Supportive Care In Cancer[JOURNAL]
Sun
200 papers
Patient-initiated rehabilitation after radiotherapy: gender and sociodemographic differences despite standardized support - a German retrospective single-center study.
Besserer A, Mutiara S, Boschan J … +2 more , Koziol MJ, Höcht S
Support Care Cancer · 2026 May · PMID 42178407 · Publisher ↗
PURPOSE: Oncological rehabilitation improves quality of life and convalescence after cancer therapy yet is not uniformly accessed. While physician referral patterns and structural access barriers are studied, data on pat...
PURPOSE: Oncological rehabilitation improves quality of life and convalescence after cancer therapy yet is not uniformly accessed. While physician referral patterns and structural access barriers are studied, data on patient decision-making under standardized conditions are lacking. This single-center study examines gender and sociodemographic differences in patient-initiated rehabilitation under standardized conditions to eliminate physician selection bias and make patient-side decision processes visible. METHODS: From January 2024 to December 2025, all patients treated at a radiation oncology department in Brandenburg, Germany received standardized written information about rehabilitation options and uniform support from social services. Patients who initiated rehabilitation were compared with the total cohort regarding gender, age, residence, insurance status, and diagnosis to identify sociodemographic factors in decision-making. RESULTS: Overall rehabilitation uptake was 17.8% (484/2,727). Females accessed rehabilitation 2.6 times more frequently than males (25.1% vs. 9.6%, p < 0.001). Patients ≤ 65 years had twice the uptake of older patients (25.8% vs. 12.3%, OR = 2.48, 95% CI: 2.03-3.03, p < 0.001). Rural residents showed higher uptake than urban residents (32.0% vs. 15.2%, OR = 2.63, 95% CI: 2.08-3.33, p < 0.001). Statutory health insurance patients had higher uptake than privately insured patients (18.7% vs. 10.4%, OR = 1.98, 95% CI: 1.36-2.90, p < 0.001). Rehabilitation uptake varied substantially by tumor entity, with breast cancer showing the highest rates (43.9%). Curative treatment intent strongly predicted uptake (OR = 13.73, 95% CI: 8.87-21.27, p < 0.001). CONCLUSION: Even with standardized information and administrative support, significant gender-specific and sociodemographic differences persist. Barriers extend beyond information deficits to include patient-specific factors requiring targeted interventions to achieve equitable rehabilitation access.
Association between preoperative quality of life (QoL) and postoperative complications after gastrectomy for gastric carcinoma.
Jang A, Jeong O
Support Care Cancer · 2026 May · PMID 42177387 · Publisher ↗
PURPOSE: Quality of life (QoL) assessments in surgical practice have traditionally focused on postoperative recovery and long-term outcomes. This study evaluated the predictive value of preoperative QoL for postoperative...
PURPOSE: Quality of life (QoL) assessments in surgical practice have traditionally focused on postoperative recovery and long-term outcomes. This study evaluated the predictive value of preoperative QoL for postoperative complications. METHODS: We retrospectively analyzed the prospectively collected data from 908 patients who underwent gastrectomy for gastric carcinoma. Preoperative QoL was measured using the EORTC QLQ-C30 and STO22 questionnaires. A multivariate logistic regression was used to develop a predictive model, and model performance was assessed with a receiver operating characteristic (ROC) curve. RESULTS: Distal gastrectomy was performed in 763 patients (84.0%) and total gastrectomy in 145 patients (16.0%). Postoperative complications occurred in 189 patients (20.8%); local and systemic complications were observed in 160 (17.6%) and 48 (5.3%) patients, respectively, with some overlap. Patients with complications had significantly lower preoperative QoL scores across multiple functional and symptom domains. The predictive model identified global health status, stomach pain, anxiety, and body image as key indicators for complications, with an area under the ROC curve of 0.630 (95% CI 0.583-0.676). High-risk QoL classification by the model was an independent predictor of complications after adjusting for clinical risk factors. CONCLUSION: Preoperative QoL, reflected in multiple functional and symptom domains, is associated with increased postoperative complications. Early identification of high-risk patients may facilitate targeted interventions to improve surgical outcomes.
Prevalence of preoperative multidimensional frailty and associated factors in middle-aged and older patients with newly diagnosed breast cancer: a cross-sectional study.
Cheng W, Zhang B, Zhang Y … +7 more , Fang J, Yan J, He H, Chen L, Zhang N, Zhang Y, Zhang M
Support Care Cancer · 2026 May · PMID 42176214 · Publisher ↗
PURPOSE: Frailty has emerged as a significant predictor of health outcomes. However, multidimensional frailty among middle-aged and older patients with newly diagnosed breast cancer remains understudied. Therefore, this...
