Supportive Care In Cancer[JOURNAL]
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200 papers
Correction to: Systematic review of prophylactic antibacterial agents for radiation‑induced oral mucositis in head and neck cancer.
Alicea DS, Hans M, Islam Z … +6 more , Schwartz R, Ow TJ, Mehta V, Garg M, McLellan BN, Kabarriti R
Support Care Cancer · 2026 Jun · PMID 42240846 · Full text
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Pre-treatment quality of life and survival outcomes in lung cancer patients: a systematic review and meta-analysis.
Avizova Z, Myssayev AO, Iztleuov YM … +2 more , Mussin NM, Tamadon A
Support Care Cancer · 2026 Jun · PMID 42240738 · Publisher ↗
BACKGROUND: Lung cancer is a leading cause of cancer-related mortality, with baseline (pre-treatment) quality of life (QOL) increasingly recognized as a potential prognostic factor for survival. This systematic review an...
BACKGROUND: Lung cancer is a leading cause of cancer-related mortality, with baseline (pre-treatment) quality of life (QOL) increasingly recognized as a potential prognostic factor for survival. This systematic review and meta-analysis evaluates the association between baseline (pre-treatment) QOL and mortality in lung cancer patients. METHODS: Following PRISMA guidelines and PROSPERO registration (CRD42023398206), we searched PubMed/MEDLINE, Web of Science, and Scopus up to July 2025 for observational studies examining baseline (pre-treatment) QOL and survival in lung cancer patients. Eligible studies used validated QOL tools and reported hazard ratios (HRs) for mortality. Data were extracted independently by two reviewers, and study quality was assessed using the Newcastle-Ottawa Scale. Random-effects meta-analyses quantified associations between global and domain-specific QOL (physical, emotional, cognitive, social) and mortality, with heterogeneity assessed via I statistics. RESULTS: Thirty-nine studies (n = 20,235 patients) across 18 countries were included. Lower baseline (pre-treatment) global QoL was associated with increased mortality risk (pooled HR = 1.07; 95% CI: 1.02-1.12), with similar associations observed for physical, emotional, and social QoL domains. Cognitive QoL (HR = 0.99; 95% CI: 0.97-1.00) and FACT-G/FACT-L scores (HR = 0.94; 95% CI: 0.80-1.09) showed no significant association. Substantial heterogeneity (I = 72-92%) was observed, likely due to variations in study design, QOL tools, and patient characteristics. CONCLUSIONS: Lower baseline QoL is associated with increased mortality risk, indicating that higher QoL is protective and associated with improved survival. Standardized methodologies are needed to address heterogeneity and enhance evidence quality. Findings may vary by disease stage; stage-stratified estimates were rarely reported.
Head and neck cancer rehabilitation: the CaRe feasibility study.
Sheill G, Grehan S, Bennett AE … +6 more , Bowe C, Broderick J, Coghlan K, Regan J, Hussey J, Connell JEO
Support Care Cancer · 2026 Jun · PMID 42240720 · Full text
PURPOSE: The aim of this study was to evaluate the feasibility and acceptability of a multi-modal exercise and education rehabilitation programme for patients post head and neck cancer (HNC) treatment. METHODS: This sing...
PURPOSE: The aim of this study was to evaluate the feasibility and acceptability of a multi-modal exercise and education rehabilitation programme for patients post head and neck cancer (HNC) treatment. METHODS: This single-arm prospective feasibility study included patients in the first 2 years following treatment for HNC. Participants completed a 10-week multi-modal exercise and education programme including twice weekly online or in-person group exercise sessions and four education sessions. Feasibility was evaluated via recruitment, adherence, and compliance to the programme. Secondary outcomes examined physical function and quality of life. The acceptability of the programme was assessed through participant feedback. RESULTS: In total, 22 participants were recruited (36% (n = 8) female, mean age 65.23 years (SD 14.53, range 27-87 years)). The recruitment rate was 24%. Most participants had a history of surgery including neck dissection (95.5%, n = 21) and seven had flap reconstruction (31.8%). Approximately 54.5% (n = 12) of the participants screened positively for lymphoedema. Five people engaged with classes online (average 16.25 classes, range 6-24). Most participants attended the in-person class (n = 14, average 9.86 classes range 1-20). One person chose to do online and in-person classes. Two participants enrolled in the online programme did not engage with the intervention. Measures of physical activity levels, strength, frailty, and physical well-being all increased significantly post intervention. Participants provided positive feedback on the programme, particularly valuing the social experience of exercising alongside peers with similar cancer experiences. CONCLUSIONS: The intervention appears feasible in a group of complex cancer survivors of HNC, with a preference for in-person exercise classes. GOV REGISTRATION NUMBER: NCT06646861.
Sociodemographic Factors related to Financial Toxicity among Cancer Patients and Survivors:"The Second Cancer Patient Experience Survey" - A Nationwide Study in Japan.
Suga K, Ito Y, Inoue K … +3 more , Ichinose Y, Higashi T, Kondo N
Support Care Cancer · 2026 Jun · PMID 42240680 · Full text
PURPOSE: Financial toxicity (FT) refers to increased risk of treatment discontinuation and anxiety in daily life due to the cost burden of cancer treatment. However, little is known about which groups of patients are mor...
