Search Results (2,580)

Background and Objectives: The pandemic caused by the SARS-CoV-2 infection has been named coronavirus disease 2019 (COVID-19) by the World Health Organization (WHO). Cancer patients may have been more adversely affected during the COVID-19 Pandemic due to their receipt of immunosuppressive treatments, higher burden of comorbidities, and greater nutritional vulnerability compared to the general population. The aim of our study is to identify potential measures by detecting changes in the nutritional statuses of patients with an oncological diagnosis who presented to our hospital during the COVID-19 pandemic, using the globally accepted NRS-2002 questionnaire. Materials and Method: Our study included 324 patients diagnosed with malignancy who applied to the outpatient clinic of Gaziantep University, Şahinbey Training and Research Hospital, Gaziantep/Türkiye, between December 2021 and January 2022 or were hospitalized in the service. Patients included in the study were evaluated in terms of clinical–demographic information and COVID-19-related characteristics using a sociodemographic data form we developed, and then the NRS-2002 questionnaire was administered. Results: Our study included 324 patients. Overall, 49.07% (159 patients) of the patients were male, and 50.93% (165 patients) were female. A total of 20.37% of our patients (66 patients) had COVID-19 disease. While those living with their families constituted 96.91% of the patients, at least one of the family members of 36.42% of the patients had COVID-19 disease. While 76.23% (247 patients) of the patients were vaccinated, 23.77% (77 patients) were not vaccinated. When NRS analyses were examined according to the type of malignancy, a statistically significant difference was found between NRS analyses according to the type of diagnosis. When NRS analyses were examined according to the stages of the diseases, it was determined that stage 4 patients were in the risk group in terms of nutrition. When NRS analyses according to age were examined, it was determined that patients over the age of 65 were in the risk group in terms of nutrition. When NRS analyses by gender were examined, it was found that male patients were in the risk group in terms of nutrition. When the NRS analyses were examined according to whether or not radiotherapy was administered, it was determined that the patients who received radiotherapy were in the risk group in terms of nutrition. Contrary to the literature, no statistically significant difference was found according to whether or not chemotherapy was administered. Conclusions: According to NRS analysis, no statistically significant differences were found in terms of nutritional status according to COVID-19 transmission and vaccination status. When NRS analyses were examined according to the delay of treatment during the pandemic period, it was found that patients who postponed treatment were in the risk group in terms of nutrition, while patients who did not postpone treatment were mostly in the follow-up group. In multivariable analyses, however, no independent relationship was identified between this parameter and NRS-2002 risk. Full article

Breast cancer constitutes one of the oncological diagnoses with the greatest impact on women’s lives, with consequences that extend beyond active treatment into a survivorship period marked by profound transformations in identity, relationships, and well-being. This study aimed to explore the impacts that breast cancer produces on the everyday lives of survivor women in the municipality of Villarrica, La Araucanía Region. A qualitative methodology with a phenomenological orientation was employed, based on discourse analysis of three focus groups with 20 female breast cancer survivors between 35 and 70 years old. The analysis identified five categories: impact on everyday life and work, management of uncertainty and fear, transformation of self-care and life priorities, support networks and community, and barriers to accessing the healthcare system. The findings demonstrate the coexistence of posttraumatic growth and persistent psychological distress, together with structural inequities that limit access to comprehensive care during the survivorship period. It is concluded that cancer survivorship demands public policy responses that are continuous, multilevel, and integrative of a gender perspective, articulating individual, family, and community interventions from primary healthcare. Full article

