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4 November: International Stress Awareness Day

Stress is a natural response to life’s challenges and changes. It helps us respond, adapt, and stay motivated. But when it becomes prolonged, it can turn into an invisible, exhausting companion that affects every aspect of daily life — body, mind, relationships, and mood. International Stress Awareness Day (4 November) is a reminder to pause, take a deep breath, and acknowledge that mental health deserves the same care as physical health.

In Greece, the mental health burden remains significant. According to the OECD (2023, Country Health Profile), around 6% of the population experiences anxiety disorders, while 7% report symptoms of depression. At the same time, more recent studies in younger age groups show that stress affects a much larger proportion: in a 2020 survey of university students, high levels of moderate to severe stress and extreme anxiety were reported. Additionally, international daily stress measurements indicate that about 58% of Greeks felt stress the previous day, placing the country among the highest in Europe and globally. These figures highlight that anxiety touches a substantial part of the population and significantly impacts daily life, emphasizing the importance of awareness and support.

Stress can manifest in multiple ways: rapid heartbeat, difficulty concentrating, insomnia, irritability, or simply feeling like there’s “never enough time.” Too often we dismiss it as “part of life.” But caring for our mind and emotions is not a luxury — it is a responsibility to ourselves. Support from mental health professionals, physical activity, connection with nature, music, art, or even a simple conversation with someone we trust can become small breaths of balance.

People living with chronic illnesses, including cancer, often face heightened stress. Anxiety about treatment, uncertainty about the future, and the physical impact of disease can intensify tension and worry. Recognizing and validating this stress is essential, as support through networks, counseling, and accessible resources can make a meaningful difference.

At Kapa3, we believe no one should face stress or illness alone. Through our programs, initiatives, and community, we offer guidance, emotional support, and practical help, highlighting that mental well-being is a shared journey and empathy is key.

Today is more than a reminder of the risks of stress. It is an invitation to speak openly without fear or shame, to create space for understanding and acceptance. Let’s learn to listen to our bodies and minds, recognize the signs, and seek help when needed. Calmness is not a luxury — it is a right for everyone.

Read more in previous articles of Kapa3: Article1, Article2, Article3

Sources:

OECD (2023), Country Health Profile: Greece
Stress, Anxiety and Depression Prevalence among Greek University Students during the COVID-19 Pandemic (2023, PLOS ONE / PMC)
Gallup Global Emotions Report 2024 – Ελλάδα: Daily Stress Measurement (58%)

Text/adaptation: Ifiyenia Anastasiou for Kapa3

Giving Voice to People with Primary Biliary Cholangitis (PBC) in Greece

Promitheas launches MyPBCVoice, an innovative initiative aimed at empowering and supporting people with Primary Biliary Cholangitis (PBC) in Greece. PBC is a rare, chronic autoimmune liver disease with symptoms such as fatigue, itching, abdominal discomfort, and psychological challenges.

MyPBCVoice focuses on patient education, information, and mutual support to improve quality of life. Activities include:

Questionnaires to assess patient needs (fill here)
A PBC-focused microsite
Interactive Facebook community for communication and support (join here)
Short videos and vidcasts with patients and experts
Online webinars
Digital archive of complaints and reports to map access barriers

We encourage everyone to share and promote this initiative to reach more patients and health professionals.

Kapa3 is proud to support initiatives like MyPBCVoice, which empower patients and foster connection and knowledge within the community.

Text/adaptation: Ifiyenia Anastasiou for Kapa3

Gut Microbiota: A Hidden Ally in Cancer Treatment

Our gut is home to trillions of microorganisms, collectively called the gut microbiota, which play a crucial role in digestion, immunity, and overall health. Excitingly, research is revealing that these tiny residents can also influence the effectiveness of cancer treatments—from immunotherapy to chemotherapy and beyond. Understanding this connection opens new possibilities for more personalized and effective cancer care.

