Hospices represent the cornerstone of modern palliative services. However, population-level data on hospice utilization and characteristics of patients dying in hospice remain limited to examine national temporal trends in hospice deaths in Italy from 2011 to 2022, with a focus on the underlying causes of death.

We performed a nationwide, population-based retrospective study using official mortality data from the Italian National Institute of Statistics. All deaths registered in Italy between 2011 and 2022 were included. Hospice deaths were identified as those occurring in licensed hospice facilities.

Hospice beds increased from 1,681 in 2011 to 3,419 in 2022, while hospice deaths more than doubled from 19,179 (3.2% of all deaths) to 43,972 (6.2%). The mean age of hospice deaths rose from 74.0 to 76.6 years. Among patients dying in hospice, neoplasms remained the leading cause of death but declined from 87.0% in 2011 to 73.8% in 2022, while cardiovascular deaths increased from 6.2% to 9.5%, neurological from 1.2% to 3.4%, and respiratory from 1.0% to 2.5%. The proportion of national neoplasm deaths occurring in hospice reached approximately 20% in 2022. Similarly, the proportion of non-neoplasm hospice deaths tripled (0.6–2.1%).

Between 2011 and 2022, hospice deaths in Italy more than doubled, reflecting substantial progress in expanding access to palliative care. The gradual increase in non-neoplasm hospice deaths suggests a shift toward greater inclusivity, although neoplasm remains predominant.

This study aimed to investigate the mediating role of perceived stigma in the relationship between cancer-related symptoms and social relationships among cancer patients.

This cross-sectional descriptive study was conducted with 250 cancer patients undergoing chemotherapy in an oncology hospital in Ankara, Türkiye. Data were collected using a sociodemographic form, the Nightingale Symptom Assessment Scale, the Cataldo Lung Cancer Stigma Scale, and the Social Relationship Scale. Descriptive analyses, group comparisons, Pearson correlation, and mediation analysis were performed with SPSS v27.0 and DataTab web-based analysis platform.

The findings revealed significant positive correlations between cancer-related symptoms and perceived stigma (r = 0.51, p < .001), and negative correlations between both cancer-related symptoms and social relationships (r = −0.24, p < .001) and stigma and social relationships (r = −0.54, p < .001). The mediation analysis suggested that perceived stigma may play a mediating role in the relationship between cancer–related symptoms and social relationships, as indicated by a non–significant direct effect and a significant indirect effect. Cancer-related symptoms significantly predicted perceived stigma (B = 0.58, p < .001), and stigma was a significant predictor of decreased social relationship quality (B = −0.72, p < .001). The indirect effect of cancer-related symptoms on social relationships via stigma was statistically significant (B = −0.42, p < .001), while the direct effect was not (B = −0.27, p = .182).

Perceived stigma is a critical psychosocial factor that may mediate the adverse impact of cancer-related symptoms on social relationships in this study. Therefore, addressing stigma may play a crucial role in maintaining social functioning in cancer care.

This study aimed to culturally adapt the Self-Blame Attributions for Cancer Scale (SBAC) into Turkish and evaluate its psychometric properties, including validity and reliability.

This methodological study enrolled 161 patients from both inpatient and outpatient oncology departments of a university hospital during a 1-year observation period (March 2024–March 2025). Participant data were obtained by using 2 instruments: a demographic questionnaire and the adapted Turkish version of “the SBAC.”

Confirmatory factor analysis revealed strong factor loadings ranging from 0.670 to 0.850, indicating good item reliability. Model fit statistics demonstrated excellent psychometric properties (χ2/df = 2.00; root mean square error of approximation = 0.079; Comparative Fit Index = 0.99; standardized root mean square residual = 0.042; Tucker–Lewis Index = 0.98; root mean square residual = 0.042). The scale showed high internal consistency, with a total Cronbach’s α of 0.93 and subscale α coefficients ranging from 0.85 to 0.90. The original 2-factor structure of the SBAC was supported.

The study confirmed the bidimensional structure (11 items) of SBAC’s Turkish version with excellent validity and reliability indices, supporting its cultural and psychometric adequacy for Turkish samples.

This study aimed to analyse respiratory infection rates (RI) in a representative cohort and evaluate if tumour size, pre-existing respiratory co-morbidities, smoking history, and tracheostomy predicted postoperative infection.

A retrospective observational study at a London tertiary head and neck oncology centre reviewed six years of patient data. BMJ Best Practice guidelines for hospital-acquired pneumonia (2022) were applied to medical records alongside postoperative RI prescriptions.