Triple-negative breast cancer (TNBC) is associated with recurrence, metastasis, and limited durable responses to immunotherapy, in part due to persistence of breast cancer stem cells (BCSCs). We investigated whether CD6-directed immunotherapy with the monoclonal antibody UMCD6 enhances immune-mediated killing and alters function of BCSC in stem cell-enriched TNBC models. The SUM-149 and SUM-159 cell lines were analyzed for CD6 ligand expression, cocultured with human peripheral blood mononuclear cells (PBMCs) treated with UMCD6, pembrolizumab, or isotype control, and assessed by live-cell cytotoxicity imaging, flow cytometry, soft agar colony formation, and extreme limiting dilution sphere assays. Both TNBC lines co-expressed the CD6 ligands CD44, CD166/ALCAM, and CD318/CDCP1. UMCD6 significantly increased PBMC-mediated apoptosis and reduced tumor cell survival in both models, with greater activity than pembrolizumab under these in vitro conditions. In surviving SUM-159 cells, UMCD6 reduced the ALDH⁺ population without significantly altering CD44⁺CD24⁻ frequency, indicating preferential effects on a distinct stem-like compartment. Functionally, UMCD6 decreased anchorage-independent colony formation and reduced sphere-forming frequency from 1/33.6 to 1/68.3 cells (P = 0.0186). These findings identify the CD6 ligand axis as a therapeutic vulnerability in BCSC-enriched TNBC and support further preclinical evaluation of CD6-directed immunotherapy as a strategy to enhance antitumor immunity while limiting tumor-initiating capacity. Full article

Background/Objectives: Despite recommendations to exercise, many individuals living with and beyond cancer do not achieve or sustain recommended physical activity levels because access to structured exercise support remains limited. We evaluated the real-world delivery of a scalable, community-based exercise model designed to address this gap. Methods: We conducted a hybrid effectiveness–implementation study of a 12-week supervised exercise intervention delivered in community settings across Alberta, Canada (in person or virtual). The primary outcome was the proportion of participants meeting physical activity guidelines at one year. Secondary outcomes included physical fitness and patient-reported outcomes. Results: Among 2570 participants, completion (90.6%) and attendance (77.1%) were high. At one year, the proportion meeting physical activity guidelines increased from 24.1% to 38.9% (p < 0.001), exceeding the prespecified target. At 12 weeks, participants demonstrated clinically meaningful gains in physical fitness, including sit-to-stand performance (+2.8 repetitions; 95% CI, 2.6, 3.9) and six-minute walk distance (+39.9 m; 95% CI, 36.9, 42.8), along with improvements in patient-reported outcomes. Improvements in fatigue and quality of life were smaller among participants receiving chemotherapy. Adverse events were rare (0.5%), with all serious events occurring among participants receiving active cancer treatment. Conclusions: This study demonstrates that structured supervision and behavioural support can be delivered through scalable, community-based models integrated with cancer care and may help patients achieve and sustain recommended physical activity levels. These findings support the translation of established exercise evidence into real-world models of care while highlighting the need for additional strategies to support long-term behaviour change. Full article

Guidelines in early breast cancer place adjuvant chemotherapy before radiotherapy, permit radiotherapy concurrently with endocrine and anti-HER2 agents, but discourage it before or during cytotoxic chemotherapy. This narrative review asks whether that convention remains defensible. Its historical basis, a single randomised trial whose distant-metastasis signal did not survive long-term follow-up, is weaker than is commonly assumed. Its contemporary basis is stronger and is stated here explicitly: an asymmetry of absolute benefit, in which a two-point gain in locoregional control yields roughly half a percentage point of mortality benefit once the EBCTCG four-to-one relationship is applied, whereas degradation of systemic therapy reaches mortality undiscounted. We specify three conditions under which a sequencing change could be justified and note that the absolute loss from a short chemotherapy delay cannot presently be quantified from randomised data. Meanwhile, chemotherapy has lengthened while radiotherapy has contracted to a one- to three-week whole-breast schedule, potentially extended when a sequential tumour-bed boost is required. The retrospective evidence is limited: one cohort offers a hypothesis-generating locoregional signal qualified by an unexpectedly high control-arm event rate and an unplanned subgroup analysis, while another supports only short-term feasibility and tolerability; neither demonstrates benefit in distant control or survival. We further argue that the population in which the question remains clinically live is narrow and probably contracting, since genomic de-escalation withdraws from chemotherapy the phenotypes with the most favourable arithmetic. Adjuvant sequencing is best regarded as an open, testable question within a defined population rather than a general case for change. Full article

