This study examined the changes in intimacy and sexuality amongst cancer patients at the end of life, including those in the final stage, and the distress they raised while experiencing those changes.

A phenomenological qualitative study, based on interviews with 35 dying cancer patients. The results were analyzed by Constant Comparison Analysis method.

Some of the dying patients reported absence of essential change in their sexual needs and ability. while others reported about changes. The changes caused seven various forms of distress to the majority of patients, for example grief due to diminution of sexuality, impact on the partner due to lack of sex and distress resulting from consciousness of the end of life. A minority did not experience distress from the sexuality changes. About a third of the interviewees were interested in sexual counseling during their dying period, and about 80% considered it important for the palliative care team to raise the issue of sexuality.

End of life patients and even those in final stages may have needs related to their intimate and sexual life. As long as the person breathes, even towards death, he can continue to live, even in the intimate aspect, so the palliative team has an important role in answering the specific and complex needs related to sexuality at the end of life. Recommendations were formulated specifically based on this research, for professional intervention regarding sexuality at the end of life, by a PASSION model.

Patients’ involvement in the decision-making process is essential for shared decision-making and optimal patient-centered care. However, when there are concerns about a patient’s cognition and judgmen, the complexity of providing patient-centered care increases. It is often necessary to evaluate patients’ decision-making capacity (DMC) to determine whether they are able to make a particular decision or whether to rely on their previously expressed wishes or the patient’s caregivers.

In this article, we present a case of an older adult with colon cancer who presented to the emergency room.

We describe how multidisciplinary care can enhance the evaluation of DMC and improve quality of care for older patients with advanced cancer.

Multidisciplinary discussions and good communication skills are essential for navigating these complex situations, reducing potential harm and maximizimizing quality of life.

This study was conducted to examine the relationship between cancer patients’ spiritual needs and their quality of life and depression levels.

This cross-sectional, exploratory study was conducted between March 2023 and November 2024. The study population consisted of cancer patients hospitalized in medical oncology departments at a university hospital in eastern Turkey. The sample consisted of 250 patients, determined by power analysis. To collect data, the “Demographic Information Form,” “Spiritual Needs Assessment Scale,” “EORTC QLQ-C30 Version 3.0 Quality of Life Scale,” and “Beck Depression Scale” were used to evaluate the patients’ sociodemographic characteristics and disease process.

There was a weak, negative, statistically significant relationship between patients’ spiritual needs and the subdimensions of the quality of life scale, specifically the general perceived health status (r = −0.297, p < 0.001), physical (r = −0.446, p < 0.001), role (r = −0.423, p < 0.001), emotional (r = −0.472, p < 0.001), cognitive (r = −0.458, p < 0.001) and social (r = −0.443, p < 0.001) functions, and finally, a weak positive correlation was found between the symptoms experienced (r = 0.376, p < 0.001) and depression levels. Additionally, a weak positive correlation between spiritual needs and depression level (r = 0.374, p < 0.001) was identified. Functional areas, depression, education level, diagnosis duration, and symptoms were identified as variables predicting spiritual needs.

In conclusion, it was determined that as the spiritual needs of cancer patients increased, their quality of life decreased and the severity of depression increased.

Diagnosis of cancer can be a stressful and life-threatening event that is associated with suicide risk.

To investigate how suicide risk changes over time after cancer diagnosis, and, specifically, when it becomes similar to that of matched controls.

Using a nationwide population-based database, we identified a total of 171 474 individuals aged ≥20 years newly diagnosed with cancer between 2009 and 2017 and 1:5 age- and sex-matched controls. We calculated adjusted hazard ratios (aHRs) with 95% confidence intervals of suicide in cancer patients for the full period and with a 1- to 5-year lag period.