PURPOSE: Financial toxicity (FT) refers to increased risk of treatment discontinuation and anxiety in daily life due to the cost burden of cancer treatment. However, little is known about which groups of patients are more likely to experience FT under universal health coverage. Thus, we aimed to explore demographics and psychological factors associated with FT among adult cancer patients in Japan. METHODS: We analyzed responses from the Patient Experience Survey, a self-administered questionnaire conducted by the National Cancer Center in 2018. Outcome indicators were aligned with the Phase 4 Basic Plan to Promote Cancer Control Programs in Japan. We used a modified Poisson regression model to analyze the association between patient demographics and FT, estimating the Prevalence Ratio (PR) and conducting subgroup analysis by sex. RESULTS: Of 6766 responses received, approximately 30% of patients reported FT. FT was categorized into "FT impacted on daily life (FT_Life)," "FT impacted on treatment-receiving behavior (FT_Tx)," and "FT led to treatment change or discontinuation (FT_DisTx)." Across all FT categories, younger age (< 40 vs. 65 + ; male: PR = 2.26 [95% CI, 0.98-5.23]; female: PR = 1.79 [95% CI, 1.01-3.17]), and those with no-one to talk to (vs. with; male: PR = 2.04 [95% CI, 1.05-3.94]; female: PR = 2.07 [95% CI, 1.09-3.93]) were consistently associated with FT. CONCLUSION: These results identify groups that require financial assistance due to cancer treatment, including younger patients, individuals with unstable employment, and those with limited interpersonal support. Strengthening social support systems is critical to enable these patients to manage treatment costs and maintain daily life.
"You lose a day for every appointment": A qualitative study of how rural versus urban residence shapes cancer care experiences in Northeast Scotland.
Carriere R, Adam R, Samuel L … +1 more , Murchie P
Support Care Cancer · 2026 Jun · PMID 42240672 · Full text
PURPOSE: Quantitative studies show that rural-dwelling cancer patients experience poorer survival than urban residents, but the mechanisms remain unclear. This study explored how rural versus urban residence shaped cance...
PURPOSE: Quantitative studies show that rural-dwelling cancer patients experience poorer survival than urban residents, but the mechanisms remain unclear. This study explored how rural versus urban residence shaped cancer care experiences among patients interviewed after primary treatment in Northeast Scotland, including treatment access, follow-up, recovery, and ongoing engagement with services. METHODS: Semi-structured interviews were conducted with adults diagnosed within the previous 6-12 months, post-primary treatment, and attending oncology follow-up at Aberdeen Royal Infirmary. Topic guides were informed by a socioecological model of rural cancer disadvantage. Interviews were audio-recorded, transcribed verbatim, anonymised, and analysed using the Framework Method. Sampling was purposive for geography, age, and sex. Ethical approval was granted by the North of Scotland Research Ethics Committee (REC 19/NS/0032). RESULTS: Twenty participants (mean age 67; 13 men, 7 women; 9 rural, 11 urban) described experiences of colorectal (n = 12), prostate (n = 3), and other cancers (n = 5). Four themes were identified: (1) impact of distance and travel time-travel amplified fatigue, costs, and uncertainty; (2) access, trust, and communication-variable GP access but high trust in the cancer centre; (3) physical and social infrastructure-benefits of improved roads, direct bus routes, and third-sector support; (4) pros and cons of rural life-rural lifestyle benefits often offset travel burdens. Men tended to rely mainly on partners, while women reported broader networks. Cancer type and age intersected with geography to shape burdens such as continence-related travel constraints after prostate surgery. CONCLUSIONS: Geography influenced the burden of accessing rather than the quality of care. Person-centred scheduling, local delivery of peripheral care, transport-aware planning, and collaboration with third-sector providers could mitigate inequities.
Clinical and geriatric factors associated with fracture risk in older adults with bone metastases: A prospective observational study.
Güner İ, Akın S, Yalçın N
Support Care Cancer · 2026 Jun · PMID 42236627 · Full text
PURPOSE: Bone metastases frequently lead to fractures, causing substantial morbidity, impaired quality of life, and poor prognosis in older adults with cancer. This study aimed to evaluate fracture risk by integrating ge...
PURPOSE: Bone metastases frequently lead to fractures, causing substantial morbidity, impaired quality of life, and poor prognosis in older adults with cancer. This study aimed to evaluate fracture risk by integrating geriatric parameters with clinical and oncological factors in older patients with bone metastases. METHODS: This prospective observational study included 55 patients aged ≥ 65 years with newly diagnosed bone metastases who initiated monthly parenteral antiresorptive therapy. Baseline evaluation included standard oncological variables and validated geriatric tools (ADL, MUST, mFI-5, and ACB). Fracture occurrence was monitored over a six-month follow-up period. Univariate Cox regression analyses were performed to identify fracture-associated factors, followed by a theoretically driven multivariable Cox regression model. Correlation analyses were used to assess associations among significant variables. RESULTS: Fractures occurred in 21 patients (38.2%). Univariate analyses showed that poorer performance status (ECOG ≥ 1; HR = 19.92), moderate functional impairment (ADL 3-5; HR = 8.39), high frailty (mFI-5 ≥ 2; HR = 9.83), osteolytic lesions (HR = 4.87), high anticholinergic burden (ACB ≥ 3; HR = 4.56), malnutrition risk (MUST ≥ 2; HR = 4.30), post-study falls (HR = 4.22), and lung metastases (HR = 2.97) were associated with increased fracture risk. Multivariable analysis identified ECOG score of 1 (aHR = 20.62) and high ACB score (aHR = 5.70) as independent predictors. Reduced functional independence and poorer performance status showed the strongest correlations with fracture occurrence. CONCLUSION: Fracture risk in older adults with bone metastases is driven predominantly by functional impairment, frailty, and medication-related vulnerability rather than tumor-related factors alone. Integrating geriatric assessment into routine oncology practice may improve fracture risk stratification and supportive care outcomes.
