Cancer incidence among adolescents is increasing, yet cancer risk reduction education remains largely absent from school-based curricula. This pilot study assessed whether a small-scale early, developmentally appropriate intervention could improve cancer literacy to support long-term risk reduction. This pilot study used a convergent parallel mixed-methods pre-post design to evaluate two separate, 45 min, school-based cancer education interventions delivered to 24 middle-school students in Pennsylvania. The intervention delivered developmentally appropriate content on cancer biology, modifiable risk factors, genetics, HPV vaccination, and self-advocacy using a low-resource, low-investment model easy for schools to implement. Pre- and post-intervention surveys assessed student knowledge, awareness, and health-related perceptions. Survey data were analyzed both descriptively using frequencies and percentages and thematically. Post-intervention results demonstrated substantial improvements across all domains. Correct definition of cancer increased from 16% to 100%. Awareness of modifiable risk factors increased to 96%, sunscreen knowledge to 90%, genetic testing awareness to 83%, and HPV vaccine understanding from 21% to 57%. Students also reported increased confidence in recognizing symptoms and engaging in health-seeking behaviors. Findings suggest that small-scale, school-based cancer education interventions are feasible and effective in improving adolescent cancer literacy. These results support the need for larger, controlled studies to evaluate long-term knowledge retention and behavioral outcomes.
In April 2024, two severe flooding events in southwestern Pennsylvania caused regional disruptions. How smaller-scale, rapidly unfolding disasters affect opioid use disorder (OUD) treatment and recovery services remains underexamined in disaster and public health research. This study explores how these localized floods influenced OUD service provision. We conducted 18 semi-structured interviews with treatment program directors, clinicians, counselors, and emergency service providers in Allegheny and Washington counties. Interviews focused on general operational challenges, disruptions in patients' OUD treatment, and adaptations made to the provision of OUD services during and after the flooding events. Participants described the April floods as disruptive but not catastrophic, noting that the impacts on service provision were substantially mitigated by telehealth infrastructure that had been established during the COVID-19 pandemic. Virtual service delivery was critical in sustaining continuity of care when transportation systems and in-person appointments were interrupted. Telehealth, however, was uneven in its effectiveness: it supported stable patients, caregivers, and those with transportation barriers, while presenting challenges for individuals in early recovery, those lacking private or safe home environments, and those with limited digital literacy. Across interviews, providers emphasized flexibility and patient-centered care as essential to adapting service delivery during the floods. Findings demonstrate that smaller, fast-onset disasters warrant greater attention in disaster preparedness planning for behavioral health systems. Strengthening telehealth access and embedding flexibility into OUD treatment models may enhance resilience for both patients and providers as climate change increases the frequency of localized hazard events.
Synchrony refers to similarity in movement between different actors such as dancing, clapping, or singing together. Prior research demonstrates that synchrony often elicits emotions that may be characterized as aesthetic or self-transcendent (e.g., awe, connectedness). Our research situated the concept of synchrony in media contexts, examining viewers' affective responses to videos featuring synchronous movement. Study 1 employed an experiment, showing that synchronized videos elicited greater awe, with awe associated with a host of prosocial outcomes reflecting connectedness and motivations to do good. Study 2 employed content analytic procedures to examine how the synchrony present in a large sample of YouTube videos was associated with user comments reflecting self-transcendent emotions, and how these emotions were associated with the salience of moral foundations. The results showed that synchrony was associated with greater feelings of awe, admiration, and elevation. Further, comments reflecting self-transcendence were associated with the salience of moral foundations, and particularly the foundation of care.