During a mean follow-up of 6.7 years, 0.3% of cancer patients (491 of 171 474) died by suicide, with incidence rates of 0.4 per 1000 person-years. Cancer patients had higher risk of suicide (aHR 1.64, 95% CI 1.48–1.81) compared with matched controls. Suicide risk remained higher than that of matched controls with a 1- or 2-year lag period (aHR 1.38, 95% CI 1.23–1.55 and aHR 1.32, 95% CI 1.16–1.50, respectively), but there was no significant difference with a 5-year lag period (aHR 1.13, 95% CI 0.93–1.38). However, those with haematologic cancers were at higher suicide risk than matched controls even 5 years after diagnosis (e.g. aHR 9.26, 95% CI 1.30–65.87 for Hodgkin lymphoma).

In cancer patients, suicide risk remained elevated for several years after diagnosis, but decreased over time and became similar to that of matched controls after 5 years. However, the temporal pattern varied by cancer type, and suicide risk remained high for patients with haematological cancers. Suicide risk screening is necessary from the time of cancer diagnosis, even in long-term survivors.

This study aimed to investigate healthcare professionals’ experiences with using the PRO Palliative Care questionnaire (PRO-Pall) to identify palliative care symptoms and problems in non-specialized palliative care settings among patients with heart, lung, and kidney disease, and cancer. The study also investigated the PRO-Pall’s potential to ensure further initiatives and care.

A national, multicenter, observational study employing a mixed-methods approach. It includes quantitative analysis using an evaluation survey (n = 286) and qualitative analysis from workshops (n = 11). Quantitative data were analyzed descriptively, while qualitative data were analyzed thematically.

Quantitative and qualitative data were organized according to 3 a priori-defined themes: Theme 1: Assessment of palliative symptoms, Theme 2: Support for dialogue, and Theme 3: Timely initiation of initiatives and care. The evaluation survey and qualitative interviews with healthcare professionals indicated that it was valuable to use PRO-Pall in a non-specialist palliative context to screen for symptoms and problems, as well as to initiate actions. PRO-Pall helped to structure the dialogue and had a positive effect on the quality of the conversation.

The findings highlight that it can be valuable to utilize the PRO-Pall in general palliative care settings for patients with heart, lung, or kidney diseases as well as cancer. When implementing PRO-Pall in practice, it is crucial to carefully consider the entire process, from administering the questionnaire to planning initiatives informed by patients’ PRO responses.

Travel distance is a key barrier for patients to participate in clinical trials or receive cancer care. The National Cancer Institute (NCI) is a major funder of cancer research infrastructure through grant programs like the NCI Cancer Center (NCICC) and NCI Community Oncology Research Program (NCORP); however, the majority of US sites that care for people with cancer do not directly receive this funding.

Through geospatial analysis we examined patient distance to NCI-funded sites and evaluated demographic subgroups to identify potential disparities in access to research opportunities. We assessed whether new NCI support to previously unfunded sites could address identified barriers in access.

NCI-funded sites tend to be in urban centers and are less accessible to low-income or rural patients. Nearly 17% of the US population over 35 years old would have to drive over 100 miles to obtain care at an NCI-funded site; only 1.6% would be beyond that distance when non-funded sites are added. For those below poverty level, the proportions are 20.2% and 1.9%, respectively. Several US regions, including the South and Appalachia, have particularly limited access to NCI-funded sites despite high cancer incidence, and much of the West and Great Plains are distant from any cancer facilities.

NCI could address travel distance as a major barrier to research participation by expanding the geographical footprint of its infrastructure funding using existing institutions in areas with identified gaps. Geospatial analysis at the census tract level is recommended and geospatial visualization can help identify strategic areas for interventions.

Being diagnosed with cancer can be stressful and has been linked to suicide. However, an updated analyses where a wide range of cancers are compared is lacking.

To examine whether individuals first-time diagnosed with cancer within the past 5 years had higher suicide rates than those with no such diagnosis. Associations with time since diagnosis, and stage and site of cancer, were analysed.

