Quality sexual relationships predict higher marital satisfaction and lower emotional distress in cancer patients. However, no studies have investigated the sexual satisfaction of patients visiting a psycho-oncology clinic. In this study, I examined characteristics of non-respondents to a sex-related question and identified characteristics and correlates of sexual satisfaction in patients visiting a psychooncology outpatient clinic in a tertiary hospital in a sex-stratified format. For 417 female and 169 male, those who answered the single sexual satisfaction item of the Functional Assessment of the Cancer Therapy-General (FACT-G) were categorized as "respondents," and others as "non-respondents" by sex. After adjusting for age, cancer diagnosis, and time after diagnosis, sex-stratified linear regression models were established using the FACT-G except the sexual item and the Hospital Anxiety and Depression Scale. Female were 1.466 times more likely to decline to answer about sexual satisfaction. Older patients, and female with active diseases or recent chemotherapy, also tended to avoid answering. Among female and male, 24.5% and 26.0%, respectively, reported no sexual satisfaction, with no between-sex difference. Lower age, a longer time since diagnosis, greater social/family well-being, and lower depressive symptoms for female and greater physical well-being for male contributed to sexual satisfaction. Psycho-oncologists should sensitively address sexual issues among older female in poor health. Paying equal attention to sexual issues for both sexes is necessary. For recently diagnosed older female with lower social/family well-being and higher depressive symptoms and male experiencing lower physical well-being, sexual issues should be thoroughly assessed.
Young adulthood is a socially and biographically formative life stage, yet young adults from ethnic-national minority groups remain underrepresented in psycho-oncology research. This study examined how Arab young adults (YA) from East Jerusalem make meaning of cancer while receiving treatment in predominantly Jewish-Israeli hospitals. Guided by a context-informed, constructivist qualitative framework, we conducted semi-structured, in-depth interviews with 15 Arab YA (aged 23-45) who were undergoing active cancer treatment. Interviews were conducted in Arabic, transcribed verbatim, and analyzed using reflexive thematic analysis to capture culturally and developmentally embedded meanings of illness and care. Two interrelated sets of lived meanings emerged. First, participants described cancer through culturally embedded frameworks shaped by stigma, secrecy, family responsibility, and faith-based interpretations that provided meaning and emotional containment. These meanings were closely tied to the future-oriented concerns and relational obligations of young adulthood. Second, participants experienced Israeli hospitals as ambivalent institutional spaces: often perceived as safe, compassionate, and politically neutral yet at times marked by cultural misattunement, language barriers, and subtle inequality. Together, the findings show that cancer was experienced not only as a medical condition but as a deeply contextualized social and developmental experience. The experience of cancer among Arab YA from East Jerusalem is shaped by the intersection of developmental stage, minority positioning, and institutional context. These findings highlight the importance of context-informed and culturally responsive psycho-oncology care for young patients from socially and politically marginalized backgrounds.
The incidence of early-onset colorectal cancer (EOCRC) has been rising globally in recent years, with an especially rapid increase in disease burden in China. Compared with late-onset colorectal cancer, EOCRC is more often diagnosed following symptomatic presentation, with greater diagnostic delay and more aggressive biological behavior. Patients are typically at critical life stages regarding career development and family building, and have urgent needs for fertility and sexual function preservation, and long-term quality of life. However, current domestic and international guidelines mostly target the general colorectal cancer population, and a systematic management framework tailored to the specific characteristics of early-onset patients is lacking. Therefore, the Hereditary Cancer Committee of the China Anti-Cancer Association organized a multidisciplinary expert panel-including specialists in colorectal