Supportive Care In Cancer[JOURNAL]
Sun
200 papers
Reduced expression of N-methyl-D-aspartate receptor and calcium signaling genes in gray matter is associated with cancer-related cognitive impairment.
Kesler SR, Franco-Rocha OY, Kogon M … +6 more , Braun S, Tolby L, Nyagaka R, De La Torre Schutz A, Blayney DW, Palesh O
Support Care Cancer · 2026 Jul · PMID 42402487 · Publisher ↗
PURPOSE: Cognitive decline is common after cancer, but little is known regarding the etiology of this adverse effect, especially in terms of molecular mechanisms. METHODS: This prospective study obtained brain imaging an...
PURPOSE: Cognitive decline is common after cancer, but little is known regarding the etiology of this adverse effect, especially in terms of molecular mechanisms. METHODS: This prospective study obtained brain imaging and cognitive testing from 50 newly diagnosed women with primary breast cancer prior to any cancer treatment and 53 female controls. Participants completed up to seven assessments for a total time span of 9.7 ± 0.92 years. Imaging transcriptomics was used to measure the expression of genes in the brain involved in N-methyl-D-aspartate (NMDA) and calcium-mediated neurotransmission. RESULTS: GRIN2A, GRIN2B, and CACNA1C were significantly expressed in gray matter in both groups (R ≥ 0.092, p ≤ 0.015). GRIN2A (t = -2.72, p = 0.018) was significantly lower in the cancer group compared to controls across timepoints. GRIN2A declined over time in patients, and this was significantly different compared to controls (χ2 = 9.73, p = 0.005). Cognitive scores were significantly lower in patients compared to controls (p ≤ 0.004). In patients, GRIN2A was significantly associated with cognitive performance over time (p ≤ 0.009). CONCLUSION: These findings suggest that gene expression involved in neurotransmission is disrupted in the brain among patients with breast cancer and may contribute to cognitive changes. Our results provide novel molecular insights regarding the roles of non-CNS cancer pathology and treatments in the brain related to NMDA signaling and pro-survival/plasticity-related pathways. Our findings also point to potential treatments for cognitive effects of cancer.
Adult cancer survivors' perceptions of immersive virtual reality exercise and its utility during chemotherapy infusion: a concurrent mixed method exploratory study.
Ferrar K, Lange B, Beltrame T … +12 more , Buckley ES, Chew KH, Foo JJ, Hollis MK, Kemp E, Koczwara B, Lim P, Mizrahi D, May N, Thomson J, Schumacher J, Hobbs D
Support Care Cancer · 2026 Jul · PMID 42400860 · Publisher ↗
PURPOSE: Virtual reality (VR) exercise may help promote physical activity in cancer survivors. Understanding infusion-specific barriers and facilitators is essential for designing effective interventions that can be inte...
PURPOSE: Virtual reality (VR) exercise may help promote physical activity in cancer survivors. Understanding infusion-specific barriers and facilitators is essential for designing effective interventions that can be integrated into chemotherapy care. This study explored adult cancer survivors' perceptions and preferences regarding VR exercise during chemotherapy infusion. METHODS: This exploratory concurrent mixed-methods study included community-dwelling adults (≥ 18 years) who had completed primary cancer treatment involving chemotherapy. Participants trialled a commercially available immersive VR exercise program paired with a sensor and seated pedal unit, completed a survey on digital technology confidence and preferences, and took part in a focus group or interview to discuss VR exercise during infusion. Qualitative content analysis was used to analyse transcripts. RESULTS: Eight cancer survivors (6 female; mean age 63.6 ± 8.3 years) participated. Most reported being confident (87%) and comfortable (75%) using digital technologies. All participants enjoyed the VR exercise and indicated they would have used it during chemotherapy if available. Positive perceptions included mental wellbeing benefits, distraction, relaxation, and potential enhancement of drug circulation. Participants also identified negative aspects of the experience and potential barriers to implementation, such as cold caps, risk of cannula dislodgement, space constraints, and infusion‑chair suitability. CONCLUSION: This study provides the first insights into cancer survivors' perceptions of immersive VR exercise during chemotherapy infusion. Findings highlight both the promise and practical considerations of integrating VR exercise into infusion care and represent an initial step toward developing a tailored VR exercise intervention for use during chemotherapy.
Efficacy of different non-pharmacological therapies on cancer-related fatigue in breast cancer patients: a network meta-analysis.
Li S, Li L, Fu L
Support Care Cancer · 2026 Jul · PMID 42400667 · Publisher ↗
BACKGROUND: Cancer-related fatigue (CRF) is a highly prevalent and debilitating symptom among breast cancer patients, yet optimal non-pharmacological management strategies remain uncertain. We aimed to compare the relati...
