Asian Pacific Journal of Cancer Care

Artificial Intelligence in Cancer Management: Promise, Pragmatism, and Preparedness

2026-05-02T11:14:21+00:00

Artificial intelligence is transforming cancer detection, treatment planning, and decision support, yet its rapid adoption risks outstripping validation, ethical safeguards, and economic sustainability. Key challenges include algorithmic bias, generalizability failures, opaque liability, and high implementation costs. Responsible integration demands clinician involvement, fairness-aware development, dynamic consent, and adaptive reimbursement. AI will augment, not replace oncologists, but its success hinges on rigorous governance and patient-centered scrutiny.

Health-Related Quality of Life and Sexual Dysfunction in Cervical Cancer Survivors: A Cross-Sectional Hospital-Based Study

2026-05-02T11:16:50+00:00

Introduction: Cervical cancer is the second most common female cancer in India. The disease and its treatment significantly affect the survivor’s quality of life and sexual health. The current study aims to determine the quality of life and sexual function after the treatment.

Methods: A cross-sectional study was performed on 100 cervical cancer survivors who were sexually active prior to the diagnosis. Quality of life and sexual functioning were assessed using three questionnaires: the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire-Core 30 (EORTC QLQ-C30), cervical Cancer Module (EORTC QLQ-CX24), and the Changes in Sexual Functioning Questionnaire (CSFQ 14-F). Descriptive and inferential statistics were used for the data analysis.

Results: The overall quality of life score was 64.4 (SD 18.6). However, physical functioning was affected as compared to the functional domains of QoL. The prevalence of sexual dysfunction was 98.9% among the survivors. Sexuality, in terms of pleasure, desire, arousal, and orgasm was low among the survivors. However, sexual pleasure, desire, and orgasm were more problematic in postmenopausal patients. (p<0.05).

Conclusion: Overall QoL was improved after the completion of the cancer treatment and also its functional domains did not deteriorate. However, sexuality was impaired in these patients. These results highlight the critical need for comprehensive survivorship care, especially for postmenopausal patients, which involves routine evaluation and treatment of physical and sexual health issues. For cervical cancer survivors, routine follow-up that includes counseling and sexual health rehabilitation may enhance their quality of life and long-term well-being.

A Study of Clinico-Pathological Profile and Correlation of Outcome with Risk groups of Pediatric Patients with Acute Lymphoblastic Leukemia at a Tertiary Care Centre in North East India

2026-05-02T11:23:15+00:00

Introduction: Outcome data on Acute Lymphoblastic Leukemia (ALL) treatment remain scarce in developing nations. This retrospective study from the Tata Memorial Centre, Northeast India, aimed to explore the clinical and pathological profiles and to correlate the outcome with risk groups in pediatric patients of ALL in this region.

Materials and methods: A retrospective analysis of 418 children newly diagnosed with ALL between May 2015 and April 2020 treated with ALL-IC BFM 2002 protocol was performed.

Results: Mean age was 7.09 years and median age was 6 years. Most patients were of the Intermediate Risk group. 93 (22.25%) patients had relapse. 72 (17.22%) patients died. After a median observation period of 61 months, the 5-year Event Free Survival (EFS) and Overall Survival (OS) were 69.5% and 72.3% for all patients respectively. Patients in the age group of 1-5 years had significantly better EFS and OS (74.6% and 82.2 %, respectively) than in those of ≥6 years (62.7% and 69.8%) (P=0.032 and P=0.043 respectively). Patients with B ALL had significantly better EFS and OS (72.6% and 75.8%, respectively) than those with T-ALL (57.8% and 59.1%) (P=0.011 and P=0.021, respectively). Patients who had initial leukocyte counts of <20×10⁹ /L had better EFS and OS (78.4% and 85.5 % vs 56.6% and 64.8%) (P=0.002 and P=0.012, respectively). Children with a good response to prednisone on day 8 achieved higher EFS and OS (77.7 % and 83.7 % vs. 29.5% and 36.4 %) (P=0.000 and P=0.012). The 5-year EFS and OS were 76.1% and 85.9% for the Standard Risk group,70.3% and 78.6% for the Intermediate Risk group, and 50.2% and 57.4% for the High Risk group (P=0.001 and 0.032, respectively). There was no significant association between sex and survival rates (P=0.731).

