Ferrari, Andrea

Massimino, Maura

Pagani Bagliacca, Elena

Patriccioli, Alice

Signoroni, Stefano

Silva, Matteo

English

AIR Universita degli studi di Milano

Pediatric Blood & CancerON CHILDREN, BLOOD AND CANCERHo Preso Un Granchio: The Sitcom Created by YoungPatients That Turns the Cancer Journey Into ComedyAndrea Ferrari1,2 Matteo Silva1 Alice Patriccioli1 Elena Pagani Bagliacca1 Stefano Signoroni3Maura Massimino11Pediatric Oncology Unit, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy 2Department of Oncology and Hemato-Oncology, University ofMilan, Milan, Italy 3Hereditary Digestive Tract Tumors Unit, Fondazione IRCCS Istituto Nazionale Tumori, Milan, ItalyCorrespondence: Andrea Ferrari (andrea.ferrari@istitutotumori.mi.it)Received: 7 January 2025 Revised: 19 January 2025 Accepted: 21 January 2025Funding: The authors received no specific funding for this work.Keywords: adolescents | art | cancer | psychological support | sitcom | young adults | youth project“We wanted to find a way to tell the story of life in the hospitalas a teenager with cancer, without scaring people, perhapseven making them laugh, while reaching everyone’s homes.”This is how Teresa, a 16-year-old girl undergoing treatmentfor osteosarcoma, describes the sitcom Ho preso un Granchio,conceived and created by the young patients of the Youth Projectin Milan.The Youth Project (https://ilprogettogiovani.org/?lang=en) waslaunched in 2011 within the Pediatric Oncology Unit of theIstituto Nazionale Tumori in Milan, with the support of theFondazione Bianca Garavaglia ETS, and is designed specificallyfor patients aged 15–24 [1, 2]. While pursuing essential medicalobjectives (such as patient access into clinical trials), the initiativeplaces a strong emphasis on the personal and social lives ofyoung patients. It offers dedicated spaces within the hospital andorganizes innovative, creative, and artistic activities, providingpatients opportunities for social aggregation and new ways ofexpression.Multiple projects have been developed over the years, focusingon fashion, photography, music, and writing [3–11]. The sitcom,a true sketch comedy of seven episodes, is the latest of theseinitiatives.The structure of how this project was carried out is similar to allthe previous ones:- All the projects span several months (the current projectinvolved the participants for 18 months spanning 2022–2024).- They involve both young patients undergoing treatment andthosewho had completed their oncology therapy and returnedto the hospital specifically for the project (for the sitcom, 20young people aged 15–24 years were involved).- They are led by professionals (a screenwriter and a director, inthis case), who work alongside the staff of the Youth Project,which includes a doctor, a psychologist, a dedicated educator,and an artistic coordinator.- They are conducted throughweekly sessions, held onWednes-day afternoons in the dedicated teen-room adjacent to theward.For this project, young patients first became writers andscreenwriters, then actors. They created their own characterswith the intention of representing themselves: for example, theLatin Lover, the Influencer, the Musician, the Needle-Phobic, andthe Problem Solver. They chose the themes for each episode basedon real-life situations they faced during their cancer journey:from the disorientation upon arriving at the hospital andadapting to a new routine to the need for freedom and normalcy.The themes we chose to explore are those that matter to people ourage, explains Marco, who was treated for Ewing sarcoma at 18.Like how you see yourself in the mirror, how you interact (or failto interact) with your friends, and finding the courage to approacha girl.The participants then worked on writing the scripts. Eachepisode’s script shared a tone of self-deprecating humor, some-times irreverent, even bordering on black humor (Figure 1). It wasThis is an open access article under the terms of the Creative Commons Attribution License, which permits use, distribution and reproduction in any medium, provided the original work is properlycited.© 2025 The Author(s). Pediatric Blood & Cancer published by Wiley Periodicals LLC.Pediatric Blood & Cancer, 2025; 72:e31582https://doi.org/10.1002/pbc.315821 of 4FIGURE 1 Backstage images taken during the filming process. In the first image, one of the participants dances while removing their prostheticleg in the sixth episode. This unscripted, spontaneous gesture showcases the patients’ self-deprecating humor and how completely at ease they feelwithin the context of the Youth Project. Source: photos by Andrea Ferrari and Alice Patriccioli.one of the most enjoyable parts of the project, says Andrea, one ofthe participants. We let our imaginations run wild. We wanted toshow viewers just how important it is to face illness with a sense oflightness and a smile. For me, it was a way to cope. You can’t staysad and angry for all nine months of chemotherapy. Despite thehumor, the storytelling