Dear colleagues,
August 28th marks the passing of Saint Augustine of Hippo, one of the most influential thinkers in Western thought.1 Among his numerous contributions, his perspective on forgiveness as a path to healing—not as forgetting or excusing but as a way of transforming suffering into reconciliation—resonates with remarkable clarity in modern oncology.
Although psycho-oncology was not a focal point in the plenary sessions at the 2025 American Society of Clinical Oncology (ASCO) Annual Meeting, mental health and psychosocial care emerged as prominent themes across numerous abstracts and dedicated sessions.2 However, this presence is yet to be structured into a cohesive framework and thus leaves many key issues, such as the following, unresolved:
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integrating psychological support into oncology care protocols;
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addressing disparities in access to mental health services for cancer patients; and
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promoting the training of psycho-oncology professionals, particularly in low- and middle-income countries.
Throughout the cancer journey, patients often face profound emotional wounds: guilt regarding past behaviors, anger toward their bodies and regret over broken relationships. These are not merely psychological burdens but also obstructions to trust, self-care and, at times, even adherence to treatment. Forgiveness can serve as a religious gesture as well as a therapeutic process—a means of compassionate self-liberation.3
Recent literature in psycho-oncology has associated forgiveness with reduced anxiety, improved sleep and enhanced quality of life.4 Beyond quantifiable outcomes, forgiveness enables patients to reframe their narratives as active protagonists with meaning and dignity instead of as victims of fate or failure. In this light, Augustine’s assertion that “God forgives to heal, not to ignore” can be reinterpreted in secular terms: forgiveness heals by reintegrating, not by erasing (Table 1).
Saint Augustine’s teachings bridge the classical world with a Christian vision, establishing an anthropology of interiority and an ethic of responsibility that continues to hold relevance today. In the Confessions, Augustine explores soul, memory, time and will, paving the way for modern introspection. He defines the human being as a complex unity of body, soul and spirit, which has shaped subsequent philosophies of identity. In fact, his notions of freedom and sin foreshadow modern moral thought, and thinkers such as Pascal, Kierkegaard, Arendt and Ricoeur have drawn from his insights. In the realm of medicine and psychology, his perspective on healing as reconciliation resonates within the field of contemporary psycho-oncology.
As we reflect on his intellectual legacy, we believe that oncology could benefit from reintroducing the language of forgiveness—not as theology but as a facet of humanism. In the era of personalized medicine, it may also be worthwhile to consider the concept of personalized reconciliation.5
Sincerely,
Dr Alberto Vannelli*
Department of Surgery
Sant’Anna Hospital
San Fermo della Battaglia
Como, Italy
Email: info@albertovannelli.it
PD Dr Sara De Dosso
Department of Medical Oncology
Oncology Institute of Southern Switzerland (IOSI)
Ente Ospedaliero Cantonale
Bellinzona, Switzerland
Email: sara.dedosso@eoc.ch
*Corresponding author
Conflict of interest
The authors have declared that the manuscript was written in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.
Funding
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Author contributions
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