surgery, medical oncology, radiation oncology, pathology, genetic medicine, reproductive medicine, psycho-oncology, and specialized nursing-to develop the Chinese Expert Consensus on the Diagnosis and Whole-Course Management of Early-Onset Colorectal Cancer (2026 version), based on evidence-based medicine and Chinese clinical practice. This consensus covers clinical issues such as the definition, epidemiological characteristics, screening and diagnosis, comprehensive treatment strategies, fertility and sexual function preservation, psychosocial support, and long-term follow-up of EOCRC, and presents 18 relevant recommendations. It aims to establish a multidisciplinary team-based whole-course management model that emphasizes both tumor control and long-term quality of life, providing a reference for the standardized diagnosis and treatment of EOCRC. 近年来，早发性结直肠癌（EOCRC）发病率在全球范围内持续上升，中国疾病负担增长尤为迅猛。与晚发性结直肠癌相比，EOCRC患者常在症状驱动下确诊，诊断延迟更为常见，肿瘤生物学行为更具侵袭性；且患者多处于职业发展和家庭组建的关键阶段，对生育力保全、性功能保护及长期生活质量均具有迫切需求。然而，目前国内外相关指南多以总体结直肠癌人群为对象，尚缺乏针对EOCRC患者特征的系统化管理框架。鉴于此，中国抗癌协会遗传性肿瘤专业委员会组织涵盖结直肠外科、肿瘤内科、放射治疗科、病理科、遗传医学、生殖医学、心理医学及专科护理等多学科专家，基于循证医学证据并结合我国临床实践，制订了《中国早发性结直肠癌诊疗与全程管理专家共识（2026版）》。本共识涉及EOCRC的定义、流行病学特征、筛查与诊断、综合治疗策略、生育力保全与性功能保护、心理社会支持及长期随访等临床问题，共整理出18条相关推荐意见，旨在构建以多学科团队为基础的全程管理模式，实现肿瘤控制与长期生活质量并重，为EOCRC的规范化诊疗提供参考。.
Cancer-related psychological distress is a major concern in comprehensive oncology care because it substantially impairs patients' quality of life and may adversely affect treatment adherence, outcomes, and prognosis. Over the past decade, research in this field has expanded rapidly; however, the overall knowledge structure, global research patterns, major contributors, and emerging hotspots remain insufficiently characterized. A bibliometric analysis is therefore needed to systematically map the development of cancer-related psychological distress research and identify evolving directions for future investigation. Publications related to cancer-related psychological distress published between 1 January 2015 and 31 December 2024 were retrieved from the Web of Science Core Collection and Scopus databases. The database searches were conducted on 10 March 2025. Bibliometric analyses were performed using VOSviewer (version 1.6.20), CiteSpace (version 6.3.R1), and the R package bibliometrix (version 5.3). Publication trends, country and institutional contributions, journal distribution, author collaboration networks, co-cited references, keyword co-occurrence, burst keywords, and thematic evolution were analyzed. A total of 7063 publications were included in the bibliometric analysis, including 6162 articles and 901 reviews. Annual publication output increased from 465 publications in 2015 to 924 publications in 2024. The main contributing countries were the United States, Australia, China, Germany, and the United Kingdom. The United States ranked first in publication volume and total citations. Psycho-Oncology and Supportive Care in Cancer were the leading journals by publication volume and total citations. Major research themes included quality of life, psychological distress, depression, anxiety, breast cancer, distress screening, survivorship, and palliative care. Seven high-frequency keywords-"cancer," "quality of life," "psychological distress," "depression," "anxiety," "breast cancer," and "distress"-each appeared more than 500 times, representing the core research topics. Emerging keywords such as "informal caregivers," "young adults," "guidelines," and "adult survivors" reflected increasing attention to caregiver support, age-specific psychosocial needs, survivorship care, and standardized clinical management. This bibliometric analysis provides a comprehensive overview of global research on cancer-related psychological distress from 2015 to 2024. The findings reveal publication trends, major contributors, collaboration patterns, core research themes, knowledge structures, and emerging topics in this field. Current research has gradually shifted from general descriptions of psychological distress toward survivorship care, caregiver support, standardized screening, and guideline-based management. Future studies should strengthen interdisciplinary collaboration, improve standardized assessment and screening approaches, and further explore emerging areas such as caregiver support, young adult cancer populations, survivorship care, and digital health and artificial intelligence-assisted approaches, which require further validation before routine clinical implementation.