Preliminary feedback from adult oncology clinic providers on a psychosocial screening tool for young adult patients with cancer.
Wrucke MW, Rickey G, Shi M … +3 more , Shear DZ, Taghavi SE, Cantu V
Support Care Cancer · 2026 Jun · PMID 42236607 · Full text
PURPOSE: Psychosocial screening integration has been recognized as a standard of care, though successful implementation relies heavily on provider engagement. The current study examined provider perceptions on integratin...
PURPOSE: Psychosocial screening integration has been recognized as a standard of care, though successful implementation relies heavily on provider engagement. The current study examined provider perceptions on integrating a psychosocial screening tool as part of the standard of care at a comprehensive cancer center that primarily serves patients with hematologic malignancies. METHODS: The Adolescent and Young Adult Psycho-Oncology Screening Tool (AYA-POST) or Adolescent and Young Adult Psycho-Oncology Survivorship Screening Tool (AYA-S-POST) was administered to patients in the Transplant and Cellular Therapies (TCT) clinic as part of a broader program development initiative. Research personnel then designed a survey to assess provider perceptions of integrating the AYA screening tool into clinical care. Survey items were adapted from a prior study. Information regarding provider perceptions of integrating age-appropriate psychosocial screening was then analyzed. RESULTS: Fourteen of the eligible 20 providers (eight physicians and six APPs) provided feedback on the AYA screening tool. A total of 13 providers (92.9%) had discussed the screener during a medical visit with a YA patient. Overall, TCT providers had neutral to positive perceptions of the AYA screening tool. CONCLUSION: Results of the current study show that providers in a high-volume adult oncology clinic have generally positive views of integrating an age-appropriate psychosocial screening at point of care. With acceptability from providers, routinely screening YAs could move toward more consistently addressing their unmet needs and enhancing the quality of their oncology care.
Efficacy of steroid-omitting antiemetic therapy in patients with advanced pancreatic cancer receiving nano-liposomal irinotecan plus fluorouracil and leucovorin.
Tokito Y, Ishigaki K, Nara K … +8 more , Endo G, Nishio H, Fukuda K, Suzuki T, Sato Y, Takahara N, Boku N, Fujishiro M
Support Care Cancer · 2026 Jun · PMID 42234263 · Full text
BACKGROUND: Nano-liposomal irinotecan plus 5-fluorouracil and leucovorin (Nal-IRI/FL) is an established second-line chemotherapy for advanced pancreatic cancer (APC). Standard antiemetic prophylaxis for this moderately e...
BACKGROUND: Nano-liposomal irinotecan plus 5-fluorouracil and leucovorin (Nal-IRI/FL) is an established second-line chemotherapy for advanced pancreatic cancer (APC). Standard antiemetic prophylaxis for this moderately emetogenic regimen includes a 5-hydroxytryptamine (5-HT) receptor antagonist and dexamethasone (Dex). However, steroid use may worsen glucose intolerance in patients with diabetes mellitus (DM), and evidence supporting Dex-omitting strategies remains limited. METHODS: We retrospectively compared prophylactic antiemetic efficacy between Dex-omitting (no steroid use) and Dex-sparing (day 1 only) regimens combined with a 5-HT receptor antagonist and neurokinin-1 (NK1) receptor antagonist in patients with APC who received Nal-IRI/FL between October 2020 and August 2024. The primary outcome was total control (TC), defined as no nausea, vomiting, or rescue medication use within 120 h. RESULTS: Patients were categorized into Dex-sparing (n = 61) and Dex-omitting (n = 13) groups. Baseline characteristics were similar except for a higher prevalence of DM in the Dex-omitting group (31% vs. 100%, P < 0.01). TC rates were comparable (80% vs. 69%, P = 0.46). Relative dose intensity was slightly higher in the Dex-omitting group (Nal-IRI, 55% vs. 62%; 5-FU, 59% vs. 68%). Progression-free survival (5.2 vs. 5.0 months, P = 0.84) and overall survival (10.1 vs. 9.4 months, P = 0.56) were also similar. CONCLUSIONS: Steroid-omitting antiemetic therapy in combination with a 5-HT receptor antagonist and NK receptor antagonist appears to be a feasible option for patients with APC receiving Nal-IRI/FL, particularly those with diabetes mellitus. However, larger prospective studies are needed to validate these findings.
Educational interventions for training oncology residents in palliative medicine: a rapid review of the available evidence to inform training standards in cancer care.
Cheng J, Centeno I, Laird BJA … +5 more , Lõhmus M, Chlebopaševienė G, Foss L, Kaasa S, Centeno C
Support Care Cancer · 2026 Jun · PMID 42234193 · Full text
BACKGROUND: Integrating palliative care into routine cancer care improves quality of life, communication, symptom control, and decision-making. Despite strong international recommendations, training in palliative and sup...
