“Surely again, to heal men’s wounds by music’s spell.”
—Euripides, Medea (480-406 BC)

Commonly defined as organized sound, music has a unique power to stir human emotions, moods, and impressions. The salutary effect of music on the sick has been reported since antiquity. Aristotle and Plato wrote about music’s ability to “heal and purify the soul.” In 1914, a JAMA article reported the benefits of a phonograph in postoperative recovery wards. Over the past few decades, the oncology community has begun to integrate various forms of music therapy into the continuum of care, especially in the setting of palliative care.

The following case history describes the origins of an Italian music therapy program called Donatori di Musica (music donors), which is a network of musicians and hospitals—mostly oncology departments—that organizes concerts in Italian hospitals. All of the musicians play for free and the concerts are private events, offered to patients and their relatives.

The Right Key

In June 2007, Gian Andrea Lodovici walked into the oncology department of the Carrara City Hospital in Carrara, Italy, for treatment of gastric cancer. The hospital’s Chief of Oncology, Maurizio Cantore, MD, recalled that at that first visit, Signor Lodovici was unfocused and completely disinterested in what his oncologist was saying.

“My concern was to quickly find a way to communicate with him because he was like a great wall without any doors to enter. I realized that the only chance I had was to speak about music, and it proved the right key with which to open a door,” Dr. Cantore told The ASCO Post.

Music was a natural way for Dr. Cantore to open communication with his patient. Since 2003, a piano has had a prominent place on his oncology ward, and local musicians have regularly performed for his cancer patients. Besides, Dr. Cantore’s new patient, Gian Andrea Lodovici, was Italy’s greatest producer of classical music.

More Than Chemotherapy

Dr. Cantore, a 57-year-old hematologist/oncologist, heads an oncology team that sees about 1,000 new cancers patients a year. His department’s therapeutic strategies emphasize a multidisciplinary approach, so that a tumor can be looked at “from different angles, in order to design therapeutic strategies combining locoregional or systemic therapies, such as intra-arterial chemoembolization, stereotactic radiotherapy, and radiofrequency ablation,” he explained.

“Over the years, we have also developed a deep expertise in the treatment of pancreatic cancer, seeing about 70 new patients a year,” said Dr. Cantore. He added, “But cancer treatment is more than chemotherapy. We integrated arts and humanity programs at the hospital to promote optimum life experiences for our patients and their caregivers, with activities, education, and a general environment that encourages a creative and constructive response to illness.”

When asked to elaborate on his famous patient’s state of mind as he entered the hospital for treatment of gastric cancer, Dr. Cantore replied, “During the previous year, Gian Lodovici was completely absorbed by his cancer. His life was centered on chemotherapy and CT scans. The future had no meaning to him as a person or as an artist. He only imagined a day-to-day existence in his pajamas with an intravenous catheter in his arm. His soul was dead. Nobody needed him but he needed everyone.”

Dr. Cantore explained how he broke through this almost impenetrable communication barrier. “When I asked Gian Lodovici to help me with his music, he suddenly realized that he was still a living man and artist with an unwelcome tenant, but with a wonderful apartment full of light.”

Reconnecting to the World

Dr. Cantore said that his patient’s relationship with the oncology staff quickly changed after becoming involved in the music project for inpatients. “He began listening to our treatment proposals and discussed them with us. Finally, we were fighting the disease together. The music project had given him a new reason to live and a goal to realize. He was reconnected to the world he once knew.”

After being totally engaged in organizing classical concerts in Dr. Cantore’s oncology department, Signor Lodovici died of his cancer in January 2008. “But in 6 months, Gian Andrea had organized the first season of extraordinary concerts with performances by six established musicians. Through this work, he created a touchable link between the world of oncology and the world of music,” Dr. Cantore said.

“In 2008, our oncology department hosted one of the most important concert seasons in Italy, with 26 concerts from March to December,” he continued. “This initiative spread quickly, and many musicians offered to perform for cancer inpatients. Other oncology departments were eager to participate in the project. The Donatori di Musica network was born.”

Unique Opportunity

Dr. Cantore explained what the music program means to him as an oncologist caring for the most vulnerable of patients. “Donatori di Musica is an extraordinary way to create meaningful relationships in an environment where it is easier to speak, explain, and ask. It offers a unique opportunity to share and discuss therapeutic choices as compared to the current informed consent required by the law. All parts of a concert are important, from the logistical preparation to the unforgettable moments of the concert itself.”

He continued, “To me, the phase of the donors’ concerts that is most important is what follows. It would be worthless to have seen the most beautiful concert of the century if the magical relationships created during the concert ceased to exist afterward. But the beauty and the importance of the donors’ music program are even more visible in the days following the concert,” he said.

Summing up his wholistic approach to cancer care, Dr. Cantore commented, “A daily life in oncology is made up of victories and defeats, of tears and hugs. It is made up of science, skin, and heart.” ■