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Prescription stimulants are commonly used to manage attention deficit hyperactivity disorder among women of reproductive age, yet their safety during pregnancy remains unclear. This study leveraged large-scale electronic health record data to assess whether use of these medications during pregnancy was associated with adverse pregnancy outcomes and to support clinicians in making informed treatment decisions. The study included adult women with deliveries from 2010 to 2022 who had two or more stimulant prescriptions before pregnancy. Participants were categorized into three mutually exclusive groups: stimulant, atomoxetine, and control (neither medication during pregnancy). The outcomes of interest included prenatal maternal, placental, fetal growth, labor-delivery, and birth-related complications occurring during pregnancy. Propensity score matching analysis was applied to reduce confounding effects in patient baseline characteristics, followed by logistic regression to assess the likelihood of each adverse pregnancy outcome type. There were 32,152 pregnant women in the analysis, including 8394 (26.1%) prescribed stimulants, 405 (1.3%) prescribed atomoxetine, and 23,353 (72.7%) controls during pregnancy. The stimulant group was 1.2-3.1 times more likely to develop prenatal maternal, placental, and birth-related complications than the atomoxetine and control groups, while the atomoxetine group was 1.1-2.3 times more likely to experience fetal growth abnormality and labor-delivery issues than the control groups. Interestingly, the stimulant group showed 54% lower odds of fetal growth restriction than the atomoxetine group. This study highlighted differential risk profiles between stimulant and non-stimulant therapies, contributing evidence that informs future research on perinatal safety. The distinct risk profiles identified for stimulant and atomoxetine therapies underscore the need for personalized treatment decisions during pregnancy.
Glioblastoma (GBM) is the most common malignant primary brain tumor and is associated with a poor prognosis. Repurposed posaconazole (PCZ) has demonstrated efficacy in vitro by targeting key metabolic pathways. The aim of this study was to determine the neuropharmacological profile of PCZ in patients with GBM through a Phase 0 first-in-human trial for this indication (NCT04825275). We conducted an open-label, non-randomized, parallel-arm trial in participants with primary or recurrent GBM. Patients in the treatment arm received oral PCZ for 7-10 days presurgically to achieve steady-state concentrations. Microdialysis catheters were implanted to measure interstitial drug levels. Postoperative tissue and fluid samples were analyzed to evaluate PCZ pharmacokinetics (mass spectrometry) and pharmacodynamics, including vascular density, apoptosis, and metabolite concentrations (lactate and pyruvate) compared to controls. The trial was closed early due to slow accrual, enrolling 2 participants in the PCZ arm and three in the control arm. No drug-related safety issues were observed. Although PCZ was undetectable in microdialysate fluid, it accumulated in tumor tissue, with concentrations showing an association with CD31-measured endothelial content. PCZ-treated tumors exhibited trends toward lower BCL2 expression indicative of increased apoptosis, and significantly lower pyruvate levels in the tumor periphery compared to controls. Plasma lactate levels in treated patients normalized to control levels over 24 h. Despite limited accrual, this trial provides the first clinical evidence that oral PCZ accumulates in human GBM tissue and shows preliminary signals of metabolic modulation. These findings provide biological rationale warranting further clinical investigation, potentially utilizing direct tissue sampling rather than microdialysis.
This study examines whether school-based health center (SBHC) access mitigates insurance-based disparities in preventive care utilization, including well-child visits and influenza (flu) vaccination, among students with primary care visits in a rural region of New York State. Using 2024 electronic health records from a regional healthcare network, we analyzed 15,267 students aged 5-18. Students were categorized by SBHC access and insurance type (Medicaid vs. commercial). Logistic regressions estimated preventive care utilization by SBHC access and insurance type, with marginal effects examining their interaction. Among students with SBHC access, visits were stratified by care site to examine the odds of SBHC and non-SBHC visits by insurance type. Models were adjusted for age, sex, community socioeconomic status, and district random effects. Overall, 53% of students had SBHC access, and 56% were Medicaid insured. Students with SBHC access and commercial insurance had the highest preventive care utilization, while Medicaid-insured students without SBHC access had the lowest. Insurance-based disparities were observed in well-child visits, and were not fully mitigated by SBHC access. However, Medicaid-insured students with SBHC access had higher utilization of well-child visits and flu vaccination than those without access, and had similar odds of well-child visits as commercially-insured students without SBHC access. Among students with SBHC access, well-child visits delivered in SBHCs showed no insurance-based disparities. Among students using primary care, insurance-based disparities were found in well-child visits. Although SBHCs did not fully eliminate insurance-based disparities, they improved preventive care utilization among Medicaid-insured students in rural areas.
