Purpose Prostate cancer is the most common malignancy in men and often leads to treatment‐related morbidity, including metabolic alterations and chronic low‐grade inflammation. Exercise has been proposed as a supportive strategy to mitigate treatment‐related adverse effects. This study systematically reviews the impact of exercise on metabolic‐, inflammatory‐, hormonal‐ and tumour‐related biomarkers in men with prostate cancer. A meta‐analysis explored potential effects according to exercise type. Methods This systematic review followed PRISMA guidelines and included studies from PubMed, Scopus and Web of Science. Eligible studies involved prostate cancer patients, an exercise intervention and reported outcomes on metabolic, immune or tumour markers. Only randomised controlled trials with a control group were included. Twenty‐five articles fulfilled the inclusion criteria. The methodological quality of the studies was assessed using the Cochrane Collaboration’s tool. Results A total of 1,093 male participants were included across trials involving resistance, aerobic, combined exercise or yoga interventions. The meta‐analysis showed a significant reduction in insulin levels within the combined exercise subgroup ( p = 0.03). C‐reactive protein was also significantly reduced in pooled analyses ( p = 0.001). No consistent significant effects were observed for testosterone, glucose, IL‐6 or prostate‐specific antigen. Conclusions Exercise may induce modest changes in selected systemic biomarkers, particularly CRP, in men with prostate cancer undergoing treatment. However, effects were heterogeneous and generally small, and current evidence does not demonstrate consistent tumour‐related modification. Exercise remains an important supportive strategy to enhance physiological resilience, but larger, high‐quality trials are required to clarify clinical relevance.
Purpose This study aimed to identify and evaluate non‐medical interventions (exercise, psychosocial, diet and nutrition, or a combination thereof) to improve functional outcomes (fatigue, mental wellbeing, sexual function, bowel function and urinary function) in men undergoing prostate cancer radiotherapy. Methods An electronic search of six databases (CINAHL, Embase, Emcare, Medline via Ovid, Scopus and The Cochrane Library) was conducted for studies published in English from 1990 onwards. Randomised controlled trials (RCTs) and quasiexperimental studies regarding non‐medical interventions delivered before, during or after radiotherapy for prostate cancer to improve functional outcomes were included in this review. Two‐stage screening (title/abstract and full text) was conducted against predefined inclusion and exclusion criteria. Data were extracted using a standardised form, and risk of bias was assessed using Joanna Briggs Institute critical appraisal tools. Results Twenty‐five RCTs and seven quasiexperimental studies met the eligibility criteria. Aerobic and resistance exercises showed promising results in improving fatigue, while multidisciplinary rehabilitation showed promise in improving urinary function. However, inconsistent findings prevented definitive conclusions about the effect of exercise on other functional outcomes. Additionally, the impact of psychosocial and dietary interventions on functional outcomes remains inconclusive due to the limited number of studies, small sample sizes, non‐randomised study design and study quality. Conclusion There is a lack of strong evidence supporting the effectiveness of non‐medical interventions in improving functional outcomes after prostate cancer radiotherapy, except for aerobic and resistance exercises for fatigue and multidisciplinary rehabilitation for urinary function. More rigorous RCTs are needed to address this evidence gap. Implications for Cancer Survivors Engaging in aerobic and/or resistance exercise can likely reduce fatigue, and multidisciplinary rehabilitation may improve urinary function in prostate cancer patients who receive radiotherapy.