BACKGROUND: Cancer-related fatigue (CRF) is a highly prevalent and debilitating symptom among breast cancer patients, yet optimal non-pharmacological management strategies remain uncertain. We aimed to compare the relative efficacy of various non-pharmacological interventions for alleviating CRF in this population through a systematic review and network meta-analysis (NMA). METHODS: We systematically searched PubMed, EMBASE, Web of Science, CINAHL, and CENTRAL from inception to June 2025 for randomized controlled trials (RCTs). Studies were included if they evaluated any non-pharmacological intervention for CRF in adult women with breast cancer. A frequentist random-effects NMA was conducted, and interventions were ranked using the Surface Under the Cumulative Ranking Curve (SUCRA). The primary outcome was CRF severity measured by validated scales. RESULTS: Twenty-six RCTs involving 2,811 patients were included, evaluating 21 distinct interventions. The network demonstrated good connectivity and no significant inconsistency (P > 0.05 for both global and local tests). Tai Chi Chih (TCC) was ranked as the most effective intervention (SUCRA = 99.1%), followed by cognitive behavioral therapy (CBT; SUCRA = 92.0%) and massage therapy (MT; SUCRA = 90.6%). Compared with usual care, all three showed large and statistically significant reductions in fatigue: TCC (SMD = -4.61, 95% CI: -6.20 to -3.02), CBT (SMD = -3.63, 95% CI: -4.87 to -2.40), and MT (SMD = -3.43, 95% CI: -4.66 to -2.20). Health education ranked lowest among active interventions (SUCRA = 19.4%). The funnel plot indicated no significant publication bias. CONCLUSION: This comprehensive NMA identifies Tai Chi Chih, cognitive behavioral therapy, and massage therapy as the most effective non-pharmacological strategies for reducing cancer-related fatigue in breast cancer patients. These findings provide robust evidence to prioritize these mind-body, psychological, and somatic approaches in clinical practice and supportive care guidelines. TRIAL REGISTRATION: The study was registered at PROSPERO on 5 February 2025 (CRD42025642351).
Lessons from the field: culturally grounded approaches to recruiting Chinese American immigrant cancer patients to psycho-oncology trials.
Lui F, Chen RY, Chang F … +5 more , Jiang R, Yang K, Zhao C, Gany F, Leng J
Support Care Cancer · 2026 Jul · PMID 42400659 · Publisher ↗
BACKGROUND: Asian Americans (AAs) are the only racial/ethnic group in the USA for whom cancer and not heart disease is the leading cause of death in men and women, and foreign-born immigrants are more likely to be diagno...
BACKGROUND: Asian Americans (AAs) are the only racial/ethnic group in the USA for whom cancer and not heart disease is the leading cause of death in men and women, and foreign-born immigrants are more likely to be diagnosed at an advanced stage than their native-born counterparts. While there is a growing literature on the development of culturally grounded interventions for AA and immigrant populations in cancer care, there is limited knowledge of researchers' experiences recruiting AAs to cancer research studies. METHODS: Between August 2023 and May 2025, trained bilingual research staff recruited eligible patients from an NCCN-designated cancer center in the Northeast to two trials piloting a counseling intervention adapted for Chinese Mandarin-speaking patients with advanced cancer. Research staff documented qualitative notes regarding contact with patients and family members in study contact logs. Contact logs of participants who declined to participate (n = 97), in addition to research reflections and amendments to the study protocol, were reviewed and coded to summarize main challenges in recruiting eligible patients to the study. RESULTS: Thematic analysis yielded six main challenges encountered during the recruitment process: (1) family member involvement, (2) limited prognostic awareness, (3) mistrust and scam concerns, (4) uncertainty and unfamiliarity with counseling and psycho-oncology, (5) unmet health-related social needs, and (6) communication difficulties related to language/dialect. Details of how the recruitment processes were modified to address challenges and facilitate study participation are described. CONCLUSION: Several recommendations are proposed for future research studies with Chinese immigrant cancer patients. During initial contact, research staff's approach with family caregivers is a major determinant of Chinese patients' willingness to participate. Social drivers of health (e.g., barriers to linguistically appropriate health care access, mistrust), health-related social needs (e.g., patients' and families' financial instability), and culturally rooted differences in prognosis sharing also affect patient engagement with research staff. Patient engagement processes should be flexible to respond to patient and caregiver needs. Culturally grounded recruitment strategies can improve rapport, build trust, and increase likelihood of recruitment and retention among Chinese immigrant cancer patients. Trial registration NCT02112188, registration date: August 30, 2023.
Photobiomodulation to prevent oral mucositis and physical function impairments after hematopoietic cell transplantation: POMFITT randomized trial.
López-Espinoza T, Araya-Castro P, Gutiérrez-Silva L … +2 more , Peña-Espinoza M, Sacomori C
Support Care Cancer · 2026 Jul · PMID 42399564 · Publisher ↗
AIM: To assess the effectiveness of photobiomodulation, compared to standard care, to prevent oral mucositis and functional impairment, and improve quality of life in adults who underwent hematopoietic cell transplantati...
AIM: To assess the effectiveness of photobiomodulation, compared to standard care, to prevent oral mucositis and functional impairment, and improve quality of life in adults who underwent hematopoietic cell transplantation (HCT). METHODS: Randomized, controlled clinical trial with 30 patients with hematologic malignancies. INTERVENTION: InGaIP diode laser treatment, starting on the first day of conditioning until day + 3, three times a week. PARAMETERS: wavelengths of 660 nm and 808 nm, 100 mW, 2 J, 20 points. OUTCOME MEASURES: oral mucositis (WHO scale), functional capacity (2-min step test), handgrip strength (Jamar dynamometer), lower limb strength (Sit-to-Stand test), quality of life (FACT-BMT), and acceptance (0-10 numerical scale). RESULTS: Participants fully adhered to the intervention (n = 15; 100%). Acceptance was rated 10/10 by 93.3% of participants. Severe oral mucositis occurred in 26.6% of the control group and 0% of the photobiomodulation group (p = 0.032). No significant differences were found between the groups in hospitalization days, handgrip strength, aerobic capacity, or lower-limb strength. CONCLUSIONS: Photobiomodulation was associated with a lower occurrence of severe oral mucositis but did not affect physical function or quality of life at discharge. Acceptance in the Chilean context was very high. TRIAL REGISTRATION: ClinicalTrials.gov: NCT06260111.