Small, topic-based mentorship groups, an alternative to one-on-one mentoring, were piloted by the Society of Breast Imaging's (SBI) Mentorship Committee (MC). This study reports the pilot program's logistics and perceived effectiveness based on participant surveys. The MC selected six mentorship topics: Fellowship Directors, Division Chiefs, Financial Literacy, Scholarship, Early Career Faculty, and Early Career Trainees. Groups were comprised of mentees, mentors, and a facilitator from the MC. Emails to SBI membership recruited participants in July 2024. Subsequently, quarterly one-hour virtual meetings were arranged by facilitators. A final survey to assess the program was distributed August 11, 2025 to September 22, 2025. Comparisons were analyzed using unpaired t-test, with P < 0.05 considered statistically significant. The pilot program involved 48 mentees, 11 mentors, and 6 facilitators. Of these, 66% (42/64) responded to the survey. Among respondents, 93% (39/42) attended at least two meetings and 64% (27/42) attended all four. When asked to rate the program on a 1-10 scale (10 = "extremely valuable"), the average response was 9.03 with mentees rating it higher than mentors (9.46 vs 7.53, P = 0.004). Likert scale average responses (1-5 with 5 = "strongly agree") were closest to "strongly agree" for most questions (total average 4.6/5, range 4.38-4.8). For 41% (17/41) of respondents, the program was their only current mentoring relationship. In addition, 38% (15/40) indicated that the program led them to seek additional mentoring opportunities. The SBI Topic-Based Small Group Mentoring pilot effectively met the needs of most respondents, supporting its establishment as a sustained program for improving mentorship within the SBI community.
Systematic and data-driven implementation strategy selection is typically a resource-intensive process limited by time and implementation science expertise. Simultaneously, implementation trials often include externally driven timelines. To facilitate the conduct of a multisite hybrid trial, we developed and deployed a tool to facilitate rigorous yet pragmatic implementation mapping for strategy selection. As part of the HATRICC-US hybrid type II stepped wedge trial, we developed a strategy selection process based on implementation mapping and the Implementation Research Logic Model. The novel process was refined across two sites, tested in two additional sites, and replicated through the remaining sites of the trial. We considered the resources required, duration, alignment with best practices in implementation science, and usefulness to clinical implementation partners. The final rapid implementation mapping process included the following seven steps: Step 1-Data Preparation; Step 2-Determinants and Change Objective Identification; Step 3-Summary Table Development & Internal Member Checking; Step 4-Identification of Implementation Strategies; Step 5-Completion of Implementation Research Logic Model; Step 6-Internal & External Member Checking; and Step 7-Completion of Tailored Implementation Blueprint and Manual. There are often significant resource barriers that prevent the rapid use of implementation mapping and the IRLM and similar tools in implementation settings. We developed rigorous and rapid methods incorporating both implementation mapping and the IRLM for leveraging pre-implementation data collection to inform implementation efforts while also being responsive to both clinical partners and funding deadlines.Clinical Trial Registration: identifier NCT04571749.