PURPOSE: Frailty has emerged as a significant predictor of health outcomes. However, multidimensional frailty among middle-aged and older patients with newly diagnosed breast cancer remains understudied. Therefore, this study aims to investigate the prevalence of preoperative multidimensional frailty and its associated factors in this population. METHODS: A total of 223 middle-aged and older patients with breast cancer were recruited from the breast surgery ward of a general hospital in China from September 2023 to July 2024. Sociodemographic characteristics, clinical information, biochemical indicators, Tilburg frailty indicator scores, physical activity scale for the elderly scores, and Resnick exercise self-efficacy scale scores were collected from all patients. Chi-square tests and independent samples t-tests were used for univariate analyses, and variables with statistical significance were included in a binary logistic regression to identify factors associated with multidimensional frailty. RESULTS: The prevalence of preoperative multidimensional frailty was 36.3% in middle-aged and older patients with newly diagnosed breast cancer. Factors associated with multidimensional frailty included higher exercise self-efficacy (OR = 0.760, p = 0.004), high self-perceived financial distress (OR = 3.996, p = 0.009), living alone (OR = 17.822, p = 0.007), difficulty falling asleep (OR = 2.858, p = 0.005), ≥ 2 comorbidities (OR = 7.995, p = 0.003), low white blood cell count (OR = 5.202, p = 0.011), and overweight or obesity (OR = 0.417, p = 0.014). CONCLUSIONS: The prevalence of preoperative multidimensional frailty is relatively high among middle-aged and older patients with newly diagnosed breast cancer and is associated with exercise self-efficacy, self-perceived financial distress, living arrangement, difficulty falling asleep, number of comorbidities, white blood cell count, and body mass index. Healthcare professionals should assess patient characteristics to identify high-risk patients preoperatively and consider developing targeted interventions to enhance exercise self-efficacy, which may be beneficial for the management of multidimensional frailty and related health outcomes.
Facilitators and barriers to the implementation of traditional Chinese exercises in cancer patients: a mixed-methods systematic review.
Gao L, Zhang L, Liu Y … +3 more , Zhang N, Li Y, Chen L
Support Care Cancer · 2026 May · PMID 42176130 · Publisher ↗
PURPOSE: To identify barriers and facilitators to the implementation of traditional Chinese exercises in cancer patients. METHODS: This was a mixed-methods systematic review. It searched for published studies from nine d...
PURPOSE: To identify barriers and facilitators to the implementation of traditional Chinese exercises in cancer patients. METHODS: This was a mixed-methods systematic review. It searched for published studies from nine different sources. Data synthesis followed a convergent integrated approach according to the Joanna Briggs Institute methodology for mixed-methods systematic reviews. Quantitative data were qualitized using thematic analysis and synthesized with qualitative data using thematic synthesis. RESULTS: Twenty-one studies were included. Forty-three implementation determinants were identified across five domains of the Consolidated Framework for Implementation Research (CFIR), including 25 facilitators and 18 barriers. Key facilitators included perceived benefits, simplicity, social support, and flexible delivery, whereas major barriers involved symptom burden, resource constraints, competing life demands, and limited organizational support. CONCLUSIONS: The implementation of traditional Chinese exercises in cancer patients is shaped by multilevel determinants across CFIR domains. Implementation outcomes depend on the alignment between intervention characteristics, patient capacity, and contextual conditions. Context-sensitive and tailored strategies are required to improve uptake and long-term sustainability.
Palliative care involvement and use of critical care therapies in patients with advanced cancer: a multicenter retrospective cohort study.
Monzón V, Di Stefano S, Gira AR … +16 more , Pratesi P, Lagos T, Najun M, Pochettino M, Leone B, Ivulich D, Huerta H, Román LAV, Vaena M, Olaizola G, Bellone E, de Andes ÁP, Nagourney J, Huespe I, Bauque S, Osatnik J
Support Care Cancer · 2026 May · PMID 42176126 · Publisher ↗
BACKGROUND: Cancer is a leading cause of mortality worldwide, and a substantial proportion of patients with advanced disease require ICU admission, where decisions regarding critical care therapies are complex. Despite r...
BACKGROUND: Cancer is a leading cause of mortality worldwide, and a substantial proportion of patients with advanced disease require ICU admission, where decisions regarding critical care therapies are complex. Despite recommendations for early palliative care integration, its implementation in ICU settings remains limited. AIM: To evaluate the association between palliative care involvement and the use of critical care therapies among critically ill patients with advanced solid tumors and in-hospital mortality. DESIGN: Multicenter retrospective cohort study. SETTING AND PARTICIPANTS: We included 292 adult patients with advanced solid tumors admitted to the ICU at three tertiary hospitals in Argentina between 2010 and 2024 who died during hospitalization. Patients were categorized according to palliative care involvement before or during ICU admission. RESULTS: Overall, 23% of patients (95% CI, 19-29) received palliative care, including 18% (95% CI, 13-22) prior to ICU admission. Use of critical care therapies was lower among patients receiving palliative care compared with those who did not (54% vs. 72%; p < 0.01). After inverse probability weighting, palliative care involvement remained independently associated with lower odds of receiving critical care therapies (adjusted OR, 0.46; 95% CI, 0.33-0.66; p < 0.01). Hospital length of stay was shorter in the palliative care group (adjusted IRR, 0.67; 95% CI, 0.57-0.78; p < 0.01). CONCLUSIONS: In this multicenter cohort of critically ill patients with advanced solid tumors, palliative care involvement was independently associated with reduced use of critical care therapies (including invasive mechanical ventilation, dialysis, parenteral nutrition, or tracheostomy) and shorter hospital length of stay, supporting its role in facilitating goal-concordant care.
Association of metabolic markers, inflammatory biomarkers, and sedentary time with comorbidities among cancer patients: Results from NHANES 2021-2023.
