Introduction: Coexisting chronic obstructive pulmonary disease (COPD) may exacerbate respiratory symptoms and impair functional status in patients with advanced non–small cell lung cancer (NSCLC). However, comparative real-world data evaluating health-related quality of life (HRQOL) across systemic treatment modalities in this comorbid population remain limited. To evaluate HRQOL among patients with advanced NSCLC and COPD receiving systemic therapy in routine clinical practice and to compare outcomes across chemotherapy, pembrolizumab, and atezolizumab groups. Materials and Methods: This multicenter real-world cross-sectional study was conducted at two oncology centers in Iraq. Patients with stage IV NSCLC and documented COPD who completed six cycles of systemic therapy were included. HRQOL was assessed using the EORTC QLQ-LC13 questionnaire after treatment completion. Pulmonary function (FEV1%) was measured post-treatment at the same time point. Statistical analyses included ANOVA with Bonferroni correction, effect size estimation (η²), multivariable linear regression adjusting for age, sex, FEV1%, smoking status, and PD-L1 expression. Results: A total of 120 patients were analyzed. Significant differences in HRQOL symptom scores were observed across treatment groups, with chemotherapy generally associated with higher symptom burden. Effect size analysis demonstrated large to very large differences across most domains. In multivariable analysis, pembrolizumab remained associated with lower symptom scores across most domains, while atezolizumab showed variable associations after adjustment. No statistically significant differences in post-treatment FEV1% were observed between groups (p = 0.094), despite numerically higher values in the immunotherapy groups. Hepatic parameters showed some differences between groups but without consistent clinical patterns. Conclusions: In this cross-sectional real-world study, treatment modality was associated with differences in HRQOL outcomes among patients with advanced NSCLC and COPD. These findings should be interpreted with caution due to the cross-sectional design, potential selection bias related to inclusion of patients completing six treatment cycles, and the absence of baseline HRQOL assessment.
Introduction: support. Late presentation, fragmented referral pathways, high out-of-pocket costs, and limited psychosocial support mark cancer care in Cameroon. Earlier research at Mbingo Baptist Hospital (MBH) highlighted major gaps in care. In response, a hospital-based patient navigation programme was introduced in 2024 to improve communication, follow-up, and patient-centred support across the cancer care continuum. To explore how the introduction of a patient navigation programme has influenced patients’ experiences of cancer care at MBH. Setting: The study was conducted at Mbingo Baptist Hospital, a major referral centre for oncology care in the North-West Region of Cameroon. Materials and Methods: A qualitative descriptive design was employed. Semi-structured interviews were conducted with nine adult cancer patients between August and September 2025, approximately one year after programme implementation. Interviews were guided by the biopsychosocial model, conducted in English, Pidgin English, or French, transcribed verbatim, and analysed thematically using inductive and deductive coding. Results: Participants reported improved care coordination, clearer communication, enhanced follow-up, and stronger psychosocial support following the introduction of patient navigation. The patient navigator facilitated appointment scheduling, interdepartmental communication, and emotional reassurance. Nevertheless, persistent challenges remained, including diagnostic delays, high treatment costs, limited insurance coverage, and travel burdens. Patients’ experiences were further shaped by social support, spiritual coping, conflict-related displacement, and cultural beliefs about cancer. Conclusion: Patient navigation strengthened relational continuity, trust, and patient engagement in cancer care at MBH but did not fully overcome structural and financial barriers. The study provides context-specific evidence to inform the integration and scaling of navigation programmes within broader health-system strengthening efforts in low-resource oncology settings.
Introduction: Conventional Breast-Conserving Surgery (BCS) is the standard management for early-stage breast tumors; however, cosmetic deformity and patient dissatisfaction may occur, particularly with larger tumors or unfavorable locations. This study aimed to compare therapeutic mammoplasty with conventional BCS regarding aesthetic outcome, patient and surgeon satisfaction, and postoperative complications. Materials and Methods: This phase II comparative study included 60 female patients with early-stage breast cancer (stage I–II) treated between October 2023 and January 2026 at Suez University and Minia Oncology Center. Patients were enrolled into two groups. Group A included 30 patients who had therapeutic mammoplasty, while Group B included 30 patients who had conventional BCS. Results: There were no statistically significant differences between the two groups regarding local recurrence and distant metastasis (P>0.05). Therapeutic mammoplasty was associated with significantly longer hospital stay and delayed initiation of adjuvant therapy (P < 0.001). However, aesthetic outcomes were significantly better in the therapeutic mammoplasty group, with 73.3% achieving good cosmetic results compared to 33.3% in the conventional BCS group (P=0.002). Additionally, the re-excision rate was significantly lower in the therapeutic mammoplasty group (P = 0.023). Moreover, patient and surgeon satisfaction were significantly higher following therapeutic mammoplasty. Furthermore, overall complication rates were significantly lower in the therapeutic mammoplasty group (P=0.004), with postoperative infection occurring more frequently after conventional BCS. Conclusion: Therapeutic mammoplasty provides superior cosmetic outcomes, higher patient and surgeon satisfaction, and fewer overall complications than conventional BCS, supporting its use in selected cases with early-stage breast cancer.