Evaluating the role of survivorship care plans in modifying disparities in health status among female cancer survivors in Maryland.
Cohen CM, Alcaraz KI, Keno LS … +2 more , Jin M, Connor AE
Support Care Cancer · 2026 Jul · PMID 42397582 · Publisher ↗
PURPOSE: To determine if receipt of survivorship care plans (SCPs) modifies the association between health outcomes of female cancer survivors and sociodemographic characteristics. METHODS: Using cross-sectional 2011-202...
PURPOSE: To determine if receipt of survivorship care plans (SCPs) modifies the association between health outcomes of female cancer survivors and sociodemographic characteristics. METHODS: Using cross-sectional 2011-2023 data from the Maryland Behavioral Risk Factor Surveillance System (BRFSS) survey, we conducted survey-weighted multivariable regression models to estimate the association between race, body mass index (BMI), education and income with self-reported general health status and poor physical and mental health days, stratified by SCP receipt, approximated as self-reporting receipt of cancer follow-up care instructions (FCI), treatment summaries (TS), or both. Individuals on active treatment and < 1 year from their cancer diagnosis were excluded. RESULTS: The study included 2,854 (non-Hispanic White (NHW; 82.8%) and non-Hispanic Black (NHB; 17.2%) female cancer survivors residing in Maryland. Half were > 10 years from their cancer diagnosis and the mean age was 64 years. Without FCI, NHB vs. NHW women reported more poor physical and mental health days (adjusted rate ratio (aRR): 1.27 (95% confidence interval (CI): 0.74-2.16) and aRR: 1.72 (95% CI: 1.14-2.61), respectively). With FCI, NHB vs. NHW women reported fewer poor physical and mental health days (aRR: 0.56 (95% CI; 0.39-0.80) and aRR: 0.47 (95% CI: 0.30-0.73); p-interaction: 0.009 and < 0.001, respectively). Similar patterns were observed for TS and FCI + TS and with education and income. CONCLUSIONS: Receipt of FCI and TS differentially modified associations between sociodemographic characteristics with self-reported physical and mental health for female cancer survivors in Maryland. Delivery of FCI and TS may improve the health status of minoritized female cancer survivors.
Personal pathways to success: an innovative program to overcome cancer patient barriers to tobacco cessation and promote patient participation.
Presant CA, Gascon B, Yeung S … +10 more , Macalintal J, Sandoval A, Raz D, Erhunmwunsee L, Cronkhite J, Davy K, Cianfrocca M, Salgia R, Fong Y, Ashing KT
Support Care Cancer · 2026 Jul · PMID 42397581 · Full text
PURPOSE: Tobacco cessation is an important supportive component of cancer care. We developed a novel program to overcome cancer patient barriers to tobacco cessation and improve outcomes. METHODS: The personal pathways t...
PURPOSE: Tobacco cessation is an important supportive component of cancer care. We developed a novel program to overcome cancer patient barriers to tobacco cessation and improve outcomes. METHODS: The personal pathways to success (PPS) program consisted of core components of a motivational interview, an instructional video on tobacco cessation, referral to cessation consultation, and/or an offer of cessation medications. Patients who agreed to participate in PPS were also offered the choice of 30 additional PPS supplemental support cessation services. Participants were active smokers before planned surgery at City of Hope (COH) and were referred to the PPS program. We compared tobacco use in patients who participated in PPS with supplemental support services to patients who did not participate. We compared non-Hispanic white patients to patients from minority groups. Evaluations of tobacco use were performed before surgery in all patients, and at 30 days, 3, 6, 9, and 12 months after surgery in PPS participants, and at 12 months in non-participants. RESULTS: Among 70 patients, 7 were re-directed by insurance to a non-COH provider. Among the other 63 patients, 58 completed the motivational interview (acceptability rate 92%). Thirty-five of 63 patients (56%) agreed to participate in PPS with supplemental support services. There was equal use of services in non-Hispanic white patients and in patients from minoritized backgrounds. Abstinence preoperatively was 17% in participants and 6% in non-participants. At 12 months after surgery, 42% of participants were abstinent versus 17% of non-participants (p = 0.11). At 12 months after surgery, 55% of participants were abstinent from combustible tobacco use (abstinent or only vaping) compared to 22% of non-participants (p = 0.037). CONCLUSIONS: The PPS program is feasible. Participation is associated with reduced cigarette use among cancer patients. Further studies are warranted. IMPLICATIONS: Allowing cancer patients to choose among a defined menu of supplemental cessation services offers a method to support patients in their goal of quitting.
Association of social determinants of health and physical functioning among breast cancer survivors.
Von Ah D, Han C, Saligan L … +7 more , Davenport AP, Williams N, Naughton M, Storey S, Yang Y, Corley M, Plascak JJ
Support Care Cancer · 2026 Jul · PMID 42397554 · Full text
PURPOSE: The purpose of this study was to address the relationship between social determinants of health (both individual and neighborhood levels) to understand more fully how social conditions are associated with physic...