Background Lung cancer is the leading cause of cancer mortality worldwide. The role of pulmonary rehabilitation (PR) in patients with inoperable advanced lung cancer remains less defined due to disease severity and poor prognosis. This scoping review aims to map the characteristics, implementation methods, outcome metrics, and effectiveness of PR in this specific population. Methods A systematic literature search was conducted across PubMed, Web of Science, CINAHL, Embase, Cochrane, and OpenGrey databases up to October 2025, following JBI guidelines and the PRISMA‐ScR checklist. Randomized controlled trials and nonrandomized intervention studies focusing on PR for patients with advanced lung cancer were included. The literature was screened and selected according to the PICOS framework, after which data were extracted and organized from the included studies and finally integrated using a narrative synthesis approach. Results Thirty‐two studies involving 1979 patients were included. Interventions were predominantly hospital‐based, and core components included aerobic and resistance training. The intervention period ranged from 2 to 12 weeks, with the intensity primarily being moderate to high. Significant improvements were consistently reported in exercise capacity, muscle strength, and symptom burden. However, evidence regarding lung function and health‐related quality of life remained heterogeneous. Completion rates varied from 44% to 100%, with disease progression being a primary barrier to adherence. None of the studies reported any serious adverse events. Conclusions PR is a safe and feasible intervention for patients with advanced lung cancer, offering clear benefits in terms of physical function and symptom management. However, maintaining high adherence remains a challenge. Future research should further explore home‐based intervention models assisted by digital rehabilitation technologies and actively promote the integration of PR into multidisciplinary palliative care pathways.
Background Lung cancer is the leading cause of cancer‐related mortality worldwide, with high incidence and low survival rate. Over the past decades, innovative treatment modalities like targeted drug therapy and immunotherapy have emerged, offering potential improvements in safety and effectiveness. Immunotherapy allows for a sustained therapeutic response by enhancing the immune response of the body to cancer cells, providing long‐term survival benefits with a manageable safety profile. However, the experiences of patients receiving immunotherapy and their family caregivers remain insufficiently explored. Objective This study aimed to explore the requirements of healthcare professionals in immunotherapy of lung cancer patients by examining and synthesizing qualitative data about the experiences of lung cancer patients receiving immunotherapy and their family caregivers, focusing on the psychological, information, and support needs to improve the quality of life of patients. Methods Systematic review and qualitative metasynthesis were conducted following the PRISMA guidelines. Searches were performed in PubMed, Embase, CINAHL, Web of Science, Cochrane, and ClinicalTrials.gov. Inclusion criteria were qualitative studies featuring quotes from adult patients or family members about their experiences with immunotherapy for lung cancer. Data extraction and synthesis were conducted using meta‐aggregation. Results Seven articles reporting on five studies were included, comprising 216 participants (96 patients, 70 healthcare professionals, and 50 family members). Four major themes emerged: (1) The quality of life of patients could be significantly influenced by their psychological state. (2) Anxiety and stress are common in patients and consequently cause their uncertainty about the treatment. (3) Although physical side effects may occur, they are generally less severe and have less impact on overall health and daily functioning compared with those associated with chemotherapy. (4) Family caregivers faced substantial stress due to financial burdens and the impact on family relations. Conclusions Patients with lung cancer receiving immunotherapy, along with their families, encounter a variety of challenges, including the management of side effects, psychological and financial stress, and uncertainty regarding treatment outcomes. Healthcare professionals should provide targeted psychological support, education about immunotherapy, and emotional stability. Patient‐centered communication and family involvement are essential for reducing anxiety and enhancing the overall care experience. Future research should focus on strategies that address these psychosocial factors and alleviate financial burdens, particularly in regions with limited health insurance, to optimize care for patients undergoing long‐term immunotherapy and improve treatment adherence.
Background Mucositis is a frequent complication of chemo‐ and/or radiotherapy treatments and causes great pain and discomfort to the affected patient. Ozone therapy is a widely studied treatment in numerous disciplines, first and foremost dermatology; the beneficial effects of this treatment have already been confirmed in this field, particularly in the healing of wounds caused by diabetes. However, there is a shortage of studies on the use of this treatment in the management of radio‐ and/or chemo‐induced mucositis. Objectives This review aims to summarise current evidence on the beneficial effects of ozone treatment in the management of chemo‐ and/or radio‐induced mucositis. Methods A systematic literature review was carried out on the main databases (Scopus, PubMed and WOS); for each of the included article, the analysis of risk of bias was performed. Results Seven articles were included in this systematic review, including six preliminary animal studies and one prospective cohort study. Analysing the variables of the studies, it seems that ozone is associated with a decrease in bacterial load, oedema and inflammatory infiltrate at the level of the lesions and a decrease in thiobarbituric acid reactive substances, indicators of oxidative stress. Conclusions The efficacy of ozone for the management of radio‐ and/or chemo‐induced mucositis is still to be confirmed as current evidence provides only two clinical studies. However, beneficial effects were highlighted and deserve to be further investigated.
