When patients are admitted to the hospital (whether as an in or out-patient), they are asked to fill in a self-evaluation form, which focuses on their emotional state. In non-functional emotional reactions, an interview with a psychologist is recommended. This is a time for in-depth awareness enabling them to shed light on their own reactions and needs. During the interview, the opportunity is explored to embark upon a process of psychological support. Support to the couple and to the family is also offered.

Counseling / The psychological support
Counseling with the psycho-oncologist is aimed at people who experience a feeling of emotional distress. The interview helps the patient to come to terms with and understand the normal reactions to stress. During the interview, the patient is assisted in the management of emotional distress and in the process of recovery in order to cope with the disease in an active and positive way.

Individual Psychotherapy
In the presence of specific psychological discomfort or symptoms which damage the patient’s well-being in addition to the physical illness, and which hinder functioning in important areas of life (work, daily activities, relationships between couples and family members), individual psychotherapy helps the patient to learn and understand their condition and to identify ways of thinking and behavior in order to deal effectively with critical situations.
A cognitive process that in addition to promoting greater self-awareness, allows the patient to strengthen self-esteem, rediscover and strengthen their own resources, redefine priorities and facilitate change.

Psychological support to family members
The Psycho-Oncology Unit helps family members deal with the illness of their family member and with the consequences that may ensue in family relationships. This help aims to facilitate adaptation to the disease, in order to improve the quality of life of the members of the whole family.

Couple counseling
Cancer affects not only the patient , but sometimes also adversely affects the relationship with the partner. The purpose of couple counseling is to understand the thoughts and feelings of both partners in order to activate resources that allow the couple to manage the emotional and practical difficulties that arise.

Sexological counseling
The destabilizing impact of a cancer diagnosis, the stress and bodily changes caused by surgical and oncological treatment sometimes radically change the relationship, emotional communication and sexuality with the partner. Sexological counseling is a helping relationship aimed at the individual or the couple, and it aims to offer support to understand physical, psychological and relational difficulties , and to find out a solution to reduce discomfort.

Psychological counseling in the genetic field
Information on the personal risk of developing a tumor often involves a number of changes at a cognitive, emotional and behavioral level. Although the oncological risk does not mean that one currently has a tumor, it is often experienced as an anticipation of the disease. The perception that a woman may have of the invulnerability of her physical state, in fact, collapses, giving way to emotional reactions of insecurity, anxiety and fear that harm physical and mental well-being and change everyday behavior. The cognitive representation corresponding to the thought: "cancer is not there, but it will be” could become pervasive and affect the lifestyle of the woman, her family and social relationships, and her physical and psychological well-being.

The psychological intervention aims to offer support to women to:

• evaluate and understand the information that the doctor has given them regarding their cancer risk.
• understand and manage the emotional consequences that the risk factors involve;
• identify cognitive, emotional and behavioral strategies to manage the awareness of cancer risk;
• communicate any choices to the family.

Relaxation therapy and stress management (Biofeedback, relaxation imagery, conscious breathing)
Cancer treatments often interfere with the quality of life of patients, not only on the physical plane, but also on the psychological plane. The proposed techniques (individual or group) can help the patient to increase their effectiveness in managing emotions and stress, promoting a better adaptation to their treatment pathway and the recovery of their physical and mental wellbeing.

P-medicine
Within the framework of the European project "P-medicine", our research team is working together with the medical oncologists to develop a set of tools designed to improve the doctor-patient interaction via a personalized approach to treatment. Such an approach aims to identify the profile of the individual patient so that the doctor can use a personalized interaction mechanism that will increase the empowerment of the patient, enabling them to feel more involved in the process of care and in treatment decisions.

Effects of adjuvant endocrine therapy on cognitive performance in patients with breast cancer: a longitudinal study
Cancer patients often report memory and concentration difficulties. Several studies have indeed shown the presence of cognitive deficits in these patients, particularly in tasks of working memory, verbal and long-term. It is not entirely known what causes these deficits, but the most likely cause seems to be the chemotherapy treatment, and the endocrine dysfunction and alterations in the metabolism of stress hormones resulting both from the treatment and from the high emotional distress characterizing these patients. Cognitive deficits in patients with breast cancer have been found, unexpectedly, even before the administration of chemotherapy or hormonal treatments, thereby lending support to the hypothesis that psychological distress generated by the diagnosis contributes towards inducing a cognitive malfunction (Berndt et al., 2009). Based on these findings, the present study aims to analyze the possible presence of cognitive deficits, with an emphasis on executive function in a sample of women receiving adjuvant endocrine therapy.

Advantages of using tobacco-free devices in heavy smokers participating in a screening program for lung cancer: a randomized study
The aim of the experimental protocol is to analyze the role that electronic cigarettes can play in helping smokers to increase their well-being, reducing the harmful effects of traditional cigarette. Smoking cigarettes with tobacco, in fact, not only increases the risk of developing lung cancer, but also has negative effects on the health of the lungs, increasing the presence of cough, phlegm and other respiratory problems. Furthermore, the smoke is correlated with a wide range of cardiovascular and respiratory diseases and other cancers. Consequently, helping heavy smokers reduce the number of smoked cigarettes is an important goal that allows both the reduction of risk of serious diseases, and the enhancement of a general improvement in the quality of life.

Impact of the intervention system and adherence to long-term care of the patient
Even in a major disease such as cancer, in which suspending treatment puts lives at risk, some individuals decide to cease treatment or screening checks. A study on the evaluation of adherence to hormonal treatment with aromatase inhibitors has shown for example that, one year after the beginning of treatment, 23% of patients are no longer adhering to treatment. In order to improve the understanding and management of patient adherence a research protocol has been developed, whereby we can highlight what features of personality, cognitive, decision-making and beliefs induce patients with breast cancer not to adhere to the prescriptions, whether pharmacological or follow-up. A better understanding of the phenomenon will allow strategies of patient empowerment to be developed, which in the final analysis, will translate into an increase in positive outcomes.

Breast reconstruction. Preferences and needs of patients and satisfaction of long-term choices
Mastectomy has consequences not only on the physical domain, but also on the psychological, social and relational domain, with a negative impact on the quality of life of women, both personally and socially. Breast reconstruction may offer the possibility to recover a good quality of life. But while there are few women who choose not to do the reconstruction, those who opt for reconstruction are faced with the decision-making dilemma "which type of reconstruction". The choice now is between two possible types: a permanent prosthesis, or implants with the woman’s own muscle tissue and/or skin. In this decision-making context, she must examine the benefits and potential risks in the short and long term, including changes in lifestyle (smokers, for example, have a higher risk of complications). The right choice depends not only on the clinical need but also on the needs and expectations of the patient. Within this research protocol, we investigate the factors that influence the perception of the variables involved and the decision-making style of each patient, in order to effectively support them in understanding the information with which they have been provided, the process of managing emotions, the perceived risk and the choice.