Background/Objectives: Patient education (PE) is a key component in the management of chronic conditions, including living with an entero-urostomy. Exploring patients’ and caregivers’ experiences may inform the development of tailored educational interventions. This study aimed to explore the perceptions, experiences, and needs of adult oncology patients with entero-urostomies and their caregivers as part of the patient education process. Methods: A descriptive qualitative study was conducted at a single Italian cancer centre using two focus group sessions integrated with PE activities. Discussions were audio-recorded and analysed through thematic analysis following the framework described by Dawadi. NVivo was used to support data management and facilitate the assessment of data saturation. Results: A total of 28 participants (15 patients and 13 caregivers) were recruited. Three main themes emerged: translational patient education as a co-constructed educational process, time as a protective and regulatory resource in everyday stoma management and living with a stoma requires adaptation and meaning-making. The first theme describes a dynamic integration of clinical, peer, and relational knowledge co-constructed by nurses, patients, and caregivers. The second theme referred to the perception of time and care contexts, including telenursing, as protective spaces supporting anticipatory coping and daily life planning. The last theme captured the embodied and psychological adaptation to living with a stoma, characterised by heterogeneous processes of acceptance and meaning-making. Conclusions: PE emerges as a relational and interactive process that supports self-care, emotional adjustment, and quality of life. The concept of translational patient education, as part of the patient education process, offers a novel framework for integrating multiple forms of knowledge within educational practices, strengthening the person-centred nature of PE programmes. These findings support the development of tailored, person-centred PE interventions that incorporate the dynamic educational ecosystem involving patients, caregivers, and stoma care nurses. They also highlight the need for further research to validate this conceptual model across diverse settings and populations. Full article

Background/Objectives: Psilocybin-assisted therapy has progressed from early proof-of-concept work to a substantially expanded evidence base, with four pivotal studies published in 2025–2026 that were not incorporated into earlier reviews. This review synthesizes the pharmacological and neurobiological foundations of psilocybin and appraises clinical evidence across major depressive disorder (MDD), treatment-resistant depression (TRD), post-traumatic stress disorder (PTSD), cancer-related distress, and substance use disorders, emphasizing long-term durability, expanding indications, and methodological limitations. Methods: A narrative review was conducted using a targeted search of PubMed/MEDLINE, Embase, Scopus, and Web of Science (January 2000–April 2026), emphasizing 2025–2026 publications. Predefined eligibility principles prioritized randomized controlled trials, long-term follow-up studies, and systematic reviews; formal PRISMA procedures were not applied, consistent with the narrative design. Results: Four 2025–2026 studies extend the evidence base: a 52-week follow-up confirming dose-dependent maintenance of antidepressant benefit after a single 25 mg psilocybin session; the first pilot study in Veterans with severe TRD, reporting a 60% response rate at three weeks; the first safety trial in PTSD, where symptom improvement tracked self-transcendent experience intensity but worsened with session anxiety; and a living review of 15 randomized trials confirming a meaningful antidepressant effect while identifying functional unblinding as a substantial threat to effect estimates. Conclusions: Evidence supports psilocybin-assisted therapy as mechanistically distinct and clinically promising, most strongly in MDD and TRD, with preliminary support in PTSD and Veterans. Functional unblinding, small open-label designs, narrow safety populations, and absent SSRI-integration protocols constrain the current conclusions. Full article

The management of oligometastatic disease has undergone a significant paradigm shift over the past two decades. Once considered uniformly incurable, selected patients with metastatic disease can now achieve prolonged progression-free survival, durable disease control, and, in carefully selected cases, long-term remission or cure through metastasis-directed therapies. Advances in stereotactic ablative radiotherapy (SABR), surgery, systemic therapies, and the emerging concept of Curative Oligometastatic Radiotherapy (CORT) have challenged the traditional distinction between curative and palliative treatment. Concurrent developments in imaging, including PET/CT, prostate-specific membrane antigen (PSMA) PET, whole-body MRI, and MR-guided adaptive radiotherapy (MR-linac), together with evolving biomarker research, are improving disease characterisation, refining patient selection, and treatment personalisation. As survival improves, an increasing number of patients are living with durably controlled metastatic cancer and experience long-term physical, psychological, cognitive, functional, and financial consequences of treatment. Despite these challenges, evidence-based survivorship pathways for patients with oligometastatic disease remain poorly defined. Supportive oncology is becoming an essential component of modern radiation oncology rather than an adjunct to cancer treatment. This emerging discipline focuses on optimising symptom control, minimising toxicity, and delivering structured survivorship care. Rather than being limited to end-of-life care, supportive oncology is embedded throughout the patient journey; from diagnosis and treatment selection to prehabilitation, rehabilitation, patient-reported outcome (PRO) monitoring, surveillance for late effects, multidisciplinary follow-up, and long-term survivorship. This review discusses how advances in precision radiotherapy, molecular imaging, biomarkers, and emerging treatment technologies are reshaping the management of oligometastatic disease while simultaneously creating a growing population of long-term survivors with increasingly complex supportive care needs. It highlights the expanding role of supportive oncology in the care of patients with oligometastatic disease, encompassing multidisciplinary symptom management and argues that improvements in disease control must now be matched by the development of evidence-based multidisciplinary survivorship pathways that integrate supportive oncology to optimise quality of life (QoL), functional independence, and patient-centred outcomes. Finally, this review highlights current evidence gaps and proposes future research priorities for developing evidence-based survivorship models for this rapidly expanding patient population. Full article