Public attitudes significantly influence cancer survivors'successful return to work, yet no validated instrument exists to assess these perceptions. This study aimed to develop and validate the Public Attitudes Questionnaire for Cancer Survivors' Return to Work, providing a practical tool for future research and practice. An initial version of the questionnaire was developed through a literature review and qualitative interviews, then refined using two rounds of Delphi expert consultation with 15 experts and a pilot study with 28 participants. The structure, validity, and reliability of the questionnaire were examined using exploratory factor analysis with 302 participants and confirmatory factor analysis with 305 participants. The final questionnaire comprised six dimensions and 25 items. Exploratory factor analysis yielded a total cumulative variance contribution of 69.649%. Confirmatory factor analysis showed a standardized fit index of 0.903 and a comparative fit index of 0.954. The Cronbach's alpha coefficient for the total questionnaire was 0.888, the split-half reliability coefficient was 0.716, and the test-retest reliability coefficient was 0.904. The Public Attitudes Questionnaire for Cancer Survivors' Return to Work demonstrates good reliability and validity, making it a valid instrument for assessing public attitudes toward cancer survivors reentering the workforce.
Theory of socio‐emotional selectivity (SST) posits that social goals and emotional priorities shift when individuals perceive their remaining lifetime as limited. While well established in aging, its relevance in severely ill patients is underexplored. This systematic review focuses on Alzheimer’s disease and cancer as conditions marked by a limited time perspective. Thirteen empirical studies were analyzed regarding (1) prioritization of emotionally meaningful relationships, (2) the role of disease progression in intensifying social selectivity, (3) links between social embedding and psychological adaptation, and (4) the role of perceived time horizon. Findings consistently support SST: patients prioritize close emotional bonds, with selectivity increasing as illness advances. Strong emotional networks are associated with greater psychological resilience and reduced distress. These results highlight the clinical value of fostering meaningful social connections in severely ill individuals. Future research should clarify causal mechanisms, particularly the mediating role of time perception, expand to other neurodegenerative conditions, and develop interventions suited to patients with cognitive or physical limitations.
Postoperative pain following breast cancer surgery remains a significant clinical challenge and may negatively affect recovery and quality of life if inadequately managed. In recent years, nonpharmacological nursing interventions have gained increasing attention as adjuncts to pharmacological pain control. This narrative review aimed to summarize the available evidence regarding the short‐term effects of hand massage on postoperative pain among women undergoing breast cancer surgery. A literature search was conducted using PubMed, CINAHL, ScienceDirect, and Google Scholar to identify studies published between July 2024 and June 2025. Clinical and experimental studies evaluating the effect of hand massage on postoperative pain intensity, anxiety, or analgesic use were considered eligible. Due to the limited availability of recent evidence, one earlier highly relevant controlled study was also included to contextualize the current findings. In total, three studies (one randomized controlled trial and two quasi‐experimental studies) met the inclusion criteria. Across the included studies, hand massage was associated with short‐term reductions in pain intensity and anxiety during the early postoperative period. However, considerable heterogeneity was observed in massage protocols, study designs, and outcome measures. Small sample sizes and methodological limitations further restrict the strength and generalizability of the evidence. In conclusion, hand massage may be considered an exploratory supportive adjunctive nursing intervention for postoperative pain management after breast cancer surgery. However, the current evidence base remains limited, heterogeneous, and methodologically constrained, requiring cautious interpretation before any clinical recommendations can be made.