Kim M, Lee J
Support Care Cancer · 2026 May · PMID 42174264 · Publisher ↗
BACKGROUND: Cancer patients experience cardiovascular and metabolic comorbidities that worsen treatment tolerance, and increase mortality risk. Metabolic dysregulation, chronic inflammation, and prolonged sedentary behav...
BACKGROUND: Cancer patients experience cardiovascular and metabolic comorbidities that worsen treatment tolerance, and increase mortality risk. Metabolic dysregulation, chronic inflammation, and prolonged sedentary behavior are recognized contributors to these adverse outcomes. OBJECTIVE: This study aimed to examine the associations of metabolic markers, inflammatory biomarkers, and sedentary time with major comorbidities among cancer patients. METHODS: A cross-sectional study analyzed data from 2021-2023 National Health and Nutrition Examination Survey. A total of 692 adults with a self-reported history of cancer were included. Body mass index (BMI), waist-to-hip ratio (WHR), blood pressure, pulse rate, high-sensitivity C-reactive protein (hs-CRP), neutrophil-to-lymphocyte ratio (NLR), and sedentary time were categorized into tertiles. Multivariate logistic regression models estimated unadjusted and adjusted odds ratios for cardiovascular, respiratory, metabolic comorbidities, controlling for age, sex, race/ ethnicity, education level, smoking status, and physical activity level. RESULTS: After adjustment, higher BMI was significantly associated with congestive heart failure, hypertension, and diabetes. Higher WHR was associated with heart attack and diabetes. SBP showed bidirectional associations, with the highest tertile associated with cardiovascular disease, respiratory disease, and diabetes. Hs-CRP was associated with congestive heart failure and hypertension. Longer sedentary time was associated with higher odds of congestive heart failure, hypertension, and diabetes. CONCLUSIONS: After adjusting for key confounders, metabolic indicators, inflammatory biomarkers, and sedentary time were associated with cardiometabolic comorbidities among cancer patients. BP parameters showed complex bidirectional associations with cardiovascular and metabolic outcomes. These finding highlight the importance of comprehensive and individualized risk assessment in cancer survivorship care.
Impact of home-based port infusion versus hospital-based peripheral infusion on anxiety, quality of life, and emergency visits in gastrointestinal cancer: a prospective observational study by the Turkish Oncology Group (TOG).
Cetin OA, Karaoglu T, Alkan A … +2 more , Yavuzsen T, Tanriverdi O
Support Care Cancer · 2026 May · PMID 42174259 · Full text
Home-based chemotherapy via port catheters offers logistical and potential psychological benefits but may pose unique challenges for patients undergoing prolonged regimens such as mFOLFOX6. Evidence on the association be...
Home-based chemotherapy via port catheters offers logistical and potential psychological benefits but may pose unique challenges for patients undergoing prolonged regimens such as mFOLFOX6. Evidence on the association between home-based infusion and anxiety, quality of life, and healthcare use in gastrointestinal (GI) cancer patients remains limited. In this prospective study, 190 GI cancer patients scheduled for adjuvant mFOLFOX6 were enrolled between July 2020 and December 2024. Patients chose either home-based port infusion (n = 94) or hospital-based peripheral infusion (n = 96). Anxiety was assessed using the State-Trait Anxiety Inventory (STAI-1 and STAI-2), and quality of life via EORTC QLQ-C30 at baseline, after six cycles (~3 months), and after 12 cycles (~6 months). Treatment-related toxicities and emergency visits were recorded. Logistic regression identified factors associated with high anxiety, low quality of life, and emergency visits. Baseline characteristics were similar between groups except for younger age in the home-based group, which lost significance after Bonferroni correction. After six cycles, home-based patients showed significantly higher state and trait anxiety than hospital-based patients (p < 0.001), though differences diminished by 12 cycles. Home-based patients also reported worse dyspnea, pain, fatigue, and nausea/vomiting after six cycles, with most symptoms improving later. Emergency visits without organic pathology were more frequent in the home-based group (32% vs. 13%, p = 0.002), although this difference did not remain statistically significant after Bonferroni correction. Multivariable analysis identified home-based infusion, living alone, social inactivity, shorter treatment duration, and low quality of life as independent factors associated with high state anxiety. Similar factors were associated with high trait anxiety, low quality of life, and emergency visits. Home-based port infusion for mFOLFOX6 is associated with transient increases in anxiety and impairments in quality of life early in treatment, which diminished by the end of treatment. Psychosocial support and close follow-up may help reduce anxiety and unnecessary emergency visits, particularly for socially isolated patients. Further randomized studies are warranted.
Recruitment strategies for a multisite telehealth trial for rural cancer survivors with ostomies.
Krouse RS, Wheeler SB, Appel S … +11 more , Sun V, Nielsen ME, Hoffman RL, Garg T, Popek SM, Sticca RP, Aka AA, McFadden CL, Hesham WM, Grant M, Holcomb M
Support Care Cancer · 2026 May · PMID 42171813 · Full text
PURPOSE: Ostomies, the surgical exteriorization of bowel for urine or stool, are part of the treatment of some cancers. We completed a randomized clinical trial testing a curriculum to help cancer survivors with ostomies...
