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Electronic patient‐reported outcome (ePRO) programs may offer advantages for patients with cancer, clinicians, health care systems, payors, and society in general; but developing and maintaining an ePRO program will require cancer centers to navigate defining meaningful problems, collecting ePROs, implementing action when those ePROs require intervention without over‐burdening clinicians, and monitoring the successes and failures of their ePRO programs. Physician informaticists from the National Comprehensive Cancer Network Electronic Health Record Advisory Group offer 10 guiding principles to consider when contemplating, building, or refining an ePRO program for patients with cancer. [ABSTRACT FROM AUTHOR]

The landscape of oncology drug development has witnessed remarkable advancements over the last few decades, significantly improving clinical outcomes and quality of life for patients with cancer. Project Optimus, introduced by the U.S. Food and Drug Administration, stands as a groundbreaking endeavor to reform dose selection of oncology drugs, presenting both opportunities and challenges for the field. To address complex dose optimization challenges, an Oncology Dose Optimization IQ Working Group was created to characterize current practices, provide recommendations for improvement, develop a clinical toolkit, and engage Health Authorities. Historically, dose selection for cytotoxic chemotherapeutics has focused on the maximum tolerated dose, a paradigm that is less relevant for targeted therapies and new treatment modalities. A survey conducted by this group gathered insights from member companies regarding industry practices in oncology dose optimization. Given oncology drug development is a complex effort with multidimensional optimization and high failure rates due to lack of clinically relevant efficacy, this Working Group advocates for a case‐by‐case approach to inform the timing, specific quantitative targets, and strategies for dose optimization, depending on factors such as disease characteristics, patient population, mechanism of action, including associated resistance mechanisms, and therapeutic index. This white paper highlights the evolving nature of oncology dose optimization, the impact of Project Optimus, and the need for a tailored and evidence‐based approach to optimize oncology drug dosing regimens effectively. [ABSTRACT FROM AUTHOR]

Plain language summary: Biomarkers may offer unforeseen insights into clinical diagnosis, as well as the likely course and outcome of a condition. In this paper, the focus is on the use of biological molecules found in body fluids or tissues for diagnosis and prediction of outcome in ovarian cancer patients. In cancer care, biomarkers are being used to develop personalised treatment plans for patients based on the unique characteristics of their tumour. This tailoring of care can be used to pursue specific targets identified by biomarkers, or treat the patient according to specific tumour characteristics. Surgery is one of the core treatments for ovarian cancer, whether it is offered in primary surgery or following chemotherapy in delayed surgery. Biomarkers already exist to guide the treatment of tumours with chemotherapy, but very little research has determined the value of biomarkers in tailoring surgical care for ovarian cancer. Such research is required to identify new biomarkers and assess their effectiveness in a clinical setting as well as to help identify specific tumour types to guide surgery. Biomarkers could help to determine the success of removing the disease surgically, or help to identify tumour deposits that persist after chemotherapy. All of these aspects would improve current practice. This Scientific Impact Paper highlights research that may pave the way towards bespoke surgery according to the biological characteristics of a tumour and aid gynaecological oncologists to provide surgical treatment according to individual need, rather than a blanket approach for all. [ABSTRACT FROM AUTHOR]

Background: Among sarcomas, which are rare cancers, many types are exceedingly rare; however, a definition of ultra‐rare cancers has not been established. The problem of ultra‐rare sarcomas is particularly relevant because they represent unique diseases, and their rarity poses major challenges for diagnosis, understanding disease biology, generating clinical evidence to support new drug development, and achieving formal authorization for novel therapies. Methods: The Connective Tissue Oncology Society promoted a consensus effort in November 2019 to establish how to define ultra‐rare sarcomas through expert consensus and epidemiologic data and to work out a comprehensive list of these diseases. The list of ultra‐rare sarcomas was based on the 2020 World Health Organization classification, The incidence rates were estimated using the Information Network on Rare Cancers (RARECARENet) database and NETSARC (the French Sarcoma Network's clinical‐pathologic registry). Incidence rates were further validated in collaboration with the Asian cancer registries of Japan, Korea, and Taiwan. Results: It was agreed that the best criterion for a definition of ultra‐rare sarcomas would be incidence. Ultra‐rare sarcomas were defined as those with an incidence of approximately ≤1 per 1,000,000, to include those entities whose rarity renders them extremely difficult to conduct well powered, prospective clinical studies. On the basis of this threshold, a list of ultra‐rare sarcomas was defined, which comprised 56 soft tissue sarcoma types and 21 bone sarcoma types. conclusions: Altogether, the incidence of ultra‐rare sarcomas accounts for roughly 20% of all soft tissue and bone sarcomas. This confirms that the challenges inherent in ultra‐rare sarcomas affect large numbers of patients. The list of ultra‐rare sarcomas, defined as those sarcomas with an incidence ≤1 per 1,000,000, comprises 56 soft tissue sarcoma and 21 bone sarcoma types. The incidence of ultra‐rare sarcomas accounts for roughly 20% of all soft tissue and bone sarcomas, confirming that challenges inherent to ultra‐rare sarcomas affect large numbers of patients. [ABSTRACT FROM AUTHOR]

The European Academy of Dermatology and Venereology (EADV) Task Forces (TFs) on Quality of Life (QoL) and Patient Oriented Outcomes, Melanoma and Non‐Melanoma Skin Cancer (NMSC) present a review of the literature and position statement on health‐related (HR) QoL assessment in skin cancer patients. A literature search was carried out to identify publications since 1980 that included information about the impact of SC on QoL. Generic, dermatology‐specific, cancer‐specific, SC‐specific, facial SC‐specific, NMSC‐specific, basal cell carcinoma‐specific and melanoma‐specific QoL questionnaires have been used to assess HRQoL in SC patients. HRQoL was assessed in the context of creation and validation of the HRQoL instruments, clinical trials, comparison of QoL in SC and other cancers, other diseases or controls, HRQoL assessment after treatment, comorbidities, behaviour modification, predictors of QoL and survival, supportive care needs, coping strategies and fear of cancer recurrence. The most widely used instruments for HRQoL assessment in SC patients are the European Organisation for Research and Treatment of Cancer Core Questionnaire (EORTC QLQ‐C30), the Functional Assessment of Cancer Therapy‐Melanoma (FACT‐M), Skin Cancer Index (SCI), Short Form 36 Item Health Survey (SF‐36) and the Dermatology Life Quality Index (DLQI). The TFs recommend the use of the cancer‐specific EORTC QLQ‐C30, especially in late stages of disease, and the melanoma‐specific FACT‐M and SC‐specific SCI questionnaires. These instruments have been well validated and used in several studies. Other HRQoL instruments, also with good basic validation, are not currently recommended because the experience of their use is too limited. Dermatology‐specific HRQoL instruments can be used to assess the impact of skin‐related problems in SC. The TFs encourage further studies to validate HRQoL instruments for use in different stages of SC, in order to allow more detailed practical recommendations on HRQoL assessment in SC. [ABSTRACT FROM AUTHOR]

The article cites a research study that examines the role of MiR- Par3L axis in breast cancer progression. It examined normal tissues and Par3L expressions in breast cancer tissues and cells. Par3L was found to be frequently down-regulated in human breast cancer cells and tissues and Par3L low-expression was associated with aggressive clinicopathological features and poor clinical outcome of breast cancer patients.