PURPOSE: The purpose of this study was to address the relationship between social determinants of health (both individual and neighborhood levels) to understand more fully how social conditions are associated with physical functioning among breast cancer survivors (BCS). METHODS: We conducted a secondary analysis of a national sample of breast cancer survivors recruited via Institutional Review Board-approved social media (i.e., Facebook) and online cancer-affiliated resource sites (e.g., Pink Ribbon Connection, Dr. Susan Love Foundation). BCS provided their address and demographic factors and completed the physical functioning survey (PF-10). Neighborhood social determinants of health (SDOH) included Yost National Rank Index and neighborhood factors (walkability and rural vs. urban status) using Geocoding. Descriptive statistics and linear regression models were used. RESULTS: BCS who were older (p = 0.038) and single (p = 0.008) had poor physical functioning. Socioeconomic factors including higher education (p = 0.001), higher income (p = 0.034), and higher neighborhood socioeconomic status (Yost Index, p = 0.016) were associated with greater physical functioning. Neighborhood factors (walkability and rural vs. urban) were not associated with physical functioning in BCS. CONCLUSION: Physical functioning of BCS was linked to age, social network (marital status), and socioeconomic status. Future interventional research is needed that accounts for individual and socioeconomic factors to mitigate their effects on the physical functioning of BCS.
Symptoms experienced during the first 4 months of chemotherapy administration: a longitudinal cohort study in an Australian cancer treatment unit.
Alexander KE, Ogle T, Scanlon B … +12 more , Farley MJ, Bradford N, Pitt E, Hoberg H, Herron E, Doyle L, Abraham R, Bentley M, Inglis PL, Colosimo M, Lane S, Yates PM
Support Care Cancer · 2026 Jul · PMID 42397550 · Full text
PURPOSE: Individuals undergoing chemotherapy experience a range of symptoms that can significantly impact their quality of life and treatment outcomes; the prevalence and severity of which can change across their treatme...
PURPOSE: Individuals undergoing chemotherapy experience a range of symptoms that can significantly impact their quality of life and treatment outcomes; the prevalence and severity of which can change across their treatment journey. This study aimed to identify and describe the longitudinal symptom experience during the first four months of chemotherapy administration across a range of cancer diagnoses. METHODS: A prospective longitudinal cohort study was conducted at a cancer centre in Queensland, Australia. Monthly surveys assessed symptoms, distress, and quality of life across 4 months of chemotherapy. RESULTS: A total of 252 participants completed baseline surveys (mean age 61 ± 12.3 years; 65% female; 40% breast cancer). Participants reported a mean of 22.5 ± 9.0 symptoms at baseline, with a statistically significant reduction in symptoms throughout the study period 21.9 ± 9.2 symptoms (p = 0.002). Fatigue (93%), insomnia (80%), and pain (72%) were most common at baseline and remained highly prevalent throughout the time period. Severe fatigue (25%), pain (15%), and constipation (15%) reduced over time, while peripheral neuropathy and decreased sexual interest increased. CONCLUSION: This study has produced insights into the high number of symptoms experienced during the initial four months of chemotherapy. Given the impact of symptoms on treatment outcomes, there is a critical need for the development of appropriate assessment tools capable of capturing this broad range of patient symptom experiences. IMPLICATIONS FOR CANCER SURVIVORS: Understanding symptom patterns over time can support early identification of high-risk patients, guide personalised supportive care strategies and optimise treatment tolerance and quality of life during and beyond chemotherapy.
Diagnosis and management of immune checkpoint inhibitor-induced dry mouth and salivary gland dysfunction in oncology patients: a systematic review.
López-Pintor RM, González-Serrano J, Villa A … +3 more , Musella G, Santos-Silva AR, Rodríguez-Molinero J
Support Care Cancer · 2026 Jul · PMID 42397548 · Publisher ↗
PURPOSE: To summarize diagnostic approaches and management strategies for dry mouth associated with immune checkpoint inhibitors (ICIs) in cancer patients. METHODS: We conducted a systematic review following PRISMA guide...
PURPOSE: To summarize diagnostic approaches and management strategies for dry mouth associated with immune checkpoint inhibitors (ICIs) in cancer patients. METHODS: We conducted a systematic review following PRISMA guidelines (PROSPERO CRD420251267861). PubMed/MEDLINE, Scopus, Web of Science, and the Cochrane Library were searched from 2011 to 8 September 2025. We included original human studies reporting xerostomia, hyposalivation, or sicca syndrome attributed to ICIs. Two reviewers independently screened and extracted data. Risk of bias was assessed using the JBI Critical Appraisal Checklists for case reports and case series, and the Newcastle-Ottawa Scale for observational studies. RESULTS: Thirty-one studies published between 2016 and 2025 were included (17 case reports, 7 case series, and 7 observational studies), comprising 1,864 ICI-treated patients and 152 reported cases of xerostomia. Nivolumab and pembrolizumab were the most frequently implicated ICIs. Onset ranged from 5 days to 22 months after ICI initiation. Diagnostic evaluation was heterogeneous, variably using salivary gland imaging and objective salivary flow. Sjögren-related autoantibodies were usually absent. Management most commonly comprised systemic corticosteroids, sialagogues, topical saliva substitutes/stimulants, and temporary or permanent ICI discontinuation. Risk of bias was overall moderate, with few high-risk studies. CONCLUSION: The available evidence is largely based on case reports and case series and is heterogeneous, which limits its certainty. This review offers protocols for the correct diagnosis and treatment of ICI-related dry mouth and salivary gland dysfunction. Treatment with systemic corticosteroids appears to be effective, in many cases avoiding the need to interrupt treatment. Future standardized criteria and prospective studies are needed to improve the available evidence.