PURPOSE: Ostomies, the surgical exteriorization of bowel for urine or stool, are part of the treatment of some cancers. We completed a randomized clinical trial testing a curriculum to help cancer survivors with ostomies in rural areas delivered by telehealth. The aim of this report is to describe modifications necessary to complete accrual in this population of cancer survivors. METHODS: Rural cancer survivors with ostomies at least 6 weeks postoperatively were randomized to group educational sessions via telehealth versus usual care. The curriculum was delivered once per week over 5 weeks; primary patient reported endpoints were at 6 months. Initial sites were University of North Carolina, City of Hope National Medical Center, and Geisinger Medical Center. Rurality was initially defined utilizing the rural-urban commuting area (RUCA) codes as 4+ (excluding RUCA 1, 2, 3). RESULTS: This study was open from August 16, 2019, to February 9, 2024. Accrual was more challenging after the COVID pandemic began in March 2020. Multiple modifications were needed to address trial recruitment challenges. Our amendments included adding six sites across the USA, expanding inclusion criteria to include RUCA 3 and then RUCA 2, and adding distance from ostomy nursing care, first to those living greater than 45 miles, and subsequently more than 25 miles. CONCLUSIONS: Accrual to cancer survivorship trials may be difficult, and unpredictable circumstances such as the worldwide pandemic may require research teams to be flexible and creative with recruitment strategies. Modifications may be necessary to ensure accrual yet maintain study integrity. TRIAL REGISTRATION: This study was registered on Clinicaltrials.gov (NCT # 03913715) on 5/29/2019.
Association between total corticosteroid dose and reduced fast-twitch rectus femoris muscle fibers after hematopoietic stem cell transplantation.
Nishikado N, Wakasugi T, Kaida K … +10 more , Umeji A, Sota K, Takemura D, Sugano K, Eimoto K, Sasanuma N, Yoshihara K, Yoshihara S, Uchiyama Y, Domen K
Support Care Cancer · 2026 May · PMID 42171801 · Publisher ↗
PURPOSE: Hematopoietic stem cell transplantation (HSCT) is a curative treatment for hematologic diseases. However, corticosteroids used to manage graft-versus-host disease can induce muscle weakness, particularly affecti...
PURPOSE: Hematopoietic stem cell transplantation (HSCT) is a curative treatment for hematologic diseases. However, corticosteroids used to manage graft-versus-host disease can induce muscle weakness, particularly affecting fast-twitch fibers. The objective of this study was to examine the association between the total corticosteroid dose and the decline in fast-twitch muscle fibers, estimated using surface electromyography (sEMG), as well as to evaluate its impact on muscle strength and physical performance. METHODS: This prospective observational study included 53 adult patients from a single center in Japan. sEMG of the rectus femoris was performed before and after HSCT to calculate the median frequency (MF), a noninvasive marker of fast-twitch fiber proportion. Additional physical function assessments included isometric knee and hip flexion strength, handgrip strength, body weight, thigh circumference, 30-s chair stand test, and maximum walking speed. Correlations between total corticosteroid dose and changes in each variable were analyzed. RESULTS: Forty-two patients completed both the pre- and post-HSCT assessments. MF, muscle strength, body weight, thigh circumference, 30-s chair stand test performance, and maximum walking speed exhibited significant reductions (all p < 0.01). The total corticosteroid dose negatively correlated with changes in MF (rs = -0.32), hip flexion strength (rs = -0.43), thigh circumference (rs = -0.32 to -0.40), and 30-s chair stand test performance (rs = -0.45). CONCLUSIONS: A higher total corticosteroid dose after HSCT may lead to a reduced proportion of fast-twitch fibers, which could be associated with impairments in muscle strength and function.
Postoperative nausea and vomiting as a predictor of chemotherapy-induced nausea and vomiting in gynecologic cancer: a retrospective cohort study.
Yamamoto S, Iihara H, Watanabe D … +6 more , Sakurai S, Kikuno K, Bomoto Y, Hayasaki Y, Isobe M, Suzuki A
Support Care Cancer · 2026 May · PMID 42171781 · Publisher ↗
PURPOSE: Postoperative nausea and vomiting (PONV) and chemotherapy-induced nausea and vomiting (CINV) share multiple patient-related risk factors, suggesting a common underlying emetogenic susceptibility. However, whethe...