Chronic non-cancer pain (CNCP) is a complex and highly prevalent condition among older adults that contributes to suffering and disability. It is frequently underestimated and normalized as part of aging. This scoping review aimed to identify and describe the consequences of CNCP on the daily lives of older adults. A scoping review was conducted following the Arksey and O’Malley framework and the PRISMA-ScR reporting guidelines. Searches were performed in five databases (CINAHL, Scopus, Web of Science, Embase, and PubMed) and in grey literature between January and February 2026. The protocol was registered in the Open Science Framework (OSF). The level of evidence was appraised using the Center for Evidence-Based Medicine criteria. Forty-four articles were included that met the established inclusion criteria. CNCP exerted a multidimensional negative impact. Physically, it was associated with increased frailty, higher risk of falls, and disability in activities of daily living. Psychologically, it correlated with anxiety, depression, and sleep disturbances. Socially, it contributed to isolation and created financial barriers that limited access to health services. CNCP represents a critical barrier to older adults’ wellbeing. Nursing should prioritize early detection and avoid the normalization of pain in clinical practice. Knowledge gaps remain regarding gender perspectives and mental health outcomes. Full article

Background/Objectives: People living with HIV (PLWH) are at substantially increased risk of anal high-grade squamous intraepithelial lesions (HSIL), a recognized precursor of anal cancer. Although the ANCHOR trial demonstrated that treatment reduces progression to invasive disease, important uncertainties remain regarding durability of response, recurrence patterns, and treatment-related toxicity across available therapeutic strategies. Methods: We conducted a systematic review of studies evaluating treatment outcomes for anal HSIL published between 2000 and 2026. PubMed, Embase, and the Cochrane Library were searched according to PRISMA guidelines, with a particular focus on studies involving PLWH. Results: A total of 45 studies comprising 6093 patients, including five randomized controlled trials, met the inclusion criteria. Definitions of treatment response, recurrence, and adverse events varied considerably across studies, together with differences in assessment methods and follow-up, limiting direct comparisons between treatment modalities. Ablative, topical, and surgical approaches achieved variable short-term clearance; however, no modality demonstrated consistent durable disease control. Recurrence rates were high, frequently exceeding 50% in PLWH, consistent with the chronic and relapsing nature of HPV-driven disease in this population. Serious adverse events were uncommon, although treatment-related morbidity was frequent and varied across modalities. Conclusions: Randomized evidence supports treatment of biopsy-confirmed anal HSIL in PLWH for prevention of squamous cell carcinoma of the anus. However, comparative evidence remains limited by few randomized trials, heterogeneous study designs, and inconsistent outcome reporting. High recurrence rates and limited durability of response support the need for improved therapeutic strategies, biomarker-driven risk stratification, and longitudinal management approaches. Full article