Background: The physical challenges faced by adolescents and young adults (AYA) after a cancer diagnosis may be different from those experienced by paediatric and older adult cancer patients. Patient‐reported outcome measures (PROMs) are valuable tools that can be useful in exploring the experiences of AYAs and identifying important issues, recurrent themes and areas to potentially improve quality of life. Objective: We compared patient‐reported physical function outcomes between AYAs diagnosed with cancer and non‐cancer controls. Method: This paper builds on a scoping review published in early 2023 and focuses on PROMs related to physical function. Results: This systematic review includes 16 studies that measured and reported on physical function PROMs in AYA cancer survivors compared with their cancer‐free peers. Of these studies, 14 found that physical function in AYA survivors was significantly worse. This paper also includes a meta‐analysis conducted on 5 studies using the EORTC‐QLQ‐C30 to measure physical function, which found that physical function score was an average of 7.03 (95% CI: −10.21, −3.86) points lower in the AYA cancer group, compared to their cancer free‐peers, a difference that is clinically meaningful. Conclusions: The results overwhelmingly demonstrate that AYAs post a cancer diagnosis have worse health‐related quality of life from a physical function perspective than their cancer‐free peers, providing a compelling argument for the need to address this issue. All but one of the studies were cross‐sectional, which highlights the need for further assessment of this group longitudinally throughout their cancer journey. [ABSTRACT FROM AUTHOR]

Background: The present study aims to summarise current knowledge and identify gaps in knowledge and research regarding experience, decision‐making and information needs around parenteral nutrition, among people with advanced cancer, and their carers. Methods: This review was informed by previous methods and guidance on conducting and reporting scoping reviews. A literature search was conducted in March 2021 using Embase, Medline, CINAHL, Google and Web of Science to identify studies that examined the experience, decision‐making process and information needs of adults with advanced cancer, and their carers, who were making decisions around commencing and discontinuing parenteral nutrition. There were no date limitations, although only papers published in English were included. Results: Of the 588 papers identified, 12 papers, all qualitative, met the eligibility criteria. Despite the reported negative aspects of home parenteral nutrition, patients and carers felt the benefits outweighed these. There was variability in whether patients and carers felt involved in decisions around commencing parenteral nutrition. No studies specifically addressed information needs. Conclusions: Research is required to explore the information that patients with advanced cancer, and their carers, need to facilitate their decision‐making around commencing and discontinuing parenteral nutrition. We recommend the development of processes for obtaining written informed consent from patients commencing parenteral nutrition to ensure that core topics are discussed on initiation, enabling patients and carers to make informed decisions. Additionally, we recommend development of a national framework to inform patients and carers of the whole discharge process on PN from decision‐making to discontinuing PN. Key points: Carers would like to receive more information around home parenteral nutrition.No studies have specifically explored the information needs of patients with advanced cancer and their carers making decisions around parenteral nutrition.The best ways to communicate information around parenteral nutrition to patients and carers are unknown.Patients should be asked if they wish to involve a carer in decision‐making.Reasons for stopping parenteral nutrition are not routinely discussed with patients.The rationale for stopping parenteral nutrition should be discussed at its initiation.We recommend the development of procedures for obtaining written informed consent from patients commencing parenteral nutrition.We recommend the development of a national, standardised framework outlining the discharge process for patients with advanced cancer on home parenteral nutrition.Research is required to explore the information that patients with advanced cancer, and their carers, need to facilitate their decision‐making around commencing and discontinuing parenteral nutrition. [ABSTRACT FROM AUTHOR]

By the middle of this century, racial/ethnic minority populations will collectively constitute 50% of the US population. This temporal shift in the racial/ethnic composition of the US population demands a close look at the race/ethnicity-specific burden of morbidity and premature mortality among survivors of childhood cancer. To optimize targeted long-term follow-up care, it is essential to understand whether the burden of morbidity borne by survivors of childhood cancer differs by race/ethnicity. This is challenging because the number of minority participants is often limited in current childhood cancer survivorship research, resulting in a paucity of race/ethnicity-specific recommendations and/or interventions. Although the overall childhood cancer incidence increased between 1973 and 2003, the mortality rate declined; however, these changes did not differ appreciably by race/ethnicity. The authors speculated that any racial/ethnic differences in outcome are likely to be multifactorial, and drew on data from the Childhood Cancer Survivor Study to illustrate the various contributors (socioeconomic characteristics, health behaviors, and comorbidities) that could explain any observed differences in key treatment-related complications. Finally, the authors outlined challenges in conducting race/ethnicity-specific childhood cancer survivorship research, demonstrating that there are limited absolute numbers of children who are diagnosed and survive cancer in any one racial/ethnic minority population, thereby precluding a rigorous evaluation of adverse events among specific primary cancer diagnoses and treatment exposure groups. Cancer 2016;122:2426-2439. © 2016 American Cancer Society. [ABSTRACT FROM AUTHOR]

Objectives: This Special issue of Psycho‐Oncology highlights examples of the application of implementation science to research in psycho‐oncology. The aim is to demonstrate the different ways that implementation science is being used to generate evidence that can more readily translate evidence into changes in clinical practice. We hope this issue fosters greater interest in using the tools of implementation science to improve the lives of people affected by cancer. Methods: The papers in the issue were selected from among those that responded to a call for submissions on the application of implementation science frameworks and methods to issues in psycho‐oncology. The focus included but was not limited to research on: understanding barriers and facilitators of intervention/practice adoption; assessing implementation outcomes, evaluating implementation strategies, and improving behavioural and/or clinical outcomes. Results: The 11 papers in this issue were grouped for presentation purposes into four common topics: barriers and facilitators to implementation; feasibility as a key implementation outcome; the design, selection and adaptation of implementation strategies; and building the foundation for psycho‐oncology research translation via systematic reviews that focus on implementation strategy design. Conclusion: These papers demonstrate the breadth of current applications of implementation science to research in psycho‐oncology. Alongside the studies featured in this issue, including cost‐effectiveness analyses, tests of nationally‐focused strategies and proactive planning for adaptation, we look forward to other innovations that will promote further growth of both disciplines to improve the integration of psycho‐oncology interventions across healthcare systems. [ABSTRACT FROM AUTHOR]

Key Clinical Message: Chyle leakage is a rare postoperative complication of breast cancer, and conservative treatments should be prioritized, with careful monitoring of drainage volume and timely surgical intervention when conservative treatments are ineffective. Chyle leaks following surgery for breast cancer are seldom encountered. Management varies with no consensus in the literature. This paper reports a case of a chylous leak after axillary dissection in a patient with breast cancer eventually cured with conservative treatment and discusses management options varied with both conservative and surgical options available to clinicians. [ABSTRACT FROM AUTHOR]

Background: Acute and late toxicities in patients treated with (chemo)radiotherapy for head and neck cancer (HNC) is common and can negatively impact quality of life and performance. Performance status instruments measure the functional ability to perform daily life activities and are important tools in the oncologic population. Aims: Since Dutch performance status scales for the HNC population are lacking, we conducted this study to translate the Performance Status Scale for Head and Neck Cancer Patients (PSS‐HN) into Dutch (D‐PSS‐HN) and to validate this version. Methods & Procedures: The D‐PSS‐HN was translated into Dutch according to the internationally described cross‐cultural adaptation process. It was administered to HNC patients and together with the Functional Oral Intake Scale completed by a speech and language pathologist at five different time points during the first 5 weeks of (chemo)radiotherapy. Patients were asked each time to complete the Functional Assessment of Cancer Therapy and the Swallowing Quality of Life Questionnaire. Pearson correlation coefficients were used to calculate convergent and discriminant validity and the evolution of D‐PSS‐HN scores was assessed by means of linear mixed models. Outcomes & Results: A total of 35 patients were recruited and > 98% of the clinician‐rated scales were completed. Convergent and discriminant validity were demonstrated, with all correlations rs between 0.467 and 0.819, and between 0.132 and 0.256, respectively. The subscales of the D‐PSS‐HN are sensitive to detect changes through time. Conclusion & Implications: The D‐PSS‐HN is a valid and reliable instrument to assess performance status in patients with HNC treated with (chemo)radiotherapy. It is a useful tool to measure HNC patients' current diet level and functional abilities to perform daily life activities. WHAT THIS PAPER ADDS: What is already known on the subject: Acute and late toxicities in patients treated with (chemo)radiotherapy for HNC are common and can negatively impact quality of life and performance. Performance status instruments measure the functional ability to perform daily life activities and are important tools in the oncologic population. However, Dutch performance status scales for the HNC population are lacking. Therefore, we translated the Performance Status Scale for Head and Neck Cancer Patients (PSS‐HN) into Dutch (D‐PSS‐HN) and validated this version. What this paper adds to existing knowledge: We translated the PSS‐HN and demonstrated its convergent and discriminant validity. The subscales of the D‐PSS‐HN are sensitive to detect changes through time. What are the potential or actual clinical implications of this work?: The D‐PSS‐HN is a useful tool to measure HNC patients' functional abilities to perform daily life activities. The tool can easily be used in clinical settings: since data collection duration is very short, this facilitates clinical (and research‐related) implementation of the scale. Patients' individual needs could be identified by using the D‐PSS‐HN, resulting in more appropriate approaches and (early) referrals if needed. Interdisciplinary communication could be facilitated. [ABSTRACT FROM AUTHOR]