A population-based cohort study design applied to nationwide, longitudinal data on all persons aged 15 years or above (N = 6 987 998) and living in Denmark between 2000 and 2021. Specific sites of cancer first-time diagnosed were considered as exposure for the subsequent 5 years, and death by suicide was examined as outcome. Adjusted incidence rate ratios (aIRRRs) were calculated using Poisson regression models and adjusted for sociodemographics, psychiatric disorders and suicide attempts prior to cancer diagnosis.

In total, 707 513 (10%) individuals were included. While 12 800 individuals died by suicide in the non-cancer group, 601 died of suicide in the cancer group, resulting in an aIRR of 2.0 (95% CI: 1.9–2.1). The highest rate was found in the period immediately following diagnosis (<6 months: 3.9, 95% CI: 3.6–4.2 versus 4–5 years: 1.8, 95% CI: 1.5–2.0). Also, higher rates were found for high-stage tumours (3.1, 95% CI: 2.8–3.4). The highest aIRRs were found for pancreatic cancer (7.5, 95% CI: 5.8–9.7) and oesophageal cancer (7.1, 95% CI: 5.4–9.3). Almost all sites of cancer analysed showed elevated rates of suicide compared with individuals without cancer.

Several recently diagnosed cancers were linked to elevated rates of suicide, especially during the first period following diagnosis. High tumour stage was associated with the highest rates, as were cancer sites with poor prognosis, suggesting prioritisation of these patient groups for suicide prevention efforts.

Individuals admitted to the Intensive Care Unit (ICU) due to cancer frequently encounter cognitive impairment and alterations in their mental health, which engenders psychological distress and considerably impacts their quality of life. In Mexico, there is an imperative for valid and reliable clinical tools to identify these symptoms, to providing timely and appropriate psychological intervention.

To determine the psychometric properties of the Intensive Care Psychological Assessment Tool (IPAT) in a Mexican population with cancer discharged from ICU.

A cross-sectional instrumental design with non-probability convenience sampling was employed. Data were collected between February 2023 and October 2024 with 75 people discharged from the ICU. Factor structure (confirmatory factor analysis), reliability (internal consistency), measurement invariance, and criteria validity (convergent, discriminant, and known-groups) were assessed. Patients were assessed during oncological hospitalization, following ICU.

The participants were predominantly male, residing in the interior of the country, with an average age of 44 years (range 19–78, SD 16.21). Internal consistency results were deemed to be satisfactory (α = 0.78) for 9 items. The CFA indices were adequate [χ2 (gl) 27.436 (24), CMIN/DF 1.143, CFI 0.96, GFI 0.97, SRMR 0.036, RMSEA 0.044] as were the scalar invariance indices for invasive mechanical ventilation [CFI = 0.871; RMSEA = 0.058; χ2/gl = 20.519 (10)] and for gender, restricted invariance indices [CFI = 0.849; RMSEA = 0.068; χ2/gl = 23.302 (12)].

The Mexican version of the IPAT for people with cancer is a valid and reliable tool for use in oncology and critical care settings in Mexico. It is recommended for use at the time of discharge from the ICU, as it allows the identification of psychological distress for timely intervention. For future considerations, diverse clinical settings and patient populations should be explored to enhance the tool’s applicability and generalizability in the varied contexts of cancer in ICU.

Social determinants of health (SDHs) exert a significant influence on various health outcomes and disparities. This study aimed to explore the associations between combined SDHs and mortality, as well as adverse health outcomes among adults with depression.

The research included 48,897 participants with depression from the UK Biobank and 7,771 from the US National Health and Nutrition Examination Survey (NHANES). By calculating combined SDH scores based on 14 SDHs in the UK Biobank and 9 in the US NHANES, participants were categorized into favourable, medium and unfavourable SDH groups through tertiles. Cox regression models were used to evaluate the impact of combined SDHs on mortality (all-cause, cardiovascular disease [CVD] and cancer) in both cohorts, as well as incidences of CVD, cancer and dementia in the UK Biobank.