Psychological interventions for patients with breast cancer often overlook the critical role of maladaptive attributional style in shaping their adjustment. Therefore, the need for theory-driven, scalable interventions that target cognitive restructuring, particularly during the vulnerable post-diagnosis period, is clear. To evaluate the effectiveness of a nurse-led attribution remodeling training intervention grounded in the Neuman systems model for improving resilience, adaptive coping, and attributional style among women newly diagnosed with breast cancer. A randomized controlled trial. A tertiary general hospital. A total of 130 eligible women newly diagnosed with breast cancer were recruited between March and November 2024. A two-arm parallel-group randomized controlled trial was conducted. Participants were randomly assigned to receive either attribution remodeling training plus routine nursing (n = 65) or routine nursing only (n = 65). The nurse-led attribution remodeling training intervention, delivered via a blended model of in-person sessions and continued support through the WeChat mobile platform, was designed to systematically reshape maladaptive attributions into more adaptive ones. Resilience (primary indicator), coping strategy (i.e., confrontation, avoidance, resignation), and attributional style (secondary indicators) were assessed at baseline and at 1, 3, and 6 months post-baseline. A linear mixed model was used to analyze the effects of group, time, and group-by-time interactions. Effect sizes (Cohen's D) were calculated based on the means and standard deviations. At the 6-month follow-up, the intervention group had better outcomes than the control group in terms of resilience (mean difference: 1.49, 95% confidence interval: 0.37, 2.61), confrontation coping (3.35 [2.33, 4.37]), and adaptive attributional style (4.16 [3.87, 4.45]). Avoidance coping showed a small increase (0.82 [0.22, 1.42]), whereas resignation coping decreased (-1.66 [-2.49, -0.83]). Group effects and group-by-time interactions were statistically significant for all outcomes. Effect sizes at 6 months ranged from small for resilience (D = 0.28) and avoidance coping (D = 0.26) to moderate for confrontation coping (D = 0.60) and resignation coping reduction (D = -0.51), and large for attributional style (D = 0.94). Attribution remodeling training is a promising and effective theory-based intervention that can enhance psychological adaptation in women newly diagnosed with breast cancer. By strengthening key defense mechanisms, as conceptualized by the Neuman systems model, the program is effective, scalable, and nurse-deliverable for psycho-oncology care, bridging a critical gap in supportive cancer care and empowering nurses as primary psychological support providers. ChiCTR2000031827, registered prospectively on April 11, 2020, www.Chictr.or.cn.
Although it is known that parents caring for adolescent and young adult (AYA) cancer patients experience physical and psychological stress, to our knowledge, there are no reports regarding thiamine deficiency (TD) in this population. From a series of cancer patient caregivers, we identified TD in a mother caring for an AYA cancer patient and report our experience with this case, as treatment enabled the prevention of Wernicke encephalopathy (WE). A 49-year-old woman who had been caring for her 18-year-old son after he developed graft-versus-host disease following bone marrow transplantation for leukemia visited our psycho-oncology department at the recommendation of her son's attending physician after witnessing her son experience a seizure. Thirteen months after the initial consultation, she developed difficulty climbing stairs, suggesting a possible physical abnormality. Blood tests revealed a markedly decreased hemoglobin level of 5.7 g/dL, and subsequent evaluation led to a diagnosis of iron deficiency anemia. Five days later, her thiamine level was found to be markedly reduced at 19 ng/mL (reference range: 24-66 ng/mL), and oral thiamine at a dose of 75 mg was initiated. No progression to WE, such as disturbance of consciousness, was observed. Parents caring for AYA cancer patients are profoundly affected both physically and psychologically by their child's condition. In the future, attention should be paid to the nutritional status (including TD) of families caring for AYA cancer patients, as this may contribute to improving quality of life for both patients and their families.
To examine how healthcare provider communication shapes referral, acceptance and ongoing integration of specialist pediatric palliative care (SPPC). A qualitative study was conducted across four pediatric cancer centers in Canada. Sixty-six healthcare providers working in oncology and palliative care settings participated in in-depth interviews. Participants included physicians, nurses, psycho-social clinicians and other members of the interprofessional health team. Transcripts were analyzed using iterative, inductive coding based on the Grounded Theory method. Communication barriers to referral and acceptance included inadequate explanations for SPPC involvement, incomplete or misleading descriptions of services, and framing SPPC solely as end-of-life care. Oncologist discomfort, avoidance, and use of ambiguous "coded" language further hindered referral conversations. Facilitators included strong communication skills, clear and comprehensive explanations of SPPC, and age-appropriate engagement with patients. For ongoing integration of SPPC, poor interprofessional communication and unclear role and responsibilities among team members created risks for fragmented care. In contrast, structured collaboration such as joint meetings, shared care planning, and proactive information exchange, supported effective integration of SPPC and consistent messaging to patients and families. Communication is central to successful SPPC referral, acceptance, and integration in pediatric oncology settings. Both clinician-family and interprofessional communication practices directly shaped understanding and engagement with SPPC services. Interventions should prioritize communication training, clearer framing of SPPC, and enhanced collaboration between teams. Early involvement of the psychosocial provider along with an SPPC specialist may further improve communication and uptake, ultimately strengthening care for children with serious illness and their families.