Deep learning is gaining importance due to its wide range of applications. Many researchers have utilized deep learning (DL) models for the automated diagnosis of cancer patients. This paper provides a systematic review of DL models for automated diagnosis of cancer patients. Initially, various DL models for cancer diagnosis are presented. Five major categories of cancers such as breast, lung, liver, brain and cervical cancer are considered. As these categories of cancers have a very high percentage of occurrences with high mortality rate. The comparative analysis of different types of DL models is drawn for the diagnosis of cancer at early stages by considering the latest research articles from 2016 to 2022. After comprehensive comparative analysis, it is found that most of the researchers achieved appreciable accuracy with implementation of the convolutional neural network model. These utilized the pretrained models for automated diagnosis of cancer patients. Various shortcomings with the existing DL‐based automated cancer diagnosis models are also been presented. Finally, future directions are discussed to facilitate further research for automated diagnosis of cancer patients. [ABSTRACT FROM AUTHOR]

This meta‐analysis was conducted to evaluate the effect of microinvasive and open operations on postoperative wound complications in low rectal carcinoma patients. Research on limited English has been conducted systematically in PubMed, Embase, Cochrane Library and Web of Science. The date up to the search was in August 2023. Following review of the classification and exclusion criteria for this research and the evaluation of its quality in the literature, there were a total of 266 related papers, which were reviewed for inclusion in the period from 2004 to 2017. A total of 1774 cases of low rectal cancer were enrolled. Of these 913 cases, the laparoscopic operation was performed on 913 cases, while 861 cases were operated on low rectal carcinoma. The overall sample was between 10 and 482. Five trials described the efficacy of laparoscopy have lower risk than open on postoperative wound infection in patients with low rectal cancer (OR, 0.72;95 % CI, 0.48,1.09 p = 0.12). Three studies results showed that the anastomotic leak was not significantly different between open and laparoscopy (OR, 0.86; 95% CI, 0.58,1.26 p = 0.44). Six surgical trials in low rectal cancer patients reported haemorrhage, and five cases of surgical time were reported, with laparoscopy having fewer bleeding compared with open surgery (MD, −188.89; 95% CI, −341.27, −36.51 p = 0.02). Compared with laparoscopy, the operation time was shorter for the open operation (MD, 33.06; 95% CI, 30.56, 35.57 p < 0.0001). Overall, there is no significant difference between laparoscopy and open surgery in terms of incidence of infection and anastomosis leak. However, the rate of haemorrhage in laparoscopy is lower，and operation time in open surgery is lower. [ABSTRACT FROM AUTHOR]

Aim: The aim of this research is to identify the main approaches and domains of palliative care quality assessment through three questionnaires used for this purpose. Design: Systematic review. Methods: The proposed analysis process consists of three stages from 2000 to 2020: (i) massive literature search, (ii) text mining and (iii) systematic reviews carried out on the QLQ C30, Zarit Burden Interview and FAMCARE questionnaires. The Preferred Reporting Items for Systematic Reviews (PRISMA‐P) have guided our research. Results: Sixteen papers were included in our study. The main findings have been summarised using a descriptive narrative synthesis approach. Systematic reviews evidenced that such tools present variable factor structures or latent domains. The results obtained are generally representative of the evidence supporting the factor structure of the QLQ‐C30 in the general cancer population. The factor structure of the Zarit Burden Interview remains ambiguous, although the idea of a unifactorial structure predominates. In the case of FAMCARE, most of the factor structures differ from the initial proposal of Kristjanson. The categorisation of the main subjective assessment approaches could be useful for the construction of a coherent system of indicators to be used in nursing practice. For its part, the variability in the latent dimensionality of the questionnaires analysed could be due to: (i) the characteristics of the sample, (ii) the population studied, (iii) cross‐cultural variability, (iv) the design of the questionnaire and (v) the analysis techniques employed. [ABSTRACT FROM AUTHOR]

Background: Improvements in treatment of head‐and‐neck cancer (HNC) have resulted in improved long‐term survival rates so there is a growing interest in long‐term consequences. Objective: The aim was to perform a smartphone‐based assessment to analyse the upper airway dysfunction‐related symptoms in HNC 1 year after radiotherapy (RT) during social distancing due to COVID‐19. Methods & Procedures: Smartphone‐based assessment on upper airway function 1 year after RT was performed. Upper airway functions include perceived impact of voice on quality of life (Voice Handicap Index, VHI‐30), swallowing (Functional Oral Intake, FOIS; and Swallowing Quality of Life questionnaire, SWAL‐QOL) and sleep‐disordered breathing (Pittsburgh Sleep Quality Index, PSQI) assessments. Additionally, quality of life was assessed using the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire. Outcomes & Results: The HNC group presented worse results in the VHI‐30 scale, in the three subscales (p < 0.001). Swallowing function also presented worse results in the HNC group, with a lower score in the FOIS questionnaire (p < 0.001) and a poorer score in the SWAL‐QOL (p < 0.001). Regarding to the sleep‐disordered breathing, the HNC group presented poorer scores in all subscales (p < 0.05). The HNC group also presented worse scores in quality of life. Conclusion: Our findings showed that HNC survivors presented a poorer upper airway function and a worse quality of life. This population needs to be systematically screened for those function impairments. WHAT THIS PAPER ADDS: What is already known on the subject: Head‐and‐neck cancer radiotherapy treatment is anatomically related to the upper airway, involved in several functions such as breathing, swallowing and speech that could be affected by the treatment. Public health restrictions caused by the COVID‐19 pandemic have made it difficult, and in many cases impossible, to see patients in person and complete assessments that are often crucial to improve their approach. Telephone interviews appear to be largely equivalent to face‐to‐face interviews, which could solve these problems. What this paper adds to existing knowledge: The aim of this study was to perform a smartphone‐based assessment to analyse the upper airway dysfunction‐related symptoms in head‐and‐neck cancer survivors 1 year after radiotherapy treatment. Our findings showed that head‐and‐neck cancer survivors who have been treated with radiotherapy presented a poorer upper airway function, with subjective speech and voice problems, swallowing and sleep‐disordered breathing compared to a control group matched for age and sex 1 year after the treatment. What are the potential or actual clinical implications of this work?: The results of this study will allow a better approach to treatment of head‐and‐neck cancer survivors. [ABSTRACT FROM AUTHOR]

Introduction: The short‐term effects of chemotherapy and irradiation are well documented; however, there is paucity regarding their long‐term effects, especially in children and adolescents. Case Description: This paper discusses the long‐term effects of chemotherapy and/or radiation received by the patients during their early childhood on the developing dentition. It comprises the compilation of 11 cases with alteration in the dental development screened from 138 cases of the childhood cancer patients who received the chemotherapy and/or radiation as a part of anticancer therapy. Results and Conclusion: The findings revealed that the age of initiation of anticancer therapy along with the synergistic effect of chemo‐irradiation, and the dose of radiation used were the principal determinants for the dental abnormalities. The root‐related abnormalities were found to be varied and more common as compared to the missing teeth and defects related to the tooth crown. [ABSTRACT FROM AUTHOR]

Background: Breast cancer is the most common type of cancer, accounting for 15% of all new cases. Hormone therapy (HT) is extremely effective in reducing breast cancer recurrence. However, adherence to HT medication is often poor due to negative side effects such as fatigue and sleep disturbances. Physical activity has been identified as a possible intervention to improve quality of life and reduce side effects of HT. Objective: The objective of this systematic review was to summarise evidence of exercise interventions for women being treated with HT for breast cancer. Method: Electronic searches were conducted from inception to March 2022 using Medline, SPORTdiscus, Embase, Scopus, PsycINFO and Web of Science databases. Searches included a combination of terms related to breast cancer, exercise, sleep disturbances, fatigue and HT. Results: Ten eligible papers were identified, and their quality was assessed. Type, frequency, duration and intensity of exercise interventions varied. Exercise types included aerobics, strength/resistance training, walking and yoga. Heterogeneity of data made it difficult to draw conclusions. However, aerobic exercise interventions provide clear improvements in fatigue and sleep disturbances. Conclusions: This review identified a lack of consistency in exercise recommendations for women being treated for breast cancer. It identifies that aerobic exercise can successfully improve fatigue and sleep disturbances, consistent with existing literature. Exercise has a range of benefits for this population, including improving psychological well‐being and quality of life. Clinicians should strongly advocate for engagement in exercise to promote overall physical and psychological well‐being in women being treated for breast cancer. [ABSTRACT FROM AUTHOR]