Background: Acute cellular rejection (ACR) remains a significant cause of graft dysfunction after liver transplantation and requires timely detection. Liver biopsy, the diagnostic gold standard for ACR, is invasive and unsuitable for frequent monitoring, while liver enzyme tests lack specificity for detecting ACR. Circulating microRNAs (miRNAs), including miR-122 and miR-885, have been previously identified as predictive biomarkers of ACR in liver transplant recipients. HepatoTrack™ is a serum-based miRNA RT-qPCR assay designed for noninvasive assessment of ACR using these biomarkers. This study evaluated the analytical performance and clinical validity of HepatoTrack™ for diagnosing ACR in liver transplant recipients. Methods: HepatoTrack™ uses 100 μL of serum and a one-step RT-qPCR workflow. It quantifies miR-122 and miR-885 normalized to miR-23a, with synthetic cel-miR-39 included as an exogenous control. Analytical validation assessed performance characteristics. Clinical performance was evaluated in a cohort of liver transplant recipients undergoing for-cause liver biopsy and used for model development and validation. Results: Analytical validation demonstrated robust assay performance. The HepatoTrack™ Prediction Score (HPS) algorithm was trained using 47 subjects from the training cohort based on a linear regression model incorporating longitudinal miRNA changes. In the independent testing cohort (n = 37), HPS achieved a sensitivity of 92.9%, specificity of 73.9%, positive predictive value (PPV) of 68.4%, and negative predictive value (NPV) of 94.4% for biopsy-confirmed ACR. HPS achieved an area under the curve (AUC) of 0.831 compared with 0.731 for ALT and 0.660 for AST. Conclusions: HepatoTrack™ support the analytical and clinical validity for detection of biopsy-confirmed acute cellular rejection in liver transplant recipients. The assay provides a noninvasive molecular test to aid in the diagnosis of acute cellular rejection and may complement existing post-transplant diagnostic evaluation.
To determine whether periurethral estrogen application is noninferior to intravaginal estrogen application for the prevention of urinary tract infections (UTIs) in postmenopausal individuals with laboratory-proven recurrent UTI. The TAPER (Techniques of Applying Vaginal Estrogen for Prevention of Recurrent Urinary Tract Infections) trial was a single-center, nonblinded, randomized noninferiority trial that compared outcomes after a twice-weekly intravaginal estradiol applicator instillation of 1.0 g cream (intravaginal) compared with periurethral digital application of 0.5 g cream (periurethral) in postmenopausal individuals with recurrent UTIs. The primary outcome was the proportion of UTI-free participants at 6 months postintervention. Secondary outcomes included number of UTIs, the amount of time elapsed to the first UTI, vaginal pH, PGI-I (Patient Global Impression of Improvement) scores, patient experience with the study drug, study drug adverse effects, and urinary and sexual function. To achieve 80% power with a type 1 error of 5% and to account for loss to follow-up, 114 participants needed to be randomized based on a noninferiority margin of 25%. Of 270 eligible individuals, 114 consented and were randomized (57 intravaginal, 57 periurethral). Participants were predominantly White (92.1%) with a mean age of 71.1 years (range 52-93). Participants reported a median of three UTIs in the 12 months before enrollment. Individuals randomized to periurethral estrogen application had a similar proportion of UTI-free participants at 6 months as those randomized to intravaginal estrogen application (50.9% vs 52.6%; risk difference, -1.75 percentage points; 95% CI, -20.0 to 17.0 percentage points). Both groups experienced a decrease in vaginal pH at 6 months; the decreases did not differ by application method (-1.2 intravaginal vs -0.8 periurethral, P =.30). Participants assigned to intravaginal estrogen were more likely to experience vaginal itching after 3 months of use than those assigned to periurethral application (24.0% vs 2.4%, P <.01). Other outcomes did not differ by route of estrogen application. For postmenopausal individuals who are experiencing recurrent UTI, periurethral application of estradiol cream is noninferior to intravaginal application for UTI prevention. Both application methods resulted in approximately half of the participants being UTI-free at 6 months. ClinicalTrials.gov , NCT05472779.