BACKGROUND: Integrating palliative care into routine cancer care improves quality of life, communication, symptom control, and decision-making. Despite strong international recommendations, training in palliative and supportive care for oncology residents remains heterogeneous, and limited evidence informs how required competencies are best developed in clinical practice. OBJECTIVES: To synthesise the available evidence on educational interventions aimed at developing palliative and supportive care competencies among oncology residents, in order to inform training approaches relevant to contemporary cancer care, including the development of harmonised recommendations in Europe. METHODS: A rapid review was conducted following PRISMA principles. PubMed was searched (2000-2025) for studies evaluating educational interventions designed to improve palliative care competencies in postgraduate medical trainees involved in oncology care. Eligible studies were synthesised narratively. RESULTS: The search identified 509 unique records, of which 20 studies met inclusion criteria. Educational interventions were grouped into immersive (n = 10), involving supervised clinical practice within specialised palliative care services, and non-immersive (n = 10) approaches (e.g. short courses, workshops, seminars). Both types of interventions were examined in relation to internationally expected palliative care competencies for oncologists. Across studies, immersive clinical rotations-most commonly lasting 4-8 weeks-consistently improved practice-relevant competencies, including communication skills, symptom management, attitudes, knowledge, and self-efficacy. Benefits did not clearly increase with longer rotations. Mandatory immersive experiences produced broader and more consistent gains than elective formats and were more likely to influence clinical behaviours relevant to cancer care. Non-immersive interventions led to more modest but meaningful improvements, primarily in foundational knowledge, perceived preparedness, and structured communication skills. One randomised controlled trial demonstrated significant improvements in observed shared decision-making behaviours. CONCLUSIONS: Short, well-structured immersive rotations (4-8 weeks), particularly when mandatory, consistently yielded broader and more practice-relevant competency gains than elective formats. Non-immersive interventions-including workshops, online modules, and simulation-contributed meaningful improvements in foundational knowledge and structured communication skills and are best understood as complementary to, rather than substitutes for, clinical immersion. Together, these findings suggest that a tiered model combining mandatory immersive and structured non-immersive components may offer a feasible approach to strengthening PC training within oncology programmes. Findings are predominantly North American; transferability to European contexts requires further research.
Characterization of anemia and its association with functional status and depression in geriatric patients with solid organ cancers.
Sunny N, Sundriyal D, Shriwastav UK … +2 more , Khanna M, Dhar M
Support Care Cancer · 2026 Jun · PMID 42234181 · Publisher ↗
PURPOSE: The ongoing demographic transition toward an aging population is accompanied by a rising number of geriatric patients with cancer. Anemia is a common finding in older patients with malignancy. This study aimed t...
PURPOSE: The ongoing demographic transition toward an aging population is accompanied by a rising number of geriatric patients with cancer. Anemia is a common finding in older patients with malignancy. This study aimed to evaluate the prevalence of anemia and its association with functional status and depression among treatment-naïve geriatric patients with solid organ cancer (SOC). METHODS: In this observational study, geriatric patients with SOC underwent screening for anemia and a comprehensive geriatric assessment (CGA). Those with anemia were further evaluated with iron studies, stool for occult blood, upper and lower gastrointestinal endoscopies, serum B12 and folate levels, Coombs test, serum lactate dehydrogenase levels, and a bone marrow examination, as appropriate. Descriptive statistics (mean, median, and standard deviation), Pearson's chi-square test, Fisher's exact test, Kruskal-Wallis test, and Wilcoxon-Mann-Whitney U test were used to analyze the data. RESULTS: One hundred and seventy-six patients were included. The median age was 67 (range 60-94) years, with a male preponderance of 76.7% (n = 135) and a stage IV, 81.8% (N = 144) disease. Anemia was detected in 51.7% (n = 91) of patients, with 51.6% (n = 47) having grade 2 severity. Iron deficiency anemia (IDA), functional IDA, possible functional IDA, and no iron deficiency (NID) were found in 23.1% (n = 21), 44% (n = 40), 12.1% (n = 11), and 16.5% (n = 15) of the patients, respectively. We found a significant association of anemia with body-mass index (P = 0.017), performance status (P < 0.005), activities of daily living (P < 0.010), instrumental activities of daily living in males (P < 0.034), balance and mobility (P = 0.016), and depression (P < 0.001). CONCLUSION: More than half of the geriatric patients with SOC were anemic at presentation, with functional IDA being the most common subtype, followed by IDA. Anemia was significantly associated with poorer functional status, impaired mobility and balance, and higher rates of depression, underscoring its substantial impact on both the physical and psychological well-being of older patients with cancer. These findings highlight the importance of comprehensive geriatric assessment and detailed characterization of anemia subtypes, including IDA, functional IDA, possible functional IDA, and NID, as management strategies may vary according to iron status.
Photobiomodulation therapy for oral mucositis: clinical experience from a supportive care program at the Indian Institute of Head and Neck Oncology.
Dharkar D, Kulkarni K, Bensadoun RJ … +1 more , Vyas V
Support Care Cancer · 2026 Jun · PMID 42234177 · Publisher ↗
BACKGROUND: Photobiomodulation (PBM), the therapeutic use of non-ionizing red to near-infrared light, has emerged as a safe, non-invasive, evidence-based modality for managing oral mucositis (OM) in oncology. OBJECTIVE:...