Objective: The UK incidence of oropharyngeal cancer has risen sharply over the last 30 years with an increase in human papillomavirus (HPV) associated diagnoses, most prevalent in younger, working age populations. This meta‐ethnography explores the psychosocial needs of HPV+ve oropharyngeal cancer patients during early recovery following (chemo)radiotherapy. Methods: Meta‐ethnography methods were used, based on the approach of Noblit and Hare. Systematic searches for relevant qualitative studies were conducted in five electronic databases (MEDLINE, PubMed, CINAHL, PsycINFO and Cochrane database) between 2010 and 2021, followed by citation searching. Results: Twenty‐three papers exploring the psychosocial needs of HPV+ve oropharyngeal cancer patients after treatment were included. Findings were synthesised to develop five constructs: 'gaps in continuity of support from healthcare professionals' reflecting unmet needs; 'changes to self‐identity' revealing the comprehensive disruption of this disease and treatment; 'unrealistic expectations of recovery' highlighting the difficulty of preparing for the impact of treatment; 'finding ways to cope' describing the distinct complexity of this experience; and 'adjusting to life after the end of treatment' exploring how coping strategies helped patients to regain control of their lives. Conclusions: Completing (chemo)radiotherapy signalled a transition from hospital‐based care to home‐based support, challenging patients to address the constructs identified. An unexpectedly difficult and complex recovery meant that despite a favourable prognosis, poor psychosocial well‐being may threaten a successful outcome. The provision of tailored support is essential to facilitate positive adjustment. [ABSTRACT FROM AUTHOR]

Locoregional recurrence of differentiated thyroid cancer (DTC) occurs in 20% of thyroid cancer patients. Currently, there are many strategies for management of locoregional recurrence of DTC that lead to local control of the disease. The introduction of lenvatinib into the therapeutic armamentarium provides a new option for the treatment of radioiodine‐refractory DTC (RR‐DTC). However, results for simultaneous treatment with lenvatinib and locoregional therapies are unknown in patients with RR‐DTC. This paper reviews the current status of this approach and gives recommendations on the management of lenvatinib during concomitant locoregional procedures. Locoregional recurrence of differentiated thyroid cancer occurs in 20% of thyroid cancer patients. Strategies for management of recurrence of radioiodine‐refractory differentiated thyroid cancer include lenvatinib. This paper reviews simultaneous treatment with lenvatinib and locoregional therapies. [ABSTRACT FROM AUTHOR]

Various reviews and meta‐analyses have shown the positive effects of mindfulness‐based interventions (MBIs) on the mental health of cancer patients and survivors. Some studies have also investigated the impact of MBIs on physiological markers of health in oncology, but a systematic review has not been conducted in this field. The current paper aims to fill this gap in the literature. Following preferred reporting items for systematic reviews and meta‐analyses 2020 guidelines, data were obtained from the databases of Pubmed, Scopus, Web of Science in May 2022. Twenty‐five studies were included. Globally, 35 biomarkers were employed in these studies and were categorized 8 groups (cortisol; blood pressure (BP), heart rate, and respiratory rate; C‐reactive protein; telomere length and telomerase activity (TA); genetic signature; cytokines and hormones; leucocyte activation; leucocyte count and cell subpopulation analysis). In seven of these categories of biomarkers, positive effects of MBIs were observed. The most promising results were obtained for cortisol, BP, TA and pro‐inflammatory gene expression. However, the generally low number of studies per single biomarker limits the possibility to draw reliable conclusions. The present review presents a comprehensive state‐of‐the‐art for MBIs in oncology on biomarkers, confirming MBIs' potential for improving physiological health in cancer patients and survivors besides those already shown in literature on psychological well‐being. [ABSTRACT FROM AUTHOR]

The rate of obesity is increasing in the Australian population, and this also includes patients with cancer. The safety and dignity of this cohort of patients is paramount as well as the timely acquisition of equipment required to assist patients with obesity to complete a course of radiation therapy (RT). The design and manufacture of equipment used in most RT departments is not suitable for the weight or BMI of all patients presenting for treatment. RT also operates under a unique set of circumstances that differs from the routine hospital environment which prompted the design of an RT bariatric protocol for use in our department. The protocol is based on the mapping of a patient's pathway from simulation and treatment. Treatment technique and equipment limitations as well as information relating to a patient with high BMI are used as trigger points that direct a patient pathway. The bariatric protocol provides the RT team with decision‐making support for appropriate resource utilisation ensuring safe and efficient treatment delivery for both the patient and staff. This paper will outline how the RT bariatric protocol was developed and implemented in our department, highlighting areas that required more attention due to the RT‐specific environment. [ABSTRACT FROM AUTHOR]

People alive many years after breast (BC) or colorectal cancer (CRC) diagnoses are increasing. This paper aimed to estimate the indicators of cancer cure and complete prevalence for Italian patients with BC and CRC by stage and age. A total of 31 Italian Cancer Registries (47% of the population) data until 2017 were included. Mixture cure models allowed estimation of net survival (NS); cure fraction (CF); time to cure (TTC, 5‐year conditional NS >95%); cure prevalence (who will not die of cancer); and already cured (prevalent patients living longer than TTC). 2.6% of all Italian women (806,410) were alive in 2018 after BC and 88% will not die of BC. For those diagnosed in 2010, CF was 73%, 99% when diagnosed at stage I, 81% at stage II, and 36% at stages III–IV. For all stages combined, TTC was >10 years under 45 and over 65 years and for women with advanced stages, but ≤1 year for all BC patients at stage I. The proportion of already cured prevalent BC women was 75% (94% at stage I). Prevalent CRC cases were 422,407 (0.7% of the Italian population), 90% will not die of CRC. For CRC patients, CF was 56%, 92% at stage I, 71% at stage II, and 35% at stages III–IV. TTC was ≤10 years for all age groups and stages. Already cured were 59% of all prevalent CRC patients (93% at stage I). Cancer cure indicators by stage may contribute to appropriate follow‐up in the years after diagnosis, thus avoiding patients' discrimination. [ABSTRACT FROM AUTHOR]

Background: Perceptual measures such as speech intelligibility are known to be biased, variant and subjective, to which an automatic approach has been seen as a more reliable alternative. On the other hand, automatic approaches tend to lack explainability, an aspect that can prevent the widespread usage of these technologies clinically. Aims: In the present work, we aim to study the relationship between four perceptual parameters and speech intelligibility by automatically modelling the behaviour of six perceptual judges, in the context of head and neck cancer. From this evaluation we want to assess the different levels of relevance of each parameter as well as the different judge profiles that arise, both perceptually and automatically. Methods and Procedures: Based on a passage reading task from the Carcinologic Speech Severity Index (C2SI) corpus, six expert listeners assessed the voice quality, resonance, prosody and phonemic distortions, as well as the speech intelligibility of patients treated for oral or oropharyngeal cancer. A statistical analysis and an ensemble of automatic systems, one per judge, were devised, where speech intelligibility is predicted as a function of the four aforementioned perceptual parameters of voice quality, resonance, prosody and phonemic distortions. Outcomes and Results: The results suggest that we can automatically predict speech intelligibility as a function of the four aforementioned perceptual parameters, achieving a high correlation of 0.775 (Spearman's ρ). Furthermore, different judge profiles were found perceptually that were successfully modelled automatically. Conclusions and Implications: The four investigated perceptual parameters influence the global rating of speech intelligibility, showing that different judge profiles emerge. The proposed automatic approach displayed a more uniform profile across all judges, displaying a more reliable, unbiased and objective prediction. The system also adds an extra layer of interpretability, since speech intelligibility is regressed as a direct function of the individual prediction of the four perceptual parameters, an improvement over more black box approaches. WHAT THIS PAPER ADDS: What is already known on this subject: Speech intelligibility is a clinical measure typically used in the post‐treatment assessment of speech affecting disorders, such as head and neck cancer. Their perceptual assessment is currently the main method of evaluation; however, it is known to be quite subjective since intelligibility can be seen as a combination of other perceptual parameters (voice quality, resonance, etc.). Given this, automatic approaches have been seen as a more viable alternative to the traditionally used perceptual assessments. What this study adds to existing knowledge: The present work introduces a study based on the relationship between four perceptual parameters (voice quality, resonance, prosody and phonemic distortions) and speech intelligibility, by automatically modelling the behaviour of six perceptual judges. The results suggest that different judge profiles arise, both in the perceptual case as well as in the automatic models. These different profiles found showcase the different schools of thought that perceptual judges have, in comparison to the automatic judges, that display more uniform levels of relevance across all the four perceptual parameters. This aspect shows that an automatic approach promotes unbiased, reliable and more objective predictions. What are the clinical implications of this work?: The automatic prediction of speech intelligibility, using a combination of four perceptual parameters, show that these approaches can achieve high correlations with the reference scores while maintaining a certain degree of explainability. The more uniform judge profiles found on the automatic case also display less biased results towards the four perceptual parameters. This aspect facilitates the clinical implementation of this class of systems, as opposed to the more subjective and harder to reproduce perceptual assessments. [ABSTRACT FROM AUTHOR]