Boosting Immunotherapy through Gut Microbes

Innovative therapies like CAR-T cell therapy, immune checkpoint inhibitors (ICIs), oncolytic viruses (OVs), and CpG-oligonucleotide immunotherapy have transformed cancer treatment in recent years. Studies show that the composition of gut microbiota can affect how well patients respond to these therapies.

For instance, certain bacteria—such as Ruminococcus, Faecalibacterium, and Akkermansia—are linked to better CAR-T outcomes, while broad-spectrum antibiotics may reduce therapy effectiveness. Similarly, gut microbes can enhance responses to ICIs by stimulating immune cells that attack tumors. OVs, which work by killing cancer cells and activating the immune system, also benefit from a healthy gut microbiota. Even CpG-based therapies are more effective when gut microbes activate immune pathways.

In short, a balanced gut microbiota can help “turn cold tumors into hot tumors,” making them more responsive to modern immunotherapies.

Gut Microbes and Traditional Treatments

Gut microbiota also affects chemotherapy and radiotherapy. Some microbes can influence drug metabolism, improving efficacy or reducing side effects. For example, bacteria like Enterococcus hirae and Barnesiella intestinihominis enhance the response to cyclophosphamide, a common chemotherapy drug, by activating immune cells.

On the other hand, disruptions in gut microbiota—often caused by antibiotics or radiation—can increase treatment toxicity, leading to issues like intestinal inflammation or mucositis. Promising strategies like fecal microbiota transplantation (FMT) and certain probiotics have shown potential to restore gut balance, reduce side effects, and improve overall outcomes.

Complementary Approaches: TCM and Probiotics

Traditional medicine can also benefit from gut microbes. Traditional Chinese Medicine (TCM) compounds, when processed by gut bacteria, can transform into more potent anti-cancer agents. Certain TCM herbs and formulas can also promote beneficial bacteria while suppressing harmful ones.

Similarly, probiotics, prebiotics, and synbiotics—foods or supplements that nourish or contain helpful bacteria—can support cancer treatment by strengthening gut immunity, reducing inflammation, and enhancing drug effectiveness. For example, in combination with chemotherapy or immunotherapy, synbiotics have been shown to reduce treatment-related side effects while boosting therapeutic benefits.

Emerging Strategies: Engineering the Microbiota

Beyond diet and probiotics, scientists are developing targeted microbiota interventions to fight cancer more precisely. These include:

Engineered microbes, designed to deliver anti-cancer agents directly to tumors.
Phage therapy, using viruses that selectively kill harmful bacteria.
Nanomedicine and OMVs (outer membrane vesicles), which can deliver drugs or immune-stimulating molecules to tumors while sparing healthy microbes.

These cutting-edge approaches are still under study, but they demonstrate the incredible potential of harnessing gut microbes to improve therapy effectiveness and reduce toxicity.

Looking Ahead: Precision Medicine and Microbiota

The future of cancer treatment may increasingly involve personalized microbiota strategies. By analyzing an individual’s gut bacteria and metabolites, clinicians could tailor therapies to maximize efficacy and minimize side effects. Combining microbiota profiling with multi-omics analysis, AI, and big data could allow doctors to predict treatment response and guide interventions in a way that was unimaginable just a decade ago.

While challenges remain—including differences in individual microbiotas, safety considerations, and regulatory hurdles—the potential is enormous. Gut microbiota represents a promising frontier in precision oncology, offering hope for more effective, safer, and individualized cancer care.

Read the full article here

Text/Adaptation: Ifiyenia Anastasiou for Kapa3

Mindfulness-Based Stress Reduction (MBSR) for Stress Relief

Mindfulness-Based Stress Reduction (MBSR) is a program developed by Professor Jon Kabat-Zinn at the University of Massachusetts Medical School, designed to help individuals focus on the present moment by observing thoughts, emotions, and bodily sensations with acceptance and without judgment. The program includes guided meditations, mindful movement exercises (such as yoga), breathing practices, and body scans, promoting mental calm, emotional regulation, and stress reduction.

