Search Results (657)

Telomeres are protective DNA sequences located at chromosome ends, essential to maintaining genomic stability. This narrative review examines how maternal lifestyle factors during pregnancy influence fetal telomere length (TL). Positive associations have been identified between offspring’s TL and maternal consumption of nutrients such as vitamins C and D, folate, and magnesium. Additionally, adherence to a Mediterranean diet and regular physical activity during pregnancy are correlated with increased placental TL, supporting fetal genomic integrity. Conversely, maternal dietary patterns high in carbohydrates, fats, or alcohol, as well as exposure to triclosan and sleep-disordered breathing, negatively correlate with offspring’s TL. Maternal infections may also shorten TL through heightened inflammation and oxidative stress. However, evidence regarding the impact of other lifestyle factors—including maternal stress, smoking, caffeine intake, polyunsaturated fatty acid consumption, obesity, and sleep quality—remains inconsistent. Given that shorter telomere length has been associated with cardiovascular, pulmonary, and neurodegenerative diseases, as well as certain types of cancer, these findings highlight the vital importance of maternal health during pregnancy in order to prevent potential adverse effects on the fetus. Further studies are required to elucidate the precise timing, intensity, and interplay of these influences, enabling targeted prenatal interventions to enhance offspring health outcomes. Full article

Background/Objectives: After diagnosis, it is common for women with breast cancer to gain weight, which is associated with worse clinical outcomes. However, traditional measures such as body weight, BMI, and waist circumference do not detect key changes in body composition, such as fat redistribution or muscle loss. The objective of this exploratory study was to assess the evolution of body composition and muscle strength after one year of treatment, and their relationship with metabolic biomarkers. Methods: Prospective observational study in newly diagnosed breast cancer patients. Body composition was assessed using bioelectrical impedance analysis (BIA) and ultrasound (US); muscle strength was measured by handgrip dynamometry. Biomarkers analyzed included glucose, insulin, Homeostatic Model Assessment of Insulin Resistance (HOMA-IR), glycosylated hemoglobin (HbA1c), total cholesterol (and its fractions), triglycerides, C-reactive protein (CRP), 6-interleukin (IL-6), vitamin D, myostatin, and fibroblast growth factor 21 (FGF-21). Results: Sixty-one women (mean age 58 years) were included. After one year, fat mass and related parameters significantly increased, while skeletal muscle mass and muscle strength decreased. Sarcopenic obesity prevalence rose from 1.16% to 4.9%. No significant changes were found in biomarkers, but positive correlations were observed between fat parameters and insulin, HOMA-IR, and triglycerides, and negative correlations with HDL-cholesterol. Conclusions: BIA and US can detect unfavorable changes in body composition that are not reflected in conventional measurements. At one year post-diagnosis, women showed increased fat accumulation, muscle loss, and reduced strength, even without significant metabolic biomarker changes. Further research is warranted to elucidate the long-term clinical implications of these findings and the external validity in larger cohorts. Full article

Background: Proximal gastrectomy (PG) with double tract reconstruction (DTR) offers organ preservation for early gastric cancers, leading to reduced vitamin B12 deficiency, less weight loss, and improved quality of life. The JCOG1401 study confirmed excellent long-term outcomes for PG in stage I gastric cancer. However, in locally advanced proximal gastric cancer (LAPGC), preserving the gastric body and lymph node station 4d may compromise margin clearance and adequate lymphadenectomy. Methods: We propose a modified PG that removes the distal esophagus, gastroesophageal junction (GEJ), cardia, fundus, and gastric body, preserving only the antrum and performing DTR. Lymphadenectomy is also adapted, removing stations 1, 2, 3a, 4sa, 4sb, 4d, 7, 8, 9, 10 (spleen preserving), 11, and lower mediastinal nodes (stations 19, 20, and 110), while preserving stations 3b, 5, and 6. Indications for this procedure include GEJ (Siewert type II and III) and proximal gastric cancers with ≤2 cm distal esophageal involvement and ≤5 cm gastric involvement. Results: In our initial experience with 14 patients, we achieved R0 resection in all patients, adequate lymph node harvest (median 24 nodes, IQR 18–38), and no locoregional recurrences at a median follow-up of 18 months. We also found favorable postoperative weight loss, reflux, and anemia in the PG cohort. Conclusion: While larger studies and long-term data are still needed, our early results suggest that modified PG—despite sparing only the antrum—retains the key benefits of PG over total gastrectomy, including better weight maintenance and improved hemoglobin levels, while maintaining oncologic outcomes for LAPGC. Full article