This article is a response to a letter received regarding a research paper titled "Long‐term effects of chemotherapy and radiation received during early childhood on the developing dentition of pediatric cancer patients." The research paper explores the impact of chemotherapy and radiation on the development of teeth in childhood cancer survivors. The letter raised concerns about the dose of radiation received by the jaw and dentition. The authors of the response address these concerns and provide additional information about the study's methodology and findings. They emphasize the need for more definitive information regarding the dose of radiation and chemotherapy received to understand their effects on dental development. [Extracted from the article]

Background: Advances in treatment mean that most children diagnosed with cancer during childhood survive. Therefore, it is increasingly important to examine the long‐term consequences of childhood cancer, including educational attainment. This systematic review investigated whether the educational attainment of childhood cancer survivors differ from the cancer‐free population. Design/methods: We searched seven databases for articles published from January 2005 to August 2018. We identified full papers in English, reporting primary data on academic attainment of adult survivors of childhood cancer, compared to a control group. Quality appraisal was conducted using the Newcastle‐Ottawa Scale. Results: Fourteen studies met the inclusion criteria. Nine papers included patients with various types of cancers, four focused on a single type of cancer, and one on patients who underwent stem cell transplantation. Of the 14 papers, 2 studies were considered good quality, 10 were considered adequate quality, and 2 were considered poor quality. Four studies reported more favorable educational attainment among survivors while six did not report significant differences. Less favorable attainment was consistently reported for CNS survivors in four studies. Conclusion: The literature does not provide a clear pattern of the long‐term consequences of childhood cancer on education attainment. While this may suggest that there is no consistent difference between the education attainment of cancer survivors and controls, it may also be the result of limitations in the existing research. To better assess the education attainment of survivors, there is a need for high‐quality studies, with appropriate comparators, and standardized measures of education attainment across countries. [ABSTRACT FROM AUTHOR]

Objective: This study aimed to compare the effectiveness of digital and face‐to‐face interventions in reducing fear of cancer recurrence (FCR) among individuals with cancer. Methods: This study was conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta‐Analyses (PRISMA) guidelines for evaluating the efficacy of psychological interventions for FCR published between July 2018 and December 2021. We searched for research papers using PubMed, Embase, and Cochrane and assessed their quality using the Revised Cochrane risk‐of‐bias tool for randomized trials. Results: Of the 2113 identified studies, we analyzed 17 samples (N = 1482) from 14 studies, of which 13 were RCTs. The overall sample showed a moderate effect size (Hedges' g = 0.607; 0.356 to 0.858; p < 0.001; I2 = 81.29%) in FCR reduction. The overall effect size was 0.621 (95% CI, 0.276 to 0.966; p < 0.001; I2 = 81.78%) for face‐to‐face interventions and 0.517 (95% CI, 0.093 to 0.941; p = 0.017; I2 = 83.19%) for digital interventions. The difference between the two effect sizes was not statistically significant. Conclusion: Our meta‐analysis suggests that digital interventions are moderately effective in reducing FCR, similar to face‐to‐face interventions. However, given the high degree of heterogeneity, this conclusion should be interpreted with caution. Further studies are required to identify the most effective digital interventions and the populations that may benefit from them. [ABSTRACT FROM AUTHOR]

We witnessed major advances in the management of heart failure (HF) in 2022. Results of recent clinical and preclinical investigations aid preventive strategies, diagnostic efforts, and therapeutic interventions, and collectively, they hold promises for a more effective HF care for the near future. Accordingly, currently available information extends the 2021 European Society of Cardiology guidelines and provides a solid background for the introduction of improved clinical approaches in the number of HF‐related cases. Elaboration on the relationships between epidemiological data and risk factors lead to better understanding of the pathophysiology of HF with reduced ejection fraction and HF with preserved ejection fraction. The clinical consequences of valvular dysfunctions are increasingly interpreted not only in their haemodynamic consequences but also in association with their pathogenetic factors and modern corrective treatment possibilities. The influence of coronavirus disease 2019 pandemic on the clinical care of HF appeared to be less intense in 2022 than before; hence, this period allowed to refine coronavirus disease 2019 management options for HF patients. Moreover, cardio‐oncology emerges as a new subdiscipline providing significant improvements in clinical outcomes for oncology patients. Furthermore, the introduction of state‐of‐the‐art molecular biologic methods, multi‐omic approaches forecast improved phenotyping and precision medicine for HF. All above aspects are addressed in this article that highlights a selection of papers published in ESC Heart Failure in 2022. [ABSTRACT FROM AUTHOR]

Background: Over the past decade, ECMO has provided temporary cardiopulmonary support to an increasing number of patients, but the use of extracorporeal membrane oxygenation (ECMO) to provide temporary respiratory and circulatory support to adult patients with malignancy remains controversial. Objectives: This paper reviews the specific use of extracorporeal membrane oxygenation (ECMO) in oncology patients. Methods: We searched PubMed, CINAHL, Cochrane Library, and Embase databases for studies on the use of ECMO in cancer patients between 1998 and 2022. Twenty‐four retrospective, prospective, and case reports were included. The primary outcome was survival during extracorporeal membrane oxygenation. Results: Most studies suggest that ECMO can be used in oncology patients requiring life support during surgery, solid tumor patients with respiratory failure, and hematological tumor patients requiring ECOM as a supportive means of chemotherapy; however, in patients with hematologic oncology undergoing hematopoietic stem cell transplantation, there was no clear benefit after the use of ECMO. Conclusion: Current research suggests that ECMO may be considered as a salvage support in specific cancer patients. Future studies should include larger sample sizes than those already conducted, including studies on efficacy, adverse events, and health. [ABSTRACT FROM AUTHOR]

Objective: Living in regional/rural areas can impact outcomes for people with head and neck cancer (HNC). Using a comprehensive state‐wide dataset, the impact of remoteness on key service parameters and outcomes for people with HNC was examined. Methods: Retrospective quantitative analysis of routinely collected data held within the Queensland Oncology Repository. Design: Quantitative methods (descriptive statistics, multivariable logistic regression and geospatial analysis). Setting: All people diagnosed with HNC in Queensland, Australia. Participants: The impact of remoteness was examined in 1991 people (1171 metropolitan, 485 inner‐regional, 335 rural) with HNC cancer diagnosed between 2013 and 2015. Main Outcome Measures: This paper reports key demographics and tumour characteristics (age, gender, socioeconomic status, First Nations status, co‐morbidities, primary tumour site and staging), service use/uptake (treatment rates, attendance at multidisciplinary team review and timing to treatment) and post‐acute outcomes (readmission rates, causes of readmission and 2‐year survival). In addition to this, the distribution of people with HNC across QLD, distances travelled and patterns of readmission were also analysed. Results: Regression analysis revealed remoteness significantly (p < 0.001) impacted access to MDT review, receiving treatment, and time to treatment commencement, but not readmission or 2‐year survival. Reasons for readmission did not differ by remoteness, with dysphagia, nutritional inadequacies, gastrointestinal disorders and fluid imbalance indicated in the majority of readmissions. Rural people were significantly (p < 0.0001) more likely to travel to care and to readmit to a different facility than provided primary treatment. Conclusions: This study provides new insights into the health care disparities for people with HNC residing in regional/rural areas. [ABSTRACT FROM AUTHOR]

