Search Results (271)

Sexual dysfunction affects an estimated 50–70% of cancer survivors but remains underrecognized and undertreated, impacting quality of life and emotional well-being. This narrative review involves a comprehensive search of PubMed/MEDLINE, CINAHL, Scopus, Web of Science, and ScienceDirect for English-language publications (January 2010–May 2025), using combined MeSH and free-text terms for ‘sexual health’, ‘cancer’, ‘nursing’, ‘roles of nurses’, ‘immunotherapy’, ‘targeted therapy’, ‘sexual health’, ‘sexual dysfunction’, ‘vaginal dryness’, ‘genitourinary syndrome of menopause’, ‘sexual desire’, ‘body image’, ‘erectile dysfunction’, ‘climacturia’, ‘ejaculatory disorders’, ‘dyspareunia’, and ‘oncology’. We used the IMRAD (Introduction, Methods, Results, and Discussion) approach to identify 1245 records and screen titles and abstracts. Fifty studies ultimately met the inclusion criteria (original research, reviews, and clinical guidelines on oncology nursing and sexual health). Results: All the treatments contributed to reduced libido, erectile dysfunction, dyspareunia, and body image concerns, with a prevalence of 57.5% across genders. Oncology nurses can provide sex education and counseling. Barriers (limited training, cultural stigma, and the absence of protocols) hinder effective intervention. Addressing these issues through sexual health curricula, formal referral systems, and policy reforms can enhance nursing care. Future research should assess the impact of targeted nurse education and the institutional integration of sexual health into cancer care. Full article

Purpose: This systematic review aims to evaluate the utility of mobile health (mHealth) applications in uro-oncology, hereafter referred to as mHealth apps, specifically examining their potential to improve patient care, symptom management, and communication in genitourinary cancer treatment. Methods: Adhering to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, a comprehensive systematic review was conducted focusing on mHealth applications for patients with genitourinary cancers. Results: The review analyzed 29 studies, which revealed that mHealth apps demonstrated potential in uro-oncology patient care. Key findings included effective symptom monitoring, enhanced decision support, and improved patient education. The applications were found to be feasible and well-accepted by patients. However, implementation challenges were identified, including technical barriers, variations in app quality, and unequal access to digital healthcare technologies. This review systematically categorized mHealth interventions into three functional domains—symptom management, decision support, and personalized care—and identified critical implementation barriers including digital inequity, high risk of bias, and app quality variability. Conclusions: Mobile health applications demonstrate promise in revolutionizing uro-oncology care. Future research should prioritize developing comprehensive applications that address a broader range of urological cancers, enhance patient–clinician communication, and undergo rigorous evaluation. Collaborative efforts among researchers, clinicians, and app developers are crucial to overcome existing limitations and maximize the potential of these innovative healthcare tools. Full article

Background/Objectives: Chronic wounds represent a significant clinical and public health challenge due to impaired tissue repair and high associated morbidity. This study investigates the therapeutic potential of the secretome derived from human mesenchymal stem cells obtained from the pulp of deciduous teeth (hDP-MSCs) in promoting skin wound healing. Methods: After confirming the mesenchymal identity and multipotent differentiation potential of hDP-MSCs by using flow cytometry and histological staining, the effects of the secretome on human keratinocyte (HaCaT) cultures were evaluated. Results: Scratch assays, performed under high- and low-glucose conditions, demonstrated that the secretome significantly promoted keratinocyte migration and wound closure without compromising cell viability. Additionally, the secretome modulated the expression of key genes involved in inflammation and tissue regeneration, including IL-1β, TNF-α, TGF-β1, and VEGF-α, in a time-dependent manner. Under inflammatory conditions induced by lipopolysaccharide, co-treatment with the secretome significantly reduced TNF-α expression and increased TGF-β1 expression, suggesting an anti-inflammatory effect. Conclusions: These findings indicate the potential of the hDP-MSC-derived secretome as a promising cell-free therapeutic strategy capable of accelerating skin regeneration and modulating the inflammatory response during the wound healing process. Full article