To map existing research on community‐based multidimensional cancer rehabilitation, specifically relating to characteristics of studies, participants, intervention formats, outcomes, and outcome measures. Searches were performed in MEDLINE, Embase, CINAHL, and Web of Science databases in May 2022 and updated in February/March 2024. The review followed the methodological guidance for scoping reviews developed by the Joanna Briggs Institute. We considered evidence from primary research, knowledge syntheses, and research protocols, and imposed no limits on study design. All authors screened independently for eligibility, using a standardized template for data extraction. We used descriptive statistics and presented the results in tables and narrative summaries. The search retrieved 6424 records, of which 104 were selected for full‐text screening. Twelve publications were included in the review, representing nine unique rehabilitation interventions. The included studies comprised 594 participants with a mean age of 59.6 years. The cancer types were mixed with an overrepresentation of breast and prostate cancer. Seven of the publications were feasibility, pilot, protocol, or intervention development studies, and only two were randomized controlled trials. Physical activity/exercise was the most common component within physical functioning, and social support/peer support was most common within psychosocial functioning. Sixty‐five tools were used to measure a range of outcomes, the most frequent being health‐related quality of life. The findings demonstrate that this field of research is in its infancy in Europe. Improving homogeneity in outcomes and outcome measures would enhance comparisons and pooling of results in future research.
This review aims to identify and evaluate the management options for the extranodal NK/T‐cell lymphoma, nasal type of head and neck in the pediatric population. The study was conducted based on a comprehensive literature review from 2009 to 2025. The following keywords were used: extranodal NK/T cell lymphoma and children and head and neck. The clinical data, including sex, age, symptoms, localization at presentation, correlation with EBV infection, treatment, and its outcome, were analyzed. A total of 64 patients were evaluated. Among these cases, the nasal site was the most involved region. Positive results for EBV infection were present in 100% of patients. The mortality rate in this study was 25%. This systematic review highlights a clear male predominance, a pronounced geographic concentration of cases in East Asia, and underscores the diagnostic importance of EBV positivity in the diagnosis of ENKTL. In the case of the chronic course of destructive processes in aerodigestive organs with no improvement after standard treatment, NK‐cell lymphomas should be considered in the differential diagnosis. Multimodal treatment strategies, particularly asparaginase‐based chemotherapy with or without radiotherapy, are associated with improved outcomes, although disease‐related mortality remains substantial. Given the limited number of pediatric cases and the heterogeneity of available data, further prospective, multicenter studies with standardized diagnostic and therapeutic approaches are essential to optimize management and improve long‐term survival.
Middle-aged and elderly survivors with gastrointestinal cancer experience negative emotions such as depression and fear of cancer recurrence. The patient's spouse is the primary caregiver, playing a pivotal role in coping with depression and fear of cancer recurrence among middle-aged and elderly survivors of gastrointestinal cancer. However, the relationships and pathways among fear of cancer recurrence, dyadic coping, and depression in gastrointestinal cancer survivors remain unclear. We conducted a cross-sectional study to investigate the mediating role of dyadic coping in the relationship between negative emotions. From February 2022 to June 2024, 235 middle-aged and elderly gastrointestinal cancer survivors were recruited from a hospital in China. Participants were investigated with a demographic and clinical questionnaire, the Dyadic Coping Inventory, the Fear of Progression Questionnaire-Short Form, and the Depression Subscale of the Hospital Anxiety and Depression Scale. The results showed that fear of cancer recurrence affected depression through dyadic coping. The direct effect was 0.083 (SE = 0.017, 95% confidence interval: 0.050-0.115). The indirect and total effects were 0.028 (SE = 0.008, 95% confidence interval: 0.015-0.045) and 0.111 (SE = 0.015, 95% confidence interval: 0.081-0.141), respectively. The mediating effect of dyadic coping accounted for 25.23% of the relationship in negative emotions. The fear of cancer recurrence affects depression through dyadic coping. Thus, when formulating interventions to alleviate depression in middle-aged and elderly gastrointestinal cancer survivors, the role of dyadic coping should be taken into consideration.