Paediatric patients undergoing treatment for acute lymphoblastic leukaemia (ALL) frequently experience significant pain and emotional distress related to procedures. While pharmacological management remains central, integrative non-pharmacological approaches such as art-based therapy (ABT) have shown promise in enhancing psychological well-being. The objective of the study is to assess the levels of self-reported procedural pain and distress among paediatric patients with ALL during the consolidation phase of treatment and to evaluate the effectiveness of a structured ABT intervention in reducing these symptoms. In an intervention study, a single group pre-post quasi-experimental design was carried out involving 21 children between the ages of 7 and 16 who had been diagnosed with ALL. The participants underwent 10 individual ABT sessions over 4 weeks. Pain and distress were measured using the Faces Pain Scale-Revised (FPS-R) and paediatric distress thermometer (PDT), respectively. Descriptive statistics and the Wilcoxon signed-rank test were employed to analyse the data. Preintervention scores indicated mild procedural pain and moderate distress levels. Postintervention, significant reductions were observed in both procedural pain (p < 0.001, z = 4.11, r = 0.90) and distress (p < 0.001, z = 4.03, r = 0.88) scores. Qualitative observations suggested improved emotional expression and relaxation through creative engagement. ABT is a feasible, low-cost and culturally adaptable intervention that significantly reduces pain and distress among paediatric patients with ALL. These findings support the integration of ABT into paediatric oncology supportive care programs, especially in resource-limited settings.
The reduction in sex hormone levels during the menopausal period substantially impacts patients' quality of life and serves as a significant risk factor for psycho-emotional disorders. Current clinical guidelines from both Russian and international sources recognize menopausal hormone therapy (MHT) as the primary method for addressing menopausal disorders. However, selecting dosage forms tailored to the patient's comorbidities and overall health status is essential. In 2026, the Russian Association of Obstetricians and Gynecologists, the Interdisciplinary Association of Specialists in Healthy Aging and Anti-Aging Medicine, and the Russian Society for the Study of Headache established an interdisciplinary council to implement an integrated approach to the management of peri- and postmenopausal women with psycho-emotional and neurological disorders. The objectives of the expert council included discussing contemporary management strategies for peri- and postmenopausal women and optimizing the application of MHT in complex clinical cases. Additionally, the council aimed to enhance scientific methodologies and devise algorithms for managing patients presenting with menopausal symptoms due to estrogen deficiency, alongside neurological and psycho-emotional disorders. The collaborative efforts of the experts culminated in a consensus document that outlines key principles for the administration of MHT to women with psycho-emotional disorders and somatic comorbidities during the peri- and postmenopausal stages. Снижение уровня половых гормонов, происходящее в менопаузальном периоде, существенно влияет на качество жизни пациенток и выступает важным фактором риска развития психоэмоциональных расстройств. Согласно актуальным российским и зарубежным клиническим руководствам, менопаузальная гормональная терапия (МГТ) признана основным методом коррекции климактерических нарушений, однако обязательным условием является индивидуальный подбор лекарственных форм с учетом имеющихся сопутствующих заболеваний и общего состояния пациентки. Экспертами Российской ассоциации акушеров-гинекологов, Междисциплинарной ассоциации по здоровому старению и антивозрастной медицине, Российского общества по изучению головной боли в 2026 г. был сформирован междисциплинарный совет по вопросам комплексного подхода к ведению женщин в пери- и постменопаузе с психоэмоциональными и неврологическими нарушениями. В цели экспертного совета входило обсуждение актуальных подходов к ведению женщин в пери- и постменопаузе и оптимизации назначения МГТ в сложных клинических ситуациях, а также совершенствование научных подходов и разработка алгоритмов ведения пациенток с климактерическими симптомами, обусловленными эстрогенным дефицитом, неврологическими и психоэмоциональными нарушениями. Результатом совместной работы экспертов стал согласительный документ, содержащий ключевые постулаты по назначению МГТ у женщин с психоэмоциональными нарушениями и сопутствующими соматическими заболеваниями в пери- и постменопаузе.