PURPOSE: Postoperative nausea and vomiting (PONV) and chemotherapy-induced nausea and vomiting (CINV) share multiple patient-related risk factors, suggesting a common underlying emetogenic susceptibility. However, whether PONV serves as a clinically meaningful predictor of subsequent CINV remains unclear. This study aimed to determine whether the presence of PONV after gynecologic cancer surgery is associated with poorer CINV control during the first cycle of postoperative paclitaxel plus carboplatin chemotherapy. METHODS: We conducted a single-center retrospective cohort study in women with gynecologic malignancies who received postoperative paclitaxel plus carboplatin chemotherapy with guideline-consistent triplet antiemetic prophylaxis. PONV was evaluated during the 120-h postoperative period and was defined by the occurrence of vomiting or the need for rescue antiemetics. CINV outcomes, including complete response (CR; no emesis and no rescue medication), complete control (CC), total control (TC), nausea, significant nausea (CTCAE grade ≥ 2), and vomiting, were assessed across acute, delayed, extended delayed, overall, and extended overall periods. Logistic regression was performed to evaluate associations between PONV and CINV while adjusting for age and the use of olanzapine. RESULTS: Among 161 eligible patients, 73 (45.3%) experienced PONV and 88 (54.7%) did not. The CR rate during the overall period (0-120 h) was significantly lower in patients with PONV than in those without PONV (73% vs 91%, p = 0.002). PONV-positive patients also had lower rates of CR, CC, and TC not only during the delayed and extended delayed phases but also across the overall and extended overall periods, and showed higher incidences of nausea and significant nausea, whereas vomiting outcomes showed minimal differences. Multivariable analysis demonstrated that PONV was independently associated with failure to achieve CR (adjusted OR 4.28, 95% CI 1.70-11.8, p = 0.003). No notable differences in adverse events were observed between groups. CONCLUSION: PONV was a significant and independent predictor of poorer CINV control despite guideline-based triplet prophylaxis, and this association remained significant after adjusting for younger age and olanzapine use. These findings suggest that PONV reflects a distinct dimension of emetogenic vulnerability and may serve as a practical clinical marker to identify patients who could benefit from risk-adapted antiemetic strategies. Prospective studies are warranted to validate these findings and evaluate tailored prophylaxis approaches for high-risk patients.
Factors associated with cancer pain management behavior among pharmacists: a cross-sectional study based on the COM-B model.
Zhang C, Li S, Liu J … +5 more , Fu Z, Chen X, Zhang Y, Xu K, Xie J
Support Care Cancer · 2026 May · PMID 42168417 · Publisher ↗
PURPOSE: To explore the influencing factors promoting the cancer pain management (CPM) behavior of pharmacists through the behavioral model and to provide a basis for formulating targeted intervention strategies. METHOD:...
PURPOSE: To explore the influencing factors promoting the cancer pain management (CPM) behavior of pharmacists through the behavioral model and to provide a basis for formulating targeted intervention strategies. METHOD: This study constitutes the third phase of a large‑scale cross‑sectional project carried out in medical institutions of all levels across different income regions of China. In the present phase, we combine the capability-opportunity-motivation (COM‑B) model with the theoretical domain framework (TDF). Univariate and multivariate analyses were conducted on the collected data, and the influencing factors of pharmacists' CPM behavior were explored through the predictive model. RESULTS: A total of 1466 hospital pharmacists from 157 cities in China participated in the survey. Multivariate analysis in this study revealed no significant correlation between pharmacists' CPM behavior and the economic level of the city they work in or whether their institution has passed the GMP-ward review. Pharmacists' department, capability, and opportunity are positively associated with pharmacists' CPM behavior. The regression coefficients are 0.048 for department, 0.081 for capability, and 0.649 for opportunity, indicating their relative strengths in predicting CPM behavior. Among them, opportunity has the strongest predictive effect on pharmacists' CPM behavior. CONCLUSION: Research shows that pharmacists' department, capability, and opportunity are significantly positively correlated with CPM behavior and have a relative advantage in predicting behavior. This finding provides a basis for formulating measures to promote pharmacists' management of cancer pain.
Correction to: Determinants of long‑term quality of life in nasopharyngeal carcinoma survivors: the roles of household income and performance status.
Wu CN, Luo SD, Wang YM … +5 more , Li SH, Hwang CF, Lai CC, Lin CY, Chen WC
Support Care Cancer · 2026 May · PMID 42166066 · Publisher ↗
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Prevalence and characteristics of persistent taste and smell dysfunction after immune checkpoint inhibitor therapy for cancer.
van Elst JM, Buffinga CM, Brand HS … +5 more , Hijmering-Kappelle LBM, Jager-Wittenaar H, Reyners AKL, Nuver J, de Haan JJ
Support Care Cancer · 2026 May · PMID 42165900 · Full text
PURPOSE: To determine the prevalence and characteristics of persistent dysfunction of taste and smell, and salivary parameters in patients after completion of ICI therapy. METHODS: In this cross-sectional study, dysfunct...
PURPOSE: To determine the prevalence and characteristics of persistent dysfunction of taste and smell, and salivary parameters in patients after completion of ICI therapy. METHODS: In this cross-sectional study, dysfunction in patients treated for cancer with ICIs was compared with dysfunction in caregivers. Subjective taste and smell dysfunction and their impact on life were evaluated using validated questionnaires. Objective taste and smell were assessed with taste strips and Sniffin' Sticks, and flow rate and biochemical composition of saliva were measured. RESULTS: A total of 50 patients and 51 caregivers were included. General characteristics of patients did not differ significantly from those of caregivers. Patients had received a median of 14 ICI cycles. The median time since the last ICI cycle was 3.7 years. Six patients (12%) reported mild subjective taste alterations and two (4%) moderate taste alterations, while two caregivers (4%) reported mild taste alterations. Patients scored lower on the appetite subscale and higher on sodium concentration compared to caregivers (respectively, p = 0.017 and p = 0.027). Objective taste and smell function, (un)stimulated saliva flow rates, and xerostomia did not significantly differ between both groups. CONCLUSIONS: These findings suggest that most patients do not experience persistent taste and smell dysfunction, and salivary changes after ICI treatment. However, a subgroup reports symptoms. As subjective experiences may not correspond with objective findings, clinicians should actively inquire about perceived sensory dysfunction as these can impact QoL. TRIAL REGISTRATION NUMBER: NCT06495008 / 2024-01-02.