As expected, this approach has been applied to reduce symptoms and improve quality of life in cancer patients. A recent systematic review published in BMC Psychology in November 2024 examined the effectiveness of MBSR in breast cancer patients, focusing on outcomes such as anxiety, depression, fatigue, quality of life, post-traumatic growth (PTG), fear of recurrence, pain, stress, and sleep.

The review included 15 randomized studies with a total of 1,937 participants. Results showed that the eight-week program significantly reduced anxiety and depression and improved quality of life compared to a six-week program or usual care. Additionally, post-traumatic growth increased and remained elevated even three months after completing the program. Fatigue decreased at the end of the program, though no statistically significant difference was found at the three-month follow-up. The method did not show significant effects on pain, stress, fear of recurrence, or sleep compared to usual care. Nevertheless, MBSR remains a powerful tool for psychological support.

At Kapa3, we believe that mindfulness can be a valuable aid for those who need it, and the results of this systematic review highlight MBSR’s value as a safe and effective intervention for the psychological support of patients.

Researchers note that a longer program duration allows participants to internalize MBSR practices and develop positive coping strategies. MBSR focuses on conscious attention to the present, with patience, acceptance, and a non-judgmental stance, helping regulate emotions and reduce negative thoughts related to the illness. Regular practice, especially in an eight-week program, appears to enhance positive outcomes, improving both psychological well-being and patients’ perception of their lives.

Parenting in Childhood Cancer: The Importance of Psychological Support

One of the hardest challenges for parents of children with cancer —emotionally and practically—is to see your child in pain and distress, especially when facing cancer. Unfortunately, according to the World Health Organization, around 400,000 children and adolescents are diagnosed with cancer every year, most commonly with leukemia, brain tumors, or lymphomas. Parents play a crucial role in improving their child’s quality of life, and their emotional well-being is the cornerstone for coping with this demanding situation. (World Health Organization, 2025)

Parenting and Childhood Cancer

Cancer can cause major upheavals and imbalances within a family. Parents in particular play a multifaceted and decisive role, often experiencing intense distress, stress, anxiety, depression, or even post-traumatic stress symptoms. According to the study by Kearney, Salley, and Muriel, parental distress negatively affects the child’s quality of life as well as family and marital relationships.
Because parents are the primary caregivers, they strive to support their children throughout all stages of treatment. Building psychological resilience against fear and stress is essential to achieving that goal. Without parental self-care, there can be no real care for the child. (Kearney et al., 2015)

The Importance of Psychological Support

Most parents develop resilience, creating a new sense of normalcy. However, additional support through psychotherapy—particularly cognitive-behavioral and family-based approaches (CBT)—can greatly help manage emotions and reduce anxiety.
Problem-Solving Skills Training (PSST), which helps individuals identify and correct unhelpful patterns of thinking and behavior, has proven effective: more than 800 mothers of children with cancer reported reduced negative emotions and distress.
Beyond professional psychological support, parents’ own outlook and access to emotional support play a significant role in how they cope. (Kearney et al., 2015)
In every case, childhood cancer places a heavy burden on parents, demanding enormous strength and dedication. Yet with self-care, they can create the foundation to better support their children.

At Kapa3, we strongly believe that psychological empowerment and emotional support for parents and caregivers of children with cancer are vital. Through awareness actions, support programs, and collaborations with mental health professionals, we aim to strengthen not only the patients but also those who stand by them every single day.

Sources: Kearney, J. A., Salley, C. G., & Muriel, A. C. (2015). Standards of psychosocial care for parents of children with cancer. Pediatric Blood & Cancer, 62(S5), S632–S683. Read more here

Sleep and Cancer: Understanding Insomnia and Nighttime Disorders

Sleep disturbances are common in people living with cancer, affecting physical health, emotional well-being, and quality of life. Insomnia—difficulty falling asleep, staying asleep, or obtaining restorative sleep—is one of the most frequent issues. It can occur at any stage of cancer and may be triggered or worsened by the cancer itself, treatments such as chemotherapy, medications, anxiety related to diagnosis, or lifestyle factors like caffeine, alcohol, or limited daytime activity.