Background and aims: This living and systematic review aimed to provide an updated summary of the available evidence on pain undertreatment prevalence in patients with cancer; correlations with some potential determinants and confounders were also carried out. Materials and methods: We updated a systematic review published on 2014, including observational and experimental studies reporting the use of the pain management index (PMI) in adults with cancer and pain, from 2014 to 2020. We conducted searches in PubMed/MEDLINE, Embase, and Google Scholar. We performed univariate and multivariable regression analyses to describe the relationship between PMI and a list of potential explanatory variables. Results: Twenty new papers were identified, yielding a total sample size of 66 studies. The proportion of patients classified as undertreated according to the year of study publication shows a higher decrease from 1994 to 2013 (−13% as relative change) than the most recent years 2014–2020 (−11%). The quality of the included studies has increased over the years (from 80% to 93%). At the multivariable analysis, a statistically significant relationship was confirmed between undertreatment and the year of the publication of the study and with a low–medium economic level of the countries, where the studies were conducted. Discussion: Despite the improvement when compared to the period 1994–2000, still about 40% of the cases identified received an analgesic treatment inadequate to the intensity of pain, according to the PMI. Despite its intrinsic limitations, PMI continues to be widely used, and it could allow a continuous monitoring of pain management across a different mix of studies and patients. [ABSTRACT FROM AUTHOR]

Objective: One of the most prevalent and disrupting symptoms experienced by cancer patients is chronic cancer-related fatigue (CCRF). A better understanding of the chronic nature of CCRF can provide valuable insights for theory and practice. The purpose of this meta-ethnography was to derive an overarching interpretative narrative on patients' experiences and responses to CCRF.Methods: We conducted a comprehensive systematic literature search in five databases (05-03-2018). In addition, papers from reference lists were retrieved. Two researchers independently screened the papers for eligibility and appraised quality (CASP-criteria). We followed the seven phases of meta-ethnography to extract, translate, and synthesise first-order constructs (ie, patients' views) and second-order constructs (ie, authors' views) from the selected studies into third-order constructs (ie, new interpretations).Results: Of the 1178 collected articles, 16 articles were included. Through synthesis, a new figure of six interrelated third-order constructs was developed: (1) embodied experience entails the dominating presence of the body; (2) (mis)recognition includes lack of recognition of CCRF by patients, relatives, and health providers; (3) small horizon describes a resultant narrowed world; (4) role change encompasses adopting other life roles; (5) loss of self refers to the impact on one's identity; and (6) regaining one's footing describes the struggle against CCRF, adaptation to CCRF and finally acceptance of a "new normal with CCRF."Conclusion: A new embodiment figure of CCRF with social (eg, (mis)recognition), spatial (eg, small horizon) and temporal dimensions (eg, regaining one's footing) was developed. This figure can help professionals to recognise CCRF, inform patients, and personalise treatment. [ABSTRACT FROM AUTHOR]

Objective: Although caregiver burden may continue to influence the mental health of cancer patients' caregivers long after bereavement, few studies have examined this issue.Methods: A systematic review was conducted to provide a summary of (1) operationalizations of caregiver burden used in this field and (2) the effect of caregiver burden on postbereavement mental health of adult caregivers of cancer patients. A systematic search of the electronic databases PubMed, Web of Science, and PsycINFO was conducted across empirical studies published in a peer-reviewed journal up until April 2017.Results: Caregiver burden was rarely defined, and it was operationalized in multiple and diverging ways. The 20 included papers present varying results but generally indicate that caregiver burden (especially emotional) has an adverse effect on postbereavement mental health.Conclusions: In future studies, researchers seeking to ascertain which aspects of caregiver burden may prove an appropriate target for prevention and intervention should first use a precise operational definition of the concept. [ABSTRACT FROM AUTHOR]

Background: The COVID‐19 pandemic resulted in rapid changes to head and neck cancer (HNC) services. Multidisciplinary team (MDT) face‐to‐face appointments were converted to telehealth appointments (telephone and video‐call) to reduce the risk of COVID‐19 transmission. The literature exploring HNC patient experience of these appointment types is limited. Aims: To explore patient experience of telehealth appointments at one UK centre during the COVID‐19 pandemic, as well as the variables that may influence patient preference for virtual or face‐to‐face appointments. Methods & Procedures: A survey‐based study design was used, with closed questions and open text options to capture the views of the participants. Quantitative data were analysed using descriptive statistics. Open text data was used to add depth to the findings. Outcomes & Results: A total of 23 participant surveys were returned. Six categories were identified: Usability; Information receiving & giving; Satisfaction; Emotions and comfort; Rapport; and Travel time and cost. Overall, participants gave positive responses to each category and indicated that telehealth appointments met their needs. Areas for clinical consideration are highlighted. Variables such as age, travel distance from hospital site, fear of COVID‐19 and information technology (IT) access did not appear to influence patient preference for appointment type. Conclusions & Implications: Going forward, telehealth may be considered for use in combination with face‐to‐face appointments in the HNC pathway. Areas for further development include a 'telehealth screening tool' that may help to identify those patients most appropriate for these appointment types, or who require support to access them. WHAT THIS PAPER ADDS: What is already known on this subject: The COVID‐19 pandemic resulted in major disruption to HNC centres across the world. Services adapted to meet the needs of patients with many implementing telehealth into pathways. Studies exploring telehealth in speech and language therapy (SLT) services with the HNC population indicate positive results. It is clear telehealth has a role in modern healthcare and should not be viewed as a temporary solution to the pandemic. It is, however, recognized that embedding telehealth into pathways is not straightforward and requires ongoing review and evaluation, which includes patient and clinician perceptions. What this study adds to the existing knowledge: The service evaluation gives insight into HNC patient experience of telehealth appointments for MDT clinics (led by SLT, dietician and clinical nurse specialist) during the COVID‐19 pandemic. Overall, patients report a positive experience of telehealth in the HNC pathway and are willing to accept this platform into their healthcare. Areas for clinical consideration are highlighted. What are the actual and clinical implications of this work?: This findings of this service evaluation can be used to support the co‐design of HNC pathways which embed telehealth as an option for patients. Areas that were important to the participants are highlighted; this includes the timing of telehealth appointments in the pathway, the need to meet the MDT face to face and the positive benefit of cost savings. The authors suggest a telehealth appointment screening tool as an area for future development. [ABSTRACT FROM AUTHOR]

Purpose: This paper reports the efficacy of the poly (ADP‐ribose) polymerase inhibitor olaparib alone and in combination with the antiangiogenesis agent cediranib compared with cediranib alone in patients with advanced endometrial cancer. Methods: This was open‐label, randomized, phase 2 trial (NCT03660826). Eligible patients had recurrent endometrial cancer, received at least one (<3) prior lines of chemotherapy, and were Eastern Cooperative Oncology Group performance status 0 to 2. Patients were randomly assigned (1:1:1), stratified by histology (serous vs. other) to receive cediranib alone (reference arm), olaparib, or olaparib and cediranib for 28‐day cycles until progression or unacceptable toxicity. The primary end point was progression‐free survival in the intention‐to‐treat population. Homologous repair deficiency was explored using the BROCA‐GO sequencing panel. Results: A total of 120 patients were enrolled and all were included in the intention‐to‐treat analysis. Median age was 66 (range, 41–86) years and 47 (39.2%) had serous histology. Median progression‐free survival for cediranib was 3.8 months compared with 2.0 months for olaparib (hazard ratio, 1.45 [95% CI, 0.91‐2.3] p =.935) and 5.5 months for olaparib/cediranib (hazard ratio, 0.7 [95% CI, 0.43–1.14] p =.064). Four patients receiving the combination had a durable response lasting more than 20 months. The most common grade 3/4 toxicities were hypertension in the cediranib (36%) and olaparib/cediranib (33%) arms, fatigue (20.5% olaparib/cediranib), and diarrhea (17.9% cediranib). The BROCA‐GO panel results were not associated with response. Conclusion: The combination of cediranib and olaparib demonstrated modest clinical efficacy; however, the primary end point of the study was not met. The combination was safe without unexpected toxicity. Randomized study of cediranib compared with olaparib and the combination for advanced or recurrent endometrial cancer demonstrated progression‐free survival of 3.8, 2.0, and 5.5 months respectively. The treatment toxicities were manageable but the study did not meet its primary end point. [ABSTRACT FROM AUTHOR]