Validation of predictive and concurrent validity of global leadership initiative on malnutrition nutritional risk screening using PNI, ALI, and GNRI as alternative tools in patients with cancer.
Wei L, Yang J, Wang S … +7 more , Xu N, Chen Y, Zhong P, Lin S, Shi H, Chen J, Xie H
Support Care Cancer · 2026 Jul · PMID 42397474 · Publisher ↗
PURPOSE: To assess the predictive and concurrent validity of Global Leadership Initiative on Malnutrition (GLIM) criteria using prognostic nutritional index (PNI), advanced lung cancer inflammation index (ALI), and geria...
PURPOSE: To assess the predictive and concurrent validity of Global Leadership Initiative on Malnutrition (GLIM) criteria using prognostic nutritional index (PNI), advanced lung cancer inflammation index (ALI), and geriatric nutritional risk index (GNRI) as alternative screening tools (vs. NRS-2002-based GLIM) for malnutrition in cancer patients. METHODS: A total of 11,693 patients with cancer were included in the retrospective cohort study. The Cox/logistic regression analyzed associations of GLIM-defined malnutrition with survival, short-term outcomes, and healthcare burden. Agreement analyses of each nutritional risk-screening tool were performed using kappa statistics and Harrell's concordance-index. RESULTS: Under the GLIM framework, all nutrition-related indicators used as nutritional risk screening tools were effective for identifying patients with poor prognosis. Logistic regression showed that the nutrition-related indicator-based GLIM criteria were useful for predicting short-term outcomes, length of stay, and hospital expenses in patients with cancer. Of different GLIM measures, the ALI-based GLIM had the best prognostic discriminative ability, followed by the PNI-based and GNRI-based GLIM, with NRS-2002 ranking the lowest. The prevalence of malnutrition determined using the GLIM criteria based on the NRS-2002, ALI, GNRI, and PNI screening was 29.4%, 25.9%, 26.9%, and 23.3%, respectively. The agreement of the ALI-based, GNRI-based, and PNI-based GLIM with the NRS-2002-based GLIM was 0.550, 0.600, and 0.496, respectively. CONCLUSIONS: Nutritional indicators can serve as an effective initial step in the GLIM criteria for nutritional risk assessment in patients with cancer, with ALI being the optimal nutritional risk screening tool. Using nutritional indicator-based GLIM criteria is effective for predicting short-term outcomes, medical burden, and long-term prognosis in patients with cancer.
The experience of time toxicity in cancer patients: a meta-synthesis of qualitative research.
Shi Y, Wang P, Ji J … +2 more , Zhao X, Wang X
Support Care Cancer · 2026 Jul · PMID 42397448 · Publisher ↗
OBJECTIVE: To systematically synthesize cancer patients' experiences of time toxicity and provide evidence-based recommendations for developing intervention strategies. METHODS: A comprehensive search strategy was employ...
OBJECTIVE: To systematically synthesize cancer patients' experiences of time toxicity and provide evidence-based recommendations for developing intervention strategies. METHODS: A comprehensive search strategy was employed to identify qualitative studies examining the phenomenon of time toxicity in cancer patients. This search was executed across multiple databases, including PubMed, Embase, Web of Science, The Cochrane Library, CINAHL (EBSCO), CNKI, Wanfang, VIP, and SinoMed, encompassing all records from the inception of each database up to December 5, 2025. The methodological rigor of the selected studies was evaluated using the Joanna Briggs Institute (JBI) Critical Appraisal Checklist for Qualitative Research. Subsequently, the findings were synthesized utilizing the JBI meta-aggregative approach and reported in alignment with the ENTREQ guidelines to ensure transparency and rigor in qualitative synthesis. RESULTS: Six articles were incorporated into the study, yielding a total of 26 findings. These findings were systematically classified into eight novel categories, which were then synthesized into three comprehensive integrated findings: (1) sources of time toxicity; (2) impacts of time toxicity; and (3) patients' active coping mechanisms for time toxicity and their expectations for support from healthcare professionals. CONCLUSION: Cancer patients experience treatment-related time toxicity and home care-related time toxicity, which adversely affects their daily lives, emotional well-being, and treatment adherence. Healthcare providers should acknowledge patients' time toxicity and provide personalized treatment schedule information; multi-dimensional assessment tools for time toxicity need further development and clinical verification in subsequent studies.
Trajectories of distress and threshold-triggered supportive care in head and neck cancer patients undergoing curative radiotherapy: a prospective observational study.
Nair P, Nair HM, Ullattil PK … +6 more , Nair AR, Nair S, Surendran HP, N V, Nair R, Dutta D
Support Care Cancer · 2026 Jul · PMID 42397439 · Full text
OBJECTIVE: To prospectively evaluate trajectories of psychological distress, symptom burden, and quality of life longitudinally, in patients with head and neck cancer undergoing curative-intent radiotherapy, while assess...
