Background: Adherence to radiotherapy is an essential factor in treatment success among patients with breast cancer. However, physical and psychological side effects often result in patients discontinuing therapy before completion. Social support and resilience are also considered to play important roles in maintaining adherence. Objective: This study aimed to develop a radiotherapy adherence model based on physical and psychological side effects, social support, and resilience among patients with breast cancer at a hospital in Banjarmasin, Indonesia. Methods: A quantitative cross-sectional study was conducted in 100 breast cancer patients undergoing radiation therapy, with each group comprising 50 patients. Participants were recruited using consecutive sampling. Study variables, consisting of physical and psychological side effects, social support, resilience, and radiotherapy adherence, were measured using adapted questionnaires based on the RTOG Acute Radiation Morbidity Criteria, EORTC QLQ-C30, MSPSS, and CD-RISC. Data were analyzed using descriptive statistics and PLS-SEM. Results: Physical and psychological side effects were negatively associated with adherence, whereas social support and resilience were positively associated with adherence. Resilience emerged as the strongest factor associated with adherence and acted as the mediator connecting treatment side effects and social support with adherence. Conclusion: Adherence is associated with the interaction of physical and psychological side effects, social support, and resilience. Resilience plays a central protective role in maintaining adherence and mediating the impacts of side effects and social support. The model developed in this study may provide a foundation for designing interventions and oncology care to improve adherence to radiation therapy in breast cancer patients.
Colorectal cancer (CRC) is one of the most common malignant neoplasms, characterized by high mortality and ranking among the leading causes of cancer-related deaths. It remains a major focus of gastroenterologists and oncologists. However, modern clinical practice increasingly promotes multidisciplinary teams, improving early diagnosis and treatment outcomes. Despite advances in oncologic diagnostics, cooperation with neurologists remains insufficient, although their role is crucial in detecting and managing post-treatment complications and paraneoplastic neurological syndromes (PNS). The prevalence of PNS is estimated at ~0.01% in the oncologic population, though likely underestimated due to limited neurological evaluation. Neurological symptoms may precede CRC diagnosis, yet their nonspecific nature often leads to misinterpretation and diagnostic delay. This article reviews studies on paraneoplastic neurological syndromes in colorectal cancer, emphasizing the neurologist’s role in oncologic diagnostics. A systematic search was performed in PubMed, Scopus, and Web of Science (2000-2025), covering case reports and clinical studies. The most frequently described PNS include paraneoplastic cerebellar degeneration, stiff-person syndrome, limbic encephalitis, and chronic inflammatory demyelinating polyneuropathy. Proper diagnosis differentiates disease progression from treatment complications. Notably, neurological symptoms may precede tumour detection by months and serve as early warning markers. In diagnosed cases, regular neurological follow-up enables earlier detection of new symptoms and better assessment of recurrence risk. Accurate interpretation of neurological signs requires close interdisciplinary collaboration, particularly with neurologists, who must maintain high diagnostic vigilance for atypical neurological presentations that may indicate an underlying malignancy
Background: Colorectal cancer (CRC) remains a global health problem. It is the most common malignancy of the gastrointestinal tract, with a global incidence of over 1.9 million cases, making it the third most common cause of cancer-related deaths worldwide. The incidence is increasing particularly in low- and middle-income countries and among individuals under 50 years of age, with lifestyle and environmental factors contributing to this trend-many of which affect the gut microbiome. Main body: Advances in CRC treatment have introduced immunotherapy, particularly for tumours with mismatch repair deficiency (dMMR) and high microsatellite instability (MSI-H). This review explores the symbiotic relationship between the gut microbiome and immunotherapy in CRC. The human colon harbours a complex microbiome composed of diverse microbial species and vast genetic diversity, with structural, metabolic, and immunomodulatory functions. Dysbiosis, influenced by factors such as diet and lifestyle, contributes to CRC pathogenesis through inflammation and metabolic disruptions. Immunotherapy, specifically immune checkpoint inhibitors (ICIs), has revolutionized cancer treatment by enhancing T cell-mediated immune responses against cancer cells. In CRC, ICIs have demonstrated efficacy in MSI-H/dMMR tumours that represent less than 15% of all CRC cases. Challenges persist in treating microsatellite stable (MSS) CRC in regard to immunotherapy. Emerging evidence suggests that specific gut microbiota compositions influence the response to ICIs by modulating systemic immune responses and tumour microenvironments, potentially having a key role for MSS CRC patients. Strategies to manipulate the gut microbiome, including probiotics and faecal microbiota transplantation, hold promise in augmenting immunotherapy efficacy. Conclusion: The review underscores the potential of the gut microbiome as a predictive biomarker and therapeutic target in CRC immunotherapy. Ultimately, harnessing the therapeutic potential of the gut microbiome represents a promising avenue for enhancing immunotherapy outcomes and advancing personalized medicine in CRC care.
Paraneoplastic syndromes with ocular manifestations are rare but clinically significant immune-mediated disorders that may precede the diagnosis of malignancy. They arise from immune cross-reactivity between tumor and ocular antigens, leading to retinal or optic nerve damage through autoantibodies, cellular immunity, or soluble mediators. This narrative review summarizes current evidence on immunopathogenesis, clinical presentation, diagnostic approach, and oncologic implications. A literature search of PubMed, Scopus, and Web of Science was conducted for publications from January 2000 to September 10, 2025. Because of heterogeneity in study design and outcomes, the evidence was synthesized qualitatively. Ocular paraneoplastic syndromes most commonly present with subacute bilateral visual dysfunction, including vision loss, photopsias, scotomas, nyctalopia, and dyschromatopsia. Cancer-associated retinopathy is typically linked to antiretinal antibodies and rapid photoreceptor dysfunction, while melanoma-associated retinopathy is associated with metastatic melanoma, TRPM1 antibodies, and an electronegative electroretinogram. Paraneoplastic optic neuropathy, including CRMP5-associated forms, may mimic inflammatory or infectious optic nerve disease and requires careful differential diagnosis. Management relies on prompt detection and treatment of the underlying malignancy together with immunomodulatory therapy tailored to the ocular phenotype. Immune checkpoint inhibitors further complicate diagnosis and management, underscoring the need for multidisciplinary care.
Cancer remains one of the leading causes of death worldwide, and conventional therapies such as chemotherapy and radiotherapy often face major limitations including severe toxicity, non-specific targeting, and drug resistance. These drawbacks have emphasized the need for innovative and targeted treatment strategies in oncology. Immunotherapy has emerged as a breakthrough approach that utilizes the body’s immune system to identify and eliminate cancer cells, offering durable responses and improved patient survival. This review was conducted through an extensive analysis of recent research articles, clinical trial data, and FDA-approved reports published between 2016 and 2025. It provides a comprehensive overview of various immunotherapeutic modalities such as checkpoint inhibitors, CAR-T cell therapy, immune modulators, and combination approaches, while also addressing mechanisms of resistance that limit therapeutic success. Our review concludes that integrating immunotherapy with conventional cancer pharmacology offers enhanced efficacy, reduced toxicity, and paves the way for future personalized and combination-based treatment.