Despite remarkable progress in cancer immunotherapy, many agents that show efficacy in murine or in vitro models fail to translate clinically. Zebrafish (Danio rerio) have emerged as a powerful complementary model that addresses several limitations of traditional systems. Their optical transparency, genetic tractability, and conserved immune and oncogenic signaling pathways enable high-resolution, real-time imaging of tumor–immune interactions in vivo. Importantly, zebrafish offer a unique opportunity to study the core mechanisms of health and sickness, complementing other models and expanding our understanding of fundamental processes in vivo. This review provides an overview of zebrafish immune system development, highlighting tools for tracking innate and adaptive responses. We discuss their application in modeling immune evasion, checkpoint molecule expression, and tumor microenvironment dynamics using transgenic and xenograft approaches. Platforms for high-throughput drug screening and personalized therapy assessment using patient-derived xenografts (“zAvatars”) are evaluated, alongside limitations, such as temperature sensitivity, immature adaptive immunity in larvae, and interspecies differences in immune responses, tumor complexity, and pharmacokinetics. Emerging frontiers include humanized zebrafish, testing of next-generation immunotherapies, such as CAR T/CAR NK and novel checkpoint inhibitors (LAG-3, TIM-3, and TIGIT). We conclude by outlining the key challenges and future opportunities for integrating zebrafish into the immuno-oncology pipeline to accelerate clinical translation. Full article

Background: This study aimed to develop a predictive model for acute gastrointestinal (GI) and genitourinary (GU) toxicity in prostate cancer patients treated with salvage radiotherapy (SRT) post-prostatectomy, using machine learning techniques to identify key prognostic factors. Methods: A multicenter retrospective study analyzed 454 patients treated with SRT from three Italian radiotherapy centers. Acute toxicity was assessed using Radiation Therapy Oncology Group criteria. Predictors of grade ≥ 2 toxicity were identified through Least Absolute Shrinkage and Selection Operator (LASSO) regression and Classification and Regression Tree (CART) modeling. The analyzed variables included surgical technique, clinical target volume (CTV) to planning target volume (PTV) margins, extent of lymphadenectomy, radiotherapy technique, and androgen-deprivation therapy (ADT). Results: No patients experienced grade ≥ 4 toxicity, and grade 3 toxicity was below 1% for both GI and GU events. The primary determinant of acute toxicity was the surgical technique. Open prostatectomy was associated with significantly higher grade ≥ 2 GI (41.8%) and GU (35.9%) toxicity compared to laparoscopic/robotic approaches (18.9% and 12.2%, respectively). A CTV-to-PTV margin ≥ 10 mm further increased toxicity, particularly when combined with extensive lymphadenectomy. SRT technique and ADT were additional predictors in some subgroups. Conclusions: SRT demonstrated excellent tolerability. Surgical technique, CTV-to-PTV margin, and treatment parameters were key predictors of toxicity. These findings emphasize the need for personalized treatment strategies integrating surgical and radiotherapy factors to minimize toxicity and optimize outcomes in prostate cancer patients. Full article

Background/Objectives: With an estimated 70% of new cancer diagnoses expected to be in older adults within the next decade, cancer care for this population has attracted increasing global attention. Additionally, older patients are less likely to receive optimal cancer treatments. Methods: This retrospective cohort study utilized data from the Samsung Medical Center Cancer Registry, which includes patients diagnosed with cancer between 2008 and 2022. A 15-year cohort analysis was conducted to examine trends and survival outcomes by cancer type and stage in patients aged 80 years and older. Results: Among 301,055 patients with cancer, 13,111 (4.4%) were aged 80 years or older at diagnosis. The proportion of patients in this age group increased from 2.4% in 2008 to 5.8% in 2022. The most prevalent cancers in patients aged ≥80 years were lung (18.9%), stomach (15.3%), and colorectal cancer (13.8%). Among individuals with localized or regional-stage disease, the 5-year survival rate was 49.66% in those aged ≥80 years compared to 81.46% in younger patients (HR = 1.41; 95% CI = 1.35, 1.46). For distant-stage disease, survival was lower, at 10.53% in patients aged ≥80 years versus 27.61% in those aged <80 (HR = 1.14; 95% CI = 1.10, 1.19). Among patients aged 80 years and older, 55% received anti-cancer treatment, with the proportion increasing from 54.5% in 2008 to 60.3% in 2021. This increase was particularly notable in individuals with distant-stage disease. Additionally, the proportion of clinical trial participants aged ≥80 years exhibited an upward trend. Patients in this age group who underwent treatment had significantly improved survival compared to those who did not, in both localized or regional disease (HR = 0.45; 95% CI = 0.42, 0.49) and distant disease (HR = 0.58; 95% CI = 0.53, 0.62). Conclusions: The findings from this cohort of the SMC Cancer Registry highlight key trends, including a rising number of patients aged ≥80 years and an increasing proportion receiving treatment, particularly after 2020, when more than 60% received therapy. Furthermore, survival benefits associated with treatment were comparable to those observed in younger patients across all cancer types. Full article