Often, insomnia begins after a sudden change in life or medication. Over time, certain behaviors may make it chronic, such as sleeping with lights or TV on, napping during the day, or consuming caffeine or alcohol in the evening. Patients with coexisting conditions, such as anxiety or depression, may be particularly vulnerable.

Clinical approaches to insomnia
Evidence supports a multi-faceted strategy. Cognitive Behavioral Therapy for Insomnia (CBT-I) has been shown to reduce sleep complaints in cancer patients and may decrease reliance on hypnotic medications. CBT-I addresses maladaptive sleep behaviors and beliefs and can be delivered in-person or through digital programs, such as the FDA-cleared application Somryst.

Pharmacological treatment may be indicated for severe or persistent insomnia, typically as short-term therapy. Commonly prescribed medications include benzodiazepine receptor agonists (e.g., zolpidem, eszopiclone), low-dose doxepin, and orexin receptor antagonists. However, evidence in cancer patients remains limited, and medication should be closely monitored to avoid long-term dependence.

Parasomnias: nocturnal behavioral events
Some patients experience unusual behaviors during sleep, including sleepwalking, night terrors, or acting out dreams (REM sleep behavior disorder). These events may be influenced by treatment, medications, metabolic changes, or other medical conditions, and can sometimes be confused with seizures or delirium. Accurate documentation of the timing, frequency, behaviors, and memory of events is crucial for diagnosis. In cases where safety is at risk, or the events are atypical, video polysomnography may be recommended.

It is a fact that sleep affects multiple physiological processes, and disruptions can influence both quality of life and potentially cancer outcomes. A comprehensive, individualized approach—considering behavioral strategies, careful use of medication, and evaluation for other sleep disorders—is essential. Ongoing research is expanding our understanding of sleep’s role in cancer progression and patient resilience.

At Kapa3, we recognize the importance of sleep in supporting the overall well-being of people living with cancer, and we encourage patients to seek guidance on managing sleep disturbances as part of comprehensive care.

Read the full article here

Text/Adaptation: Ifiyenia Anastasiou for Kapa3

Scientific Seminar: Psychosocial Support after Cancer Treatment and Post-Traumatic Growth

The Psychology Laboratory of INEB/CEST (Institute of Applied Biosciences / CERTH), with the support of the Municipality of Thessaloniki, is organizing on Saturday, 1 November 2025 (10:00–15:00), at the “Manolis Anagnostakis” Hall of the Thessaloniki City Hall, the scientific seminar “Psychosocial Support after Cancer Treatment and Post-Traumatic Growth.”

The event, initiated by the Psychology Laboratory as part of the IC-GROWTH research project, focuses on the psychological and social dimensions of life after cancer treatment, highlighting good practices for care, empowerment, and post-traumatic growth.

The program includes expert presentations and an open discussion with the audience, featuring researchers, healthcare professionals, and representatives from patient associations.

Participation is free, but pre-registration is required through the following form:
Registration Form

This seminar offers a valuable opportunity for learning and sharing experiences on psychosocial support and care after cancer treatment.

Kapa3 supports initiatives that strengthen mental health and quality of life for individuals who have experienced cancer.

Date: Saturday, 1 November 2025
Time: 10:00–15:00
Location: “Manolis Anagnostakis” Hall, Thessaloniki City Hall

Depression and Cancer Mortality: A Critical Link Across Major Cancer Types

Depression is a common but often underrecognized condition among cancer patients, affecting up to 20–30% of individuals diagnosed with the disease. Beyond its impact on quality of life, mounting evidence suggests that depression can significantly influence cancer outcomes, including survival. A recent meta-analysis of 65 cohort studies spanning colorectal, breast, lung, prostate, and mixed cancers provides compelling evidence that depression diagnosed after a cancer diagnosis is associated with a substantially increased risk of mortality.

The analysis revealed that patients with depression faced an 83% higher risk of dying from colorectal cancer, a 59% higher risk in lung cancer, a 74% higher risk in prostate cancer, and a 23% higher risk in breast cancer compared to non-depressed patients. Across mixed cancer types, depression increased the risk of cancer mortality by 38%. These findings underscore that the psychological burden of cancer is not merely an emotional challenge but a critical factor affecting survival outcomes.

