06 Cross18 Abstract Is01

Liječ Vjesn 2023; godište 145; (Supl.
2) 18th Croatian Student Summit
Abstracts
Invited Speakers
IS01 IS02
Stress and the endocrine system Psycho-oncology: yesterday, today, tomorrow
Assistant Professor Maja Baretić, M.D., PhD Professor Marijana Braš, M.D., PhD
Division of Endocrinology, Department of Internal Center for Palliative Medicine, Medical Ethics and
Medicine, University Hospital Centre Zagreb Communication Skills, School of Medicine, University
School of Medicine, University of Zagreb of Zagreb
DOI: https://doi.org/10.26800/LV-145-supl2-IS01 DOI: https://doi.org/10.26800/LV-145-supl2-IS02
PLENARY
Stress as a state of unbalanced homeostasis, triggered by Modern knowledge about the psychosocial and
intrinsic or extrinsic agents that affect physiologic and psychobiological dimensions of oncological diseases, resulting
behavioral responses aiming to get optimal body balance. from clinical experiences and numerous types of research,
Stress affects all systems of the body, as well as endocrine led to the intensive development of psycho-oncology, which
glands. The main parts of the endocrine system involved in is characterized by a strong integration between several
the response to stress are the hypothalamic-pituitary-adrenal professional disciplines (oncology, psychiatry, psychological
axis and the autonomic nervous system which interact with and social sciences, neuroscience, family medicine, palliative
other parts of the central nervous system and peripheral medicine, etc.). Psychosocial aspects of oncological diseases
organs. The catecholamine hormones epinephrine and have attracted a lot of attention during the last few decades
norepinephrine reacted rapidly to stress being secreted from due to the high prevalence and mortality of oncological
the adrenal medulla. They have numerous effects on behaviour, diseases, but also because of the development of psycho-
metabolism, and the cardiovascular system and their response neuro-endocrine-immunology and novel insights about the
is commonly termed the fight-or-flight-or-freeze response. The interconnectedness of soul and body in the whole of medicine.
glucocorticoid hormones are released from the adrenal cortex In this presentation, the historical development of psycho-
interacting with intracellular receptors and initiating gene oncology will be shortly discussed, do llowed by a review
transcription. It means that glucocorticoids have a delayed, but of the current state of psycho-oncology in the world and
more sustained effect than catecholamines. The glucocorticoids in the Republic of Croatia. Special emphasis will be
orchestrate a wide array of responses to the stressor. They have placed on the clinical presentations of the most common
direct effects on behavior, metabolism and energy exchange, psychiatric disorders in oncology and the discussion
reproduction, growth, and the immune system. Stress can also of individual therapeutic interventions (psychotherapy,
lead to changes in the serum level of many other hormones psychopharmacotherapy, sociotherapy, the role of art in
like growth hormone and prolactin. Numerous endocrine therapy, etc.), but also on the importance of promoting various
disorders can be caused and/or worsened by stressors like preventive activities. Psychiatric/psychological support helps
gonadal dysfunction, psychosexual dwarfism, and obesity. the patient's cooperation in all phases of treatment, with the
Exposure to endogenous or exogenous stress can also alter the aim of the "oncology patient" retaining their personhood with
clinical status of many preexistent endocrine disorders such their usual life challenges, responsibilities, and pleasures.
as precipitation of adrenal crisis and thyroid storm. The aim Communication skills in oncology are extremely
of hormonal response to stress is to pull together adaptive important, so the latest knowledge about the most
responses against the specific agent that triggers tension. If common communication "challenges" will be presented,
a response to stress is deficient or excessive it can result in such as telling bad news, discussing the prognosis and
psychological pathology and alerted endocrine response. Even risks of certain forms of treatment, conversations related
more, under conditions of long-term stress, the glucocorticoid- to the end of life, conducting family meetings, etc.
mediated effects become maladaptive and can lead to disease. How to promote person-centered medicine and people-
Long-term exposure to common stress in experimental centered health care in psycho-oncology? How to educate
animals showed epigenetic changes in DNA influencing health professionals, patients, and the general public about this
how genes that control mood and behaviour are expressed. area? How to use new technologies in psycho-oncology? What
can we expect in the future? The presentation will try to answer
these questions, but it is even more important to stimulate the
discussion and thoughts of other participants with the aim of
faster development of psycho-oncology in the Republic of
Croatia and a better understanding of "mind-body" medicine
in this century, which we proudly call the century of the mind.
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Liječ Vjesn 2023; godište 145; (Supl.

2) 18th Croatian Student Summit

DOI: https://doi.org/10.26800/LV-145-supl2-IS01 DOI: https://doi.org/10.26800/LV-145-supl2-IS02

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