remained sincere and intimate, balancingstrength and vulnerability.Even the title of the series reflects this ironic tone. It is inspiredby a clever wordplay in Italian that is difficult to translate directlyinto English. It revolves around the phraseHo preso un Granchio,which literally translates to “I caught a crab.” In Italian, thisphrase carries a double meaning. On one hand, it can figurativelyrefer to receiving a cancer diagnosis, as the crab is symbolicallylinked to cancer (even in the zodiac sign). On the other hand, inItalian slang, the same phrase can mean “I made a mistake” or“I got tricked,” an expression used when someone misjudges asituation or gets caught in an unexpected problem.The most challenging part of the project, according to the youngparticipants, was the filming process. Scenes were shot in thepediatric outpatient clinic after regular hours, making for longand tiring sessions. Acting was both fun and demanding, withmany scenes requiring multiple takes under the guidance of ameticulous director to ensure high-quality footage (as in previousprojects, the quality of the final product was a priority for effectivecommunication). In two episodes, the patients had the chance toact alongside guest stars Aldo, Giovanni, and Giacomo, famousItalian comedians, adding a further exciting element to theproject.The final result consisted of a series of seven episodes, filmed inItalian, each 6–7 min long (Table 1). The episodes were broadcaston Mediaset television channels and made available for a year ontheMediaset Infinity platform. This dedicated space also includesspecial content such as interviews and insights about the YouthProject and adolescent cancer. The link to the platform is thefollowing:+Like previous initiatives of the Youth Project, this kind ofcreative and artistic workshop may have multiple goals:- These projects offer young people a valuable opportunity toshare and connect with those who can truly understand them,because no one can understand until they’ve been through itthemselves. This enables those just starting treatment to looktoward recoverywith hope and credibility. AsMarta, one of theyoung participants in the sitcom, says: The Youth Project is theplace where you feel welcomed and understood. It’s like a bonfireon the beach, a space where you can gather without needing toexplain yourself to anyone, where you feel free. . . a place whereyou can simply be yourself despite the illness.- These projects provide a sense of normalcy (or a semblanceof it) and provide space for lightness, laughter, and coloramidst their journey through illness and treatment. Theyserve as a reminder to everyone—including the participantsthemselves—that before being patients, they are, above all,teenagers.- These projects allow young people, by being involved ininitiatives with professionals, to feel important, especially2 of 4 Pediatric Blood & Cancer, 2025 15455017, 2025, 5, Downloaded from https://onlinelibrary.wiley.com/doi/10.1002/pbc.31582 by Universita'Degli Studi Di Mila, Wiley Online Library on [18/06/2025]. See the Terms and Conditions (https://onlinelibrary.wiley.com/terms-and-conditions) on Wiley Online Library for rules of use; OA articles are governed by the applicable Creative Commons LicenseTABLE 1 The seven episodes of Ho preso un Granchio.Episode 1The AlienA new patient, a spoiled girl, is admitted to the hospital and believes she has arrived at a five-starluxury hotel. Her initial attitude softens as the other patients introduce themselves one by oneEpisode 2The BetTwo hospitalized boys make a bet about winning over a girl, but clinical “unexpected events”(such as the effects of diuretics) are always lurking around the cornerEpisode 3The CollectionA boy with a fear of needles must produce a fresh sample of semen for cryopreservation. Hisfellow patients try to help himEpisode 4The AuditionA theater-loving girl undergoing treatment auditions for a role in a play. Concerned about herhair loss, she receives encouragement from her wardmates, leading to a surprising endingEpisode 5SnowWhite and the SevenGramsA girl’s return from the operating room turns into a fairy tale adventure when a clumsy nurseadministers the wrong dose of morphine, sending her on a whimsical journey with SnowWhiteand the Seven DwarfsEpisode 6The Forbidden PartyThe group of patients, breaking ward rules, plans a sushi party behind the doctors’ backs.However, one of them turns out to be a spy, throwing their plans into chaosEpisode 7The LegSix months later, the patients are back at the hospital for follow-up visits. One boy is scheduled toreceive a new prosthetic leg, but the prosthesis is delayed. The group tries to improvise a solution,leading to a series of hilarious mishapsduring a time that can be particularly challenging for theirself-esteem.