BACKGROUND: Photobiomodulation (PBM), the therapeutic use of non-ionizing red to near-infrared light, has emerged as a safe, non-invasive, evidence-based modality for managing oral mucositis (OM) in oncology. OBJECTIVE: To evaluate the feasibility and therapeutic outcomes of photobiomodulation therapy (PBMT) within a structured multidisciplinary supportive care pathway at a charitable oncology center in India, specifically comparing outcomes against a historical control cohort. METHODS: This observational cohort study included 132 patients with head and neck squamous cell carcinoma undergoing curative or adjuvant radiotherapy/chemoradiotherapy. PBMT was initiated at first clinical evidence of mucositis (WHO grade ≥ 1). Baseline for analysis was defined as the time of PBMT initiation. Outcomes were compared with a matched historical control cohort (n = 100) treated prior to PBMT implementation. RESULTS: Severe mucositis (grades 3-4) in the PBMT cohort declined from 57% at baseline (time of PBMT initiation) to 2% at 8 weeks. The PBMT cohort demonstrated significantly superior outcomes compared to historical controls, including lower peak mucositis grades (2.9 vs. 3.5; p < 0.01), shorter duration of severe mucositis (1.2 vs. 3.4 weeks; p < 0.01), and reduced opioid reliance (57% vs. 85%; p < 0.01). CONCLUSION: PBMT was associated with improved mucositis severity and pain outcomes within a structured supportive care framework in head and neck cancer patients in tertiary cancer center. Compared with historical controls, PBMT was associated with lower peak mucositis grades shorter duration of severe mucositis and reduced opioid use. This findings suggest that PBMT may represent a practical adjunct in resource constrain oncology settings.
Longitudinal assessment and predictors of subjective taste change after hematopoietic cell transplantation (HCT).
Hovan AJ, Brennan MT, Hasséus B … +10 more , Raber-Durlacher JE, Huysmans MC, Laheij AMGA, van Leeuwen SJM, Legert KG, Isom S, Kline DM, Blijlevens NMA, Johansson JE, von Bültzingslöwen I
Support Care Cancer · 2026 Jun · PMID 42234168 · Full text
PURPOSE: The aims of this investigation within the Orastem study were to describe the prevalence of subjective taste change, levels of patient-reported distress associated with taste change, and factors predicting taste...
PURPOSE: The aims of this investigation within the Orastem study were to describe the prevalence of subjective taste change, levels of patient-reported distress associated with taste change, and factors predicting taste change after hematopoietic cell transplantation (HCT) with a particular focus on factors predictive of severe and/or persistent (present at 12 months) taste change. METHODS: Altogether, 238 patients at five cancer centers were followed during HCT hospitalization and up to 12 months post-HCT. Patients with taste change were compared to non-affected patients with respect to gender, age, transplant type, previous chemotherapy, conditioning regimen(s), oral mucositis, pre-HCT salivary flow, oral hygiene status and, in allogeneic HCT recipients, chronic oral graft-versus-host disease (GVHD). Distress from taste change was also evaluated. RESULTS: During hospitalization, taste change was reported by over one-third (81/238) of patients to an open question on oral symptoms; of these, 41% reported taste change as their worst/most bothersome oral symptom. To a specific question on distress due to taste change, 76% of all patients reported some level of distress. Taste change from previous chemotherapy and full intensity conditioning were risk factors for severe taste change during hospitalization. At three months, allogeneic transplant patients reported a higher rate of severe taste change compared to autologous transplant patients. Increased age predicted severe taste change at 6 and 12-month follow-up. At twelve months, 13.1% of patients reported distress from taste change. CONCLUSION: This study confirmed taste change as a common clinical complaint post-HCT. Taste change remained a significant issue for a small subset of patients at 12 months. Further research is required to develop effective preventive and management strategies for this common oral side-effect post-HCT.
Nutritional status, dietary antioxidant capacity, and dietary diversity in patients with newly diagnosed hematological malignancies: a case-control study.
Koyuncu BN, Yilmaz M, Koseoglu FD
Support Care Cancer · 2026 Jun · PMID 42230396 · Full text
PURPOSE: Nutritional status and dietary antioxidant capacity are important determinants of clinical resilience in cancer; however, data in hematological malignancies remain limited. We aimed to compare nutritional status...
PURPOSE: Nutritional status and dietary antioxidant capacity are important determinants of clinical resilience in cancer; however, data in hematological malignancies remain limited. We aimed to compare nutritional status, dietary total antioxidant capacity (DTAC), and dietary diversity between patients with newly diagnosed hematological malignancies and healthy controls. METHODS: This case-control study included 34 patients with newly diagnosed hematological malignancies (12 lymphoma, 11 leukaemia, 11 multiple myeloma) and 34 age- and sex-matched healthy controls aged 18-65 years. DTAC was estimated using the ferric reducing antioxidant power (FRAP) method based on a validated food frequency questionnaire. Nutrient intakes and the dietary diversity score (DDS) were derived from 3-day dietary records. Nutritional status was assessed using the Global Leadership Initiative on Malnutrition (GLIM) criteria, along with fat-free mass index (FFMI), and mid-upper arm circumference (MUAC). RESULTS: Patients had significantly lower DTAC levels than controls (3.85 ± 1.58 vs. 8.68 ± 3.21 mmol/day, p < 0.05). According to GLIM criteria, 35.3% of patients had moderate malnutrition and 26.5% had severe malnutrition, A declining trend in DTAC was observed with worsening malnutrition (p = 0.034), although this did not reach the significance threshold after multiplicity adjustment. Low muscle mass was more prevalent in patients as assessed by both FFMI and MUAC. Energy, protein, zinc, vitamin E, and folate intakes were significantly lower in patients (all p < 0.05), whereas DDS did not differ (p > 0.05). DTAC was positively correlated with intakes of coffee, whole-grain bread, green vegetables, citrus fruits, and fresh fruit (p ≤ 0.05). CONCLUSIONS: Significant differences in nutritional status and DTAC between patients and healthy individuals suggest that suboptimal dietary patterns may accompany hematological malignancies at diagnosis. These findings highlight the potential importance of adequate macro- and micronutrient intake; however, further prospective studies are needed to determine whether targeted nutritional interventions can improve clinical outcomes or contribute to long-term risk reduction.