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Effective pulmonary nodule (PN) evaluation and management is essential to diagnosing early-stage lung cancers while avoiding unnecessary invasive procedures. Key knowledge gaps exist regarding how clinicians manage PNs and which opportunities for improvement should be prioritized. Which factors contribute to clinicians' PN evaluation and management practices, and what are perceived barriers to optimal clinical care? From August 2024 to December 2025, we performed an exploratory sequential mixed methods study of clinicians who care for patients with PNs. First, we conducted semi-structured qualitative interviews with 40 clinicians across multiple specialties before thematically analyzing interview transcripts to develop and administer a quantitative online survey nationwide. We descriptively analyzed survey data, triangulated results with representative interview quotes, and performed exploratory analyses assessing factors associated with survey responses, selected by a priori study objectives and qualitative findings. Of 3,588 U.S. clinicians e-mailed to participate in the survey, 192 (5.4%) across general pulmonology, interventional pulmonology, thoracic surgery, and other specialties completed it. Most clinicians (70.8%) reported using risk assessment tools to evaluate PN cancer risk, with clinical risk prediction models (70.3%) more commonly used than commercial biomarkers (18.8%). Most participants (63.5%) believed that an ideal risk assessment tool should prioritize not missing a lung cancer diagnosis rather than avoiding unnecessary invasive procedures. Clinicians generally agreed that PN evaluation is challenging (71.4%) and requires shared decision-making (95.8%), multidisciplinary collaboration (91.1%), and improvement (85.9%). Only 50.5% reported having the clinical resources necessary to provide optimal PN care. Participants ranked PN tracking and risk assessment tools as the top priorities for improving PN clinical care. Clinicians find PN evaluation challenging, requiring multidisciplinary collaboration, shared decision-making, and improvement, but many lack adequate resources to provide optimal care. Future efforts should focus on improving system-level PN tracking and cancer risk assessment.
Achilles tendon ruptures are serious injuries that significantly impair performance and career longevity among professional football players. The incidence of these injuries in National Football League (NFL) athletes has increased over the past decade. Given the sport's high physical demands and the potential for long-term functional limitations, understanding the extrinsic factors contributing to Achilles tendon tears is crucial. The purpose of this study was to evaluate the role of extrinsic factors in the incidence of Achilles tendon ruptures among NFL players. Playing surface, timing within the season, quarter of play, and days of rest prior to the tear were examined. It was hypothesized that Achilles tendon tears would occur more frequently on artificial turf, during the fourth quarter of games, and in the latter half of the regular season. Descriptive epidemiology study. Publicly available NFL injury data from 2010 to 2023 were retrospectively reviewed. Injury reports and related articles from major sports media sources were used to identify players placed on the injured reserve due to Achilles tendon ruptures sustained during official games. Descriptive statistics summarized player characteristics. Game-level analyses were conducted using analysis of variance and Pearson chi-square testing, while player-level comparisons utilized 1-sample t tests and chi-square tests of independence. P < .05 was considered statistically significant. Of 1,477 players initially identified with ankle injuries, 103 players (103 ankles) sustained complete Achilles tendon ruptures across 101 games. The incidence of Achilles tears was highest in 2023 (n = 14 [13.59%]) and 2020 (n = 13 [12.62%]). The highest weekly incidence of tendon tear occurred in week 4 of the regular season (n = 13 [12.62%]). No significant differences in injury patterns were observed based on playing surface (2.68% grass vs 1.88% turf; χ2 = 0.18; P = .67), game quarter (P = .18), or season timing (first half 57.42% vs. second half 27.18% of the season, P = .07). Our study demonstrated that Achilles tendon ruptures in NFL players have increased in frequency since 2020, without significant associations between playing surface, game timing, or season progression. Identifying modifiable external risk factors may help guide injury prevention strategies and optimize player training and conditioning.