In the fully adjusted models, compared to the favourable SDH group, the hazard ratios for all-cause mortality were 1.81 (95% CI: 1.60–2.04) in the unfavourable SDH group in the UK Biobank cohort; 1.61 (95% CI: 1.31–1.98) in the medium SDH group and 2.19 (95% CI: 1.78–2.68) in the unfavourable SDH group in the US NHANES cohort. Moreover, higher levels of unfavourable SDHs were associated with increased mortality risk from CVD and cancer. Regarding disease incidence, they were significantly linked to higher incidences of CVD and dementia but not cancer in the UK Biobank.

Combined unfavourable SDHs were associated with elevated risks of mortality and adverse health outcomes among adults with depression, which suggested that assessing the combined impact of SDHs could serve as a key strategy in preventing and managing depression, ultimately helping to reduce the burden of disease.

Supporting a family member with cancer poses significant challenges for family caregivers, who have unmet supportive care needs. Psychosocial oncology professionals (PSOP) are often the primary source of support for cancer caregivers in Iran. Given the lack of supportive care resources, innovative strategies are needed to support caregivers. This study explores the views of PSOP and caregivers regarding the challenges, potential solutions, and the role of digital technologies in supporting caregivers.

Employing a qualitative descriptive design, we conducted individual interviews and focus groups with 30 participants (15 PSOPs and 15 caregivers), recruited from five settings in Tehran, Iran(2023-2024). All sessions were audio-recorded, transcribed verbatim, and analyzed using thematic analysis.

PSOP identified challenges in delivering psychosocial care to caregivers , including inconsistency, uncertainty, and fragmented use of technology. Their recommendations included flexible psychosocial care via blended multi-modal digital technologies, professional development opportunities, and formal recognition and integration within the oncology setting. Caregivers experiencing frustration with the healthcare system expressed a need for family-centered care, flexible psychosocial care, and organized peer support networks.

Current psychosocial care in Iran is insufficient and misaligned with the preferences of PSOP and caregivers. PSOP and caregivers advocate for flexible psychosocial care through blended digital strategies. Public health strategists in Iran, as a low-resource setting with a family-centered context, should optimize resource utilization by prioritizing the training of PSOP, developing blended digital interventions, and leveraging trained peers to provide navigation and support to families, thereby easing the PSOP workload.

Cancer patients often suffer from refractory symptoms near death. The use of sedatives aims to relieve suffering caused by these symptoms. The practice varies broadly. The aim of this study was to evaluate the role and trends of midazolam use in cancer patients dying in a university hospital oncology ward.

The study population of this retrospective registry-based study consists of patients who died in a university hospital oncology ward in Eastern Finland in 2010–2018 (n = 639). Information about treatment decisions, midazolam use, and background factors were gathered.

During the study period, 14.7 % of the patients dying in the ward received midazolam with sedative intent prior to death. 4.7 % (n = 30) of the whole study population had continuous infusion and the rest of the midazolam use was one or multiple single doses. Documented discussion of possible palliative sedation (PS) use was found in almost one third of all patients. Out of those, eventually receiving midazolam with sedative intent, two thirds had had this discussion. The most common symptoms leading to midazolam were dyspnea, pain, and delirium. In continuous use the median midazolam infusion rate was 4.0 mg/h. The continuous infusion started median of 23.25 h and multiple single doses 19 h before death. If only one dose of midazolam was needed, it was given median of 30 minutes prior to death and the most common symptom was dyspnea. Those who received midazolam were more likely to be younger (p = 0.003) and had had a palliative outpatient clinic visit (p = 0.045).

This is the first study to report the trends and practices of midazolam use for refractory symptoms in Finland. Midazolam was used for approximately every 7th dying cancer patient. Applying midazolam was supported by a history of palliative clinic visits and younger age.

This study sought to examine the validity and reliability of the Turkish adaptation of the Peace, Equanimity, and Acceptance in the Cancer Experience (PEACE) scale. The primary objective was to evaluate the scale’s psychometric properties in measuring acceptance and coping among cancer patients.