- Being projects that span several months, these initiatives helppatients regain a sense of the future and make longer termplans. Thinking and planning ahead holds immense value foryoung people who previously had future-oriented goals (likegetting a driver’s license, starting university, or going on atrip with friends) but suddenly find their horizon limited todischarge dates or the next round of chemotherapy.- These projects give patients—and their doctors—a platformto make their voices heard, with the goal of raising aware-ness among both the scientific community and the generalpublic about the specific challenges faced by adolescents withcancer.- Finally, these projects provide patients with the opportunityto freely express their emotions, fears, and hopes throughcreative outlets, which can often serve as more accessible andvivid tools than a traditional psychological therapy session.For young people, sharing their stories is essential to processwhat is happening to them, understand it, and come to termswith it.The use of art—and more specifically the use of drama, theater,film, or cinema—to support emotional, social, and psychologicalhealth has a long history of research and a solid scientific liter-ature to support it. For example, various studies have describedhow some psychological discomforts could be improved bywatching specific movies, involving various areas of functioning(from logical to visual-spatial, from musical to interpersonal)[12–14]. Although the so-called cinematherapy generally has apassive approach (patients watching movies), other “creativearts therapies” may involve a more active role for patients.“Drama therapy” is an umbrella term for a variety of clinicalmodalities that utilize the principles of theater and drama tohelp patients achieve therapeutic goals. It is generally an activeand experiential practice that can involve play, embodiment,projection, witnessing, and improvisation to provide the contextfor participants to tell their stories, set goals, solve problems, andexpress feelings [15–19].The project we present in this article is not actually a real dramatherapy project. On the one hand, it is undoubtedly true that someaspects may coincide with the methodologies of drama therapy,for example, the aim of offering patients a new way to tell theirstories, the fact that patients create characters and act (even if ourpatients actually act themselves). On the other hand, however,we cannot say that Ho preso un Granchio, like other YouthProject laboratories, is a clinical and evidence-based interventionto accomplish specific goals within a therapeutic relationship by acredentialed professional. In our project, in fact, there is no qual-ified drama therapist leading the intervention (the professionalsinvolved are a screenwriter and a director). Althoughwe certainlyexpect that our projects can have a potential positive impact onpatients’ well-being, they do not have specific psychological goalsand do not provide methods for measuring their effectiveness.Furthermore, the laboratories are always organized in ways thatemphasize the aspects of social aggregation and fun for the youngpatients.We feel that the evocative message of this project could be veryuseful for the purpose of drawing attention to the topic of adoles-cents with cancer and their unique characteristics (their complexpsychological sphere, their clinical challenges, the need for age-appropriate care models, and environments) [20], and we believethat it may be valuable to share with the international scientificcommunity.TheYouth Project represents a patient-centeredmodel that can bereplicated in other centers and countries. Ho preso un Granchioand other laboratories demonstrate how hospitals can—andmust—make room for art, beauty, and imagination [21]. It isnot only a story of resilience but also a reminder that healinginvolvesmore thanmedicine: It also requires hope, creativity, andconnection. Hospitals can become places for producing beautyand culture, thanks to the amazing power of young patientsto see beautiful things—and their profound sense of life—in3 of 4 15455017, 2025, 5, Downloaded from https://onlinelibrary.wiley.com/doi/10.1002/pbc.31582 by Universita'Degli Studi Di Mila, Wiley Online Library on [18/06/2025]. See the Terms and Conditions (https://onlinelibrary.wiley.com/terms-and-conditions) on Wiley Online Library for rules of use; OA articles are governed by the applicable Creative Commons Licenseplaces that should not normally be associated with the idea ofbeauty.Author ContributionsAll authors contributed to designing the study concept, reviewingliterature, and preparing and editing the manuscript.AcknowledgmentsThe authors thank the Fondazione Bianca Garavaglia ETS for its supportof the Youth Project. The authors would like to express their gratitudeto everyone who made Ho preso un Granchio possible: Davide Stecconi(director), Federica Di Rosa (screenwriter), Federico Ruga (sound engi-neer), Cristian De Giglio (cinematography), Stefano Signoroni and theRuggeri twins (musicians), special guests Aldo, Giovanni, and Giacomo,young Greg for his cameo, Gaetano Pappuini, Cristiano Nardò, TobiaPassigato, Camilla