Conclusion: The study demonstrates that, with proper risk stratification and corresponding treatment modifications, it is feasible to administer an effective regimen in India and to achieve satisfactory event-free and overall survival outcomes.

Varied Head Position in Supraclavicular Nodal Irradiation using IMRT Technique and its Effect on Dysphagia in Breast Cancer Patients

2026-05-02T11:26:06+00:00

Introduction: Locally advanced breast cancer patients undergo a tri-modality therapy in which radiotherapy has a significant role. Toxicities associated with adjuvant radiotherapy are reduced to a minimum with the advancement of techniques, but the acute toxicities that occur during supraclavicular field radiation, like pharyngitis and esophagitis, need to be addressed. To reduce the severity of the dysphagia, variation in head position during radiation is also a commonly used and scarcely studied method. The purpose of the study is to compare the dose received by the Pharyngo-Esophageal Segment in the head-straight and head-turn positions and its correlation with dysphagia.

Methods: One hundred patients were randomized into head-straight or head-turn positions during immobilization. After the simulation scan, the targets and organs at risk were contoured in both groups according to the guidelines, and additionally, the Pharyngo-Esophageal Segment was contoured. Both groups received the same radiation dose to the supraclavicular field using the intensity modulated radiotherapy technique and were assessed for dysphagia.

Result: Fifty-three right-sided and 47 left-sided breast cancers were accrued with their age ranging from 30 to 82 years. The average Pharyngo-Esophageal Segment length, of mean dose, maximum dose, and dose of 2cc volume in head straight position group were 4.5 cm, 24 Gy, 40.4 Gy, and 25.9 Gy, respectively; whereas in head turn group the values were 5.5 cm, 30.3 Gy, 41.2 Gy, and 34.4 Gy, respectively. These parameters were significantly lower in the head straight position than head turn position, with the p-value being p=0.005, p<0.001, p=0.04, p<0.001, respectively.

Conclusion: The head straight immobilization can be considered during supraclavicular irradiation, as it significantly reduces dose to the Pharyngo-Esophageal Segment.

Prostate Cancer in Asia: Epidemiology, Association with Human Development Index and Projections to 2040

2026-05-02T11:29:39+00:00

Purpose: This study aimed to characterize the incidence and mortality of contemporary prostate cancer (PCa) across Asian countries, assess their association with the level of national development, and estimate the future regional burden of PCa by 2040.

Results: In 2020, Asia accounted for 371,225 of 1,414,259 global incident
PCa cases (26.2%) and 120,593 of 375,304 deaths (32.1%). Incidence and death counts were concentrated in China, Japan, and India across 47 Asian countries. The Human Development Index (HDI) showed a positive correlation with the age-standardized incidence rate (ASIR) (r = 0.59, p = 0.000025) and with key components, including life expectancy (r = 0.59), mean years of schooling (r = 0.54), and income per capita (r = 0.46). The age-standardized mortality rate (ASMR) correlated more modestly with HDI (r = 0.30, p = 0.049979) and showed mixed associations with its components. Several countries reported mortality counts that exceeded incident counts, indicating substantial limitations in cancer registration and vital statistics. Under demographic-change assumptions (baseline rates held constant), Asia is projected to contribute the largest absolute global increases by 2040: +349,434 incident cases and +135,911 deaths versus 2020. Ten countries are expected to account for most of the regional rise.

Conclusions: Asia already contributes more than one-quarter of global PCa cases and one-third of deaths, and is on track for the largest absolute increase in PCa burden by 2040. Clinically, these trends imply a rapid rise in the demand for urologic, radiation, and medical oncology services, particularly in countries projected to shoulder the greatest increases. The strong HDI-ASIR gradient is biologically plausible, reflecting longer life expectancy, westernization of diet and lifestyle, and wider use of prostate-specific antigen testing in more developed settings, while the weaker HDI-ASMR association suggests that early detection and effective treatment are not yet consistently translating into survival gains. From a public health perspective, the findings support tailored regional strategies: scaling risk-adapted early detection and survivorship programs in higher-HDI systems and prioritizing diagnostic capacity, multimodal treatment access, financial protection, and registry strengthening in lower- and middle-HDI countries. Focusing investments on countries expected to experience the largest absolute increases offers a direct route to limiting mortality growth by 2040.

