapy on spiritual well-being in breast cancer patients: a randomized controlled study.

Spiritual well-being is directly related to the quality of life in breast cancer patients. Mindfulness-based therapy interventions can decrease distress levels in women with breast cancer, while improving spiritual well-being. To investigate the effect of mindfulness-based therapy on spiritual well-being in breast cancer patients. This randomized controlled clinical trial was conducted in accordance with the Consolidated Standards of Reporting Trials. A total of 70 participants were enrolled from September, 2021 to July, 2022. Primary outcome included spiritual well-being, and secondary outcome included quality of life. The data were collected using the Patient Sociodemographic and Medical Data Form and Functional Assessment of Chronic Illness Therapy-Spiritual Well-Being (SpWB) (FACIT-Sp Version 4). In the statistical analysis, the independent sample t test and paired sample t test were used to examine the intervention effect on primary and secondary outcomes, according to numbers, percentage, mean, standard deviation, and conformity to normal distribution. The average age of the therapy group was 42.22 ± 6.86, and the control group was 41.64 ± 6.04. The average score of meaning (12.25 ± 3.03), overall score average of the spiritual well-being (31.56 ± 8.90), the emotional well-being (13.46 ± 5.78) and physical well-being (16.71 ± 5.59), and overall average score of the quality of life (66.98 ± 17.72) of the therapy group was statistically significantly higher (p < 0.05). The mindfulness-based training may enhance the spiritual well-being and quality of life of breast cancer patients. Nurses should be encouraged for mindfulness-based training sessions to make it a widespread practice, and to regularly evaluate the results. NCT05057078 (date: September 27, 2021).

Chemotherapy Induced Alopecia Distress, Body Image and Psychosocial Wellbeing among Breast Cancer Patients: The Moderating Role of Locus of Control

To explore the relationship of chemotherapy induced distress with body image and psychological wellbeing, this study was proposed considering locus of control as a moderating variable among breast cancer patients. This study was a cross-sectional research. A convenient Sample of 80 breast cancer patients were selected from different hospitals of Islamabad and Rawalpindi. Chemotherapy Induced Alopecia Distress Scale (CADS), Body Image Scale (BR23), Psychosocial Well-being Scale (EORTC QLQ C30), and Health Locus of Control Scale (HLCS) were used to find the relationship between study variables. The study found a significant association between chemotherapy-induced alopecia, body image, and psychosocial well-being in breast cancer patients. The moderating role of Locus of Control was found to be insignificant between chemotherapy induced alopecia distress, body image, and psychosocial well-being. The results of present research study highlighted the negative effect of hair loss on dissatisfaction of body image and wellbeing of psychological and social factors, emphasizing the need for comprehensive psychosocial support for these patients. The study also underscores the importance of considering individuals' locus of control when designing interventions to mitigate the psychosocial effects of hair loss.

Attachment and general well-being in breast cancer patients: Mediation of body esteem and social support

This study aimed to explore the mediation of body esteem and social support in the relationship between attachment and general well-being in breast cancer patients. We collected data from 150 women with breast cancer and 150 healthy women. Employing bootstrap analysis with 5 000 samples using the ordinary least squares regression, we found that higher attachment avoidance was significantly associated with lower general well-being in both the breast cancer patients and healthy comparison peers. Also, body esteem and social support were significantly associated with attachment anxiety and attachment avoidance and general well-being. Furthermore, body esteem significantly mediated the relationship between attachment avoidance and well-being in breast cancer patients directly through social support; while social support significantly mediated the relationship between attachment anxiety and attachment avoidance and well-being in breast cancer women directly by body esteem. Therefore, body esteem and social support played a chain intermediary role between attachment avoidance and well-being. These findings suggest a need for breast cancer support programmes for women to enhance their body esteem and sense of social support in the context of their recovery efforts.