Recent breakthroughs in cancer immunotherapy have shown remarkable success, yet treatment efficacy varies significantly among individuals. Emerging evidence highlights the gut microbiota as a key modulator of immunotherapy response, while vitamin D (VD), an immunomodulatory hormone, has garnered increasing attention for its potential interactions with gut microbiota and immunotherapy outcomes. However, the precise mechanisms and clinical applications of VD in this context remain controversial. This study systematically analyzed peer-reviewed evidence from PubMed, Scopus, Web of Science, PsycINFO, and MEDLINE (January 2000–May 2025) to investigate the complex interplay among VD, gut microbiota, and cancer immunotherapy. This review demonstrates that VD exerts dual immunomodulatory effects by directly activating immune cells through vitamin D receptor (VDR) signaling while simultaneously reshaping gut microbial composition to enhance antitumor immunity. Clinical data reveal paradoxical outcomes: optimal VD levels correlate with improved immunotherapy responses and reduced toxicity in some studies yet are associated with immunosuppression and poorer survival in others. The bidirectional VD–microbiota interaction further complicates this relationship: VD supplementation enriches beneficial bacteria, which reciprocally regulate VD metabolism and amplify immune responses, whereas excessive VD intake may disrupt this balance, leading to dysbiosis and compromised therapeutic efficacy. These findings underscore the need to elucidate VD’s dose-dependent and microbiota-mediated mechanisms to optimize its clinical application in immunotherapy regimens. Future research should prioritize mechanistic studies of VD’s immunoregulatory pathways, personalized strategies accounting for host–microbiota variability, and large-scale clinical trials to validate VD’s role as an adjuvant in precision immunotherapy. Full article

Background/Objectives: Adequate vitamin D levels are essential for various physiological functions, including cell growth, immune modulation, metabolic regulation, DNA repair, and overall health span. Despite its proven cost-effectiveness, widespread deficiency persists due to inadequate supplementation and limited sunlight exposure. Methods: This systematic review (SR) examines the relationship between vitamin D and the reduction of cancer risk and mortality, and the mechanisms involved in cancer prevention. This SR followed the PRISMA and PICOS guidelines and synthesized evidence from relevant studies. Results: Beyond genomic actions via calcitriol [1,25(OH)₂D]-receptor interactions, vitamin D exerts cancer-protective effects through mitigating inflammation, autocrine, paracrine, and membrane signaling. The findings reveal a strong inverse relationship between serum 25(OH)D levels and the incidence, metastasis, and mortality of several cancer types, including colon, gastric, rectal, breast, endometrial, bladder, esophageal, gallbladder, ovarian, pancreatic, renal, vulvar cancers, and both Hodgkin’s and non-Hodgkin’s lymphomas. While 25(OH)D levels of around 20 ng/mL suffice for musculoskeletal health, maintaining levels above 40 ng/mL (100 nmol/L: range, 40–80 ng/mL) significantly lowers cancer risks and mortality. Conclusions: While many observational studies support vitamin D’s protective role in incidents and deaths from cancer, some recent mega-RCTs have failed to demonstrate this. The latter is primarily due to critical study design flaws, like recruiting vitamin D sufficient subjects, inadequate dosing, short durations, and biased designs in nutrient supplementation studies. Consequently, conclusions from these cannot be relied upon. Well-designed, adequately powered clinical trials using appropriate methodologies, sufficient vitamin D₃ doses, and extended durations consistently demonstrate that proper supplementation significantly reduces cancer risk and markedly lowers cancer mortality. Full article