Predictors of Major Postoperative Complications in Oncologic Reconstructive Surgery: A Single-Center Cohort Study in a Resource-Limited Setting

2026-05-02T11:45:06+00:00

Introduction: Oncologic reconstructive surgery is essential for restoring form and function but carries a high risk of postoperative complications in resource-limited environments. Identifying robust, readily available predictors is critical for risk stratification and improving surgical outcomes in these settings.

Materials and Methods: A retrospective cohort study was conducted on 69 adult patients who underwent complex reconstructive surgery following oncologic resection at a tertiary center in Yemen (2018–2024). The procedures included local flaps (n = 41, 59.4%), skin grafts (n = 19, 27.5%), and regional/distant flaps (n = 9, 13.0%). Data on demographics, comorbidities, defect characteristics, ASA classification, and preoperative serum albumin were collected. The primary outcome was a major postoperative complication (Clavien-Dindo grade ≥III), assessed over a 30-day postoperative period. Independent predictors were identified through multivariable logistic regression.

Results: The cohort was predominantly male (68.1%, n=47) with a mean age of 54.1 years. Head and neck reconstruction (71.0%, n=49) for basal cell carcinoma (63.8%, n=44) was most common. The major complication rate was 29.0% (n=20), including surgical site infection (11.6%, n=8) and flap/graft failure (8.7%, n=6). The presence of a major complication was strongly associated with worse clinical outcomes, resulting in a 100% procedural failure rate (p<0.001), a 45.0% unplanned readmission rate (p<0.001), and a significantly longer median hospital stay (12.0 vs. 6.0 days, p<0.001). Multivariable analysis identified defect size >50 cm² (adjusted Odds Ratio [aOR] 3.65, 95% CI: 1.55–8.59, p<0.01), ASA class III (aOR 2.85, 95% CI: 1.25–6.50, p=0.01), and preoperative hypoalbuminemia (< 3.5 g/dL) (aOR 2.70, 95% CI: 1.15–6.33, p=0.02) as independent predictors.

Conclusion: Large defect size, higher ASA class, and hypoalbuminemia were independent predictors of major postoperative complications in this resource-limited setting. These factors are associated with increased procedural failure, readmission, and extended hospital stays, providing a practical framework for preoperative risk assessment. Key limitations of this study include its retrospective, single-center design and moderate sample size. Despite this, these findings enable targeted nutritional and surgical optimization to mitigate complications. Further prospective, multi-center studies are necessary to validate and expand upon these findings.

The Attitude of Muslim Cancer Patients Toward Fasting During Ramadan: A Cross-Sectional Study in A Single Iraqi Cancer Center

2026-05-02T11:52:53+00:00

Introduction: Fasting of adults during the holy month of Ramadan is an important issue for Muslims as it is one of the five pillars of Islam. Muslim cancer patients usually face perplexities concerning fasting during Ramadan, as it can be exempted because of the cancer disease itself or the complications of its treatment. This issue has received limited attention in the literature and needs more interest and study.

Materials and Methods: This study was conducted on adult Muslim cancer patients who visited the Anbar Cancer Center in Anbar province, Iraq, to receive their treatment cycles during and after Ramadan of the Hijri year 1445 (the period from 11 March 2024 until 7 May 2024). All the consecutively selected patients were interviewed to assess their behaviors during Ramadan and whether they experienced treatment complications. A structured questionnaire was used during the interview, and the severity of treatment-related gastrointestinal side effects was graded using the National Cancer Institute – Common Terminology Criteria for Adverse Events (NCI–CTCAE, version 5.0).

Results: A total of 88 patients participated in this study. Sixty-four (72.7%) were females, and 24 (27.3%) were males. The median age of the participants was 49 years. Breast cancer was the most common cancer, occurring in 39 (44.3%) patients. Fifty-six (63.6%) sought advice regarding fasting from either an oncologist (54.5%) or an Imam (9.1%). Only 37 (42%) patients managed to fast during Ramadan (excluding treatment days), while 51 (58%) could not, mainly due to allowances in Islam (21, 41.2%) or fatigue (16, 31.4%).

Conclusion: Cancer patients who did not fast were more than those who could fast during Ramadan. More than half of the patients sought advice regarding fasting, and most of them discussed this issue with their oncologists. There were no significant changes observed in the treatment-related gastrointestinal toxicities among fasting patients when comparing the fasting period to the post-Ramadan period. Together with related works, the findings of this study may guide physicians, especially oncologists, in mapping a path for cancer patients during Ramadan.