Patient-Centered Care (PCC)-that which addresses individual values, needs, and preferences-is a critical component of cancer care. Value-driven care requires evidence on outcomes that matter to patients, but Patient-Centered Outcomes (PCOs) are inconsistently defined and measured. This scoping review maps and charts the literature on PCOs in gastrointestinal (GI) cancer care and the measures used to assess them with the aim of facilitating a shift toward more PCC. We searched Medline, Embase, CINAHL, the Cochrane Library, and APA PsycINFO databases (2000-2025) to identify studies involving adult patients with GI cancers that reported or discussed at least one PCO, excluding survival. We summarized PCOs, measures used to assess them, and key study characteristics. Using qualitative cluster analyses, we then organized PCOs into a three-level hierarchy. Of 1626 studies screened, 140 met inclusion criteria. Across these studies, we identified 187 PCOs and 286 measures. PCOs were grouped into six clusters: symptoms (27.4%), psychosocial (23.6%), lifestyle (23.1%), functional status (11.6%), care experience (8.5%), and healthcare utilization (5.8%). The most commonly mentioned PCO measures were three questionnaires: the EORTC QLQ-C30 (8.1%), FACT-G (4.2%), and the EQ-5D (2.5%). A wide range of PCOs and corresponding measures have been reported in GI cancer care research, with symptom, psychosocial, and lifestyle related PCOs being the most frequently studied. Considerable heterogeneity exists in both the PCOs reported and the measures used to assess them. Identifying PCOs that matter most to patients and standardizing their measurement will be essential to advancing PCC.
With the improving survival rates of malignant tumors, the focus of attention in cancer research is shifting toward a better understanding of long-term treatment-related adverse effects that impact quality of life, with particular focus on cancer-related cognitive impairment. This phenomenon, commonly referred to as "chemobrain" in the literature, manifests as deficits in attention, memory, processing speed, and executive functions. Although the frequency of objectively measured cognitive deficits detected through neuropsychological assessments are moderate, subjective complaints often result in significant deterioration of quality of life. The present review aims to provide a multidisciplinary overview of chemobrain, emphasizing its epidemiological characteristics, neurobiological and psychosocial factors, and options for evidence-based psychological interventions. Alongside neurotoxic, inflammatory, hormonal, and neuroendocrine mechanisms associated with chemotherapy, the review highlights distress, cognitive compensation, and discrepancies between subjective complaints and objectively measurable cognitive deficits. Diagnostic challenges and evidence-based psychotherapeutic approaches-especially cognitive behavioral therapy (CBT), mindfulness-based interventions, and rehabilitation-are also discussed. This analysis highlights the complex nature of chemobrain and the need for further research to develop targeted, individualized therapeutic protocols.
To examine whether otolaryngology-specific symptom burden is associated with perceived and self-stigma among nasopharyngeal carcinoma (NPC) survivors, and the mediating role of emotional well-being. Prospective observational cohort with repeated assessments. Kaohsiung Chang Gung Memorial Hospital, Taiwan. From April 2021 to October 2024, 340 NPC survivors (560 assessments) completed stigma questionnaires (assessing perceived stigma [PS] and self-stigma [SS]) and condition-specific symptom instruments (SNOT-22, ETDQ-7, EAT-10). Gaussian kernel smoothing illustrated symptom trajectories over time. Linear mixed-effects models identified factors independently associated with stigma, while mediation analysis quantified indirect effects via the SNOT-22 emotional domain. Participants had a median age of 53 years (IQR 44.0-61.5) and a median follow-up of 36 months (IQR 14.0-82.0). PS > 0 occurred in 8.0% of assessments, whereas high SS (> 2.5) was present in 9.5%. High-stigma groups exhibited significantly worse symptom trajectories. In adjusted models, only the SNOT-22 emotional domain was independently associated with PS (β = 0.036; 95% CI 0.004-0.068; p = 0.026) and SS (β = 0.075; 95% CI 0.053-0.097; p < 0.001), with large between-group effect sizes (d = 0.97 and 1.41, respectively). Mediation analyses indicated full mediation of most symptom-PS associations and partial mediation of symptom-SS associations by the emotional domain. Emotional well-being may be an important correlate of both perceived and self-stigma in NPC survivorship. Whether addressing emotional well-being can reduce stigma warrants evaluation in future studies.