PurposeThe aim of this study is to assess the presence of sarcopenia in multiple myeloma (MM) patients both before and after autologous stem cell transplantation (ASCT) and to investigate if ASCT is a causative factor for sarcopenia. This study is the first to examine the impact of ASCT on sarcopenia in individuals with MM via bioelectrical impedance analysis (BIA), computed tomography (CT), and performance tests simultaneously.Materials and MethodsThe prospective study was conducted from January 2022 to April 2023. The median duration of the follow-up period was 12 months. All of the participants were assessed for sarcopenia by BIA, CT, and performance tests at 1 month (+/- 2 weeks) prior to the conditioning regimen and 6 months (+/- 4 weeks) following the transplant. The EWGSOP 2018 guideline was used for sarcopenia diagnosis.ResultsIn the study, 102 patients who were >= 18 years and diagnosed with MM according to the criteria established by the International Myeloma Working group (IMWG) were enrolled. Pre-ASCT, 47 (46%) patients and post-ASCT, 51 patients (50%) were sarcopenic (p = 0.12). Pre-ASCT, a low skeletal muscle index (SMI) was identified in 51% of the patients, and this percentage increased to 56% after ASCT (p = 0.03). In multivariate analysis, female sex (odds ratio [OR]: 1.25; 95% CI: 1.12-1.38; and p = 0.007), higher Hematopoietic Cell Transplantation-Specific Comorbidity Index (HCT-CI) score (OR: 1.16; 95% CI: 1.04-1.29; and p = 0.008), and lower body mass index (BMI) (OR per unit increase: 0.94; 95% CI: 0.88-0.99; and p = 0.045) were independently associated with sarcopenia.ConclusionsOur study revealed a high prevalence of sarcopenia among individuals with MM. We demonstrated that individuals with comorbidities, a low BMI, and female sex have a higher predisposition to sarcopenia. There was no increase in the occurrence of sarcopenia after ASCT; however, SMI decreased.
Objective: To investigate the prevalence and characteristics of shoulder pathologies in women with breast cancer-related lymphedema (BCRL) using magnetic resonance imaging (MRI), and to compare these findings with those in controls of comparable age distribution presenting with shoulder pain but without malignancy or lymphedema. Methods: In this retrospective case-control study, 45 women with BCRL and 45 controls of comparable age underwent shoulder MRI for unilateral shoulder pain. MRI findings included rotator cuff tendinopathies or tears, joint degeneration, and intra-articular or bursal effusion. Associations between lymphedema-related factors and effusion were examined using univariable and multivariable logistic regression analyses. Inter-reader agreement for effusion detection was also assessed. Results: MRI-detected effusion was significantly more frequent in the BCRL group than in controls (73.3% vs. 15.6%, p < 0.001), while the frequency of normal shoulder findings was notably lower (2.2% vs. 17.7%, p = 0.03). Rotator cuff and biceps pathologies were more common in the BCRL group, but the differences did not reach statistical significance. Within the BCRL group, patients with effusion had a significantly longer mean lymphedema duration in descriptive comparisons (p = 0.007), whereas lymphedema duration was not an independent predictor of effusion in logistic regression analysis. Lymphedema severity showed no significant association with specific MRI abnormalities. Conclusion: Women with BCRL showed a higher prevalence of shoulder joint effusion on MRI than controls, while normal shoulder findings were less frequent. Effusion may represent a correlational imaging marker associated with chronic lymphatic dysfunction rather than a direct causal consequence. These findings support the selective use of imaging in BCRL patients presenting with shoulder complaints and highlight the need for prospective studies incorporating oncologic treatment parameters and functional outcomes.