Incidence and Clinical Characteristics of Brain Metastases at Wahidin Sudirohusodo and Hasanuddin University Hospitals, Makassar, Indonesia: An 11-Year Retrospective Study

2026-05-02T11:55:45+00:00

Introduction: Brain metastases (BM) are the most frequent intracranial tumors in adults, yet epidemiological data remain limited in Indonesia. This study aimed to describe the incidence, clinical presentation, and management patterns of BM over an 11-year period at two tertiary referral hospitals in South Sulawesi, Indonesia.

Materials and Methods: This retrospective multi-center study included patients diagnosed with BM at Dr. Wahidin Sudirohusodo Hospital and Hasanuddin University Hospital in Makassar, Indonesia, from 2013 to 2024. Patients were included if they had radiologically confirmed BM (CT or MRI) and histologically verified primary malignancies. Data on demographics, clinical symptoms, lesion number and location, primary tumor origin, treatment modalities, and mortality outcomes were extracted from medical records. Statistical analyses included descriptive summaries and chi-square test to explore associations between clinical variables and outcomes.

Results: Of 248 patients, most were female (55.2%) and aged 46–65 years (64.5%). Most patients presented with a single lesion (74.6%), predominantly in the parietal lobe (20.6%). Headache was the most common presenting symptom (50.4%). Lung (48.4%) and breast carcinoma (27.0%) were the leading primary malignancies. Conservative management was the predominant treatment (53.6%), followed by chemotherapy (40.7%), while surgical and radiotherapeutic interventions were infrequent. Mortality was higher in patients receiving conservative therapy (59.4%, p = 0.028) and those with multiple lesions (66.1%, p = 0.042).

Conclusion: BM in our cohort were predominantly associated with lung and breast malignancies and most frequently presented as single lesions in middle-aged adults. The high reliance on conservative management reflects both late-stage presentation and limited access to advanced neuro-oncologic interventions. These findings highlight the need for early detection, expanded therapeutic capacity, and multidisciplinary care to improve outcomes for patients with BM in resource-limited settings.

Synthesis, and Evaluation of a 4,4′-Methylenedianiline-Based Ligand and some Complexes as Against Colorectal Cancer

2026-05-02T11:58:46+00:00

Introduction: The researchers sought to create a new bis-azo ligand as a progression of their previous studies.

Materials and Methods: The ligand, designated as 6,6 (methylenebis (4,1-phenylene)) bis (diazene-2,1-diyl)) bis (2,4-dimethylphenol), was produced, followed by the preparation of a variety of chelate complexes with Pd+2, and Au+3 ions. The characterization of these compounds was performed using advanced techniques such as elemental analysis, FT-IR spectroscopy, H, NMR spectroscopy, thermal analysis, through DSC to elucidate the synthesized complexes.

Results: Analysis indicated that the complexes produced with Pd+2, and Au+3 ions demonstrated a 2:1 metal-ligand ratio. The ligand was identified as bidentate (N-O) in nature. Molecular docking methods were employed to assess the effectiveness of these compounds in cancer treatment. The cytotoxicity of the 6-MPDDB dye ligand and its palladium (II) complex in colorectal carcinoma was assessed Using the MTT method. The dye and its metal complexes were evaluated for their antioxidant activity by assessing their ability to scavenge free radicals using the DPPH assay, with ascorbic acid serving as the standard. The IC₅₀ values were determined, revealing that the ligand demonstrated notable free radical inhibition, whereas the antioxidant potential of the complexes differed according to their respective IC₅₀ values.

Conclusion: The synthesized ligand and its Pd(II) and Au(III) complexes demonstrated well-defined structural characteristics and promising biological activities. Overall, the results suggest their potential as effective antioxidant and anticancer agents, warranting further investigation.

Prognostic Determinants in Children with Wilms’ tumor Treated with Neoadjuvant Chemotherapy: A Single-center Prospective Cohort from Vietnam

2026-05-02T12:06:56+00:00

Introduction: Evidence on prognostic determinants in Vietnamese children with Wilms’ tumor presenting with imaging-defined risk features remains limited despite internationally standardized use of neoadjuvant chemotherapy. To describe treatment outcomes and explore factors associated with event-free survival (EFS) in children with unilateral stage II–IV Wilms’ tumor treated with SIOP-2001–based neoadjuvant chemotherapy followed by delayed nephrectomy at a single tertiary center in Vietnam.