Fear of cancer recurrence (FCR) is one of the most common psychological challenges faced by breast cancer survivors. However, limited qualitative research has examined survivors' lived experiences, personal interpretations, and support needs related to FCR. This study aimed to explore the experiences, perceptions, and support needs of breast cancer survivors and to identify existing gaps and preferences in the available support systems. A qualitative photo-elicitation study was conducted between January and March 2025 with 15 breast cancer survivors at two large tertiary hospitals in Beijing, China. Participants submitted 76 photographs, and thematic analysis of the photographs and interviews identified six themes: experiencing and understanding fear of cancer recurrence; experiencing and understanding co-occurring symptoms; impact of co-occurring symptoms; coping strategies for fear of cancer recurrence and co-occurring symptoms; advice to fellow patients for coping with fear of cancer recurrence; and suggestions to healthcare workers for improved support and communication. The themes reflected symptom-related triggers, coping practices including physical activity, and needs for information, peer, and healthcare support. These findings highlight the need for routine screening for fear of cancer recurrence and associated co-occurring symptoms, as well as the provision of clear informational support and psychoeducation. They also suggest the importance of integrating psychological, rehabilitative, and peer-related support into survivorship care. Based on these findings, a conceptual framework was developed to inform future survivorship care and support strategies for breast cancer survivors.
Youth with cancer may face acute and long-term academic and social challenges. Most existing research has relied on cross-sectional or single-informant methods to describe these challenges. This longitudinal, convergent mixed-methods study aimed to characterize academic and social challenges faced by youth with cancer, from the perspective of youth, caregivers, and educators-from onset of diagnosis into survivorship. Seventy-five triads of youth (Mage = 9.07 years, SDage = 3.15 years, range 5-14 years), caregivers, and educators completed a Perceptions Questionnaire across three timepoints: at diagnosis (T1), mid-treatment (T2), and one-year post-treatment (T3). Higher ratings indicated greater perceived impact on school attendance, medical issues, teacher knowledge, social issues, and academic performance. A subset of fifteen triads also participated in semi-structured Waking Day interviews at parallel timepoints. A convergent analysis involving mixed modeling using questionnaire data and trajectory analysis by three qualitative coders characterized patterns of change and compared diagnostic groups. Significant disruptions were observed at T1, which mostly improved over time (p < 0.001). Academic and social concerns persisted for those with brain tumors or who were female. Caregivers and educators consistently expressed concern about long-term academic impact, while youth showed decreasing concern compared to caregivers and educators (b = 0.61, SE = 0.26, p = 0.02 and b = 0.76, SE = 0.31, p = 0.02). Qualitative responses generally suggested more difficulties than questionnaire data and provided additional context. Results affirm the importance of ongoing needs assessment for youth with cancer through multiple methods. Findings also may inform tailored psychosocial and educational interventions to enhance the quality of life for youth affected by cancer and their families.
Bereaved parents seek ways to maintain connections with their deceased child throughout their lifelong grief. These continuing bonds may bolster parental social functioning, yet limited research has explored continuing bonds early in bereavement. To explore how parents maintain connection with their child within the first 2 years following death. Parents of children who died from cancer 6-24 months prior completed the 11-item Continuing Bonds Scale (CBS) and an open-ended question querying ongoing connections. CBS scores ranged from 11 to 55, with higher scores indicating stronger continuing bonds. We examined associations between CBS scores and parent/child factors and qualitatively analyzed free-text responses. Among 128 parents who completed the CBS, 103 (80%) provided free-text responses. Most respondents identified as non-Hispanic (91%), white (81%), and female (63%). Surveys were completed a mean of 15 (range 8-26) months after the child's death. The mean CBS score was 45.6 (SD = 7.8), indicating strong continuing bonds. Mothers reported higher scores than fathers (mean 46.9, SD = 7.2 vs. 43.4 SD = 8.2, p = 0.023). Free-text responses fell into five thematic domains: (1) physical connection; (2) symbolic and spiritual connection; (3) emotional and relational connection; (4) continuing shared experiences; and (5) legacy and action. Most parents described ongoing connections across multiple domains. Bereaved parents exhibit strong and complex continuing bonds in early bereavement. Improved understanding of these continuing bonds may help to develop supportive interventions focused on strengthening bonds that facilitate grief integration and potentially mitigate long-term psychosocial sequelae.