Background/Objectives: Stereotactic radiotherapy (SABR) is a recognized standard treatment modality for localized prostate cancer, though data is limited regarding the risk of increased toxicity when including the elective nodes (ENI) for high-risk disease. Placement of a peri-rectal spacer can decrease the risk of toxicity to the rectum when administering high-dose prostate radiotherapy. Herein we present toxicity findings for patients who underwent five-fraction prostate SABR with ENI in a setting with peri-rectal spacing. Methods: Genitourinary (GU) and gastrointestinal (GI) toxicity data was analyzed for patients with ≥12 months of follow-up who were treated with curative-intent five-fraction SABR with ENI. A radiopaque hydrogel spacer was placed for all eligible patients. The primary endpoints were the three-month toxicity, which was measured using CTCAEv5, and quality of life (QoL), which was measured using EPIC 26. Secondary endpoints included intermediate-term GU and GI toxicity between 6 and 12 months. Univariable logistic regression was used to assess associations between baseline patient characteristics and the presence of a peri-rectal hydrogel spacer and GU and GI toxicity. Results: Among the 100 patients treated, 69 had grade group 4/5 disease and 40 had evidence of T3a/3b extension. The ENI dose was 25 Gy/5, and 78.9% of the patients received 40 Gy to the prostate, while the remainder were given 36.25–37.5 Gy. A total of 70% underwent placement of a radiopaque hydrogel spacer. GU toxicities of grades 1, 2, and 3 were reported in 28/22/1% of the patients, respectively, at three months; in 18/11/0% at six months; in 11/9/0% at nine months; and in 5/3/0% at twelve months. GI toxicities of grades 1 and 2 were reported in 14/0% of the patients at three months and 8/1% at six months, with all cases resolving by nine months. MCICs in the urinary incontinence, urinary obstructive, and bowel domains were reported in 5%, 18%, and 4% at three months; by twelve months, these values decreased to 2%, 2%, and 0%, respectively. The presence of a hydrogel spacer resulted in reductions in high and intermediate doses to the rectum and had a significant inverse association with short-term GI toxicity (HR: 0.09, CI: 0.27–0.35, p: 0.0004). Conclusions: In this prospective series, five-fraction SABR including ENI was well tolerated, and the presence of a hydrogel spacer was associated with a lower risk of rectal toxicity. Full article

Background/Objective: The Empty Spiracles Homeobox 2 (EMX2) gene is a homeobox transcription factor that is critical for the development of the central nervous system and genitourinary system during embryogenesis. EMX2 has been shown to regulate cellular differentiation, migration, and proliferation through its involvement in transcriptional control. Dysregulation of EMX2 expression has been implicated in various pathological conditions, including cancer, but the precise molecular mechanisms underlying EMX2 functions in cancer remain incompletely understood. In this study, we focus on the expression profile and the prognostic significance of EMX2 in esophageal squamous cell carcinoma (ESCC). Methods/Results: The expression levels of EMX2 in clinical ESCC samples varied and appeared to be lower than those in adjacent normal tissues. In addition, EMX2 expression was detected in some of the 20 ESCC cell lines but not in others and was correlated with 5-FU sensitivity. EMX2 expression in ESCC cell lines was strongly associated with colony formation capacity in soft agar, and EMX2 knockdown decreased colony formation. Enforced expression of EMX2 decreased the side population (SP) ratio in FACS analysis but increased colony formation in SP fractions. Although it is a preliminary experiment, xenograft in immunodeficient (NOD) scid mice suggested that the forced expression of EMX2 increased tumorigenic capacity in vivo. A Kaplan–Meyer analysis of patients from whom 20 ESCC cell lines or 18 ESCC tissue samples were obtained indicated that EMX2 expression was a poor prognostic marker. Conclusion: EMX2 has a unique function in ESCC stemness and its expression is the stamped marker of poor prognosis in ESCC patients. Full article

Advancements in immune monitoring and modulation technologies are driving transformative changes in cancer immunotherapy. These innovations are crucial for assessing patient-specific immune responses, enabling more accurate predictions of therapeutic efficacy and enhancing treatment outcomes. This review provides a comprehensive overview of current technologies used in immune monitoring, such as flow cytometry, single-cell RNA sequencing, and multiplex cytokine profiling. It also explores cutting-edge immune modulation methods, such as biomaterials that activate immune cells and genetically engineered cell-based therapies. We examine the strengths and limitations of these techniques and identify areas where further progress is needed. In particular, we explore how personalized therapies, real-time monitoring systems, and artificial intelligence shape the future of immune-based treatments. Through a comparative analysis of existing platforms and emerging solutions, this paper underscores the importance of integrating diverse scientific approaches—from immunology and bioengineering to data science—in advancing safer, more effective cancer treatments. This interdisciplinary approach promises to enhance the precision and accessibility of immune-based therapies, offering new hope for improved cancer care. Full article