Materials and Methods: We conducted a prospective cohort study of 64 consecutive children managed at Children’s Hospital 2 (Ho Chi Minh City) between April 2013 and June 2016, with follow-up through June 2019. Eligibility required ≥1 imaging-defined risk feature on baseline computed tomography. Patients received SIOP-2001–based neoadjuvant chemotherapy (vincristine and actinomycin D with risk-adapted addition of doxorubicin), followed by delayed nephrectomy and postoperative risk-adapted therapy. Tumor volume was calculated by the ellipsoid formula, and relative volumetric response was recorded. Chemotherapy response was assessed using RECIST 1.1. EFS was estimated by Kaplan–Meier analysis. Given the small number of events (n = 4), Cox regression was prespecified as exploratory, with parsimonious multivariable models and emphasis on effect sizes and confidence intervals.

Results: Median tumor volume decreased from 487.9 cm³ to 206.8 cm³ (p < 0.001). Imaging-defined risk features declined substantially (e.g. perirenal fat invasion 85.9%→43.8%, renal/IVC thrombus 20.3%→6.3%, suspicious hilar nodes 20.3%→4.7%, tumor rupture 9.4%→3.2%). Overall response rate was 89.1% (complete or partial response); 10.9% had stable or progressive disease. At a mean follow-up of 46.9 months, 4 events (2 relapses, 2 deaths) occurred, corresponding to a 4-year EFS of 92.2%. In exploratory multivariable Cox models limited to two predictors, high histopathologic risk and poor chemotherapy response were associated with higher hazards of relapse or death, but with wide confidence intervals reflecting limited precision.

Conclusions: In this exploratory analysis, postoperative histopathologic risk grouping and preoperative chemotherapy response appeared more informative for prognosis than baseline imaging extent. These findings are hypothesis-generating and should be validated in larger multicenter cohorts.

A 24-Year Pathological Pattern and Survival Analysis of Lung Cancer Patients: A Single-Center Study in Northern Iran (2001–2024)

2026-05-02T12:11:24+00:00

Introduction: Lung cancer remains the leading cause of cancer-related mortality worldwide, with limited survival in low- and middle-income countries due to late diagnosis and restricted access to advanced therapies. Longterm cohort data from underrepresented regions such as northern Iran are scarce. This study seeks to provide insights into disease progression in the region and contribute to future strategies for improved diagnosis, treatment, and prevention.

Materials and Methods: This 24-year retrospective cohort included 957 patients with primary lung cancer treated at Shahid Rajaee Radiotherapy Center in northern Iran. Demographic, histopathological, and survival data were analyzed using Kaplan–Meier estimates and log-rank tests, and prognostic factors were assessed with Cox proportional hazards models. A scenario-based sensitivity analysis was performed to examine the impact of missing mortality data.

Results: The mean age at diagnosis was 62.5±11.6 years. NSCLC constituted the majority of cases, predominantly squamous cell carcinoma and adenocarcinoma. Median overall survival (OS) was significantly longer in NSCLC than SCLC (29 vs. 13 months, p<0.01). Overall survival was 39.9%, with 1-, 2-, and 5-year survival rates of 60.8%, 48.5%, and 41.4%, respectively. Metastatic status particularly brain metastasis was the strongest predictor of mortality (HR=1.767, 95% CI: 1.464–2.132, p<0.001). Sensitivity analysis demonstrated that OS declined to 8% under the most conservative assumption that all patients with unknown status were deceased, indicating potential overestimation of survival due to missing follow-up data.

Conclusion: This long-term cohort underscores the prognostic significance of metastatic burden especially brain involvement and reveals survival patterns shaped by referral-center dynamics and incomplete follow-up. These findings highlight the need for improved early detection, molecular profiling, and broader access to contemporary systemic therapies to enhance lung cancer outcomes in resource-limited settings.

Factors Affecting Survival in Cervical Cancer Stage IIIB Treated with Radiation Therapy

2026-05-02T12:16:36+00:00

Introduction: To evaluate the factors affecting overall survival (OS) and local control (LC) rates in patients with uterine cervical cancer FIGO stage IIIB treated with radiation therapy (RT).