PC41. Sexual Well-being in Patients with Breast Cancer Surgery: Trends, Associated Factors, and Interventions

PURPOSE: Sexual well-being is the third most common concern reported by breast cancer patients, but often overlooked in postoperative survivorship. This study aims to understand sexual well-being in breast cancer patients, including the trend, associated factors, and interventions. METHODS: We analyzed patients who underwent post-mastectomy breast reconstruction or lumpectomy and completed the BREAST-Q sexual well-being module between 2010 and 2021. We compared sexual well-being in reconstruction and lumpectomy patients over time, delineated associated factors, and evaluated the incidence and impact of sexual medicine consultation. RESULTS: 16,061 lumpectomy and breast reconstruction patients were included. Reconstruction patients had consistently lower sexual well-being than lumpectomy patients, from preoperative to 5-year follow-up (p<0.001). In reconstruction, factors associated with lower sexual well-being at 1-year included separated/single marital status, higher BMI, postmenopausal status, and psychiatric disorders (p<0.05). Patients with more advanced cancer, axillary dissection, and skin-sparing mastectomy (vs. nipple-sparing) had lower sexual well-being. Overall, 5.5% of reconstruction patients received a sexual medicine consultation. Patients who received the consultation were younger, from lower income bracket, underwent lymph node dissection, and had lower preoperative scores than those without consultation (p<0.05). BREAST-Q scores improved from 36.4±21.5 to 41.3±19.5 (p=0.004) following intervention. CONCLUSION: Decreased sexual well-being is imperative to consider in breast reconstruction patients, particularly among those who are separated/single or have psychiatric disorders and advanced cancer. Only a small fraction of patients receives sexual medicine consultation, yet such intervention improves patients’ sexual health. Providers should assess sexual well-being in breast reconstruction and refer for sexual medicine consultations when appropriate.

A Hypofractionated Radiotherapy Schedule with a Simultaneous Integrated Boost for Breast Cancer: Outcomes including Late Toxicity and Health Quality.

Introduction: This study aimed to evaluate the long-term adverse effects on the physical appearance and overall well-being of breast cancer patients who receive hypofractionated radiotherapy as whole breast and simultaneous integrated boost (SIB) treatment, utilizing intensive modulated radiotherapy (IMRT), volumetric modulated arc therapy (VMAT), or a hybrid therapy approach. Material/Methods: This investigation involved administering hypofractionated SIB-VMAT therapy to individuals diagnosed with early-stage breast cancer. Treatment was carried out over a three-week period in which a total dose of 48.06 Gy was given to the entire breast and 54 Gy was given to the tumor bed. Data on skin toxicity and cosmetic outcomes were analyzed both during the acute phase and during the three-month and five-year follow-up periods after treatment. Results: A total of 125 patients treated between December 2014 and December 2016 were included in the study. The data of these patients with at least 5 years of follow-up were analyzed. Conclusions: Considering these long-term results, hypofractionated SIB-VMAT can be considered a viable treatment choice, even for patients with unfavorable conditions.

Spiritual well-being in breast cancer patients

Introduction: Breast cancer patients frequently experience spiritual discomfort due to the disease, its diagnosis, and its repercussions. When end-of-life patients’ spiritual needs are not adequately served, they are forced to deal with an overall burden of daily distress and anxiety that affects their emotional and spiritual health. Several studies indicate that, when coping with cancer, people frequently turn to spirituality. Spirituality and religiosity have been associated with less depressive symptoms, enhancing well-being throughout cancer treatment and in cancer survivors. This study sought to characterize the spiritual health of breast cancer patients (religious well-being and existential well-being).Methods: A descriptive observational study design was used, and the population of this research was breast cancer patients at the public hospital. The sample total of this research was 104 respondents. The samples were chosen using non-probability sampling with a purposive sampling technique. Spiritual well-being as a variable was measured using the spiritual well-being scale. Data were then analyzed for categorization into less, enough, and good, expressed in frequencies and percentages. Results: The result of this research shows that good religious well-being with a total of 63 (60,6%) and existential well-being enough with a total of 56 (53,8%).Conclusions: This study demonstrates the responder’s good existential and religious well-being categories. Palliative care can be added to medical therapies and programs to promote spiritual well-being, such as spiritual counseling, meditation, and dhikr therapy, which can be helpful for patients with breast cancer.Keywords: breast cancer; existential well-being; religious well-being; spiritual well-being

Abstract P5-08-08: Ultrasound-guided injection with or without rehabilitation exercise in breast cancer survivors with sub-acromion-deltoid bursitis: a pilot randomized clinical study