Pediatric bone sarcoma patients and survivors may experience psychosocial challenges related to childhood cancer after their intensive, body-altering treatment. This cross-sectional study aimed to evaluate generic and survivor-specific psychosocial outcomes in a national cohort of pediatric bone sarcoma patients and survivors, and to explore associations between these outcomes. Patients treated for pediatric bone sarcoma, at least 2 years post-diagnosis, completed age-appropriate Pediatric Quality of Life Inventory (PedsQL) and PROMIS measures (generic outcomes). Patients ≥18 years additionally completed the impact of cancer-childhood survivor (IOC-CS) (survivor-specific outcomes). Generic psychosocial outcomes of patients were compared with age- and sex-specific Dutch normative data using one-sample t-tests. Linear regression analyses, adjusted for age and sex, examined associations between generic and survivor-specific outcomes. In total, 139 patients participated (45% female). Mean age was 20.4 years (SD = 5.5) and mean time since end of treatment was 7.0 years (SD = 5.2). Patients scored significantly worse than normative values on cognitive functioning, pain interference, and health-related quality of life. In other generic domains, such as depressive symptoms or anxiety, patients scored comparably to or better than normative values. Survivor-specific outcomes were most positive in the socializing domain and most negative in the thinking and memory domain. Approximately 20% reported moderate-to-severe negative impact in at least one survivor-specific domain. Overall, pediatric bone sarcoma patients demonstrated psychosocial outcomes comparable to or more favorable than normative values. However, specific domains showed worse outcomes. In addition, a substantial subgroup experienced moderate-to-severe negative impacts of childhood cancer. This highlights the importance of monitoring psychosocial functioning and, where indicated, targeted interventions to address challenges.
Lower-grade gliomas (LGG) are a subgroup of primary brain tumours. People with LGG often live long-term with wide-ranging symptoms and impairments (e.g., seizures, cognitive impairment) and uncertainty about their disease progression. Self-management interventions can improve quality-of-life (QoL) in cancer survivors; however, adaptability, acceptability, and feasibility of existing interventions for people with LGG is unclear. Co-design, with multiple stakeholders, an early prototype supported self-management intervention for people with LGG. Co-design activities followed two sequential phases. Phase one comprised three semi-structured interview sets with people with LGG, caregivers, and healthcare professionals (HCP). Desired support and design preferences were inductively identified and mapped to the TIDieR checklist; this informed a paper prototype outline. Phase two comprised four discussion groups with people with brain tumours, caregivers, and HCPs, and a survey. These activities considered the prototype design, feasibility, and acceptability. A preliminary intervention logic model was developed from Phases one and two, evidence and self-management theory. Early co-design findings indicate preference for a blend of online and face-to-face access to information and support with consideration given to technology literacy and accessibility. A support 'toolkit' was desired for advice, signposting, and support, with the option for caregivers to access intervention content, where appropriate. To improve QoL, the intervention needs to improve symptom knowledge and self-efficacy for symptom management, and support psychological adjustment and independence. This groundwork, involving multiple stakeholders, will help ensure intervention acceptability, feasibility and effectiveness. There is scope for wider applicability to other brain tumour groups.