Experiences of racially, ethnically, sexual- and gender-minoritized adolescents and young adults with cancer in the Canadian health care system.
Oberoi S, Hanson K, Shauman M … +14 more , Zohair M, Duong J, Scott I, Ramasamy V, Wilson K, van Velzen R, Tayabee Z, Schulte F, Stirling M, Louis D, Lix LM, Garland A, Mahar A, Hatala A
Support Care Cancer · 2026 Jun · PMID 42230355 · Publisher ↗
OBJECTIVES: Our study aimed to investigate the experiences of adolescents and young adults (AYAs) with cancer from racially/ethnically diverse and/or 2SLGBTQIA + communities within the Canadian healthcare system to ident...
OBJECTIVES: Our study aimed to investigate the experiences of adolescents and young adults (AYAs) with cancer from racially/ethnically diverse and/or 2SLGBTQIA + communities within the Canadian healthcare system to identify areas for improvement in their cancer care experience. METHODS: The study included participants who self-identified as racially/ethnically diverse and/or 2SLGBTQIA + , diagnosed with cancer between ages 15 and 39 years, currently aged 18 years or older, and received or were receiving cancer care in Canada. Patient partners with lived experience of cancer were recruited as collaborators. Semi-structured virtual interviews were conducted using an interview guide, and transcripts were analyzed using framework analysis. RESULTS: Twenty-three participants (17 racially/ethnically diverse; 1 sexual/gender diverse; 5 both racially and sexually diverse) were interviewed. Positive experiences reported by participants included being able to identify with healthcare providers (HCPs), effective communication, comprehensive information sharing, and access to support services tailored for younger patients. Negative experiences were characterized by perceptions of judgmental attitudes and racialization from HCPs, the necessity of self-advocacy to obtain resources, systemic barriers to care, and psychosocial difficulties. Participants' recommendations for improving cancer care included increasing the diversity of HCPs, implementing equity, diversity, and inclusion training, and enhancing both communication and information dissemination practices. CONCLUSION: The experiences of diverse AYAs revealed both facilitators and barriers to equitable cancer care. Findings emphasize the need for workforce diversity and equity-informed practices to advance culturally responsive oncology care. Précis: This study examined the cancer care experiences of racially/ethnically diverse and/or 2SLGBTQIA + adolescents and young adults in Canada, revealing both supportive interactions and significant barriers such as discrimination and systemic inequities. Participants recommended increasing provider diversity, equity-focused training, and improved communication to create more inclusive and responsive cancer care.
Diagnostic predictive models for cancer-related fatigue: current evidence and future directions.
Liang F, Wang M, Li K … +3 more , Lv D, Qian T, Bu Z
Support Care Cancer · 2026 Jun · PMID 42230345 · Publisher ↗
PURPOSE: To evaluate the performance and methodological quality of published diagnostic prediction models for cancer-related fatigue (CRF), and to provide evidence for clinical practice and future research. METHODS: A sy...
PURPOSE: To evaluate the performance and methodological quality of published diagnostic prediction models for cancer-related fatigue (CRF), and to provide evidence for clinical practice and future research. METHODS: A systematic review and meta-analysis were conducted. PubMed, Web of Science, the Cochrane Library, Embase, and Scopus were searched from inception to October 18, 2024, for studies developing or validating diagnostic prediction models for CRF. The pooled area under the receiver operating characteristic curve (AUC) and 95% confidence interval (CI) were calculated using R. Heterogeneity was assessed using the I statistic and Cochran's Q test, publication bias was explored using funnel plots and Egger's test, and risk of bias was evaluated with the Prediction Model Risk of Bias Assessment Tool (PROBAST). RESULTS: A total of 8418 records were identified, of which 13 studies met the inclusion criteria. These studies included 23 cohorts, 444,447 cancer patients, and 11 diagnostic prediction models. The pooled AUC was 0.83 (95% CI = 0.78-0.87), indicating moderate-to-good discrimination. However, substantial heterogeneity was observed (I > 94%), suggesting that the pooled estimate should be interpreted with caution. PROBAST assessment indicated a high risk of bias in most studies, mainly related to statistical analysis and reporting. Egger's test suggested possible funnel plot asymmetry, but this finding should be considered exploratory because of the small number of studies and high heterogeneity. CONCLUSION: Existing CRF diagnostic prediction models show moderate-to-good discrimination in research settings, but their performance varies across populations, outcome definitions, and modeling approaches. Future studies should prioritize large-scale, multi-center, multiethnic, and externally validated models to improve early identification and precise management of CRF.
Prognostic impact of weight loss during first-line chemotherapy in extensive-disease small cell lung cancer.
Fujisaki T, Naito T, Kumaki S … +10 more , Kataoka S, Saito S, Matsuda S, Kobayashi H, Ko R, Wakuda K, Ono A, Murakami H, Takahashi T, Kenmotsu H
Support Care Cancer · 2026 Jun · PMID 42228208 · Publisher ↗
PURPOSE: The adverse prognostic impact of cancer cachexia is well recognized. We aimed to evaluate the prognostic impact of weight loss during first-line platinum-based chemo(immuno)therapy in patients with extensive-dis...