Factors associated with unplanned healthcare encounters in pediatric cancer patients.
Beauchemin MP, Dupuis LL, Aftandilian C … +26 more , Agarwal V, Baggott C, Bradfield SM, Cannone D, Caywood EH, Crellin-Parsons N, Demedis J, Dickens D, Esbenshade AJ, Freyer DR, Grimes AC, Kelly KM, King AA, Klesges LM, Kyono W, Nagasubramanian R, Orgel E, Orsey AD, Roth ME, Sherani F, Vettese E, Walsh A, Woods-Swafford W, Yu LC, Tomlinson GA, Sung L
Support Care Cancer · 2026 May · PMID 42165869 · Publisher ↗
INTRODUCTION: Pediatric cancer therapies can cause complications that drive unplanned healthcare encounters (e.g., emergency visits and unplanned admissions). Characterizing their frequency and risk factors is important...
INTRODUCTION: Pediatric cancer therapies can cause complications that drive unplanned healthcare encounters (e.g., emergency visits and unplanned admissions). Characterizing their frequency and risk factors is important for resource planning, family counseling, and targeted mitigation strategies. In a secondary analysis of data from a cluster-randomized controlled trial of symptom monitoring in pediatric cancer patients, the primary objective was to describe the characteristics of unplanned healthcare encounters. The secondary objective was to identify risk factors associated with unplanned healthcare encounters. METHODS: This was a sub-analysis of a cluster-randomized trial of 10 sites randomized to symptom screening and 10 sites randomized to usual care. We included English- or Spanish-speaking pediatric patients newly diagnosed with cancer who were 8-18 years of age receiving any cancer treatment. At symptom screening sites, enrolled participants were reminded to complete symptom screening with Symptom Screening in Pediatrics Tool (SSPedi), a validated symptom screening and assessment, three times weekly for 8 weeks. The healthcare team was notified for severely bothersome symptoms. Emergency department visits, and unplanned clinic visits and admissions were determined from families and charts. Encounter documentation was reviewed to determine if the unplanned encounter was related to SSPedi symptoms. RESULTS: Among the 444 participants from 20 participating sites, there were 652 unplanned encounters and the most common were emergency room visits (n = 269) followed by unplanned clinic visits (n = 143) and unplanned admissions (n = 240). Pain was the primary reason for emergency room visits (59, 13.3%), unplanned clinic visits (52, 11.7%), and unplanned admissions (19, 4.3%). Nausea/vomiting was the next most common symptom for emergency room visits (40, 9.0%), unplanned clinic visits (4, 0.9%), and unplanned admissions (14, 3.2%). In multivariable analysis, leukemia diagnosis (P = 0.0003), site randomization (P = 0.018), and increasing physician full-time equivalents per 100 new cancer diagnoses (P = 0.032) were associated with more unplanned encounters. CONCLUSIONS: Unplanned healthcare utilization is common among newly diagnosed pediatric cancer patients. The association between unplanned healthcare utilization and standardized symptom screening and increasing physical full-time equivalents warrant further investigation. Key aspects to the implementation of routine symptom screening among pediatric patients with cancer will be resource allocation to prevent and manage common symptoms including those that may lead to unplanned healthcare visits.
Subcutaneous adipose tissue outperforms muscle strength as an indicator of survival and quality of life in patients with cancer: a multicenter cohort study.
Dai XT, Zhang X, Ge YZ … +7 more , Liu CA, Wang HH, Wang N, Qin J, Song CH, Shi HP, Cong MH
Support Care Cancer · 2026 May · PMID 42165856 · Publisher ↗
BACKGROUND: Anthropometry regarding muscle and fat is related to the mortality and quality of life in patients with cancer. We evaluated the role of muscle (hand grip strength, HGS) and fat (triceps skinfold thickness, T...
BACKGROUND: Anthropometry regarding muscle and fat is related to the mortality and quality of life in patients with cancer. We evaluated the role of muscle (hand grip strength, HGS) and fat (triceps skinfold thickness, TSF) in survival and quality of life among patients with cancer. METHODS: The study included 15,788 (53.9% men) patients with cancer from the Investigation on Nutrition Status and Clinical Outcome of Common Cancers Project of China. Outcomes included survival and health-related quality of life (QoL). Statistical analysis was performed using a maximally selected rank statistical method for sex-specific cutoff values. Cox analysis and Kaplan-Meier curves were used for survival analysis, and one-way ANOVA trend testing was used for quality of life. RESULTS: The patients' mean age was 57.25 ± 11.66 years. High TSF (adjusted HR = 0.77, 95% CI = 0.72-0.81, P < 0.001) and high HGS (adjusted HR = 0.72, 95% CI = 0.68-0.76, P < 0.001) were positively associated with survival. Patients with high TSF and low HGS (adjusted HR = 0.61, 95% CI = 0.54-0.68, P < 0.001) had better survival than patients with low TSF and high HGS (adjusted HR = 0.73, 95% CI = 0.67-0.78, P < 0.001). The quality of life of patients with high TSF and low HGS was also better than that of patients with low TSF and high HGS. The results were consistent in subgroup analyses of men and women and in sensitivity analyses that excluded patients who died within 6 months. CONCLUSIONS: TSF and HGS are positively associated with survival and quality of life. Considering the differences in TSF and HGS between men and women, fat mass is a better indicator of patients' survival and quality of life than muscle function.