Mechanisms Linking Depression and Cancer Outcomes

Depression may influence cancer progression through multiple biological and behavioral pathways. Biologically, depression is associated with chronic systemic inflammation, dysregulation of the hypothalamic-pituitary-adrenal (HPA) axis, immune suppression, autonomic dysfunction, oxidative stress, and impaired DNA repair. Elevated pro-inflammatory cytokines, including interleukin-6 (IL-6) and tumor necrosis factor-alpha (TNF-α), can contribute to tumor growth and metastasis. In older patients, depression may exacerbate age-related immune dysfunction, creating an environment more permissive to cancer progression.

Behaviorally, depression affects health-related actions and treatment adherence. Depressed patients are more likely to delay seeking medical care, adhere poorly to chemotherapy, radiotherapy, and hormonal therapies, and engage in unhealthy habits such as smoking, poor nutrition, and physical inactivity. Social isolation and reduced support systems further increase vulnerability, compounding the negative impact on survival.

Clinical Implications and Interventions

The strong association between depression and cancer mortality highlights the urgent need to integrate mental health care into routine oncology practice. Psychological interventions, such as cognitive-behavioral therapy (CBT), supportive-expressive therapy, and mindfulness-based approaches, have shown promise in reducing distress and improving adherence to cancer treatment. Pharmacological management, including selective serotonin reuptake inhibitors (SSRIs), may also support mental health and potentially influence cancer outcomes, though more research is needed to understand their role fully. Early identification and treatment of depressive symptoms should be considered a priority for oncologists, mental health professionals, and healthcare policymakers alike.

Limitations and Future Directions

While this meta-analysis provides robust evidence, several limitations should be noted. The observational nature of the studies prevents establishing causality, and differences in study design, depression assessment methods, and patient populations contribute to heterogeneity. Future research should explore longitudinal and randomized studies to clarify causal pathways and identify the most effective interventions to reduce depression-related mortality. Investigating the interactions between depression, inflammation, and cancer biology may also reveal targets for novel supportive therapies.

Depression is not just a psychological burden for cancer patients—it is a significant predictor of mortality across multiple cancer types. These findings call for systematic depression screening and tailored interventions as integral components of oncology care.

Organizations like Kapa3 play a vital role in supporting the mental health of cancer patients, offering resources and guidance that can improve both quality of life and treatment outcomes. Integrating psychological support into cancer care ensures that mental well-being is recognized as an essential part of the healing process.
In line with this mission, Kapa3 participates in MELODIC, a new European initiative dedicated to supporting the mental health of young adults (18–30 years old) living with or beyond cancer.

Read the original article here

The Power of Social Support in Cancer Care

Why connection is as vital as treatment

Mental health professionals consistently emphasise the value of a strong social support network. Social support is among the strongest predictors of emotional well-being and overall quality of life. It refers to the extent to which our social and emotional needs are met through the people and communities around us, such as family, friends, colleagues, and groups that share our values and experiences.

Group interventions, for example, have been shown to reduce psychological stress by providing individuals with chronic illnesses the opportunity to connect and share experiences (Jackson et al., 2019). Studies have found that cancer patients who felt more supported by family, friends, or their community experienced less distress, coped more effectively, and had a greater sense of control during treatment. Tangible support, in particular, was more significant for older patients, who may face greater physical challenges due to age or disability (Ahmad et al., 2013).

Furthermore, social support fosters optimism and resilience, which are key factors that help patients adapt to illness. By strengthening hope and inner confidence, social connections help protect against anxiety and depression, acting as a buffer against the emotional impact of stress (Ruiz-Rodríguez et al., 2022).

But what comes first — support or coping? The systematic review by Bottaro and colleagues (2023) suggests the relationship is bidirectional: people who receive strong support cope better, and those who cope better are more likely to seek and maintain strong relationships. It’s a cycle of connection that reinforces recovery.