PURPOSE: The adverse prognostic impact of cancer cachexia is well recognized. We aimed to evaluate the prognostic impact of weight loss during first-line platinum-based chemo(immuno)therapy in patients with extensive-disease small-cell lung cancer (ED-SCLC). METHODS: We retrospectively reviewed 187 of 346 ED-SCLC patients (54%) treated between 2009 and 2021, and collected body weight at three time points: 6 months before, at the start of the first cycle, and at the beginning of the third cycle of initial chemotherapy. Based on pretreatment cachexia defined according to the Fearon criteria (weight loss > 5% or > 2% with BMI < 20 kg/m within 6 months) and > 2% weight loss from the start of chemotherapy to the beginning of the third cycle, we classified patients into four groups: those without weight loss both before and during chemotherapy (n = 75) (non-weight-loss group), those without weight loss before but with weight loss during chemotherapy (n = 34), those with weight loss before but not during chemotherapy (n = 46), and those with weight loss both before and during chemotherapy (n = 32). We evaluated survival outcomes and gastrointestinal toxicities during the first two cycles. RESULTS: Median overall survival (OS) differed significantly among the groups (p = 0.020), with the non-weight-loss group showing more favorable survival than the other groups (adjusted hazard ratios, 1.51-1.65; all p ≤ 0.05). The non-weight-loss group experienced fewer grade ≥ 2 anorexia and nausea/vomiting events during the first two cycles. CONCLUSIONS: In patients with ED-SCLC, the absence of weight loss before and during chemotherapy was associated with longer OS and fewer gastrointestinal toxicities. These findings underscore the importance of early supportive care to prevent weight loss, including proactive management of gastrointestinal toxicities during chemotherapy.
Pretreatment neutrophil-to-lymphocyte ratio (NLR) as a potential risk marker for febrile neutropenia (FN) in breast and ovarian cancer during first-cycle chemotherapy.
Saif F, Qureshi FN, Ahmad A … +5 more , Durrani F, Azam NUA, Ullah I, Ahmed ZUD, Khan AR
Support Care Cancer · 2026 Jun · PMID 42228187 · Publisher ↗
PURPOSE: The neutrophil-to-lymphocyte ratio (NLR) is a readily available inflammatory biomarker for predicting febrile neutropenia (FN) in cancer patients. This study aimed to evaluate the association between pretreatmen...
PURPOSE: The neutrophil-to-lymphocyte ratio (NLR) is a readily available inflammatory biomarker for predicting febrile neutropenia (FN) in cancer patients. This study aimed to evaluate the association between pretreatment NLR and the risk of FN in breast and ovarian cancer patients. METHODS: In this prospective study, 130 patients (109 breast, 21 ovarian) were analyzed. Pretreatment NLR was measured, and the optimal cutoff was determined using receiver operating characteristic (ROC) curve analysis. Clinical and pathological variables, including age, body surface area (BSA), chemotherapy regimen, chemotherapy setting, cancer type, and stage, were assessed using univariate analyses, followed by parsimonious multivariable models adjusting for selected clinical covariates. Internal validation was performed using bootstrap resampling. Subgroup analyses were conducted according to cancer type, chemotherapy regimen, and treatment setting. RESULTS: ROC analysis showed an area under the curve (AUC) of 0.628 (95% CI 0.511-0.746) for NLR. An NLR cutoff ≥ 2.1 demonstrated a sensitivity of 72.7%, specificity of 50%, positive predictive value of 27.9%, negative predictive value of 90%, and showed a borderline association with FN in univariate analysis (OR 2.67, 95% CI 0.97-7.33, p = 0.057). This association was not consistently significant after adjustment or across subgroup analyses. Bootstrap validation demonstrated stability of the estimated effects without materially altering statistical significance. Other clinical variables, including age, body surface area, cancer type, stage, and chemotherapy regimen, were not significantly associated with FN. CONCLUSION: Pretreatment NLR demonstrated a trend toward association with chemotherapy-induced FN; however, its discriminatory performance was limited, and statistical significance was not consistently achieved. These findings suggest that NLR may reflect an underlying inflammatory signal but is insufficient as a standalone predictive marker. Further validation in larger external cohorts is warranted before clinical application can be considered.
Post-COVID-19 changes in care-seeking behaviors among Chinese cancer survivors: a cross-sectional study.
Zuo Y, He J, Bai Z … +4 more , Xie H, Zhang Q, Yang K, Zhang J
Support Care Cancer · 2026 Jun · PMID 42228181 · Publisher ↗
PURPOSE: To investigate changes in care-seeking behaviors among Chinese cancer survivors following the lifting of COVID-19 control measures, identify demographic, clinical, and socioeconomic predictors of professional ca...
PURPOSE: To investigate changes in care-seeking behaviors among Chinese cancer survivors following the lifting of COVID-19 control measures, identify demographic, clinical, and socioeconomic predictors of professional care use, and to assess perceived convenience and severity of care needs post-pandemic. METHODS: We conducted a cross-sectional survey in Southwest China between May 2023 and January 2024. A total of 477 valid responses were collected using convenience sampling from outpatient clinics, rehabilitation units, and online survivor networks. Group differences in care-seeking before and after COVID-19 control were tested with Chi-square and Kruskal-Wallis tests. Paired Chi-square tests were applied to compare pre- and post-COVID-19 behaviors. Multivariable Poisson regression with robust error variance was used to identify independent predictors of professional care-seeking. RESULTS: Hospital visits declined from 54.1% before control to 40.0% after, while online consultations increased from 8.2% to 22.2% and self-care rose from 27.0% to 33.1%. Perceived convenience of care worsened, with inconvenience reports rising from 32.7% to 43.4%, and the proportion of survivors reporting severe or very severe illness increased. Older age, higher income, higher education, cohabitation, multiple comorbidities, and better functional status were significant predictors of professional care-seeking. CONCLUSIONS: Post-COVID-19, cancer survivors in China shifted toward online and self-care modalities, while hospital use declined. Access to professional care is shaped by socioeconomic and functional factors, which leads to disparities in survivorship care. IMPLICATIONS FOR CANCER SURVIVORS: Expanding telemedicine, strengthening community oncology services, and addressing socioeconomic and functional barriers are essential to ensure equitable access to care. Building resilient, integrated models that combine hospital, community, and digital modalities may better support survivors during future public health emergencies.