Robot-assisted surgery has transformed the landscape of genitourinary cancer treatment, offering enhanced precision, reduced morbidity, and improved recovery compared to open or conventional laparoscopic approaches. As the field matures, a new generation of technological innovations is redefining the boundaries of what robotic systems can achieve. This narrative review explores the integration of artificial intelligence, advanced imaging modalities, augmented reality, and connectivity in robotic urologic oncology. The applications of machine learning in surgical skill evaluation and postoperative outcome predictions are discussed, along with AI-enhanced haptic feedback systems that compensate for the lack of tactile sensation. The role of 3D virtual modeling, intraoperative augmented reality, and fluorescence-guided surgery in improving surgical planning and precision is examined for both kidney and prostate procedures. Emerging tools for real-time tissue recognition, including confocal microscopy and Raman spectroscopy, are evaluated for their potential to optimize margin assessment. This review also addresses the shift toward single-port systems and the rise of telesurgery enabled by 5G connectivity, highlighting global efforts to expand expert surgical care across geographic barriers. Collectively, these innovations represent a paradigm shift in robot-assisted urologic oncology, with the potential to enhance functional outcomes, surgical safety, and access to high-quality care. Full article

Advancements in radiotherapy (RT) techniques such as intensity modulation, image guidance, and hypofractionation have facilitated a satisfactory survival outcome in prostate cancer (PCa) patients. However, virtually all PCa patients suffer from various types and extents of radiation toxicities, which are mainly gastrointestinal (GI) and genitourinary (GU) in nature, eroding their quality of life. Thus, early mitigation and preventative measures should be offered, enabled by accurate toxicity prediction. This scoping review provides a comprehensive summary of reported acute and late GI and GU toxicity predictors of conventional fractionation (CFRT), moderate hypofractionation (MHRT), and ultra-hypofractionation (UHRT). A total of 169 studies published between the years 2000 and 2024 (inclusive) were identified from four databases, with 127 and 78 studies investigating GI and GU toxicities, respectively. Univariate analysis was employed in 139 studies to identify predictors, while 94 studies involved multivariate analysis, 40 involved internal model validation, and 5 performed external model validation. Among all studies, dosimetric predictors are the most reported factors, followed by patient, clinical, treatment, disease, genetic, and radiomic features. However, their applicability and performance have not yet been extensively proven in external validation involving multicenter studies. Future predictive studies should also focus on deeper multimodality information, such as radiomics, in addition to the categories of factors consolidated in this study, for an all-rounded investigation. A multicenter study is highly encouraged for prospective external validation. Further investigations into delivered doses and sub-volumes of various regions of interest are necessary. Comprehensive reporting items suggested in this work shall facilitate the reproducibility and comparability of the results. Full article

Objective: To systematically evaluate the effectiveness and safety of radiofrequency ablation (RFA) for managing pain caused by spinal metastases. This review aimed to consolidate evidence on RFA’s analgesic efficacy and associated risks to inform clinical practice in palliative cancer care. Methods: A systematic review adhering to PRISMA guidelines was conducted. Databases were searched for studies evaluating RFA for spinal metastases pain. Inclusion criteria specified: randomized or non-randomized studies (prospective/retrospective); ≥3 adult patients; RFA used alone or combined with other treatments; reported pre- and post-RFA pain assessments; English language publication. Data extracted included patient demographics, primary tumor type, lesion location, pain scores (e.g., NRS/VAS), and complications. Pain response was assessed using definitions including the International Consensus Pain Response Endpoints (ICPRE) and definitions for moderate (≥2-point reduction) and high (≥4-point reduction) effectiveness. Results: This review included 33 studies, totaling 1336 patients (53.7% female) and 1787 treated lesions. The majority (85%) of studies reported highly effective pain management (≥4-point pain score reduction). The remaining 15% showed moderate effectiveness (≥2-point reduction). All studies reported achieving at least a partial pain response per ICPRE criteria. Mean pain scores decreased significantly from baseline (7.56/10) within 24–72 h (3.65) and remained low at 4 weeks (2.99), 12 weeks, and 24 weeks (both 2.70). Common primary cancers were lung (27.6%), breast (26.2%), and genitourinary (11.3%). Lesions were primarily in the thoracic (47.9%) and lumbar spine (47.3%). Crucially, no life-threatening (grade IV–V) complications occurred. The overall rate of grade I–III complications was low at 2.11%. Limitations: This systematic review is limited by its study-level nature, preventing detailed subgroup analyses regarding specific metastasis characteristics or the impact of complementary therapies. Conclusions: This systematic review suggests that RFA is a safe and effective treatment for pain control in patients with spinal metastases. It provides both rapid (within 24 h) and durable mid-term (up to 24 weeks) analgesia. The favorable safety profile, with a low complication rate, supports RFA as a valuable complimentary option within the multidisciplinary palliative management of painful spinal secondary tumors. Future randomized-controlled studies may help to further define its role when associated with other treatments. Full article