Fregonese, the entire Mediafriends and Mediasetteam (particularly Massimo Ciampa and Maria Paniagua Aller); and—ofcourse—all the patients and their families.Open access publishing facilitated by Universita degli Studi di Milano, aspart of the Wiley - CRUI-CARE agreement.Conflicts of InterestThe authors declare no conflicts of interest.Data Availability StatementThe data that support the findings of this study are available from thecorresponding author upon reasonable request.References1. A. Ferrari, C. A. Clerici, M. Casanova, et al., “The Youth Project at theIstituto Nazionale Tumori in Milan,” Tumori 98 (2012): 399–407.2. C. Magni, L. Veneroni, M. Silva, et al., “Model of Care for Adolescentsand Young Adults With Cancer: The Youth Project in Milan,” Frontiers inPediatrics 4 (2016): 88.3. A. Ferrari, P. Gaggiotti, M. Silva, et al., “Searching for Happiness,”Journal of Clinical Oncology 35, no. 19 (2017): 2209–2212.4. E. Pagani Bagliacca, M. Silva, L. Veneroni, et al., “YOUTH: TheSweatshirt Collection Created by Adolescent Cancer Patients on theYouth Project in Milan,” Lancet Oncology 21 (2020): 341–342.5. A. Ferrari, M. Silva, G. Facchetti, et al., “The Podcast “Based on a TrueStory”: A Journey Into the World of Young Cancer Patients,” Tumori 108,no. 5 (2022): 512–516.6. A. Ferrari, L. Veneroni, C. A. Clerici, et al., “Clouds of Oxygen:Adolescents With Cancer Tell Their Story in Music,” Journal of ClinicalOncology 33, no. 2 (2015): 218–221.7. A. Ferrari, S. Signoroni,M. Silva, et al., ““Christmas Balls”: AChristmasCarol by the Adolescent Cancer Patients of the Milan Youth Project,”Tumori 103, no. 2 (2017): e9–e14.8. S. Signoroni, L. Veneroni, E. Pagani Bagliacca, et al., ““Summer Is You”:Adolescents and Young Adults With Cancer Sing About Their Desire forSummer,” Pediatric Blood & Cancer 66, no. 5 (2019): e27630.9. A. Ferrari, M. Silva, A. Patriccioli, et al., “Playing Cards Designed byYoung Cancer Patients With the Youth Project in Milan,” Tumori 108, no.2 (2022): 189–190.10. A. Ferrari, M. Silva, A. Patriccioli, et al., ““As If by Magic”: YoungCancer Patients Become Magician’s Apprentices, Finding Magic in TheirLives Again During Their Hospital Treatments,” Pediatric Blood &Cancer70, no. 5 (2023): e30268.11. A. Ferrari, M. Silva, A. Patriccioli, S. Signoroni, and M. Massimino, “IWas Only Sixteen,” Tumori 110, no. 3 (2024): 209–211.12. G. Solomon, The Motion Picture Prescription: Watch This Movie andCall Me in the Morning (Aslan Publishing, 1995).13. D. P. R. Chieffo, L. Lafuenti, L. Mastrilli, et al., “Medi-Cinema: A PilotStudy on Cinematherapy and Cancer as a New Psychological Approachon 30 Gynecological Oncological Patients,” Cancers 14 (2022): 3067.14. I. Testoni, E. Rossi, S. Pompele, et al., “Catharsis Through Cinema: AnItalian Qualitative Study on Watching Tragedies to Mitigate the Fear ofCOVID-19,” Front Psychiatry 12 (2021): 622174.15. R. Feniger-Schaal and H. Orkibi, “Integrative Systematic Reviewof Drama Therapy Intervention Research,” Psychology of Aesthetics,Creativity, and the Arts 14, no. 1 (2020): 68–80.16. C. C. Thomas, C. R. Armstrong, J. S. Frydman, et al., “A Snapshot ofEmpirical Drama Therapy Research: Conducting a General Review of theLiterature,” GMS Journal of Arts Therapies 1, no. 2 (2019): Doc02.17. C. R. Armstrong, J. S. Frydman, and S. Wood, “Prominent Themes inDrama Therapy Effectiveness Research,” Drama Therapy Review 5, no. 2(2019): 173–216.18. L. L. Wood and D. Mowers, “The Co-Active Therapeutic TheatreModel: A Manualized Approach to Creating Therapeutic Theatre WithPersons in Recovery,” Drama Therapy Review 5, no. 2 (2019): 217–234.19. J. S. Frydman, A. Cook, C. R. Armstrong, et al., “The DramaTherapy Core Processes: A Delphi Study Establishing a North AmericanPerspective,” Arts in Psychotherapy 80 (2022): 101939.20. A. Ferrari, D. Stark, F. A. Peccatori, et al., “Adolescents and YoungAdults (AYA) With Cancer: A Position Paper From the AYA WorkingGroup of the European Society for Medical Oncology (ESMO) and theEuropean Society for Paediatric Oncology (SIOPE),” ESMO Open 6, no.2 (2021): 100096.21. A. Ferrari, T. Perillo, G. M. Milano, et al., “The Power of Art andthe Powers of Adolescents With Cancer: Age-Specific Projects at ItalianPediatric Oncology Centers,” Tumori 110, no. 4 (2024): 218–226.4 of 4 Pediatric Blood & Cancer, 2025 15455017, 2025, 5, Downloaded from https://onlinelibrary.wiley.com/doi/10.1002/pbc.31582 by Universita'Degli Studi Di Mila, Wiley Online Library on [18/06/2025]. See the Terms and Conditions (https://onlinelibrary.wiley.com/terms-and-conditions) on Wiley Online Library for rules of use; OA articles are governed by the applicable Creative Commons License

Ho Preso Un Granchio: The Sitcom Created by Young Patients That Turns the Cancer Journey Into Comedy

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Ho Preso Un Granchio: The Sitcom Created by Young Patients That Turns the Cancer Journey Into Comedy

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