Abstract BACKGROUND: Due to the increasing overall survival of breast cancer (BC) patients, a growing interest has been raised in the current literature on disabling consequences of cancer and its treatment [1,2]. In particular, after radical surgery for BC, patients might frequently be affected by functional limitation of the shoulder joint, potentially related to the immobilization, surgical scar tensions, axillary web syndrome, subpectoral prostheses or expanders, or peripheral nerve damage [3]. In this scenario, several challenges are still open in the therapeutic approach to this disabling condition and the optimal management of shoulder dysfunction in breast cancer patients is far from being fully characterized. Therefore, the aim of this study was to assess the effects of a comprehensive rehabilitation program including ultrasound-guided injection of the sub-acromion deltoid bursa (SAD) followed by a rehabilitation exercise protocol in terms of feasibility, pain relief, upper limb function, quality of life, and safety. METHODS: In this study, we recruited consecutive breast cancer women referring to a Physical Medicine and Rehabilitation in Northern Italy and suffering from SAD bursitis in the absence of tendon lesions. Patients were assessed for eligibility and subsequently randomly assigned 1:1 to two groups. Group A received ultrasound-guided percutaneous injection of the SAD bursa (lidocaine and triamcinolone acetate) followed by a rehabilitation exercise program of 5 sessions lasting 1 hour each., while Group B received ultrasound-guided percutaneous injection only. Patients were assessed at baseline (T0), after a week (T1), and after 3 months (T2). The outcomes were numerical pain rating scale (NPRS), handgrip strength (HGS) test, European Organization for Research and Treatment of Cancer Quality of Life Questionnaire (EORTC QLQ-C30), the Oxford Shoulder Score (OSS), Global Perceived Effect (GPE), and safety. RESULTS: Thirty-seven patients were enrolled and randomly assigned to Group A (n=19; mean age: 56.05 ± 10.30 years; body mass index (BMI): 23.58 ± 2.79 kg/m2) and Group B (n=18; mean age: 58.39 ± 12.09 years; BMI: 22.72 ± 3.16 kg/m2). No major or minor adverse events were reported after this multidisciplinary intervention. Statistically significant within-group differences were found in both groups in terms of NPRS after the treatment (p &amp;lt; 0.05) and after the follow-up (p &amp;lt; 0.05). The between-group analysis showed significant differences in pain intensity (NRS: 2.16 ± 1.39 vs 4.78 1.77; p &amp;lt; 0.05), isometric muscle strength (25.11 3.20 vs 20.33 4.92; p&amp;lt; 0.001), shoulder function (OSS: 17.00 3.27 vs 33.11 6.471; p&amp;lt; 0.0001), and EORTC QLQ-C30 (Functional subscale: 88.74 7.71 vs 77.67 13.64; p=0.017; Symptom subscale: 11.43 8.56 vs 19.61 13.72; p=0.048; Global Health subscale: 79.36 13.72 vs 70.56 8.26; p=0.022) of the after the follow-up. However, no significant differences (p &amp;gt; 0.05) were reported at T1. CONCLUSION: Our findings showed that a comprehensive rehabilitation approach including ultrasound-guided injection combined with rehabilitation exercise might be safe, well-tolerated, and effective in breast cancer patients with SAD bursitis. These data emphasized the positive role of an interdisciplinary rehabilitation management in pain management and improving overall well-being of breast cancer patients. Further studies with larger samples and longer follow-ups are needed to confirm our data. REFERENCES: 1. Nardin S et al. Breast Cancer Survivorship, Quality of Life, and Late Toxicities. Front Oncol 2020, 10, 864. 2. D’Egidio V et al. Counseling interventions delivered in women with breast cancer to improve health-related quality of life: a systematic review. Qual Life Res 2017, 26, 2573-2592, doi:10.1007/s11136-017-1613-6. 3. Hidding JT et al. Treatment related impairments in arm and shoulder in patients with breast cancer: a systematic review. PLoS One. 2014 May 9;9(5):e96748. Citation Format: Lorenzo Lippi, Alessandro de Sire, Arianna Folli, Francesco D’Abrosca, Alessio Turco, Giuseppina Bonizzi, Nicola Fusco, Marco Invernizzi. Ultrasound-guided injection with or without rehabilitation exercise in breast cancer survivors with sub-acromion-deltoid bursitis: a pilot randomized clinical study [abstract]. In: Proceedings of the 2022 San Antonio Breast Cancer Symposium; 2022 Dec 6-10; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2023;83(5 Suppl):Abstract nr P5-08-08.