Introduction. Mortality rates from malignant neoplasms can be considered a key marker of adverse environmental impacts. The aim of this study was to assess the association between exposure to ionizing radiation and the risk of mortality from malignant neoplasms among the population of Kazakhstan living in areas adjacent to the Semipalatinsk Nuclear Test Site (SNTS). Materials and Methods. The main source of data used in this study was the mortality sub-register of the population living in territories adjacent to the Semipalatinsk Nuclear Test Site (SNTS). The main study group included residents of the Abay District (n = 1300) and Beskaragay District (n = 414). In total, 478 residents of the Kokpekty District, where the radiation dose was minimal, were included in the control group. The median effective radiation dose was 864 mSv for the population of the exposed group, whereas in the control group, it was 67 mSv. Results. The highest RR values were observed in the periods 1965–1969 (RR = 6.14; 95% CI: 4.04–9.34) and 1970–1974 (RR = 6.14; 95% CI: 4.19–8.99). Age-standardized mortality rates (ASMR) in the study group were significantly higher than those in the control group. A dose–response relationship was established: with each 10.0 mSv increase in radiation dose, the risk of cancer mortality increased by 0.9% (OR = 1.009; 95% CI: 1.008–1.010; p < 0.001). Conclusions. The obtained results indicate a significant association between long-term exposure to ionizing radiation due to testing at the Semipalatinsk Nuclear Test Site and increased cancer mortality among the population of adjacent territories. Full article

Triple-negative breast cancer (TNBC) remains a highly aggressive malignancy with limited therapeutic options and frequent resistance to platinum-based chemotherapy. Rosmarinic acid (RA), a naturally occurring polyphenol, has attracted considerable interest as a potential chemosensitising agent. This study investigated the anticancer activity and the underlying mechanisms of RA combined with cisplatin (CDDP) in 4T1 breast cancer cells while assessing the cytotoxic responses of non-cancerous HaCaT keratinocytes as a preliminary indicator of differential treatment sensitivity. Cytotoxicity was assessed using the MTT assay, followed by calculation of the Combination Index (CI), Drug Reduction Index (DRI), and Selectivity Index (SI). The generation of intracellular reactive oxygen species (ROS) was evaluated by DCFH-DA fluorescence imaging, and the functional contribution of oxidative stress was examined using N-acetyl-L-cysteine (NAC) rescue experiments. Apoptosis was analysed by Annexin V/PI flow cytometry, NucBlue nuclear staining, and Calcein-AM/propidium iodide (PI) Live/Dead fluorescence imaging. Three-dimensional (3D) tumour spheroids were used to assess treatment-induced alterations in spheroid morphology, morphometric parameters, viability based on adenosine triphosphate (ATP), and Live/Dead staining. The expression of genes related to apoptosis was determined by RT-qPCR, and potential molecular mechanisms were explored using the construction of protein–protein interaction (PPI) networks together with Gene Ontology (GO) and Kyoto Encyclopaedia of Genes and Genomes (KEGG) pathway enrichment analyses. The combination of RA + CDDP exhibited strong synergistic cytotoxicity in 4T1 cells while demonstrating comparatively lower toxicity toward HaCaT keratinocytes. Combination treatment markedly increased intracellular ROS generation, whereas NAC significantly reduced ROS accumulation and partially restored cell viability, indicating that oxidative stress is a major but not exclusive mediator of cytotoxicity. Combined treatment significantly enhanced apoptotic cell death, increased chromatin condensation and membrane damage, upregulated the expression of Bax, Casp9, Cycs, and Trp53, and downregulated Bcl2, consistent with transcriptional regulation of intrinsic apoptotic signalling. In 3D tumour spheroids, the combination markedly reduced spheroid size, disrupted structural integrity, decreased ATP-based viability, and substantially increased tumour cell death compared to monotherapy. Bioinformatic analyses identified central genes related to apoptosis and cell survival and predicted significant enrichment of PI3K/Akt, p53, MAPK, and apoptosis signalling pathways. RA significantly potentiates the antitumor efficacy of CDDP through synergistic induction of ROS-associated apoptotic signalling while showing a more favourable cytotoxic response in 4T1 breast cancer cells than in non-cancerous HaCaT keratinocytes. The integrated findings from two-dimensional (2D) and 3D models, NAC rescue experiments, molecular analyses, and bioinformatics collectively support the potential of RA as a promising chemosensitising adjuvant for CDDP-based breast cancer therapy and warrant further validation in preclinical in vivo models. Full article