In the Women's Health Initiative (WHI) Dietary Modification (DM) randomized trial, a low-fat dietary pattern intervention reduced breast cancer mortality (P = 0.02). Higher dietary advanced glycation end-products (dAGE) may be associated with higher breast cancer incidence. In this report, we examined whether the WHI dietary intervention influenced dAGE consumption. Of 48,835 postmenopausal women randomized (40:60) to dietary intervention versus usual diet comparison, 40,209 had food frequency questionnaires at baseline, and serially through 5-7 years, which were used to estimate dAGE scores (kilo Unit/1000 kilocalories [kU/1000 kcal]) using a commonly referenced database. Multivariate regressions with repeated dAGE measures were examined by randomization group. Baseline mean dAGE scores were similar for intervention (7542 kU/1000 kcal, standard deviation (SD) = 912) and comparison (7514 kU/1000 kcal, SD = 917) groups. Through 5-7 years, dAGE scores were persistently lower in intervention versus comparison groups (mean range 5361-6236 kU/1000 kcal versus 7159-7669 kU/1000 kcal (P < 0.0001). The WHI low-fat dietary pattern intervention substantially reduced dAGE consumption. NCT00000611; Date: 10/28/1999.
Epithelioid cell histiocytoma (ECH) has been previously classified as a rare variant of fibrous histiocytoma (FH). The epithelioid nature of this lesion imitates the appearance of neoplastic lesions such as melanocytic, dermatofibroma/histiocytoma, non-Langerhans histiocytosis such as reticulohistiocytoma, atypical fibroxanthoma, and rhabdomyosarcoma. Most ECH cases are characterized by Anaplastic lymphoma kinase (ALK) protein rearrangement and overexpression. ALK has several fusion partners, the most common being Sequestosome 1 (SQSTM1) which produces proteins involved in signal transduction and autophagy. A recent detection of ALK protein expression and/or ALK gene rearrangement in ECH suggests that it may be biologically different from conventional FH. The epithelioid nature of the lesion in this case imitates the appearance of neoplastic lesions such as melanocytic, dermatofibroma/histiocytoma, non-Langerhans histiocytosis such as reticulohistiocytoma, atypical fibroxanthoma, and rhabdomyosarcoma. Owing to the unusual morphology and aberrant immunohistochemical staining pattern, the sample was analyzed through next-generation sequencing (NGS), which showed the presence of a fusion of genes Sequestosome 1 (SQSTM1) and Anaplastic lymphoma kinase (ALK). SQSTM1 gene produces proteins involved in signal transduction pathways and autophagy, whereas ALK mainly serves the role of cellular communication and development. The most well-known ALK fusion partners include SQSTM and Vinculin (VCL). The spectrum of neoplasms produced through these fusions is wide as seen in lung adenocarcinoma and renal cell carcinoma (EML4-ALK), epithelioid histiocytoma (SQSTM1::ALK and VCL-ALK), and pediatric renal cell carcinoma (VCL-ALK) among others. We hope this case is a helpful addition to the literature to further aid diagnoses of future ALK fusion cases.