Photobiomodulation for hormone therapy-induced sexual dysfunction in women with breast cancer: a prospective quasi-experimental clinical study with a parallel observational group.
Vieira LR, Rezende LF
Support Care Cancer · 2026 Jun · PMID 42228167 · Publisher ↗
BACKGROUND: Breast cancer survivors undergoing hormone therapy frequently experience vaginal pain and sexual dysfunction, which negatively affect quality of life. These symptoms are often undertreated, and new therapeuti...
BACKGROUND: Breast cancer survivors undergoing hormone therapy frequently experience vaginal pain and sexual dysfunction, which negatively affect quality of life. These symptoms are often undertreated, and new therapeutic approaches are needed. PURPOSE: To evaluate the effects of photobiomodulation (PBM) on vaginal pain, sexual function, safety, and tolerability in women with breast cancer undergoing hormone therapy. METHODS: A prospective, quasi-experimental clinical study was conducted with 24 women presenting hormone therapy-induced sexual dysfunction, who underwent four weekly intra- and extra-cavitary PBM sessions (blue LED-440 nm, 8 min; red LED-660 nm, 20 min). Eight eligible participants who declined the intervention due to embarrassment were followed as an untreated observational group. Assessments were performed before and after the intervention using the Female Sexual Quotient Questionnaire (QS-F) and the Visual Analog Scale (VAS) for vaginal pain. RESULTS: At baseline, 82.6% of participants reported maximum vaginal pain (VAS = 10), and 78.2% presented absent or severely impaired sexual function. After four PBM sessions, 79.1% of the women reported complete absence of pain, with mean VAS scores decreasing from 9.46 ± 0.98 to 1.04 ± 2.17 (p < 0.0001). Sexual function also improved significantly, with mean QS-F scores increasing from 23.25 ± 23.47 to 87.21 ± 17.93 (p < 0.0001), and 95.8% of participants reporting good to excellent sexual function after treatment. The intervention was well tolerated, with no adverse events reported. The observational group showed no changes in the evaluated outcomes. CONCLUSION: PBM proved to be safe, well tolerated, and clinically effective in reducing vaginal pain and improving sexual function in women with breast cancer undergoing hormone therapy, representing a promising therapeutic alternative.
Decision-making driving factors in breast reconstruction among premenopausal breast cancer patients in China: a Q-methodology study.
Liu Q, Wang Q, Liang D … +5 more , Qiu J, Martin-Payo R, Lv Q, Fu MR, Zhang X
Support Care Cancer · 2026 Jun · PMID 42223723 · Publisher ↗
OBJECTIVES: Breast reconstruction improves body image, sexual experience, and well-being in patients with breast cancer. However, only about 10% of patients in China choose breast reconstruction. The objective of this st...
OBJECTIVES: Breast reconstruction improves body image, sexual experience, and well-being in patients with breast cancer. However, only about 10% of patients in China choose breast reconstruction. The objective of this study is to explore types of breast reconstruction decision-making and driving factors among Chinese premenopausal patients. METHODS: This was a mixed-methods study based on Q-methodology, conducted from May 2024 to October 2024. First, 15 premenopausal breast cancer patients who underwent breast reconstruction were selected using maximum variation purposive sampling for semistructured interviews, generating a Q-sample dataset consisting of 36 statements. Then, 18 premenopausal patients who underwent breast reconstruction were selected as the P-sample using the same sampling method; these 18 patients performed Q-sorting on the 36 statements within a specified Q-sorting grid and completed in-depth interviews after sorting. Data analysis was primarily conducted using Ken-Q software, which automatically generated standardized Q-sort results. Combined with these standardized Q-sort results and interview contents, the study analyzed the decision-making driving types and factors influencing patients' choices of breast reconstruction. RESULTS: Principal component analysis identified six factors with eigenvalues > 1, collectively accounting for 72% of the total variance. Based on the ideal Q-sort simulated by the software, three types of decision-making factors were identified. The social participation and youth advantage co-dominant type was motivated by professional advice, younger age, and social engagement. The aesthetic appearance and case-based encouragement co-dominant type was driven by a desire for body image, aesthetics, and the influence of other's successful surgeries. The medical professional advice and financial status co-dominant type was shaped by trust in medical professionals, confidence in the healthcare team, and financial considerations. CONCLUSIONS: Premenopausal patients with breast cancer in China who underwent breast reconstruction demonstrated various decision-making types. The findings may assist Chinese healthcare providers as well as healthcare providers in other countries with similar Eastern cultural backgrounds in understanding and exploring the drivers of breast reconstruction choices during shared decision-making processes. This work can help in developing targeted interventions and establishing clinical protocols that empower patients to make choices that align with their preferences and best interests.
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