OBJECTIVE: To prospectively evaluate trajectories of psychological distress, symptom burden, and quality of life longitudinally, in patients with head and neck cancer undergoing curative-intent radiotherapy, while assessing the feasibility of a predefined threshold-triggered supportive care framework in routine radiotherapy practice. METHODS: Our prospective observational cohort study, conducted at a single tertiary care-centre, enrolled 100 adult patients, who were diagnosed with head and neck cancers and were subsequently planned for definitive or adjuvant RT between January and December 2023. Psychological distress was assessed using the Hospital Anxiety and Depression Scale (HADS) and NCCN Distress Thermometer (NCCN-DT), the overall symptom burden was measured using the Edmonton Symptom Assessment Scale (ESAS), and quality of life using the Functional Assessment of Cancer Therapy-Head and Neck (FACT-H&N). Assessments were performed at baseline, once weekly during radiotherapy, at the time of RT completion, and at 1 and 3 months post-RT completion. A structured supportive care protocol was activated using predefined screening thresholds. Longitudinal changes were analysed using repeated-measures methods and paired non-parametric comparisons. RESULTS: Median HADS increased from 4.0 (2.0-7.0) at baseline to 7.0 (4.0-9.5) at week 2, before declining to 2.0 (0.0-6.0) at 3 months post-RT completion (p < 0.001). NCCN-DT and ESAS scores worsened during treatment and improved after RT completion. FACT-H&N scores declined from 128 (120-138) at baseline to 98.5 (84-117) at treatment completion, with recovery to 126 (117-138) at 3 months post-RT completion (p < 0.001). Enteral feeding support increased from 24% at baseline to 44% by RT treatment completion. Supportive care activation was recorded in 68% of patients. An exploratory analysis using early week-2 screening positivity identified a higher-burden subgroup with greater distress and lower FACT-H&N scores during treatment, but substantial recovery by 3 months. CONCLUSIONS: Psychological distress among patients undergoing curative-intent head and neck radiotherapy is dynamic, with peaks early in the treatment course, and is often closely aligned with symptom burden and treatment-related functional decline. The use of a structured, threshold-triggered supportive care framework is feasible in routine radiotherapy workflows, assisting in the identification of patients who require timely multidisciplinary support. Given the observational design and absence of a comparator arm, findings may be interpreted as associative rather than causal.
Interventions to improve the psychosocial outcomes of individuals with lymphedema: a systematic review.
Stolker S, Yin S, Auslander W
Support Care Cancer · 2026 Jul · PMID 42393468 · Full text
PURPOSE: Lymphedema is a common and enduring consequence of cancer treatment with substantial physical and psychosocial morbidity, yet research predominantly focuses on physical outcomes. This systematic review examines...
PURPOSE: Lymphedema is a common and enduring consequence of cancer treatment with substantial physical and psychosocial morbidity, yet research predominantly focuses on physical outcomes. This systematic review examines psychosocial interventions for individuals with lymphedema, describing the intervention characteristics, methodological quality, and strength of the evidence. METHODS: A systematic literature search was conducted of studies published through November 2025. Empirical interventions with psychosocial components and outcomes for individuals with lymphedema were eligible. Methodological quality was assessed. Strength of the evidence was determined by combining quality with intervention effectiveness. RESULTS: Ten studies met inclusion criteria, including mind-body (n = 3), education and support (n = 3), and physical activity (n = 4) intervention models, and most delivered following completion of decongestive therapy. Psychosocial outcomes included mental health (n = 8) and quality of life (n = 6). Methodological rigor was mixed, with MQRS scores ranging from 5-13 (of 14). Interventions delivered in combined in-clinic and remote settings demonstrated stronger evidence for improving mental health outcomes than either setting alone. CONCLUSION: Few empirical evaluations exist targeting the psychosocial needs of individuals with lymphedema, particularly during intensive phases of decongestive therapy. Heterogeneity in intervention models, outcome measures, and treatment timing limits cross-study comparisons; however, hybrid delivery approaches show promise for improving psychosocial outcomes. Greater integration of psychosocial care across the lymphatic care continuum, supported by standardized outcome measures, may strengthen supportive care for individuals living with lymphedema.
Central venous access device-associated complication costs in paediatric cancer care.
Comber ER, Royle R, Ullman AJ … +7 more , Gibson V, Takashima M, Keogh S, Eisenstat DD, Martin M, Moore AS, Byrnes J
Support Care Cancer · 2026 Jul · PMID 42390771 · Full text
PURPOSE: Central venous access devices (CVADs) are commonly inserted in paediatric patients requiring cancer treatment and supportive care. However, these devices carry a high risk of complications such as central line-a...
PURPOSE: Central venous access devices (CVADs) are commonly inserted in paediatric patients requiring cancer treatment and supportive care. However, these devices carry a high risk of complications such as central line-associated bloodstream infections (CLABSI), venous thromboembolism (VTE), and occlusion, and are associated with significant management costs. This study aimed to determine the average cost of each CVAD-associated complication type, per complication event, and investigate which elements are the key cost drivers of these estimates. METHODS: This Australian prospective observational cohort study, embedded within a randomised controlled trial, acquired data from hospital purchasing departments, the Medicare Benefits Schedule Book, the National Hospital Cost Data Collection (NHCDC) Public Sector 2022-2023 Report, and local (state-based) enterprise bargaining agreements. Price per resource unit was multiplied by associated resource use and summed across all resources to estimate the mean complication cost per event. An average cost per complication event for each complication type was then determined. RESULTS: In a sample of 310 paediatric oncology patients, 101 unique patients experienced 275 CVAD-associated complication events. Of these events, estimated per-event direct costs for CVAD-associated complications were as follows: occlusion (A$2712 (95% CI $1198-$4225)), CVAD-associated venous thromboembolism (A$17,510 (95% CI $5840-$29,181)), confirmed CLABSI (A$38,995 (95% CI $22,394-$55,596)), and suspected CLABSI (A$16,030 (95% CI $12,971-$19,090)). CONCLUSION: CVAD-associated complications remain a palpable cost in paediatric cancer care, with CLABSI carrying the highest cost burden. Therefore, investing in preventative care is encouraged to minimise the burden of complication costs to the healthcare system, and reduce the physical and emotional burden on patients and their families. With admission costs comprising a high percentage of complication-associated costs, efficient and effective evidence-based care must be delivered to ensure a shorter length of stay, simultaneously improving the patient experience.