RI occurred in 32% of patients, more often in those with tracheostomy (36%) than intubation (12%). Infected patients were older (p=0.025), had tracheostomy (p=0.045), and underwent bilateral neck dissection (p<0.001). ICU (p=0.008) and hospital LOS (p<0.001) were significantly higher. Age, smoking, respiratory disease, tumour stage, and airway type were not predictors.

RI were more frequent in tracheostomised patients, though assessed risk factors were not predictive. Further research should explore additional contributors and evaluate targeted interventions to reduce incidence.

Adult children caring for a parent with cancer often assume the role of a “surrogate seeker,” looking online for information regarding their parent’s diagnosis, which they may then discuss with their parent’s clinician. The current study aims to apply the previously developed “Stoplight typology” to explore caregivers’ experiences discussing online health information with their parents’ clinicians and factors associated with each response type within the typology.

We conducted an online survey of adult children caring for a parent with a blood cancer about their experiences communicating with their parent and their parent’s clinicians. We used regression analyses to examine the association between physician responses as categorized according to the stoplight typology with 3 caregiver communication measures assessing eHealth literacy, caregiver communication, and physician–caregiver and patient communication. Second, we examined the experiences participants had with clinician communication about online health information.

A total of 121 caregivers completed the survey. Over half reported clinicians giving green light responses, with fewer reporting yellow or red light responses. Lower eHealth literacy significantly predicted greater likelihood of red light responses, whereas higher self-reported communication skills predicted more green light and fewer red light responses; neither communication measure predicted yellow responses. Thirty-two percent did not discuss their most recent online search with clinicians, most commonly because they saw no need. Seventy-four percent had discussed online information with a clinician, and 56% of these encounters were coded as green light responses. Among caregivers who had been told not to search online, 77% continued to do so despite the clinician’s discouragement.

The study findings provide support for the stoplight typology in a caregiver population. Although most clinician responses were engagement responses, results demonstrate that the rejection response is ineffective. Future research could examine caregivers who reported lower eHealth literacy to target for future intervention.

To explore cancer patients’ understanding of Advance Care Planning (ACP) and identify the main barriers hindering its effective implementation in clinical practice.

This qualitative descriptive study included Brazilian women with breast cancer aged 18–75 years, all with preserved functional status, recruited by convenience sampling. Exclusion criteria were difficulty using online calls or significant communication impairment. Data collection involved a sociodemographic questionnaire and a follow-up interview. After receiving an informational brochure, participants were contacted by video call 14 days later and asked, “How do you understand what ACP is?” Interviews were conducted confidentially at home, transcribed, and analyzed according to qualitative research reporting guidelines.

Sixty-one women participated. Most had difficulty understanding ACP; nearly 40% could not define it. Main barriers included cultural resistance to discussing death, reliance on family members or physicians for decision-making, and lack of clear information. Many participants confused ACP with preventive care. A conceptual multilevel model was developed, showing how cultural taboos, family dependence, and systemic inertia interact to sustain barriers through a feedback loop in which cultural avoidance reinforces structural gaps and institutional neglect.

This study provides evidence on how ACP is understood and misinterpreted by cancer patients in a middle-income Latin American setting, an area that remains underrepresented in the literature. By demonstrating that misconceptions, cultural taboos, and systemic barriers operate through a reinforcing multilevel process, the findings offer a conceptual framework that explains why ACP remains marginal in routine oncology care. The model highlights critical points for intervention, including patient education, professional communication, and institutional support, and is directly applicable to similar sociocultural contexts characterized by strong family involvement and biomedical dominance. These results have clear implications, supporting the integration of ACP as a proactive, relational, and value-based process rather than a late end-of-life intervention.

The families of cancer patients experience many forms of distress, as a result of their loved one’s cancer diagnosis. However, there have been no reports of suicide attempts of caregivers directly linked to the diagnosis of advanced cancer in a family member.

We reported a caregiver who attempt suicide two months after his wife was diagnosed with advanced cancer.

The subject was a 69-year-old male who had been caring for his wife, diagnosed with advanced stomach cancer, for two months. The patient’s husband, acting as her caregiver, was referred by his wife (a cancer patient) to meet with a nurse. He reported insomnia and a desire for hastened death. Despite repeated recommendations for specialized care at a caregiver clinic, he declined. Following an argument with his wife at home, he felt unable to cope and attempted suicide. The husband had no psychiatric history but had a history of colon cancer. After the attempt suicide, he began visiting the “Caregivers’ Clinic,” where he received ongoing psychological support that continued until the death of his wife.

In cancer care, it is essential to continuously assess not only the patient’s suicide risk, but also that of closely related family members.

High-risk cutaneous squamous cell carcinoma represents 3–5 per cent of all cutaneous squamous cell carcinomas but causes most disease-specific deaths. Head and neck tumours are often high risk. Recent phase-3 trials have challenged surgery plus or minus radiotherapy as standards of care. This review updates definitions and evidence on emerging treatments.

