Towards an integrated model of defense in gynecological cancer. Psychoneuroimmunological and psychological factors, between risk and protection in cancer: A review

Current cancer conceptualization and management focuses it as a chronic disease that could be directly modulated by psychosocial stressors. An individual is considered a cancer survivor from the time of diagnosis and from the balance of his or her life, including health, mental states, identity, sexuality and financial standings. Moving within the theoretical frames of Psychooncology and Psychoneuroimmunology (PNI), this review aims to analyze, in cancer population and in the specific subsample of ovarian cancer, literature regarding PNI pathways as cancer exacerbating factors, PNI pathways promoting cancer survivorship, adaptive psychological variables linked to Quality of Life and specific areas of psychological pain. Scientific books and full-text articles published in English between 20032013were collected. Evidences were collected of the key role of the stress activation main secretions on tumorigenesis and tumor progression, highlighting the role of life events coping. Evidences of the protective role of Parasympathetic Nervous System activation, expressed through the Heart Rate Variability in cancer survivorship and quality of life were also collected. Were detected the main psychological issues in cancer and specific critical psychological sufferance for Ovarian Cancer (sexual impairments, body image alterations). Was also identified the protective central role of Social Support in cancer adjustment. This literature systematic review seems to give the possibility to hypothesize a new model, here called “Integrated Model of Defense” which, integrating psychological and physiological factors, could suggest a protective mechanism in time and quality of survivorship in cancer and, more specifically, in Gynecological Cancer.