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

“We wanted to find a way to tell the story of life in the hospital as a teenager with cancer, without scaring people, perhaps even making them laugh, while reaching everyone's homes.” This is how Teresa, a 16-year-old girl undergoing treatment for osteosarcoma, describes the sitcom Ho preso un Granchio, conceived and created by the young patients of the Youth Project in Milan. The Youth Project (https://ilprogettogiovani.org/?lang=en) was launched in 2011 within the Pediatric Oncology Unit of the Istituto Nazionale Tumori in Milan, with the support of the Fondazione Bianca Garavaglia ETS, and is designed specifically for patients aged 15–24 [1, 2]. While pursuing essential medical objectives (such as patient access into clinical trials), the initiative places a strong emphasis on the personal and social lives of young patients. It offers dedicated spaces within the hospital and organizes innovative, creative, and artistic activities, providing patients opportunities for social aggregation and new ways of expression. Multiple projects have been developed over the years, focusing on fashion, photography, music, and writing [3-11]. The sitcom, a true sketch comedy of seven episodes, is the latest of these initiatives. For this project, young patients first became writers and screenwriters, then actors. They created their own characters with the intention of representing themselves: for example, the Latin Lover, the Influencer, the Musician, the Needle-Phobic, and the Problem Solver. They chose the themes for each episode based on real-life situations they faced during their cancer journey: from the disorientation upon arriving at the hospital and adapting to a new routine to the need for freedom and normalcy. The themes we chose to explore are those that matter to people our age, explains Marco, who was treated for Ewing sarcoma at 18. Like how you see yourself in the mirror, how you interact (or fail to interact) with your friends, and finding the courage to approach a girl. The participants then worked on writing the scripts. Each episode's script shared a tone of self-deprecating humor, sometimes irreverent, even bordering on black humor (Figure 1). It was one of the most enjoyable parts of the project, says Andrea, one of the participants. We let our imaginations run wild. We wanted to show viewers just how important it is to face illness with a sense of lightness and a smile. For me, it was a way to cope. You can't stay sad and angry for all nine months of chemotherapy. Despite the humor, the storytelling remained sincere and intimate, balancing strength and vulnerability. Even the title of the series reflects this ironic tone. It is inspired by a clever wordplay in Italian that is difficult to translate directly into English. It revolves around the phrase Ho preso un Granchio, which literally translates to “I caught a crab.” In Italian, this phrase carries a double meaning. On one hand, it can figuratively refer to receiving a cancer diagnosis, as the crab is symbolically linked to cancer (even in the zodiac sign). On the other hand, in Italian slang, the same phrase can mean “I made a mistake” or “I got tricked,” an expression used when someone misjudges a situation or gets caught in an unexpected problem. The most challenging part of the project, according to the young participants, was the filming process. Scenes were shot in the pediatric outpatient clinic after regular hours, making for long and tiring sessions. Acting was both fun and demanding, with many scenes requiring multiple takes under the guidance of a meticulous director to ensure high-quality footage (as in previous projects, the quality of the final product was a priority for effective communication). In two episodes, the patients had the chance to act alongside guest stars Aldo, Giovanni, and Giacomo, famous Italian comedians, adding a further exciting element to the project. The final result consisted of a series of seven episodes, filmed in Italian, each 6–7 min long (Table 1). The episodes were broadcast on Mediaset television channels and made available for a year on the Mediaset Infinity platform. This dedicated space also includes special content such as interviews and insights about the Youth Project and adolescent cancer. The link to the platform is the following: Episode 1 The Alien Episode 2 The Bet Episode 3 The Collection Episode 4 The Audition Episode 5 Snow White and the Seven Grams Episode 6 The Forbidden Party Episode 7 The Leg The use of art—and more specifically the use of drama, theater, film, or cinema—to support emotional, social, and psychological health has a long history of research and a solid scientific literature to support it. For example, various studies have described how some psychological discomforts could be improved by watching 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 a passive approach (patients watching movies), other “creative arts therapies” may involve a more active role for patients. “Drama therapy” is an umbrella term for a variety of clinical modalities that utilize the principles of theater and drama to help patients achieve therapeutic goals. It is generally an active and experiential practice that can involve play, embodiment, projection, witnessing, and improvisation to provide the context for participants to tell their stories, set goals, solve problems, and express feelings [15-19]. The project we present in this article is not actually a real drama therapy project. On the one hand, it is undoubtedly true that some aspects may coincide with the methodologies of drama therapy, for example, the aim of offering patients a new way to tell their stories, the fact that patients create characters and act (even if our patients actually act themselves). On the other hand, however, we cannot say that Ho preso un Granchio, like other Youth Project laboratories, is a clinical and evidence-based intervention to accomplish specific goals within a therapeutic relationship by a credentialed professional. In our project, in fact, there is no qualified drama therapist leading the intervention (the professionals involved are a screenwriter and a director). Although we certainly expect that our projects can have a potential positive impact on patients’ well-being, they do not have specific psychological goals and do not provide methods for measuring their effectiveness. Furthermore, the laboratories are always organized in ways that emphasize the aspects of social aggregation and fun for the young patients. We feel that the evocative message of this project could be very useful for the purpose of drawing attention to the topic of adolescents with cancer and their unique characteristics (their complex psychological sphere, their clinical challenges, the need for age-appropriate care models, and environments) [20], and we believe that it may be valuable to share with the international scientific community. The Youth Project represents a patient-centered model that can be replicated in other centers and countries. Ho preso un Granchio and other laboratories demonstrate how hospitals can—and must—make room for art, beauty, and imagination [21]. It is not only a story of resilience but also a reminder that healing involves more than medicine: It also requires hope, creativity, and connection. Hospitals can become places for producing beauty and culture, thanks to the amazing power of young patients to see beautiful things—and their profound sense of life—in places that should not normally be associated with the idea of beauty. All authors contributed to designing the study concept, reviewing literature, and preparing and editing the manuscript. The authors thank the Fondazione Bianca Garavaglia ETS for its support of the Youth Project. The authors would like to express their gratitude to everyone who made Ho preso un Granchio possible: Davide Stecconi (director), Federica Di Rosa (screenwriter), Federico Ruga (sound engineer), Cristian De Giglio (cinematography), Stefano Signoroni and the Ruggeri twins (musicians), special guests Aldo, Giovanni, and Giacomo, young Greg for his cameo, Gaetano Pappuini, Cristiano Nardò, Tobia Passigato, Camilla Fregonese, the entire Mediafriends and Mediaset team (particularly Massimo Ciampa and Maria Paniagua Aller); and—of course—all the patients and their families. Open access publishing facilitated by Universita degli Studi di Milano, as part of the Wiley - CRUI-CARE agreement. The authors declare no conflicts of interest. The data that support the findings of this study are available from the corresponding author upon reasonable request.