Narrative review.

High-risk cutaneous squamous cell carcinoma is defined by size greater than 2 cm, deep invasion, poor differentiation, perineural/lymphovascular invasion, nodal spread or immunosuppression. Surgery remains central, with adjuvant radiotherapy improving locoregional control. The KEYNOTE-630 trial of adjuvant pembrolizumab showed a non-significant recurrence-free survival gain (hazard ratio 0.76), with benefit in elderly and extracapsular extension subgroups. The C-POST trial established adjuvant cemiplimab as the first systemic therapy significantly improving disease-free survival (hazard ratio 0.32; 24-month disease-free survival 87 per cent vs 64 per cent). Emerging strategies include neoadjuvant programmed cell-death protein 1 blockade, circulating tumour DNA-guided monitoring and combinations.

Cemiplimab redefines the post-operative standard; pembrolizumab awaits confirmation. Future directions include earlier immunotherapy, biomarker validation and access expansion.

The importance of palliative care in cancer care is underscored, yet there is a significant gap in research specifically focusing on the role of social workers in palliative cancer care. This qualitative study aims to better articulate the specific roles of social workers within palliative oncology settings.

Data were collected by semi-structured Zoom interviews with social workers in palliative cancer care between November 2023 and January 2024. Thematic analysis was used to identify unique themes.

Ten social workers in palliative cancer care were recruited for this study. Eight key themes related to social workers’ role emerged from the interviews. These were the following: (1) mapping out holistic needs through a biopsychosocial–spiritual assessment, (2) providing individual and family counseling, (3) patient and family psychoeducation, (4) resource identification and referral, (5) building communication bridges between patients, families, and oncology teams, (6) promoting patient and family engagement and voice in shared decision-making in cancer care, (7) providing anticipatory grief and bereavement counseling, and (8) strengthening team resilience and fostering well-being.

This study builds upon prior work by focusing specifically on the roles of palliative care social workers in oncology. The findings highlight the multifaceted roles of social workers, demonstrating their capacity to deliver holistic care to cancer patients, families, and healthcare providers to enhance quality of care. The findings may help inform the development of training curricula and practice standards for the subspecialty of oncology-focused palliative social work.

To investigate whether taste perception of two artificial sweeteners—aspartame and neohesperidin dihydrochalcone (NHDC)—is causally associated with the risk of site-specific cancers.

A two-sample Mendelian randomisation (MR) study.

Genetic instruments for taste perception (6 for aspartame; 13 for NHDC) were obtained from a genome-wide association study (GWAS) of Australian adolescents, and cancer outcome data were sourced from publicly available GWAS datasets.

Genetic data for taste perception from 1757 Australian adolescents and genetic data for cancers from large-scale GWAS cohorts, including UK Biobank (n 500 000) and FinnGen (n 500 000).

A one sd increase in the genetically predicted perceived intensity of NHDC was associated with an increased risk of male genital cancer (OR = 1·11, 95 % CI: 1·04, 1·19) and prostate cancer (OR = 1·03, 95 % CI: 1·01, 1·08) based on FinnGen data. These associations persisted after multivariable MR adjustment for glucose and aspartame perception but were not replicated in the UK Biobank. A weak protective association between aspartame perception and cervical cancer (OR = 0·998, 95 % CI: 0·997, 0·999) was observed, but this attenuated to null in sensitivity analyses.

This study found no compelling evidence that perception of aspartame or NHDC during adolescence causally influences later-life cancer risk. The findings highlight the importance of evaluating individual artificial sweeteners separately in future research examining potential health effects.

Communicating a cancer diagnosis to a child is a complex challenge for parents. This study aims to explore (1) the communication strategies and beliefs of parents with cancer when communicating with their children and (2) the needs of these parents.

Semi-structured interviews were conducted with parents with cancer being treated at an Italian comprehensive cancer center and their healthy partners, when present. The interviews were analyzed through a constructivist approach using reflexive thematic analysis. The number of parents to be interviewed was not predetermined, but the meaning saturation procedure was followed.

Ten parents were interviewed, meaning saturation was reached at the seventh interview. Five themes were created: (1) the challenges parents faced at this sensitive time; (2) the emotions parents experienced; (3) the beliefs that may have influenced how they communicate the illness to their children; (4) the strategies parents used to communicate the illness to their children and (5) parents’ perception of their children’s understanding of the illness. Fifty-seven needs, often unmet, were also identified and were grouped into three categories: (1) “existential” needs; (2) support needs; and (3) needs related to continuing to be and act as parents.

This study provides important insights for healthcare professionals to consider in order to better support and care for these parents.