The source of support also plays a crucial role. Patients often view family, friends, and partners as the most important sources of support for coping with diagnosis and treatment. However, when the type of support offered doesn’t align with the patient’s needs, it can feel less meaningful or even unhelpful.

While loved ones form the core of emotional care, healthcare professionals are often the first and most consistent source of reassurance. According to the literature, patients who feel heard, respected, and well-informed by their medical team cope more effectively and experience less anxiety. Ruiz-Rodríguez and colleagues highlight that optimism and resilience grow when medical staff communicate openly and offer encouragement. Compassionate communication from healthcare providers strengthens patients’ ability to manage their illness, creating a positive feedback loop between support and wellbeing (Bottaro et al., 2023).

At Kapa3, we witness this truth daily. Through our community programs, research, and advocacy, we work to create environments where no one faces cancer alone. Social support is not only emotional, it’s practical, cultural, and profoundly human. Healing doesn’t happen only in hospitals; it happens in homes, workplaces, and communities.

References

Ahmad, M., Khan, M. A., & Shirazi, M. (2013). Perception of Social Support by Cancer Patients. International Journal of Psychology and Behavioral Sciences, 3(5), 115–122. https://doi.org/10.5923/j.ijpbs.20130305.01

Bottaro, R., Craparo, G., & Faraci, P. (2023). What is the direction of the association between social support and coping in cancer patients? A systematic review. Journal of Health Psychology, 28(6), 135910532211311. https://doi.org/10.1177/13591053221131180

Jackson, M., Jones, D., Dyson, J., & Macleod, U. (2019). Facilitated group work for people with long-term conditions: A systematic review of benefits from studies of group-work interventions. British Journal of General Practice, 69(682), 363–372. https://doi.org/10.3399/bjgp19x702233

Ruiz-Rodríguez, I., Hombrados-Mendieta, I., Melguizo-Garín, A., & Martos-Méndez, M. J. (2022). The importance of social support, optimism and resilience on the quality of life of cancer patients. Frontiers in Psychology, 13. https://doi.org/10.3389/fpsyg.2022.833176

Article by: Despina Chrysostomidou, Psychologist for Kapa3 Research Insights

Disability Card in Greece: What You Need to Know

The Disability Card was established under Law 4961/2022 (FEK A’ 146, Article 106) and is regulated by Ministerial Decision 16996/2023 (FEK B’ 932/23-02-2023).
It serves as a unified proof of identity and disability, which must be accepted by all public and private entities.

Read the text of Ministerial Decision 16996/2023 (Article 20) here.

In short, the Disability Card offers:

Proof of disability without the need to show medical certificates or documents from KEPA.
Priority service at public offices, utilities, banks, and hospitals.
Free or reduced access to museums, archaeological sites, and cultural events for the cardholder and their companion.
Use of special facilities (e.g., seats or parking spaces for people with disabilities).
Mutual recognition of the Card in EU countries where an agreement exists.

Card format

The Card is digital, but it can also:

Be saved as a PDF,
Be printed,
Be added to the Gov.gr Wallet,
And will soon be available in a plastic card format.

How to obtain it

The process is simple:

Visit the National Disability Portal here: karta.epan.gov.gr
Log in with your Taxisnet credentials.
If a valid disability certificate exists, the Card is issued immediately.
The same process applies for minors or companions using their respective Taxisnet credentials.

Applications for the plastic disability card began on November 18, 2025. The process is carried out as described above (through the National Disability Portal), and the plastic card is sent by registered mail within a two-week period.

For any inquiries, you can call: Helpdesk 210-3007606 or send an email to: helpdesk@epan.gov.gr

KAPA3 continues to stand by cancer patients and their families, offering reliable guidance and practical support so that every patient feels safe and fully informed about their rights and benefits.

For oncology patients who want detailed information on all the exemptions and benefits they are entitled to, KAPA3 has compiled a complete guide in the “Exemptions and Benefits” section of its website here.

Text/adaptation: Ifiyenia Anastasiou for KAPA3