Background: Marital intimacy plays a significant role in patients' quality of life. However, colorectal cancer (CRC) and ostomy surgery can disrupt this important aspect of life. Despite its significance, there is no specialized tool to assess marital intimacy in this population. Therefore, this study aims to develop and validate the Chinese Marital Intimacy Scale for CRC survivors with an ostomy (CRCO) (Ch-MIS-CRCO). Methods: An observational cross-sectional study was conducted following the instrument development procedures outlined by DeVellis, which include instrument formation and psychometric testing phase. Content validity was evaluated by content validity index (CVI), while construct validity was examined by exploratory factor analysis (EFA) and confirmatory factor analysis (CFA). Convergent validity was assessed using correlations with the Lock and Wallace Marital Adjustment Test, Ostomy Adjustment Scale, and Stoma-QOL. Known-groups validity was evaluated across clinically relevant subgroups. Floor and ceiling effects were examined, and internal consistency reliability was assessed using Cronbach's alpha. Results: The initial 52-item pool was refined through content validity assessment, pilot testing, item analysis, and EFA, resulting in a final 25-item scale across four dimensions, with eigenvalues ranging from 1.62 to 8.83, explaining 63.09% of the total variance. The scale demonstrated excellent model fit (chi 2/df = 1.61; CFI = 0.95; TLI = 0.94; RMSEA = 0.05). Convergent validity was supported by significant correlations with the Lock and Wallace Marital Adjustment Test (r = 0.49), Ostomy Adjustment Scale (r = 0.55), and the Stoma-QOL (r = 0.59). Known-groups validity was confirmed, with higher scores observed among patients without ostomy complications, those with complete self-care ability, and those whose primary caregiver was their spouse (all p < 0.05). No floor or ceiling effects were detected. Internal consistency was high, with Cronbach's alpha of 0.93 for the total scale and 0.85-0.90 for the subscales. Conclusion: The Ch-MIS-CRCO demonstrates strong psychometric properties and can be effectively used to evaluate marital intimacy among CRC survivors with an ostomy, further helping to predict and improve patients' quality of life.
Introduction Breast cancer is the most common cancer in women, and early detection is vital for reducing mortality. Psychological and cultural factors like fear and fatalism can limit screening participation. Objectives This study examined how women's fear and fatalism levels affect their early detection behaviours and the relationships among these variables. Methods A descriptive and cross-sectional design was used. The study was conducted between 1 November 2024 and 25 February 2025, with 433 women registered at Family Health Centres. Data were collected using the 'Personal Information Form', 'Breast Cancer Fear Scale' and 'Breast Cancer Fatalism Scale'. Analyses included descriptive statistics, t-test, ANOVA, post hoc (Tukey, LSD), Pearson correlation and linear regression tests. Results Among the participants, 52.4% performed breast self-examination, 25.4% had a clinical breast examination and 26.2% of women over 40 had a mammogram. Age, education, marital and employment status, having children and willingness to learn about breast cancer significantly affected fatalism (p < 0.05). Employment status, having children and willingness to learn significantly affected fear levels (p < 0.05). Early detection practices were not significantly associated with fear or fatalism scores (p > 0.05). Regression analysis revealed that fatalism (B = 0.308, p = 0.036) and willingness to learn (B = 3.343, p < 0.001) significantly predicted breast cancer fear. Conclusion Enhancing knowledge and health literacy, along with improving access to screening, is essential for increasing screening behaviours. Regression analysis revealed that fatalism significantly predicted breast cancer fear. Increasing fatalistic beliefs may intensify fear responses and potentially contribute to avoidance of early detection behaviours. Therefore, addressing fatalistic perceptions may help reduce fear and promote screening participation. Health professionals should actively guide women, with a focus on those experiencing high fear and fatalism, as reducing these factors can support greater participation in early breast cancer detection. Health professionals should actively guide women, with a focus on those experiencing high fear and fatalism, as reducing these factors can support greater participation in early breast cancer detection.