Materials and Methods: A retrospective study was conducted on 229 patients diagnosed with FIGO stage IIIB cervical cancer who received external beam RT (EBRT) followed by high-dose rate intracavitary brachytherapy (HDR-ICBT) at the Division of Radiation Oncology, Srinagarind Hospital, Khon Kaen University, Thailand, between January 1, 2009, and December 31, 2011. Key prognostic factors, including age, pre-treatment hemoglobin level, tumor size, histology, pelvic side wall involvement, concurrent chemoradiation (CCRT), equivalent dose in 2 Gy (EQD2) at point A, parametrial boost, and overall treatment time (OTT), were analyzed. Survival and local control rates were estimated using the Kaplan-Meier method; hazard ratios (HR) were calculated via Cox proportional hazards regression. Toxicities were recorded per CTCAE v4.03 and RTOG/EORTC criteria.

Results: A total of 229 patients were analyzed.The median age was 55 years (range 33-79). The 5-year OS rate was 41.9% and the 5-year LC rate was 71.4%. Multivariate analysis identified pre-treatment hemoglobin <10 vs. ≥10 g/dL (HR=1.565, p=0.017), tumor size <5 vs. ≥5 cm (HR=0.621, p=0.008), squamous cell carcinoma (SCCA) histology vs. non-SCCA (HR=0.62, p=0.035), unilateral vs. bilateral pelvic side wall involvement (HR=0.691, p=0.049), and RT alone vs. CCRT (HR=1.852, p=0.001) as significant prognostic factors for OS. For LC, significant factors included age ≥50 years, higher hemoglobin, squamous histology, and smaller tumor size. Grade 3-4 gastrointestinal toxicities were most common; no grade 4 hematologic toxicity was seen.

Conclusion: Pre-treatment hemoglobin level, tumor size, pelvic side wall involvement, histology, and CCRT were significant predictors of survival in FIGO stage IIIB cervical cancer treated with EBRT plus HDR-ICBT. Optimizing these factors may improve outcomes.

Stage-Dependent Differences in Quality of Life Among Breast Cancer Patients Prior to Initiation of a Line of Systemic Therapy: A Cross-sectional Study

2026-05-02T12:25:46+00:00

Introduction: Disease stage is a key determinant of health-related quality of life (HRQoL) in breast cancer, yet stage-specific HRQoL data prior to systemic therapy remain limited in low- and middle-income countries (LMICs). Understanding baseline HRQoL variation across stages may support more tailored supportive care. This study aimed to evaluate stage-specific differences in baseline HRQoL among women with breast cancer prior to initiation of a line of systemic therapy.

Materials and Methods: In this cross-sectional study at two referral centers in East Java, Indonesia, we consecutively enrolled women with histologically confirmed breast cancer before initiating a new line of systemic therapy. Sociodemographic and tumor characteristics were documented, and HRQoL was assessed using validated Indonesian versions of the EORTC QLQ-C30 and QLQ-BR23. Patients were categorized as having early-stage (n=14), locally advanced (n=62), or metastatic disease (n=30). Group differences were examined using the Kruskal–Wallis test with Bonferroni-adjusted pairwise comparisons.

Results: Invasive ductal carcinoma predominated across stages (80–100%), with higher-grade tumors more frequent in locally advanced disease and Luminal B subtypes more common in advanced stages. Global health status differed significantly by stage (p=0.004), with both early-stage versus metastatic disease (p=0.009) and locally advanced versus metastatic disease (p=0.021) comparisons remaining significant after Bonferroni correction. Social functioning showed stage differences (p=0.022), though pairwise comparisons did not remain significant. Pain demonstrated significant overall variation (p=0.041), with early-stage versus metastatic disease showing a Bonferroni-adjusted difference (p=0.034). Systemic therapy–related side effects differed across stages (p=0.025), but no pairwise comparison met the corrected threshold. Emotional, cognitive, and body-image scores were similar across groups.

Conclusion: Prior to systemic therapy, women with metastatic breast cancer reported significantly lower global health status and higher pain compared with those with early-stage disease, while other differences across stages were more modest after adjusting for multiple comparisons. These findings underscore the value of incorporating baseline HRQoL assessment into oncology evaluation to identify patients with greater supportive-care needs, particularly those presenting with advanced disease.