Background: Endocrine therapies are accompanied by side effects that significantly impact the quality of life (QoL) of women with breast cancer. Adequate diet is important for fulfilling nutritional requirements, preserving health, and supporting therapy in this vulnerable population. Methods: This preliminary study evaluated the QoL of life and dietary intake in 185 women with breast cancer on two therapies, aromatase inhibitors (AIs) and tamoxifen, using the Functional Assessment of Cancer Therapy—Endocrine Symptoms (FACT-ES), European Organization for Research and Treatment of Cancer Quality of Life Questionnaire (EORTC QLQ-C30), and Breast Cancer Specific Questionnaire (QLQ-BR23) and a 24 h dietary recall. A total of 185 women were included in the study and fulfilled the FACT-ES, of whom 73 fulfilled other two questionnaires and a 24 h recall. Results: No significant differences were found in the overall QoL between groups. Joint pain (95.3%) and reduced libido (84.7%) were most common with AIs, while tamoxifen users more frequently reported weight gain and irritability (93.0%, each), and vasomotor and gynecological symptoms. Macronutrient intake was similar, though AIs users consumed more energy-dense (p ≤ 0.001) and sugary foods (p = 0.034), while tamoxifen users had higher omega-6 PUFA intake. Both groups exhibited suboptimal intake of vitamin D, calcium, and selenium, and a higher phosphorus consumption relative to recommended daily values. Conclusions: Preliminary findings showed that QoL and dietary intake were comparable between patients with BC on AIs and tamoxifen treatment. Endocrine-related symptoms were more prevalent among tamoxifen users, whereas joint pain was most common in AIs users. Nutritional interventions may be warranted in both groups to ensure adequate intake of essential micronutrients in accordance with recommended dietary guidelines. Full article

Background/Objectives: Cervical cancer is a leading cancer-related cause of death among women, with recurrence being a serious clinical issue. Recent evidence demonstrates that long non-coding RNAs (lncRNAs) affect cancer recurrence. This research investigates vitamin D’s regulatory actions in the recurrence of cervical cancer, centering on the involvement of lncRNA. Clinical data on 738 patients shows that greater serum vitamin D levels are linked to reduced recurrence rates and enhanced disease-free survival (DFS). Methods: A transcriptomic analysis of CaSki cervical cancer cells using data from the GEO dataset GSE267715 identified that vitamin D controls genes that prevent cervical cancer recurrence. Machine learning predictors CatBoost, LightGBM, Extra Trees, and Logistic Regression and feature selection methods such as ANOVA F-test, mutual information, Chi-squared test, and Recursive Feature Elimination (RFE) are used to identify predictors of recurrence, evaluating model performance using accuracy, precision, recall, ROC AUC, confusion matrices, and ROC curves. Result: CatBoost performs the best overall, producing an accuracy of 95.27%. CatBoost provided an ROC AUC of 0.9930, a precision of 0.9296, and a recall of 0.9706, and this implies a significant trade-off between the ability to detect metastatic cases correctly. Conclusions: These data identify the therapeutic potential of vitamin D as a regulatory compound and lncRNA as a potential therapeutic target in the recurrence of cervical cancer. Full article

Background/Objectives: Pomegranate (Punica granatum) peel, often discarded as waste, contains abundant bioactive compounds such as polyphenols, vitamins, flavonoids, tannins, anthocyanins, and many more. This contributes to remarkable bioactivities, including anticancer, anti-inflammatory, antioxidant, antibacterial, and antifungal properties. Pancreatic cancer is a deadly cancer with a 9% survival rate. Its aggressiveness, invasiveness, quick metastasis, and poor prognosis significantly decrease the survival rate. Thus, we aim to explore pomegranate peel as a possible alternative medication for treating pancreatic cancer through virtual methods. Methods: Firstly, bioactive compounds were collected from multiple databases and screened for oral bioavailability (OB) ≥ 0.3 and drug likeness (DL) ≥ 0.18 scores. Simultaneously, network pharmacology was employed to extract the most probable targets for pancreatic cancer. Further computational analyses were performed, including molecular docking, molecular dynamics simulation, and in silico pharmacokinetics evaluation. Results: Consequently, the top 10 key targets from network analysis were AKT1, IL6, TNF, SRC, STAT3, EGFR, BCL2, HSP90AA1, HIF1A, and PTGS2. However, only AKT1, EGFR, BCL2, HSP90AA1, and PTGS2 exhibited strong binding affinities with pomegranate compounds, which are significantly declared in affected cells to enhance cancer progression. Outcomes from molecular dynamics simulations, particularly RMSD, RMSF, hydrogen bonding, and radius of gyration (Rg), confirmed stable interactions between 1-O-Galloyl-beta-D-glucose, epicatechin, phloridzin, and epicatechin gallate with respective target proteins. Conclusions: This suggests that pomegranate peels hold anticancer bioactive compounds for treating pancreatic cancer. Surprisingly, most compounds adhere to Lipinski’s and Pfizer’s rules and display no toxicity. However, as this study relies entirely on computational methods, experimental validation is necessary to confirm these findings and assess real-world efficacy and potential side effects. Full article