Preclinical Effects Of Melatonin On The Development Of Ehrlich's Tumor: A Biochemical, Cognitive, And Molecular Approach.

It has already been shown that melatonin is an antitumoral molecule that affects malignant cells via some mechanisms. The benefit played by this hormone on cancer is due to its antioxidant effects. This study aimed to evaluate the preclinical effects of melatonin in mice with the Ehrlich ascites tumor. Twenty Balb/ c male mice with Ehrlich tumor were treated with different melatonin doses. Their inflammatory and oxidative stress were accessed by gene expression. Hepatotoxicity and hematological parameters were also evaluated through biochemical analyses. Animal welfare was analysed weekly from the categories guided by the NC3Rs. Gene expression analyses have shown that only Tnfα and Sod1 were expressed in all groups studied. Only the M-3 group showed increased Tnfα expression compared to the control. All groups treated with melatonin showed decreased Sod1 expression compared to the control. No signs of hepatotoxicity were caused by any of the melatonin doses used in the treatment. In animals with Ehrlich´s tumor treated with melatonin, a decrease in oxidative stress, an amelioration in welfare and in cognitive tasks could be observed, even if the treatment has not reduced the size of the tumor itself. In parallel with the already patented use of melatonin in the treatment of sleep disorders or chronic kidney disease, our results propose its use to improve the general well-being of breast cancer patients.

Use of Telemedicine to Improve Cognitive Functions and Psychological Well-Being in Patients with Breast Cancer: A Systematic Review of the Current Literature.

The diagnosis and side effects of breast cancer (BC) treatments greatly affect the everyday lives of women suffering from this disease, with relevant psychological and cognitive consequences. Several studies have reported the psychological effects of receiving a diagnosis of BC. Moreover, women undergoing anticancer therapies may exhibit cognitive impairment as a side effect of the treatments. The access to cognitive rehabilitation and psychological treatment for these patients is often limited by resources; women of childbearing age often encounter difficulties in completing rehabilitation programs requiring access to care institutions. Telemedicine, which provides health services using information and communication technologies, is a useful tool to overcome these limitations. In particular, telemedicine may represent an optimal way to guarantee cognitive rehabilitation, psychological support, and recovery to BC patients. Previous studies have reviewed the use of telemedicine to improve psychological well-being in BC patients, and a few have investigated the effect of telerehabilitation on cognitive deficits. This study systematically reviewed the evidence on the cognitive and psychological effects of telemedicine in BC patients. Current evidence suggests that telemedicine may represent a promising tool for the management of some psychological problems experienced by breast cancer patients, but more controlled studies are needed to clarify its effectiveness, especially for cognitive deficits. The results are also discussed in light of the intervening and modulating factors that may mediate both side effect occurrence and the success of the interventions.

The Effect of Vinyasa Yoga Practice on the Well-Being of Breast-Cancer Patients during COVID-19 Pandemic.

Vinyasa yoga practice improves body fitness and potentially positively affects practitioners' well-being and health. Due to the diverse intensity of practice and positions customized to the practitioner's needs, it can also support cancer patients. Undertaking physical activity that has a potentially positive effect on well-being and health was particularly important during the self-isolation that followed the COVID-19 pandemic. The purpose of this study was to evaluate the impact of three-month mild and moderate intensity vinyasa yoga practice on breast-cancer patients' stress perception, self-confidence, and sleep quality during COVID-19 induced self-isolation. Female breast-cancer patients participated in twelve-weeks of online vinyasa practice during the COVID-19 induced self-isolation period. Meetings were held once a week, where 60-min vinyasa yoga sequences were followed by 15 min of relaxation. Patients completed pre- and post-intervention surveys to evaluate changes in the following outcomes: stress perception, self-confidence, and sleep quality. Forty-one female patients enrolled in the Vinyasa course completed the pre-intervention survey, while 13 attended all the meetings and completed the post-intervention survey. The effect of the twelve-week yoga and relaxation practice significantly reduced sleep problems and stress of oncological patients. The participants also declared an improvement in their general well-being and self-acceptance. Dynamic forms of yoga combined with mindfulness techniques can be applied to patients treated for oncological diseases. It contributes to improving their well-being. However, in-depth studies are needed to analyze the complexity of this effect.