Self-reported peripheral neuropathic symptoms in long-term adolescent and young adult (AYA) cancer survivors: results of the SURVAYA study.
Scheltes DA, Janssen SHM, Bijlsma RM … +11 more , Kaal SEJ, Kerst JM, Tromp JM, Bos MEMM, van der Hulle T, Lalisang RI, Nuver J, Kouwenhoven MCM, van der Graaf WTA, Mols F, Husson O
Support Care Cancer · 2026 Jul · PMID 42390635 · Full text
PURPOSE: Adolescent and young adult cancer survivors (AYAs; 18-39 years old at initial cancer diagnosis) face unique challenges throughout their disease trajectory and are, therefore, a distinct population within the onc...
PURPOSE: Adolescent and young adult cancer survivors (AYAs; 18-39 years old at initial cancer diagnosis) face unique challenges throughout their disease trajectory and are, therefore, a distinct population within the oncology community. A common side effect of some cancer treatments is neuropathy, which can affect patients' quality of life ongoing. AYA-specific studies on long-term effects, such as neuropathy, are lacking. This study investigated the prevalence of, and factors associated with self-reported peripheral neuropathic symptoms in long-term AYA cancer survivors. METHODS: This questionnaire study (SURVAYA study) examined patient-reported outcomes among long-term AYA cancer survivors (5-20 years post-diagnosis). Data were collected through a questionnaire and by the Netherlands Cancer Registry. Analyses included descriptive statistics and multivariable logistic regression. RESULTS: Three thousand seven hundred forty-one AYAs were included in this secondary analysis. Overall, the prevalence of self-reported peripheral neuropathic symptoms was 19.8% and was higher among AYA cancer survivors who received chemotherapy. In addition, female sex, older age at diagnosis, primary education or none, secondary vocational education, higher vocational education, head and neck cancer, germ cell tumours, lymphoid haematological malignancies, thyroid cancer, current or former smoking, higher physical activity levels and rheumatoid arthritis were associated with a higher likelihood of reporting peripheral neuropathic symptoms. CONCLUSION: This study highlights the socio-demographic, clinical and health and lifestyle factors associated with self-reported peripheral neuropathic symptoms in Dutch long-term AYA cancer survivors. This can inform healthcare providers to further identify high-risk groups within the AYA cancer survivors and provide additional monitoring of these patients. Future research should include a longitudinal assessment of peripheral neuropathic symptoms, including baseline scores which were not available in this study.
Meaning-centered psychotherapy for Chinese caregivers of patients with advanced cancer: Cultural and linguistic adaptation.
Takemura N, Li AC, Applebaum AJ
Support Care Cancer · 2026 Jul · PMID 42390618 · Full text
PURPOSE: Cancer incidence is rising in Hong Kong, with over half of common cancers diagnosed at advanced stages, placing substantial demands on families and driving high caregiver distress. Meaning-centered psychotherapy...
PURPOSE: Cancer incidence is rising in Hong Kong, with over half of common cancers diagnosed at advanced stages, placing substantial demands on families and driving high caregiver distress. Meaning-centered psychotherapy for cancer caregivers (MCP-C) shows promise in Western settings but requires cultural tailoring for Chinese caregivers whose values are shaped by Confucian ethics. This study aimed to culturally and linguistically adapt MCP-C for Chinese caregivers of patients with advanced cancer in Hong Kong to enhance acceptability, relevance and conceptual equivalence. METHODS: Guided by the ORBIT model and Bernal's ecological validity model (EVM), we conducted semistructured interviews with nine cancer caregivers and eight healthcare professionals (oncologists, nurses, social worker and clinical psychologist). The manual was translated and transcreated into traditional Chinese. Analysis used a hybrid deductive-inductive approach anchored to EVM domains with dual independent coding and consensus adjudication. RESULTS: Adaptations spanned all eight EVM domains (language, persons, metaphors/stories, content, goals, methods, concepts and context), including reframing "meaning" around family roles and filial responsibility, integrating Cantonese idioms, simplifying terminology, rebranding as a "meaning-centered well-being program," and enabling online delivery to improve feasibility. CONCLUSION: This systematic adaptation preserved therapeutic fidelity while enhancing cultural fit for Chinese caregivers. A mixed-methods feasibility study will evaluate acceptability, appropriateness and preliminary outcomes (meaning in life, distress, spiritual well-being and benefit finding) to inform subsequent efficacy trials.
Nonpharmacological interventions for preventing delirium in adult patients with cancer: a systematic review and meta-analysis.
Kanno Y, Shinsato K, Kako J … +5 more , Matsuda Y, Inoue S, Tanimukai H, Wada S, Hasegawa T
Support Care Cancer · 2026 Jul · PMID 42390613 · Full text
PURPOSE: To determine whether nonpharmacological interventions reduce delirium incidence in adult patients with cancer and to identify effective intervention strategies. METHOD: We conducted a systematic review and meta-...