Background: Although vitamin D supplementation is simple, inexpensive, and safe, vitamin D deficiency remains widespread, especially in developing communities. The aim of our study was to assess vitamin D levels among patients with gynecological cancers and compare them with those in patients with benign tumors living in rural and urban areas. Methods: This is a clinical retrospective study covering data analysis from March 2021 to July 2023. A total of 686 patients with uterine or ovarian tumors were analyzed. An electrochemiluminescence immunoassay method was used to assess vitamin D concentrations. Other laboratory blood tests were also performed on the admission day. Results: A significant reduction in vitamin D levels in oncological vs. non-oncological patients (median 23 (17, 33) ng/mL vs. 28 [21, 36] ng/mL, p < 0.001) was observed. The lowest vitamin D concentration was found in patients with ovarian cancer (median 22 (16, 32) ng/mL), followed by those with endometrial cancer and cervical cancer—median 24 (18, 35) ng/mL and 26 (20, 31) ng/mL, respectively). We found no differences in the vitamin D concentration between various histopathological types of ovarian cancers (p = 0.07). No correlation between the vitamin D concentration and age (r = 0.03, p > 0.05) was noted. A negligible negative correlation between vitamin D levels and BMI was observed (r = −0.095, p = 0.03). Additionally, those living in cities had a significantly reduced vitamin D concentration compared to those living in rural areas. No significant differences were demonstrated in vitamin D concentrations between malignant and benign tumors among patients living in rural areas (p = 0.17). Conclusions: Gynecological oncology patients have significantly lower vitamin D levels compared to non-oncological patients. In our patient population, ovarian and endometrial cancers were frequently associated with vitamin D deficiency. While this observation does not establish causation, it highlights the potential value of monitoring vitamin D levels and addressing deficiencies as part of broader cancer prevention and management strategies. Full article

Background/Objectives: Prostate cancer (PCa) is the second most common malignancy among men worldwide and a leading cause of cancer-related mortality. In 2022, over 1.4 million new cases were reported globally, with a prevalence exceeding 5 million. Despite its widespread occurrence, the incidence and mortality of PCa show substantial geographic variation, influenced by factors such as genetic predisposition, healthcare access, lifestyle, and the adoption of screening programs. Regions with high PCa incidence, such as Northern America and Oceania, often have lower mortality rates due to early detection and advanced healthcare infrastructure. Conversely, areas with limited access to medical resources, such as parts of Africa and Latin America, experience higher mortality rates. Methods: This review explores non-modifiable risk factors such as age, family history, and race, emphasizing their role in PCa development and progression. Results: Modifiable factors, including diet, physical activity, alcohol consumption, and smoking, are also addressed, with evidence suggesting their potential in mitigating risk. Emerging data on medications such as 5-alpha reductase inhibitors and statins, as well as dietary supplements such as vitamins D, indicate their potential for chemoprevention, though further research is needed to solidify these findings. Healthcare disparities, especially in low- and middle-income regions, highlight the need for equitable access to diagnostic tools and treatment options. The review underscores the significance of tailored screening approaches, particularly in high-risk populations, to optimize outcomes while minimizing overdiagnosis and overtreatment. Conclusions: The review concludes with recommendations for future research, including the need for standardized screening protocols and the exploration of novel biomarkers for early detection. By synthesizing epidemiological data and current evidence, this review aims to enhance understanding of PCa risk factors, geographic disparities, and preventive strategies, ultimately contributing to improved global PCa management and outcomes. Full article