Cyclic adenosine monophosphate and cyclic guanosine monophosphate are key regulators of cellular physiology and tissue homeostasis. Conventional experimental models have provided fundamental insights into cyclic nucleotide pathways; however, they often fail to fully recapitulate essential features of in vivo systems. Two-dimensional cell cultures lack spatial organization, while animal models incompletely capture cell–cell interactions and the dynamic microenvironment shaping signaling processes. In recent years, advanced three-dimensional and microengineered systems have emerged as tools to bridge this gap. In this review, we discuss how three-dimensional and organ-on-chip systems are transforming the study of cyclic nucleotide signaling by enabling reconstruction of tissue architecture and signaling niches. Spheroids and organoids provide robust models to investigate compartmentalized signaling and intercellular communication. Complementarily, microfluidic organ-on-chip devices introduce controlled mechanical cues, perfusion, and tissue interfaces, enabling real-time monitoring of signaling dynamics. We highlight recent advances in microphysiological systems for investigating the spatial and temporal dynamics of cyclic adenosine monophosphate and cyclic guanosine monophosphate signaling, including biosensors, live-cell imaging, and genome editing. We further discuss applications in physiological and pathological contexts, including metabolic, cardiovascular and cancer diseases, and outline current challenges and future perspectives for integrating three-dimensional and organ-on-chip technologies. Full article

Breast cancer is the most common cancer in women, causing more than 600,000 deaths every year. The human microbiome is increasingly recognized as a key regulator of cancer initiation, progression, and therapeutic response. Postbiotics—defined as non-viable microbial cells and/or their structural components and metabolites that confer health benefits—are emerging as promising and safer alternatives to live probiotics in oncology. This review provides a comprehensive mechanistic overview of the potential role of postbiotics against cancer, with a specific focus on breast cancer. Preclinical evidence demonstrates that selected postbiotics exert dose- and time-dependent anticancer effects against multiple breast cancer subtypes by modulating key oncogenic pathways (such as PI3K/AKT and NF-κB) and inducing epigenetic regulation through histone deacetylase inhibition. Beyond direct effects on tumor cell proliferation and apoptosis, postbiotics influence the breast cancer microenvironment by reshaping cytokine networks, suppressing pro-metastatic inflammation, and enhancing antitumor immune responses through the activation of NK cells and T cells. We also provide emerging links between microbiome composition, estrobolome activity, and breast cancer subtype-specific biology. Despite these encouraging findings, the clinical translation of postbiotics in oncology remains limited. Currently, only one registered clinical trial investigates postbiotics in the oncology setting (melanoma), and no clinical trials have specifically evaluated postbiotics in breast cancer patients. This highlights a substantial translational gap between preclinical evidence and clinical application. Accordingly, well-designed, tumor-specific clinical trials are urgently needed to validate the safety, efficacy, and therapeutic potential of postbiotics as novel strategies in personalized breast cancer management. Full article

Residential radon is an invisible radioactive gas produced during the uranium-238 decay series and is an established cause of lung cancer. In Canada, recent national surveillance suggests that about one in five residential buildings may exceed the national radon guidelines, yet household testing remains uncommon. This narrative clinical review translates international and Canadian evidence into practical primary-care and hospital-to-community actions. Evidence was prioritized from carcinogen classifications, World Health Organization guidance, pooled residential case–control analyses, Canadian surveillance and guidance, and the peer-reviewed literature on mechanisms, histology, and risk communication. Radon-222 can enter buildings from soil gas; its short-lived progeny deposits in the respiratory tract and emits high-linear-energy-transfer alpha particles that can damage bronchial epithelial DNA. Because elevated levels cannot be reliably predicted from symptoms, smoking status, house age, or community maps, clinicians should use a simple workflow: ask about prior testing and lower-level occupancy; test with a long-term, approved device in the lowest occupied level; act by interpreting the result, advising mitigation, and directing patients to certified radon professionals when needed; document the exposure assessment, result, advice, referral, and retesting plan; and follow up after mitigation or major building changes. This review clarifies Canadian residential and workplace guidance, contrasts global reference-level approaches, and distinguishes radon prevention from lung cancer screening. No individual patient information or human-subject data are reported. Full article