Gratitude and psychological distress among cancer patients undergoing radiotherapy: The chain-mediating roles of optimism and sense of coherence.
Wang S, Ge R, Zhang Y … +6 more , Xu W, Zhang Z, Sun A, Zhang W, Zhu Y, Wan H
Support Care Cancer · 2026 May · PMID 42159793 · Publisher ↗
PURPOSE: This study examined how optimism and sense of coherence mediated the relationships between gratitude and psychological distress among cancer patients in China. METHODS: This cross-sectional study was conducted b...
PURPOSE: This study examined how optimism and sense of coherence mediated the relationships between gratitude and psychological distress among cancer patients in China. METHODS: This cross-sectional study was conducted between September 2023 and June 2024. A total of 215 cancer patients undergoing radiotherapy completed questionnaires assessing sociodemographic variables, disease-related factors, gratitude, optimism, sense of coherence, and psychological distress. A chain mediation model was tested using the PROCESS macro in SPSS to examine the chain mediating roles of optimism and sense of coherence in the relationship between gratitude and psychological distress. RESULTS: Psychological distress was negatively correlated with gratitude, optimism, and sense of coherence. Gratitude had a negative effect on psychological distress through three distinct pathways: the mediating effect of optimism (effect = - 0.017), the mediating effect of sense of coherence (effect = - 0.015), and the chain mediating effect of optimism and sense of coherence (effect = - 0.008), accounting for 17%, 15%, and 8% of the total effect, respectively. CONCLUSIONS: Gratitude influences psychological distress in cancer patients both directly and indirectly through optimism and sense of coherence. The improvement of psychological distress should not be limited to symptom relief, but should also focus on enhancing patients' positive emotional experiences and fostering positive psychological resources to improve psychological distress.
Marital status and post-radical prostatectomy outcomes: results from the SEARCH database.
Burwell A, Ithisuphalap J, Janes JL … +10 more , Helms VM, Amling CL, Aronson WJ, Cooperberg MR, Kane CJ, Klaassen Z, Terris MK, Rivera LG, Freedland SJ, Sleight AG
Support Care Cancer · 2026 May · PMID 42154317 · Full text
PURPOSE: Social support, specifically marital status, has been shown as a significant prognostic factor for survival of multiple malignancies, including prostate cancer. However, this has not been investigated in an equa...
PURPOSE: Social support, specifically marital status, has been shown as a significant prognostic factor for survival of multiple malignancies, including prostate cancer. However, this has not been investigated in an equal access Veterans Affairs (VA) cohort where other support systems exist that may minimize the potential benefit of social support from a partner. METHODS: We retrospectively reviewed data from 9,931 patients undergoing primary radical prostatectomy (RP) in the VA from 1988-2020 across 9 VA centers. Univariable and multivariable Cox proportional hazards models were used to test the association between marital status and biochemical recurrence (BCR), metastasis, castration-resistant PC (CRPC) and prostate cancer specific mortality (PCSM). RESULTS: 8,285 patients met the inclusion criteria: 54% were married, 30% were divorced/separated, 9% were single/never married, and 6% were widowed at the time of RP. Single/never married men were younger (median 61 vs 62-65 years), had surgery more recently (median 2009 vs 2003-2008), had higher PSA (median 6.9 ng/mL vs 6.4-6.8 ng/mL), and had lower BMI (median 27 vs 28) compared to other groups (all p < 0.05). The median time to BCR was significantly shorter for divorced/separated men (188.2 months) and single/never married men (154.8 months) compared to married men (243.0 months). Consistent with this finding, compared to married men, divorced/separated men had higher risk of BCR (HR = 1.12; 95% CI 1.03-1.21), as did single/never married men (HR = 1.13; 95% CI 1.00-1.28). However, these associations were insignificant in multivariable analyses (all p > 0.05). CONCLUSION: Among men with localized prostate cancer undergoing RP within the VA, we found no association between marital status-defined as a demographic indicator of self-reported relationship category-and oncologic outcomes. Whether marital satisfaction or perceived partner support, which were not assessed in this study, influence post-RP outcomes remains to be investigated.
Nutritional prehabilitation in patients with head and neck cancer: an evidence mapping analysis.
Song Y, Li Y, Pan L … +4 more , Luo M, Li H, Liu J, Ding Y
Support Care Cancer · 2026 May · PMID 42154293 · Publisher ↗
BACKGROUND: Head and neck cancer patients are often at high risk of malnutrition due to the disease and its treatment, and pretreatment nutritional prehabilitation is an important strategy for improving prognosis; howeve...