PURPOSE: To determine whether nonpharmacological interventions reduce delirium incidence in adult patients with cancer and to identify effective intervention strategies. METHOD: We conducted a systematic review and meta-analysis following PRISMA guidelines. PubMed, CENTRAL, CINAHL, and Ichushi-Web were searched through September 30, 2024, for randomized controlled trials (RCTs). Two authors independently extracted data, assessed the risk of bias using the Cochrane Risk of Bias 2 tool, and evaluated the certainty of evidence using the Grading of Recommendations Assessment, Development and Evaluation approach. The primary outcome was delirium incidence. A random-effects model was used for the meta-analysis. The study protocol was registered with UMIN-CTR (No. UMIN000051804; registered August 2, 2023). RESULTS: Overall, 12 RCTs involving 2,747 patients were included. Interventions were categorized into multicomponent interventions, bright light therapy, rehabilitation, and anesthesia or oxygen management. The meta-analysis of five trials showed that multicomponent interventions significantly reduced delirium incidence (risk ratio [RR], 0.43; 95% confidence interval [CI], 0.31-0.60; moderate-certainty evidence), with benefit predominantly observed in postoperative settings. The evidence for bright light therapy was inconclusive (RR, 0.31; 95%CI, 0.07-1.31; very low-certainty evidence). Most of the included studies had concerns regarding the risk of bias, mainly due to a lack of blinding. CONCLUSION: Multicomponent nonpharmacological interventions may reduce delirium incidence in adult patients with cancer, particularly in postoperative or perioperative settings. However, the certainty of evidence is moderate, and the included studies vary in patient populations, intervention components, and healthcare settings. Evidence for standalone interventions and prevention strategies in palliative or end-of-life care remains limited and inconclusive.
Mental illness and health literacy in people with cancer: the Australian National Health Survey analysis.
Ng HS, Dods C, Dimian J … +2 more , Woodman R, Beatty L
Support Care Cancer · 2026 Jul · PMID 42390605 · Full text
PURPOSE: To examine factors associated with mental illness (MI) in people with and without cancer, and the associations between cancer, MI and health literacy (HL). METHODS: This cross-sectional study was conducted using...
PURPOSE: To examine factors associated with mental illness (MI) in people with and without cancer, and the associations between cancer, MI and health literacy (HL). METHODS: This cross-sectional study was conducted using data from the Australian National Health Survey 2017-2018 and HL Survey. All participants aged ≥ 25 years were categorised into four groups based on self-reported cancer and MI. Multivariable logistic regressions were performed to examine characteristics associated with MI, with stratification by cancer status. General linear models were used to assess the association between nine individual HL domain scores and cancer and MI. RESULTS: About 30% of people with cancer (n = 690/2276) and 27% of those without cancer (n = 3483/12920) reported having a MI. Several characteristics were associated with higher odds of MI in both cancer and non-cancer groups: female gender, younger age, obesity, currently smoking, residing in a major city, lower socioeconomic status, having more comorbidities and being physically less active. For most of these characteristics, the associated risk was higher in people with cancer. MI was negatively associated with seven individual HL domain scores, whilst having cancer was negatively associated with only one domain. CONCLUSION: Risk factors for MI appeared to be similar in persons with and without cancer, but the associated relative risks are higher in those with cancer. HL is negatively associated with both MI and cancer, with stronger associations for MI. Improving HL in those with MI and cancer has the potential to improve modifiable risk factors and outcomes of this population.
User profiles of young breast cancer survivors on Chinese social media: machine learning-based text mining analysis study.
Jiang L, Wang X, Liu Y … +5 more , Zou F, Yi R, Sun Z, Xu J, Hu Y
Support Care Cancer · 2026 Jul · PMID 42387063 · Publisher ↗
PURPOSE: Social media is vital for improving healthcare access, especially among disadvantaged groups. During the COVID-19 pandemic, young breast cancer survivors (YBCSs) in China increasingly relied on social media for...
PURPOSE: Social media is vital for improving healthcare access, especially among disadvantaged groups. During the COVID-19 pandemic, young breast cancer survivors (YBCSs) in China increasingly relied on social media for health information, shaping their experiences and needs. However, little is known about how their online behaviors changed during such crises. This study examines the characteristics and health needs of Chinese YBCSs on social media during the pandemic, providing evidence to inform public health management in emergencies. METHODS: We used web crawlers to collect 6,415 breast cancer-related posts from Sina Weibo and Zhihu (November 30, 2017-May 31, 2022). Posts were filtered using operational criteria, combining manual screening and machine learning models. Text mining and natural language processing were applied to construct multidimensional user profiles across three pandemic phases: pre-pandemic, outbreak, and normalization. RESULTS: In total, 2,640 posts from YBCSs were included for analysis. YBCSs' online activity increased markedly during the outbreak (from 0.37 to 2.22 posts/hour), with peak engagement during leisure times but shorter active durations. Content shifted from treatment-focused discussions to collective encouragement and pandemic-related topics, then returned to disease management in the normalization phase. Sentiment was generally positive, with fluctuations during the outbreak and stabilization in the normalization phase (sentiment index 0.17-0.38). CONCLUSION: This study underscores the significant impact of the COVID-19 pandemic on YBCSs, highlighting shifts in temporal routines, content priorities, and emotions. The findings redefine the perspective on managing healthy lives of these vulnerable and fragile groups in the post-crises era, and emphasize the urgent need for timely health information support and equality in healthcare through social media platforms with machine-learning approaches.
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