ART THERAPY OF CANCER PATIENTS IN THE CONTEXT OF ONCOLOGICAL REHABILITATION DURING THE COVID 19 PANDEMIC AND THE WAR IN UKRAINE

Y.V. Dumanskiy¹, O.V. Bondar², A.I. Rybin², O.V. Kuznetsova²

¹ R.E. Kavetsky Institute of Experimental Pathology, Oncology and Radiobiology, Kyiv,

²Odesa National Medical University, Odesa, Ukraine

DOI: https://doi.org/10.15407/oncology.2023.04.292

After the diagnosis is made, a cancer patient goes through a long period of acceptance and awareness, which certainly leaves an imprint on his psycho-emotional state. And the emergence of another unexpected negative factor, like war in Ukraine and the COVID19 pandemic, multiplies the degree of depression, panic, despair, denial of the fact of the disease, and sometimes refusal of treatment. Aim: to assess the effectiveness of art therapy in complex antitumor treatment in patients with locally advanced or metastatic HER2-negative hormone-dependent breast cancer (HDBC), stimulation of patients’ skills for unlimited creativity, an emotional outburst of negative energy. Object and methods: 125 patients with HDBC: 87 patients (69.6%) – metastatic cancer (of which, skeletal bone lesions – 59 (67.8%), lungs – 20 (22.9%), orbit – 1 (1.1%), liver – 2 (5.9%), ovaries – 2 (2.3%), peritoneal carcinoma – 4 (4.6%), ascites – 2 (2.3%)). 38 (30.4%) patients have locally advanced cancer. The patients studied the effectiveness of anticancer therapy: letrozole 2.5 mg per day daily + palbociclib 125 mg per day from 1 to 21 days daily against the background of art therapy (pictures “by numbers”). Patients independently chose drawings, colors, images, canvas sizes, and timeframes for completing the work, as well as pronounced their choice. Results:  complex antitumor treatment (letrozole + palbociclib) against the background of art therapy made it possible to achieve an objective effect in 112 patients: 44 (35.2%) – CR (complete answer), 52 patients (41.6%) – PR answer), 17 patients (13.6%) – SD (stabilization of the process), progression of the process was registered in 12 patients (9.6%). Comparative analysis has shown that 74 (59.2%) chose drawings of flowers, 19 (15.2%) – landscapes, 10 (8.0%) – animals and 20 (16.0%) – others. The majority of patients (61.6%) chose a drawing in dark colors as their first work, and the subsequent ones were done with bright colors, which indicates an improvement in the psycho-emotional status, quality of life of patients against the background of art therapy and was associated with the disappearance of despondency and uncontrollable fear.

Keywords: art-therapy, breast cancer, quality of life, COVID-19, war in Ukraine, oncological rehabilitation.

References

1. 1. Bondar OV, Rybin AI, Kuznetsova OV. Interactive training of future doctors during the war. Іn: Modern Trends and Prospects for Development of Higher Medical (Pharmaceutical) Education in Ukraine, 2023: 29–32. (in Ukrainian)
2. www.cdc.gov/coronavirus/2019-ncov/specific-groups/high-risk-complications.html
3. Simcock R, Thomas TV, Estes, et al. COVID-19: Global radiation oncology’s targeted response for pandemic preparedness. Clin Transl Radiat Oncol 2020; 22 :55–68. doi: 10.1016/j.ctro.2020.03.009.
4. You B, Ravaud A, Canivet A, et al. The official French guidelines to protect patients with cancer against SARS-CoV-2 infection. Lancet Oncol 2020; 21 (5): 619–21. doi: https://doi.org/10.1016/S1470-2045(20)30204-7.
5. Liang W, Guan W, Chen R, et al. Cancer patients in SARS-CoV-2 infection: a nationwide analysis in China. Lancet Oncol 2020; 21 (3): 335–7.
6. Valuysʹka A. Istoriya i vydy art-terapiyi. Classes with teachers. Psykholoh 2012; (13–14): 66–7. (in Ukrainian)
7. Voznesensʹka O. Shlyakhom art-terapiyi u poshuku natkhnennya. Psykholoh 2011; (17): 3–5 (in Ukrainian)
8. Coles CE, Aristei C, Bliss J, et al. International Guidelines on Radiation Therapy for Breast Cancer During the COVID-19 Pandemic. Clin Oncol (R Coll Radiol) 2020; 32 (5): 279–81. doi: 10.1016/j.clon.2020.03.006.
9. www.asco.org/asco-coronavirus-information/care-individuals-cancer-during-covid-19
10. Andreychyn SR. Systema vprovadzhennya art-metodiv u roboti praktychnoho psykholoha. Praktychna psykholohiya ta sotsialʹna robota 2009; 5: 13-18. (in Ukrainian)
11. Tararina O. Art-terapiya – dzherelo natkhnennya i samorehulyatsiyi. Psykholoh 2012; (13–14): 4. (in Ukrainian)
12. Shenikhova ZH. Farby i manka v art-terapevtychniy roboti. Psykholoh 2012; (13–14): 107–109. (in Ukrainian)