BACKGROUND: Head and neck cancer patients are often at high risk of malnutrition due to the disease and its treatment, and pretreatment nutritional prehabilitation is an important strategy for improving prognosis; however, the existing evidence still needs to be systematically synthesized. PURPOSE: To systematically describe and evaluate the evidence related to pretreatment nutritional prehabilitation in patients with head and neck cancer through evidence mapping to provide a basis for clinical practice. METHODS: Computerized searches of CNKI, Wan-fang, VIP, SinoMed, PubMed, Web of Science, Cochrane Library, Embase, and CINAHL were performed from the time of database construction to May 2025, to include systematic review/meta-analysis of nutritional prehabilitation of patients with head and neck cancer, randomized controlled trials, and observational studies. The Risk of Bias Tool, Newcastle-Ottawa Scale (NOS), and AMSTAR-2 scale were used to evaluate the methodological quality of the included studies, respectively, and the current status of the studies was demonstrated using a combination of text and graphs. RESULT: Then, 6 systematic evaluations/meta-analyses, 13 randomized controlled trials, and 4 observational studies were finally included. The largest number of studies was published in China, and all study populations consisted exclusively of patients with head and neck cancer. Interventions include pretreatment immunonutritional interventions, nutritional risk screening-guided interventions, standard enteral nutritional support, disease-specific nutritional formula support, nutritional counseling, and pretreatment swallow training. The outcome indicators mainly focused on the patients' nutritional status, complication rates, length of hospital stay, body weight, and BMI, etc. However, the methodological quality of the included studies needs to be improved. The results of the studies all showed that nutritional prehabilitation benefits the prognosis of patients with head and neck cancer. CONCLUSION: Overall evidence suggests that nutritional prehabilitation can improve patients' nutritional status and enhance their prognosis and quality of life, showing beneficial effects. More high-quality, large-sample clinical studies should be conducted in the future to guide the clinical implementation of nutritional prehabilitation.
Can non-pharmacological strategies in cancer patients support perceived appetite? A scoping review.
Holst JP, Christensen ME, Lang NR … +2 more , Mehlsen MY, Tobberup R
Support Care Cancer · 2026 May · PMID 42154240 · Publisher ↗
PURPOSE: This review aims to identify and synthesize existing literature on non-pharmacological interventions in cancer patients in which perceived appetite was assessed as a specific outcome, either alone or as part of...
PURPOSE: This review aims to identify and synthesize existing literature on non-pharmacological interventions in cancer patients in which perceived appetite was assessed as a specific outcome, either alone or as part of broader symptom or quality-of-life measures. METHODS: Systematic searches were performed using Embase, PubMed, CINAHL, and PsycINFO databases. Eligible studies included quantitative research involving adult cancer patients with poor appetite. All records were screened independently by two reviewers. RESULTS: A total of 3021 records were screened, and 29 studies met the inclusion criteria. These studies were grouped into four categories: mindfulness and relaxation, psychological or psychosocial, education and self-care, and multicomponent/comprehensive supportive-care programs. Interventions were heterogeneous in type, intensity, and delivery. Across categories, structured, repeated, and actively guided interventions were more consistently associated with improvements in perceived appetite, whereas brief or passive interventions showed limited effects. Interventions that incorporated personalization and required active patient engagement demonstrated greater effectiveness, suggesting the importance of sustained and individualized support. To support interpretation of these heterogeneous findings, results were synthesized using a conceptual framework linking intervention characteristics to psychological, sensory, physiological, and behavioral mechanisms influencing appetite perception. Within this framework, non-pharmacological appetite support appears to operate indirectly through pathways such as emotional regulation, sensory engagement, stress reduction, and active coping, rather than through appetite-specific mechanisms alone. CONCLUSION: Structured, actively guided, and repeated non-pharmacological interventions show potential to improve perceived appetite in cancer patients, whereas brief or passive interventions appear less effective. Findings suggest that appetite support operates primarily through indirect psychological, sensory, and behavioral pathways, as captured in a conceptual framework. Further research should develop and evaluate well-defined, mechanism-informed interventions.
Mapping methods and tools for measuring patient experience in oncology settings: a scoping review.
Kowalska JC, Storman D, Michalska K … +4 more , Świerz M, Maraj M, Zając J, Domagała A
Support Care Cancer · 2026 May · PMID 42151551 · Full text
PURPOSE: Patient experience (PX) is crucial for evaluating healthcare quality in oncology, encompassing comprehensive interactions from diagnosis through survivorship. However, the field lacks consensus on PX measurement...
PURPOSE: Patient experience (PX) is crucial for evaluating healthcare quality in oncology, encompassing comprehensive interactions from diagnosis through survivorship. However, the field lacks consensus on PX measurement and its conceptualization. The aim of this scoping review was to systematically map methods and tools used to measure PX in original studies, while providing detailed characteristics of each tool. METHODS: Guided by the Arksey and O'Malley framework, this review involved a systematic search across six databases up to May 2025. RESULTS: Data from 109 original studies, identifying 43 unique tools, were extracted and synthesized narratively. Survey-based questionnaires predominated, with national cancer PX surveys being most frequently used (44%). Despite this, significant fragmentation was evident, with most tools used in limited studies (1-2). 63% of tools lacked explicit theoretical foundations, and psychometric reporting was imprecise. Consistently measured domains included information/communication, care coordination, and respect/dignity. CONCLUSIONS: The measurement of PX in oncology is diverse but inconsistent, marked by a lack of standardization, theoretical ambiguity, and insufficient psychometric validation. Therefore, it is highly challenging to transfer such results into impactful clinical interventions for patients. Addressing these gaps through theory-driven tool development, rigorous validation, and culturally appropriate adaptations, especially for cancer survivorship and diverse global contexts, is essential.
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