Nutrition insecurity is a major driver of poor cardiovascular health in Indigenous communities. Medically tailored meals that reclaim traditional foods may improve heart failure outcomes and quality of life. Community-based participatory methods were used to design Medically Utilized Tailored Traditional Foods to Optimize Nutrition in Heart Failure (MUTTON-HF), a culturally and medically tailored meal program incorporating traditional Navajo foods and recipes. To determine the efficacy of a culturally and medically tailored meal program on the incidence of hospitalizations and emergency department visits. This pragmatic, open-label randomized clinical trial was conducted from May to November 2025 at 2 Indian Health Service sites in rural Navajo Nation. Eligible patients were adults with heart failure who were receiving care at the study sites and had a hospitalization or emergency department visit during the last 12 months. All patients were followed for 12 weeks for outcomes, death, and adverse events. The data were analyzed from December 2025 to February 2026. Patients were randomized in a 1:1 ratio to 8 weeks of a culturally and medically tailored meal program or usual dietary advice. The primary end point was the proportion of patients with an all-cause hospitalization or emergency department visit within 90 days. Secondary outcomes included hospitalizations or emergency department visits separately, and for heart failure specifically, and change in Kansas City Cardiomyopathy Questionnaire scores, food insecurity, financial strain, blood pressure, and weight from enrollment to 8 weeks. A total of 206 patients (mean [SD] age, 65.8 [14.2] years; 87 female individuals [42%] and 119 male individuals [58%]; 203 American Indian individuals [99%], 2 American Indian or Alaskan Native and White individuals [0.97%], and 1 White individual [0.03%]; ejection fraction, 48%) were randomized. The primary outcome was significantly less frequent in the intervention arm (43 [40.6%] vs 57 [57.0%]; relative risk, 0.72; 95% CI, 0.54-0.96; P = .02), which was driven mainly by reduced hospitalizations (13 [12.3%] vs 26 [26.0%]). There was a lower incidence of heart failure hospitalizations specifically (4 [3.8%] vs 13 [13.0%]). The Kansas City Cardiomyopathy Questionnaire score and food security measures had significantly greater increases in the intervention arm while measures of financial strain, weight, and blood pressure significantly decreased in the intervention arm. Adverse events were uncommon. In this randomized clinical trial, an Indigenous Food is Medicine intervention reduced the incidence of hospitalization and emergency department visits among patients with heart failure. Community-based interventions that leverage protective assets of Native communities are needed to advance Indigenous health. ClinicalTrials.gov Identifier: NCT06549699.
Peutz-Jeghers syndrome (PJS) is a rare genetic disorder characterized by hamartomatous polyps and mucocutaneous hyperpigmented freckles, whereas Crohn's disease (CD) is a condition characterized by chronic intestinal inflammation. Here, we present a rare case report of an 11-year-old male who presented with both CD and PJS. To our knowledge, this is only the fifth case report describing both of these diseases in the same patient. While CD is relatively common in industrialized countries, having CD in conjunction with PJS is exceedingly rare. This paucity of data describing the coexistence of the two conditions in the same patient has led to a general lack of guidance and screening recommendations in patients with both of these diseases. It is known that each disorder alone increases a patient's risk of malignancy; however, more data are needed to determine the appropriate cancer screening algorithm for patients with these dual diagnoses as well as management approaches.
Head and neck cancer (HNC) is associated with substantial morbidity, functional impairment, and represents a substantial socioeconomic burden worldwide. Although advances in surgery, radiotherapy (RT), and systemic therapies have improved oncologic outcomes, treatment-related toxicities frequently overlap with profound economic consequences for patients and caregivers. Financial toxicity (FT), defined as the objective financial burden and subjective financial distress associated with cancer care, has emerged as a clinically relevant determinant of treatment adherence, quality of life (QoL), and survival. In HNC, FT appears particularly critical during active treatment, when multimodal therapies, nutritional compromise, work interruption, transportation costs, and supportive care needs converge. This structured narrative review synthesizes current literature regarding FT during active treatment for HNC, focusing on conceptual definitions, measurement approaches, temporal dynamics, clinical and psychosocial consequences, and health system determinants. The review was conducted according to the Scale for the Assessment of Narrative Review Articles (SANRA) framework using searches of PubMed/MEDLINE, Scopus, Embase, and Google Scholar. Available evidence suggests that FT may emerge early during treatment and evolve dynamically throughout the care trajectory. Lower socioeconomic status, treatment intensity, work interruption, and limited social support have been reported in association with increased FT. FT has also been linked to worse health-related QoL, higher symptom burden, treatment interruptions, hospitalization, and reduced survival, although the limited number of studies and methodological heterogeneity preclude definitive conclusions. Emerging evidence suggests that FT may be partially modifiable through interventions such as financial counseling and patient navigation. Future research should prioritize prospective and interventional designs using standardized multidimensional instruments capable of capturing both objective and subjective domains of FT. Integrating routine FT assessment into supportive oncology workflows may help identify vulnerable patients and support more equitable, patient-centered HNC care.