The paper aims to show the multilevel and complex cooperation and the inclusion of the psychotherapist leading the psychotherapy in the medical team at the radiotherapy and clinical oncology clinic. We illustrate these interventions with the case of Stan. This 43‐year‐old firefighter was diagnosed with advanced head and neck cancer and pre‐existing mental health problems meeting the criteria of ICD‐10: obsessive‐compulsive disorder, post‐traumatic stress disorder and psychoactive substance abuse. During the treatment, suicidal thoughts and impulses emerged, triggered at the hospital by electronic noises and the feeling of entrapment without a way out. This situation put the patient at high risk and the whole healthcare team needed an urgent effective response. The patient agreed to stay in the secured room, where he was cared for by doctors, nurses, a dietitian, and a psychotherapist. He actively attended daily sessions with noticeable engagement. Psychotherapy sessions focused on alleviating posttraumatic stress disorder and OCD. Mindfulness and breathwork‐based exercises were implemented to increase non‐judgemental self‐awareness and regulate the over‐aroused nervous system. As a result, the patient's mental health has improved and the completion of the cancer treatment was possible. Psychotherapy, good therapeutic alliance, and attentive teamwork effectively managed his mental health and treatment‐related symptoms. [ABSTRACT FROM AUTHOR]

Background: Patients with pre‐existing severe mental disorders are significantly less likely to receive guideline‐recommended cancer treatment and seems to have a significantly lower rate of cancer survival compared to patients with cancer without mental disorders. Aim: To perform a systematic review on barriers at patient‐, provider‐ and system‐levels in cancer trajectories of patients with pre‐existing severe mental disorders. Method: A systematic review was performed following the PRISMA guidelines (PROSPERO ID: CRD42022316020). Results: Nine eligible studies were identified. Barriers at patient‐level included lack of self‐care and ability to recognize physical symptoms and signs. Provider‐level barriers included stigma from health care professionals on mental disorders, whereas system‐level barriers included fragmented health care and consequences of this. Conclusion: This systematic review found that barriers at patient‐, provider‐ and system‐levels exist in cancer trajectories for patients with severe mental disorders, causing disparities in cancer care. Further research is needed to improve cancer trajectories for patients with severe mental disorder. [ABSTRACT FROM AUTHOR]

Background: Fragmented and complex healthcare systems make it difficult to provide continuity of care for patients with advanced cancer near the end of life. Nurse‐based cross‐sectoral navigation support has the potential to increase patients' quality of life. The objective of this paper was to evaluate associations between navigation support and health care utilization, and the associated costs of care. Methods: The evaluation is based on claims data from 37 statutory health insurance funds. Non‐randomized recruitment of the intervention group (IG) took place between 2018 and 2019 in four German hospitals. The comparison group (CG) was defined ex post. It comprises nonparticipating clients of the involved health insurance funds matched on age, gender, and diagnosis in a 1:4 ratio to the IG. Healthcare resource utilization was compared using incident rate ratios (IRRs) based on negative binomial regression models. Linear mixed models were performed to compare differences in lengths of hospital stays and costs between groups. Results: A total of 717 patients were included (IG: 149, CG: 568). IG patients showed shorter average lengths of hospital stays (IG: 11 days [95% CI: 10, 13] vs. CG: 15 days [95% CI: 14, 16], p < 0.001). In the IG, 21% fewer medications were prescribed and there were on average 15% fewer outpatient doctor contacts per month. Average billed costs in the IG were 23% lower than in the CG (IG: 6754 EUR [95% CI: 5702, 8000] vs. CG: 8816 EUR [95% CI: 8153, 9533], p < 0.001). Conclusions: The intervention was associated with decreased costs mainly as a result of a non‐intended navigation effect. The social care nurses had navigated patients within the hospital early, needs‐oriented and effectively but interpreted their function less cross‐sectorally. Linkage of hospital‐based navigators with the outpatient care sector needs further exploration. [ABSTRACT FROM AUTHOR]

Objectives: The aim of this systematic review was to estimate the osteoradionecrosis rate in patients with head and neck cancer due to teeth extraction performed before radiotherapy and to identify possible risk factors. Material and Methods: PRISMA protocol was used to evaluate and present the results. PubMed, Scopus and Web of Science were used as search engines: English full‐length papers of clinical studies, in peer‐reviewed journals, were investigated. Cumulative meta‐analysis was performed with a random effects model (PROSPERO registration code: CRD42018079986). Results: Among 2,020 records screened, 8 were included in this review. Sixteen of 494 patients who underwent tooth extraction before radiotherapy developed osteoradionecrosis, with an osteoradionecrosis incidence of 2.2% (95% Confidence of Interval = 0.6–3.9, p <.185, I2 = 3,044%). All cases were reported in the mandible. No other clinical risk factor for osteoradionecrosis was detected. Conclusions: Even if it is generally recommended to remove oral foci before radiotherapy, this systematic review confirmed that teeth extractions before radiotherapy represent a risk factor for osteoradionecrosis; the considerable amount of missing data prevented us from identifying other possible risk factors for osteoradionecrosis onset. Major efforts should be done to perform sounder methodological clinical investigations. [ABSTRACT FROM AUTHOR]

Objective More than 50% of patients with cancer experience pain. Patient empowerment has been highlighted as central to success in pain management. Up to now, no clear model for this patient group exists, yet several strategies to empower patients have been used in clinical practice. This review examines how empowerment or related concepts have been described in relation to pain management in patients with cancer. With the help of a conceptual model, recommendations for clinical practice are provided. Methods An integrative review was conducted, using the databases PubMed, CINAHL and PsycINFO. We evaluated papers discussing empowerment or related concepts in relation to pain management in patients with cancer. We analyzed the term 'empowerment' semantically. Results From a total of 5984 identified papers, 34 were included for analysis. Empowerment has been described with the concepts self-efficacy, active patient participation, increasing abilities, and control of life. Most papers focus on pain treatment induced by the professional caregiver or on the active involvement of the patient, and not on the combination of both. The following elements of empowerment could be discriminated: role of the patient, role of the professional, resources, self-efficacy, active coping, and shared decision making. Conclusions On the basis of these findings, we propose a conceptual model to empower patients in controlling cancer pain. We recommend focusing on pain treatment given by the professional, on the active involvement of the patient, and on the interaction of both. Our model might also be useful for other patient groups or specific contexts, especially in symptom management. Copyright © 2014 John Wiley & Sons, Ltd. [ABSTRACT FROM AUTHOR]

Aim: The purpose of this systematic review was to determine the effectiveness of self‐management interventions for older adults with cancer and to determine the effective components of said interventions. Methods: We conducted a systematic review of self‐management interventions for older adults (65+) with cancer guided by the Preferred Reporting Items for Systematic Reviews and Meta‐Analysis statement. We conducted an exhaustive search of the following databases: Ageline, AMED, ASSIA, CINAHL, Cochrane, Embase, Medline, PsychINFO, and Sociological Abstracts. We assessed for quality using the Cochrane Risk of Bias tool and Down & Black for quasi‐experimental studies, with data synthesized in a narrative and tabular format. Results: Sixteen thousand nine hundred and eight‐five titles and abstracts were screened, subsequently 452 full‐text papers were reviewed by two independent reviewers, of which 13 full‐text papers were included in the final review. All self‐management interventions included in this review measured Quality of Life; other outcomes included mood, self‐care activity, supportive care needs, self‐advocacy, pain intensity, and analgesic intake; only one intervention measured frailty. Effective interventions were delivered by a multidisciplinary teams (n = 4), nurses (n = 3), and mental health professionals (n = 1). Self‐management core skills most commonly targeted included: problem solving; behavioural self‐monitoring and tailoring; and settings goals and action planning. Conclusions: Global calls to action argue for increased emphasize on self‐management but presently, few interventions exist that explicitly target the self‐management needs of older adults with cancer. Future work should focus on explicit pathways to support older adults and their caregivers to prepare for and engage in cancer self‐management processes and behaviours. [ABSTRACT FROM AUTHOR]

Aims: To assess the association between length of dental arch and oral health‐related quality of life in head and neck cancer patients post‐radiotherapy. Methods: Thirty head and neck cancer participants reported their oral health‐related quality of life using the oral health impact profile‐14 instrument and their global self‐rating of general and oral health. All patients had received chemotherapy and radiotherapy. The length of dental arch was assessed in three tooth relational categories: canine‐to‐canine, shortened (premolars to premolars), and long (molars to molars) dental arches. Inclusion of participants for any of the three categories required verification of opposing teeth relationship with Shim Stock paper. Results: Out of 30 head and neck cancer patients, eight (27%) had a canine‐to‐canine dental arch, 14 (46%) had a shortened dental arch, and eight (27%) had a long dental arch. The median oral health impact profile‐14 scores for participants respectively with the canine‐to‐canine dental arch was six (IQR = 9.25), seven (IQR = 8) for participants with shortened dental arch, and 11 (IQR = 12.5) for participants with long dental arch. There were no significant differences in oral health impact profile‐14 scores between the three‐tooth relational groups (Kruskal‐Wallis H = 0.769, df = 2, P‐value =.681). Similarly, there were no significant differences between three‐tooth relational groups on the self rating of general (Chi‐squared = 1.714, df = 2, P‐value =.424) and oral health (Chi‐squared = 1.393, df = 2, P‐value =.498). Conclusion: Within the limitations of this study, no association was found between the length of dental arch and oral health‐related quality of life in head and neck cancer patients post‐radiotherapy. Other factors such as dry mouth, oral mucositis, loss of taste, and trismus should be considered as contributory factors to reduced oral health‐related quality of life in head and neck cancer patients post‐radiotherapy, particularly in relation to eating difficulties. [ABSTRACT FROM AUTHOR]