The study included 90 cancer patients who completed the 12-item PEACE scale. The scale consists of two distinct subscales: the 5-item Peaceful Acceptance subscale and the 7-item Struggle With Illness subscale. Reliability was examined using Cronbach’s alpha and test-retest reliability (r = 0.916). Content validity was assessed using the content validity index (CVI = 0.84). Both exploratory factor analysis (EFA) and confirmatory factor analysis (CFA) were employed to examine the underlying factor structure and evaluate model fit indices.

The internal consistency for both subscales was satisfactory (Cronbach’s α = .78 for both). EFA indicated that the two subscales explained 53.169% of the total variance. CFA substantiated the two-factor model, demonstrating adequate model fit indices (χ2/df = 1.689,Root Mean Square Error of Approximation = 0.088). These findings collectively establish the Turkish version of the PEACE scale as a psychometrically sound tool.

The PEACE scale is a valid and reliable instrument for assessing levels of acceptance and coping in cancer patients. Its use can help healthcare professionals better understand patients’ emotional states and guide interventions aimed at improving their quality of life.

Laryngeal dysplasia is a pre-cancerous lesion within the larynx. This study aims to identify factors influencing progression to cancer by analysing long-term follow-up data.

Data from 221 patients diagnosed between 2005 and 2017 were reviewed retrospectively. Patient demographics, treatment strategies and follow-up results were compared.

Progression to cancer occurred in 26 patients (11.7 per cent). A significant association was found between cancer progression and initial biopsies obtained from the anterior commissure (34.6 per cent in progressing cases vs. 6.2 per cent in non-progressing; p < 0.001). Carcinoma in situ cases showed a higher progression rate (21.7%) compared to mild dysplasia (3.4 per cent) (p = 0.007). The group with cancer progression also had higher rates of other cancers (15.4 per cent vs. 2.1 per cent; p = 0.008), including lung cancer (11.5 per cent vs. 0 per cent; p = 0.001).

The study determined an 11.7 per cent progression rate of laryngeal dysplasia to cancer. Lesions involving the anterior commissure carried an approximately 8.1-fold increased risk of progression.

Expressive writing interventions (EWIs) are associated with important psychological and physical outcomes in patients with cancer. However, EWIs have not been widely integrated into routine psychosocial care of cancer populations. A review of the current literature on EWIs’ impact on the cancer patient experience, including qualitative analyses of patient perspectives, will increase our understanding of barriers and facilitators to adoption in clinical settings.

To bridge existing gaps in the literature by examining quantitative and qualitative studies on EWIs for patients with cancer. To present recent data examining the benefits of EWI’s for patients with cancer.To provide strategies for clinicians engaging in EWI’s for their patients.

Informed by the Preferred Reporting Items for Systematic reviews and Meta-Analysis (PRISMA) guidelines, we completed a scoping review of relevant quantitative and qualitative articles published from 2015 to 2025 to assess the impact of EWIs on health-related outcomes (e.g., physical symptoms and quality of life [QOL]) as well as approaches to improve their use in patients with cancer.

Of the 28 studies with 3527 patients that we analyzed, 24 were quantitative and 4 were qualitative. Most studies were conducted in the USA (42.8%) or China (28.6%) and included patients with breast cancer (71.4%) or only included women (71.4%). Of the patients in the studies, 46.8% identified as White, 42.8% as Asian, 5.5% as Black, and 4.5% as Latino. Twenty-one of the quantitative studies found that EWIs were positively associated with cancer patients’ QOL and/or physical health outcomes. Of the 4 qualitative studies, themes of narrative reconstruction, cultural disclosure norms, and intervention delivery format emerged. The characteristics of EWI methods can be tailored to maximize therapeutic benefits through cultural adaptation, timing, and privacy.

Despite promising associations between EWIs and health-related outcomes in patients with cancer, EWIs for cancer populations are heterogeneous and randomized clinical trials are limited. Larger trials that establish the efficacy of EWIs in diverse cancer populations are warranted.