Ocular flutter is an uncommon ophthalmic finding that may indicate paraneoplastic phenomena, and it is clinically characterized by intermittent bursts of conjugate, horizontal saccades without an intersaccadic interval. Ocular flutter must be differentiated from opsoclonus, which, although also characteristic of certain paraneoplastic syndromes, is instead defined by multidirectional saccades on both the horizontal and vertical planes. This report describes a very rare presentation of anti-Ri syndrome in a patient with an undiagnosed breast cancer, presenting with ocular flutter, dizziness, blurred vision, photophobia, and vomiting. Comprehensive evaluations, including contrast-enhanced brain Magnetic Resonance Imaging (MRI), brain Computed Tomography (CT) scan, ophthalmological assessment, viral serology, complete blood count and thyroid, renal coagulation, hepatic function assessments, vitamin D and B12 levels, were all normal. Upon excluding other potential etiologies for the neurological symptoms, a paraneoplastic origin was considered. Serological tests confirmed the presence of anti-Ri onconeural antibodies, and a whole-body CT scan identified nodules in the right breast. Despite surgical excision of the primary tumor and subsequent medical therapy, there was no improvement in the neurological symptoms. Follow-up evaluations at 2 months, 6 months, 1 year and 2 years revealed persistent vestibular and neurological symptoms, with serum tests remaining positive for anti-Ri antibodies and no clinical or radiological evidence of neoplastic recurrence. Full article

Background and Aims: Colorectal cancer (CRC) remains the third most common cancer worldwide and a leading cause of cancer-related death. Chemoprevention through widely used pharmaceutical agents has garnered increasing interest due to its potential cost-effectiveness and accessibility. This review summarizes current evidence from observational studies, randomized controlled trials, and meta-analyses on the association between commonly prescribed medications and CRC incidence and survival, with particular emphasis on low-dose aspirin and oral anticoagulants (OACs). Scope: Aspirin is the most extensively studied agent, with substantial evidence supporting its protective effect on CRC-specific survival, particularly in long-term users, those with COX-2 overexpression, or PIK3CA mutations. OACs have recently gained attention due to their association with increased gastrointestinal bleeding, which may facilitate earlier CRC detection. While emerging evidence suggests a possible survival benefit through this mechanism, data remain heterogeneous and affected by methodological challenges such as lead-time bias. Metformin is associated with improved CRC outcomes, primarily in patients with type 2 diabetes, though its direct anti-tumor potential remains under investigation. Corticosteroids, statins, and beta-blockers have both limited and inconclusive evidence. Finally, recent studies on vitamin D, calcium, and folic acid suggest inconsistent associations, often confounded by lifestyle factors or underlying comorbidities. Conclusions: While promising, chemoprevention strategies require further validation in well-designed, mechanistically informed studies that account for confounding variables, treatment duration, and tumor biology. Personalized prevention—guided by genetic, molecular, and clinical risk factors—represents a promising path forward. Full article

Breast cancer is the leading cause of death among women, and its treatment often involves chemotherapy and hormone therapy, which can compromise bone mineral density (BMD). Tamoxifen, a selective estrogen receptor modulator, has different effects depending on the patient’s hormonal status. On the one hand, in postmenopausal women, it has a protective effect on BMD; on the other hand, in premenopausal women, it can accelerate bone loss, increasing the risk of osteoporosis and fractures. The reduction in estrogen levels during treatment is a key factor in this bone loss. This review underscores the importance of early risk assessment and regular monitoring of bone mineral density, along with the adoption of individualized pharmacological and non-pharmacological strategies, such as calcium and vitamin D supplementation and physical exercise, to preserve bone health in premenopausal women with breast cancer undergoing endocrine therapy. Full article

Cervical cancer ranks third among malignant diseases of the female reproductive system and progressively develops through a series of pathological changes known as cervical intraepithelial neoplasia (CIN). Despite being extremely aggressive and causing increased mortality, the main treatment options include surgery or a combination of chemotherapy and radiotherapy, often based on cisplatin-based chemotherapy and external beam radiotherapy or brachytherapy. Cervical dysplasia is an abnormal growth of cells on the surface of the cervix that could lead to cervical cancer. CIN most commonly occurs at the squamocolumnar junction of the cervix, a transitional zone between the squamous epithelium of the vagina and the columnar epithelium of the endocervix. The primary cause of CIN is chronic infection of the cervix with Human Papillomavirus (HPV). Oxidative stress (OS) and chronic inflammation are associated with HPV-induced cervical dysplasia. Reactive oxygen species (ROS) facilitate the progression of CIN through DNA damage, immune evasion, and cellular mutations. Thus, the inflammatory environment, characterized by increased expression of proinflammatory cytokines, contributes to epithelial transformation. Given these mechanisms, antioxidants, including vitamins A, C, D, E, polyphenols, and carotenoids, are being investigated for their potential as adjunctive therapies in CIN management. This review aims to provide a comprehensive analysis of the influence of oxidative stress, antioxidants, and inflammation on cervical cancer. Full article