Aim: Timely recruitment of eligible participants is essential for the success of clinical trials, with insufficient accrual being the leading cause for premature termination of both oncology and non‐oncology trials. Methods: In this paper we further elaborate on the challenges for patient participation in oncology trials from physician, patient, healthcare system, and some trial‐related perspectives. Results: We present strategies such as use of digital healthcare technologies, real‐world data and real‐world evidence, decentralized clinical trials, pragmatic trial designs, and supportive services to increase patient participation. Conclusions: Multifaceted measures are necessary to increase patient participation, especially for those who are under‐represented in cancer trials. [ABSTRACT FROM AUTHOR]

Objective: The purpose of this meta-synthesis was to explore the experience of living with symptoms caused by colorectal cancer (CRC) and its treatment from the perspectives of those affected.Methods: In a systematic search of qualitative studies published up to September 2017, 21 relevant papers were identified. The meta-ethnography followed the approach developed by Noblit and Hare. To relate key themes from one paper to similar themes of different papers, a "reciprocal translation" was carried out.Results: Through synthesis, a new model was developed during treatment ("lines-of-argument synthesis"). Two constructs of experiences took place before the illness. Six third-order constructs were developed to capture patients' experiences during treatment, including "disruption in life through CRC" as well as the complex and circular experiences summarized as "experiences of symptoms and challenges by CRC". In contrast, experiences in dealing with changes that CRC and the treatment imply were "making sense of the experience", "sharing the experience", "experiences with controlling ones' body", and "experiences with reforming life".Conclusions: This meta-ethnography clarifies fundamental aspects of patients' experience in very different settings or starting points by specifying a more complete and holistic spectrum of experiences with CRC and its treatment. [ABSTRACT FROM AUTHOR]

Objectives: Screening can detect cancer earlier. Uptake of breast, cervical, and bowel cancer screening in England is below 75%. This study identifies the barriers and facilitators underpinning HCP screening behaviours which can support screening uptake, and reviews the design of real-world interventions targeting these, assessing for congruence between the two. The aim was to provide recommendations to improve the design of interventions.Design and Methods: Barriers/facilitators were identified by a literature review and qualitatively coded using the theoretical domains framework (TDF). Interventions were identified by stakeholders and coded using the behaviour change wheel and the taxonomy of behaviour change techniques. Congruence was assessed through comparing the intervention designs with behavioural science experts' recommendations which link the TDF domains to intervention design. Recommendations targeted missed opportunities.Results: Barriers/facilitators were extracted from 60 papers and most frequently coded to the TDF domains: environmental context and resources, knowledge and beliefs about consequences. Thirty-one interventions were identified, most frequently education, training or enablement functions, delivered via communication/marketing or service provision, and using BCTs designed to shape knowledge or highlight the consequences of or antecedents to screening. Intervention design was largely congruent with recommendations. However, there was less use of persuasion and modelling intervention functions and a reliance on BCTs such as providing instruction when other BCTs could be considered.Conclusions: Recommendations include to consider a broader range of intervention functions and BCTs, particularly for training interventions which should make use of recommended BCTs such as 'graded tasks'. [ABSTRACT FROM AUTHOR]

Aim: Preoperative anaemia is common in colorectal cancer patients. Little attention has been given to the prevalence and consequences of postoperative anaemia. The aim of this study was to systematically review the published literature and determine the knowledge of the prevalence and impact of postoperative anaemia in colorectal cancer patients. Methods: The databases Cumulative Index of Nursing and Allied Health Literature (CINAHL) and Medline, via EBSCOhost, were systematically searched to identify suitable articles published between 2004 and 2020. After an initial search, articles were screened and all eligible articles reporting on the prevalence of postoperative anaemia and clinical and long‐term outcome data in colorectal cancer patients undergoing surgery were included. The Risk of Bias 2.0 tool for the assessment of randomized controlled trials and the Risk of Bias 1.0 tool for non‐randomized studies were used for the assessment of bias in the studies selected in our review. Results: Six studies, one randomized control trial and five cohort studies, were included with a total population size of 1714. The prevalence of anaemia at discharge of 76.6% was reported as the primary end‐point in only one study. The rate of red blood cell transfusion and length of hospital stay were found to be significantly increased in anaemic patients, while postoperative infection rate results were variable. Quality of life scores and overall survival at 5 years were significantly affected among anaemic patients as reported in two papers. Conclusion: The available limited evidence on postoperative anaemia indicates its high prevalence with negative impact on clinical and long‐term outcomes. Further research is required to standardize the measurement and address the true impact of correcting postoperative anaemia on functional and oncological outcomes. [ABSTRACT FROM AUTHOR]

Objective: Quality survivorship information is an essential component of cancer care. However, survivors often report not receiving this information and healthcare professionals report limited practical guidance on how to effectively deliver survivorship information. Therefore, this study used realist review methods to identify mechanisms reported within the published literature for communicating survivorship information and to understand the contextual factors that make these mechanisms effective. Methods: Full‐text papers published in CINAHL, PubMed, Web of Science, Scopus, Cochrane Library, and Academic Search Ultimate were included. Studies included in this review were conducted in Australia between January 2006 and December 2023, and reported on how information regarding survivorship care was communicated to adult cancer survivors living in the community. This review utilized realist methodologies: text extracts were converted to if‐then statements used to generate context‐mechanism‐outcome theories. Results: Fifty‐one studies were included and six theories for mechanisms that underpin the effective delivery of survivorship information were formed. These include: (1) tailoring information based on the survivors' background, (2) enhancing communication among providers, (3) employing dedicated survivorship staff, (4) providing survivorship training, (5) reducing the burden on survivors to navigate their care, and (6) using multiple modalities to provide information. Conclusions: Findings can inform practical guidance for how survivorship care information is best delivered in practice. Clinicians can apply this guidance to improve their individual interactions with cancer survivors, as can policymakers to develop healthcare systems and procedures that support effective communication of cancer survivorship information. [ABSTRACT FROM AUTHOR]

Background: In recent years, certain body composition measures, assessed by computed tomography (CT), have been found to be associated with chemotherapy toxicities. This review aims to explore available data on the relationship between skeletal muscle and adiposity, including visceral adipose tissue (VAT), subcutaneous adipose tissue (SAT), intramuscular and intermuscular adipose tissue and their association with chemotherapy toxicity in non‐metastatic colorectal cancer (CRC) patients. Methods: A systematic literature search following PRISMA guidelines was conducted in Medline, Embase, Cochrane and Web of Science, for papers published between 2011 and 2023. The search strategy combined keywords and MESH terms relevant to 'body composition', 'chemotherapy toxicities', and 'non‐metastatic colorectal cancer'. Results: Out of 3868 studies identified, six retrospective studies fulfilled the inclusion criteria with 1024 eligible patients. Low skeletal muscle mass was strongly associated with increased incidence of both chemotherapy toxicities and dose‐limiting toxicity (DLT). The association of VAT, intramuscular and intermuscular adiposity was heterogeneous and inconclusive. There was no association between SAT and chemotherapy intolerance. No universal definitions or cut‐offs for sarcopenia and obesity were noted. All studies utilized 2‐dimensional (2D) CT slices for CT body composition assessment with varied selection on the vertebral landmark and inconsistent reporting of tissue‐defining Hounsfield unit (HU) measurements. Conclusion: Low skeletal muscle is associated with chemotherapy toxicities in non‐metastatic CRC. However, quality evidence on the role of adiposity is limited and heterogeneous. More studies are needed to confirm these associations with an emphasis on a more coherent body composition definition and an approach to its assessment, especially regarding sarcopenia. [ABSTRACT FROM AUTHOR]