Inverse Association of Omentin-1 and Vitamin D with FGF-23 Levels in Prostate Cancer: A Predictive Biomarker Panel

2026-05-02T12:30:32+00:00

Introduction: Omentin-1 is typically expressed in vascular endothelial cells, mesothelial cells, airway goblet cells, and adipose tissue stromal cells. Fibroblast growth factor-23 (FGF-23) is primarily secreted by osteocytes, modulates renal phosphate reabsorption and suppresses vitamin D activation. Vitamin D , a fat-soluble vitamin, modulates immune responses, bone metabolism and calcium homeostasis. Prostate cancer remains a major worldwide health concern among males with emerging evidence linking these biomarkers to cancer progression due to their anti-inflammatory, antioxidant and potential anti tumorigenic properties. Objectives: This study aimes to determine whether serum levels of omentin-1, vitamin D, and FGF-23, taken together can predict prostate cancer status.

Materials and Methods: A case-control approach was conducted at a single center Al-Amal Centre/ Medical City of Imam Hussain in Karbala/ Iraq, during December 2022 until June 2023. Serum samples were collected from 30 prostate cancer patients’ post-treatment and 30 age-matched (45–70 years) healthy male controls. Serum concentrations of FGF-23, omentin-1, irisin and vitamin D were measured using ELISA.

Results: The patient group exhibited significantly elevated FGF-23 levels (240.8 ± 55.2 ng/ml) compared to controls (163.1 ± 22.4 ng/ml p < 0.001). Conversely, the level of irisin; omentin-1; vitamin D was markedly reduced in patients (21.9 ± 3.2, 10.3 ± 2.9, and 6.4 ± 0.7 ng/ml respectively; p < 0.001) relative to controls (60.8 ± 3.5, 38.8 ± 6.6, and 19.1 ± 2.4 ng/ml respectively). The ROC curve analysis identified serum FGF-23 and omentin-1 and vitamin D as highly accurate molecular indicator for detecting PCa progression (with AUC value; 0.956, 0.958 and 0.938 respectively).

Conclusions: These circulating factors may be considered as promising diagnostic tools and vitamin D deficiency emerging as a particularly significant risk factor within this study cohort.

Post-Treatment Perspectives on Health Literacy and the Misperception of Breast Cancer Recurrence Risk: A Scoping Review

2026-05-02T12:33:17+00:00

Introduction: Many breast cancer survivors continue to experience emotional challenges after completing treatment. Fear of cancer recurrence (FCR) and misperception of recurrence risk, including both overestimation and underestimation, can shape survivors’ well-being and influence how they participate in follow-up care. Health literacy (HL), defined as the ability to find, understand, and use health information, plays an essential role in how survivors interpret health messages and make decisions about their ongoing care. However, the connection between HL and recurrence risk misperception has not been clearly synthesized. This scoping review maps existing patterns and associations, rather than causal relationships, between HL, FCR, and recurrence risk misperception among post-treatment breast cancer survivors.

Materials and Methods: Guided by the Joanna Briggs Institute framework and PRISMA-ScR guidelines, searches were conducted in PubMed, Scopus, CINAHL, ScienceDirect, and grey literature from January 2010 to April 2025. Studies were included if they involved adults in the post-treatment phase and examined HL alongside cognitive or emotional outcomes related to recurrence.

Results: Thirteen studies met the inclusion criteria, most using cross-sectional designs across the United States, Europe, and Asia. Many survivors overestimated their recurrence risk and demonstrated low HL, especially older adults and individuals with lower educational attainment. HL was consistently linked to more accurate risk understanding and, in some studies, mediated the effects of FCR on functional recovery.

Conclusion: HL is a meaningful and modifiable factor that influences how survivors understand and cope with the possibility of cancer returning. Strengthening survivorship communication and developing culturally responsive patient education strategies may help survivors feel more informed, supported, and confident as they navigate life after treatment.

Exercise and Regulation of PI3K/Akt/mTOR and AMPK Pathways in Cancer: Molecular Mechanisms and Therapeutic Implications: A Narrative Review

2026-05-02T12:37:11+00:00

Overview: Dysregulation of the PI3K/Akt/mTOR and AMPK pathways is central to cancer development, driving uncontrolled cell growth, metabolic disturbances, and resistance to cell death and therapy. Exercise has emerged as an effective non-drug strategy that can modify these pathways and influence tumor-related cellular processes.