Introduction: Breast cancer (BC) is a diverse disease characterized by the uncontrolled growth of mammary cells, resulting in tumors with invasive and metastatic capabilities. The advancement of this disease is affected by intricate signaling networks, as Oncostatin (OSM) is a pleiotropic cytokine that regulates inflammation, proliferation, and differentiation. This study aimed to evaluate serum Oncostatin M (OSM) levels in Iraqi women with breast cancer and investigate its correlation with insulin resistance (IR) and disease progression across different clinical stages. Furthermore, the study explores the potential of the OSM pathway as a future therapeutic target. Materials and Methods: In a case-control design, 90 newly diagnosed triple-negative BC patients (Stages I–IV) were compared with 90 age-matched healthy controls. Serum OSM and insulin were measured using ELISA, while fasting serum glucose (FSG) and liver enzymes (ALT, AST, ALP) were determined spectrophotometrically. Metabolic indices, including HOMA-IR, HOMA-β, and HOMA-S%, were calculated. Results: Serum Oncostatin M (OSM) levels were significantly elevated in BC patients (120.46 ±pm 18.97 pg/ mL) compared to healthy controls (70.16 ±12.50 pg/mL; P < 0.001). A stepwise progressive increase in OSM was observed alongside advancing tumor stages (I–IV). BC patients exhibited marked metabolic and hepatic disruption, evidenced by significantly higher FSG, insulin, HOMA-IR, and liver enzymes, with a concomitant decrease in HOMA-S% (P < 0.001). Strong positive correlations were found between OSM and both HOMA-IR (r = 0.733) and insulin (r = 0.721). ROC analysis demonstrated excellent performance for OSM (AUC = 0.927), with 89.7% sensitivity and 84.3% specificity at an exploratory cut-off of 99.46 pg/mL. Conclusion: Serum Oncostatin M (OSM) serves as a significant marker of progression in Iraqi women with breast cancer, correlating strongly with insulin resistance. Our findings highlight OSM as a key indicator of the metabolic-inflammatory axis; Further longitudinal studies are warranted to validate its potential as a therapeutic target.
Introduction: To evaluate baseline hematological characteristics and stage-wise variation of platelet-based inflammatory indices, platelet lymphocyte ratio (PLR), platelet neutrophil ratio (PNR), and platelet eosinophil ratio (PER) in patients with head and neck squamous cell carcinoma (HNSCC), and to examine their association with disease stage. Materials and Methods: This retrospective observational study included 831 treatment-naïve HNSCC patients treated between January 2022 and December 2025. Hematological parameters were obtained from baseline complete blood counts, and PLR, PNR, and PER were calculated. As data were non-normally distributed (Shapiro–Wilk test, p < 0.001), results are reported as median (interquartile range), and comparisons across stages were performed using the Kruskal–Wallis test with Dunn’s post hoc analysis. Multivariable logistic regression was used to assess independent associations adjusting for age, gender, tobacco use, and tumor site. Results: Inflammatory indices demonstrated right-skewed distributions, with median PLR, PNR, and PER of 162.3, 48.7, and 1078.4, respectively. All indices showed significant stage-wise increases (p < 0.001). ROC analysis revealed that PLR had the highest discriminative ability for advanced disease (AUC: 0.741; 95% CI 0.701-0.781), followed by PER (AUC: 0.651; 95% CI 0.613-0.699) and PNR (AUC: 0.635; 95% CI 0.585- 0.686). On univariate analysis, PLR, PNR, PER, tobacco use, and tumor site were significantly associated with stage. However, on multivariable regression, only PLR (adjusted OR: 1.013, p < 0.001) and tumor site remained independently associated with advanced-stage disease. Conclusion: Platelet-based inflammatory indices demonstrate significant associations with disease stage in HNSCC. These findings likely reflect underlying systemic inflammatory changes associated with tumor burden; however, their prognostic or predictive utility requires validation in prospective studies with survival outcomes.