Objective: To review the efficacy and safety of reduced dose compared to standard dose Enzalutamide treatment for patients with castration-resistant prostate cancer (CRPC). Methods: PubMed, Scopus, Web of Science, and Cochrane databases were searched for randomized controlled trials and cohort studies reporting the use of Enzalutamide in reduced and standard doses in patients with castration-resistant prostate cancer. Searches were limited to articles published in the English language. Outcome assessments included progression-free survival (PFS), overall survival (OS), adverse events, and serum prostate-specific antigen (PSA) response. Results: Ten studies met the inclusion criteria, including 2481 patients treated with Enzalutamide. Seven studies were retrospective cohorts, two were prospective trials, and one was a prospective cohort. No consistent relationship was identified between OS and PFS and the Enzalutamide dosage. Reduced doses of Enzalutamide decreased the incidence of adverse events, particularly among elderly patients. Conclusions: This systematic review suggests that reduced doses of Enzalutamide in CRPC may maintain therapeutic efficacy in selected patients while improving tolerability. However, inconsistent findings and methodological limitations highlight the need for prospective randomized trials to define optimal and individualized dosing strategies. Full article

This study aimed to identify the cytokine expression profile in prostate cancer (PCa) patients compared to healthy individuals. Plasma samples from 75 PCa patients and 14 healthy controls were analyzed using Multiplex ELISA (Luminex) to measure the expression levels of 12 cytokines: IL-4, IL-5, IL-6, IL-10, IL-1β, IL-17A, IL-12p70, MCP-1/CCL2, MIP-1α/CCL3, MIP-1β/CCL4, TNF-α, and IFN-γ. Differences in cytokine expression levels were analyzed using the Mann–Whitney test, Wilcoxon’s rank-sum test, Spearman’s rank correlation, and K-means Clustering unsupervised machine learning to validate cytokine expression patterns. In PCa patients, MIP-1α/CCL3, MIP-1β/CCL4, IFN-γ, and interleukins exhibited significantly higher expression levels; conversely, TNF-α and MCP-1/CCL2 both had decreased expression compared to healthy individuals. The clustering analysis confirmed that PCa patients exclusively exhibit the highest associations with MIP-1α/CCL3, IFN- γ, IL-12p70, IL-4, and IL-5. Furthermore, specific correlations between IL-4 and MIP-1 beta, IL-4 and IFN-gamma, IL-5 and IL-12p70, and IL-5 and IFN-gamma in PCa patients did not occur in healthy individuals. Such results will guide forthcoming in vitro and in vivo human prostate cancer-drug treatment models, paving the way for exploration of future drug targets and candidates with potential to predict FDA-approved prostate cancer treatment responses by targeting cytokine levels and the oncogenesis pathways. Full article

Prostate cancer (PCa) is the most frequently diagnosed malignancy in the male genitourinary tract. However, the regulatory mechanism of competitive endogenous RNAs (ceRNAs) in PCa remains unclear. In this study, we first performed immune scores of mRNA data from 481 PCa samples using single-sample Gene Set Enrichment Analysis (ssGSEA). Based on the immune scores, we then evaluated the tumor immune microenvironment and analyzed 28 types of immune cells in PCa, we constructed a comprehensive network with four lncRNAs (MEG3, PCAT1, SNHG19, TRG-AS1), three miRNAs (hsa-miR-488-3p, hsa-miR-210-5p, hsa-miR-137), and twenty-seven mRNAs (including H2AFJ, THBS1, HPGD). Among the 28 immune cell types, seven immune cell types were found to be significantly associated with clinical characteristics. These network nodes have prognostic significance in multiple cancers and play critical roles in malignancy development, indicating the network’s predictive capability. We also observed a strong correlation (r = 0.6) between T-helper type 1 (Th1) cells and lncRNA network modules. The network connectivity highlights the association between immune therapy biomarkers for PCa, particularly those related to H2AFJ, THBS1, and HPGD. These findings provide valuable insights into the ceRNA regulatory network and its implications for immune-based therapies in PCa. Full article