Methods: This review compiles evidence from 2015 to 2025 on how exercise impacts PI3K/Akt/mTOR and AMPK signaling in cancer.

Results: Findings show that exercise activates AMPK, an energy sensor that boosts glucose uptake, insulin sensitivity, autophagy, and mitochondrial biogenesis. Through AMPK activation, exercise reduces anabolic signaling and excessive protein synthesis, which often promotes tumor growth, while supporting healthier metabolism. At the same time, exercise inhibits the PI3K/Akt/mTOR pathway, reducing cell proliferation, affecting growth factors like insulin and IGF-1, and restoring metabolic balance across tissues. These combined effects improve cellular stability, lessen tumor-promoting mechanisms, and may enhance responsiveness to cancer treatments, making exercise a valuable complement for cancer prevention and therapy. Most current insights come from preclinical studies or epidemiological data, with few clinical trials examining exercise-induced molecular changes in human tumors.

Conclusion: More research is needed to identify optimal exercise regimens, understand pathway-specific effects, and evaluate their clinical relevance to better incorporate exercise into personalized cancer care.

Cancer Communication Disparities in High-Income and Low-Income Countries: A Narrative Review and Call for Cooperation

2026-05-02T12:41:24+00:00

Medical journalism is essential for shaping health behaviors, influencing policy, and guiding the public toward better health outcomes. However, disparities in access to evidence-based information between high-income countries (HICs) and low-income countries (LICs) compromise global cancer control efforts. This narrative review synthesizes current literature and expert perspectives on cancer communication disparities and proposes an ethically grounded, multisectoral framework to foster collaboration among journals, policymakers, global health agencies, and technology stakeholders. Evidence suggests that limited cancer awareness, restricted access to reliable information, and sociocultural barriers in LICs contribute to delayed diagnosis and suboptimal prevention. Open-access publishing, culturally tailored mass media, capacity building, and international collaborations are key strategies to reduce these disparities and improve cancer outcomes worldwide.

Pathologic Response to Neoadjuvant Subcutaneous Fixed-Dose Pertuzumab–Trastuzumab (Phesgo®) and Chemotherapy in HER2-Positive Locally Advanced Breast Cancer: A Case Series and Literature Review

2026-05-02T12:44:20+00:00

Background: Globally, breast cancer (BC) is the most prevalent malignancy among females and a significant health concern in India. A notable proportion of BC cases are human epidermal growth factor receptor 2-positive (HER2+), characterized by HER2 overexpression or gene amplification, often associated with aggressive tumor behavior. Dual anti-HER2 therapy with trastuzumab and pertuzumab, combined with chemotherapy, is the standard of care, particularly in the neoadjuvant setting for tumor stage T2 or node-positive HER2+ BC. Phesgo®, a fixed-dose subcutaneous formulation of trastuzumab, pertuzumab, and hyaluronidase, offers a convenient and time-efficient alternative to intravenous infusions, with potential implications for improving patient comfort and streamlining healthcare resource utilization.

Case presentation: This case series reports on six patients with HER2+ BC who received neoadjuvant chemotherapy with Phesgo® at the Department of Medical Oncology, Tertiary Cancer Care Center, Government Medical College, Kozhikode, Kerala,India. Clinical data, including presenting symptoms, examination findings, investigations, management, and treatment response, were reviewed and reported descriptively. Among six patients, Phesgo® led to a pathological complete response in three (50%) cases. Residual cancer burden class 0 was observed in four cases. No side effects such as diarrhea or injection site reactions were reported. No patient experienced a decline in left ventricular ejection fraction or clinical cardiac events. These findings are corroborated by a literature review indicating comparable efficacy and safety between subcutaneous and intravenous modes of administrationin treating HER2+ BC.

Results: This series demonstrates that neoadjuvant Subcutaneous Fixed-Dose Pertuzumab–Trastuzumab (Phesgo®) is an effective and safe option for HER2+ breast cancer, achieving significant pathological responses without cardiac toxicity or injection-site complications.

Conclusion: It represents a viable, convenient alternative to intravenous therapy that may enhance patient comfort and healthcare efficiency.