The Geriatric 8 (G8) screening tool is widely used to assess frailty in elderly patients with cancer. However, its significance in patients undergoing esophagectomy remains unclear. This study aimed to evaluate the association between preoperative G8 scores and postoperative outcomes in elderly patients who underwent esophagectomy for esophageal cancer. This study retrospectively analyzed 130 patients aged ≥ 65 years who underwent esophagectomy for esophageal cancer. The patients were classified into tertiles (low, medium, and high) based on their G8 scores. Postoperative and survival outcomes were compared, and multivariable logistic regression analysis was used to assess the association between G8 scores and postoperative outcomes. The median G8 score was 13 (interquartile range (IQR): 11.5-15). Postoperatively, severe complications occurred in 23.8%, reoperation in 6.9%, and readmission in 12.3% of patients. The median length of hospital stay was 17 days (IQR: 14-25 days). Patients with lower G8 scores had significantly higher rates of severe complications, reoperation, prolonged hospitalization, and readmission (all P < 0.05). G8 score showed a significant inverse association with severe complications (adjusted odds ratio 0.73, 95% confidence interval, 0.59-0.88, P < 0.001). Patients with lower G8 scores were significantly less likely to receive systemic chemotherapy after disease recurrence (P = 0.017) and their overall survival was unfavorable (P = 0.046). Lower preoperative G8 scores were associated with higher rates of severe complications, reoperation, prolonged hospitalization, and readmission. The G8 screening tool helps to predict postoperative outcomes in elderly patients undergoing esophagectomy for esophageal cancer.
Sexual dysfunction is common after prostate radiotherapy, yet communication barriers remain unclear. This multinational study assessed radiation oncologists' practices, attitudes, and sexual-health training. The International Geriatric Radiotherapy Group (IGRG) disseminated a 38-item cross-sectional survey to radiation oncologists across 17 countries. The instrument captured demographics, discussion frequencies, perceived barriers, referral patterns, and attitudes toward oncosexuality. Data was analyzed with descriptive statistics, chi-square tests, and multivariable logistic regression. An exploratory sensitivity analysis restricted to respondents reporting regular management of patients receiving radiotherapy with potential impact on sexual health (≥ 1 such patient per month) was performed. Among 117 radiation oncologists, 87% (102/117) reported some clinical exposure to patients receiving radiotherapy with potential impact on sexual health, and 57% (67/117) reported regular exposure (≥ 1 patient per month). 48% reported that patients rarely initiated discussions, and 8% never addressed the topic. Main barriers were time (39%), competing oncologic priorities (35%), and embarrassment (26%); 60% felt discomfort with older patients. Multivariable analysis revealed a "training paradox": clinicians with formal sexual-health training (56%) had significantly lower odds of initiating discussions at the first visit (OR 0.37, 95% CI 0.15-0.94, p = 0.037) and higher odds of embarrassment with older patients (OR 5.72, 95% CI 2.09-15.65, p = 0.001), independent of age, gender, experience, and practice setting. These findings suggest that awareness-focused sexual-health training alone may be insufficient; behaviourally anchored communication training and formal referral pathways are needed.
Patients with pre-existing severe mental disorders (SMDs), defined as moderate to severe depression, bipolar disorder, or schizophrenia, face barriers to optimal cancer care and may experience elevated mental and physical symptom burden and reduced quality of life. To assess health-related quality of life (HRQoL) and psychiatric symptom burden among patients with SMD before initiating cancer treatment. In this case-control study, 120 patients with lung, breast, or head and neck cancer were included. The patients were matched 1:2 with controls without SMD, using sex, age (±5 years), cancer type, and treatment intent. Recruitment occurred at the first oncology visit (January 2023-June 2025). HRQoL and psychiatric symptoms were measured using the European Organisation for Research and Treatment of Cancer Quality of Life Questionnaire Core-15 Palliative and Symptom Checklist-92 questionnaires. Patient characteristics were extracted from electronic medical journals. Means with confidence intervals (CI) and mean ratios were calculated to compare the two groups. Patients with cancer and pre-existing SMD reported significantly poorer HRQoL than matched controls, with a mean of 56.67 (95% CI 48.75-64.58), compared to patients without SMD (mean: 69.01 (95% CI: 65.20-72.90)). Similarly, both physical and emotional functioning were lower in the SMD group, and the psychiatric symptom burden was substantially higher among patients with SMD. Patients with cancer and pre-existing SMD initiate cancer treatment with substantially poorer HRQoL, higher emotional and physical symptom burden, and markedly elevated psychiatric symptom burden compared with controls. These findings highlight the need for early, integrated psychiatric and supportive care to improve outcomes in this high-risk group.