Understanding patient perceptions of cancer care is crucial for improving treatment experiences and health outcomes. This study explores female patient-reported experiences with cancer care. Our aim was to identify areas for improvement and enhance patient-centered approaches in specialty and primary care settings.

This was a prospective observational study using ResearchMatch. Our eligibility criteria were 40 years or older adult cancer diagnosis, female, and treated for cancer in the United States.

Among the eligible participants (n = 1224), 64 responded to the invitation and 57 completed the survey (89% participation proportion). The majority of the respondents were not receiving treatment during the study period (68%). Of those, 89% completed the recommended treatment, and 10% stopped the treatment before completion. Nearly 80% of respondents saw the same oncologist during the treatment at every appointment, and only 8% reported changing clinicians during their primary cancer treatment. Over 63% of respondents were not seeing the same primary care clinician as they did when they were first diagnosed. Respondents reported facing challenges with employment and ability to return to work (26%), being able to afford medication (21%), and paying medical bills (15%).

This study, albeit for a small number of participants (n = 57) identified strengths and challenges in cancer care. Consistent oncologist involvement and proximity to care centers was consistently reported during active treatment. Discontinuity with primary care, however, may warrant further inquiry. Reported financial, employment and access issues support previous studies that identified these as major challenges during and after active cancer treatment. Our study underscored the need to enhance patient-centered coordination and support to improve cancer and survivorship care outcomes.

In November 2024, the fourth annual Symposium focusing on early-age onset cancer (EAOC) was hosted by the Colorectal Cancer Resource & Action Network (CCRAN), assembling clinicians, researchers, and patients virtually to discuss challenges in early detection and diagnosis of individuals afflicted with EAOC across tumour types. The meeting addressed the rising rates of EAOC and identified strategies to overcome barriers to timely detection and diagnosis by closing gaps in public and healthcare provider knowledge on symptoms of cancer in younger adults and reducing inequities in standard screening for younger age groups. Discussions also encompassed the various factors that serve as impediments to accessing diagnostic testing and obtaining results, as well as the critical need for access to diagnostics such as comprehensive genomic profiling (CGP), the results of which could be imperative in helping to guide clinical decisions regarding effective and well-tolerated targeted therapies. The Symposium generated key calls to action regarding increasing EAOC education and awareness among primary care providers and the public, re-evaluation of cancer screening programs' eligibility criteria to include younger populations, and mechanisms to reduce waiting times for diagnostic testing by addressing technologist shortages and improving access to CGP through national collaborative strategies and increased funding.

Sexual dysfunction is a prevalent and often under-addressed concern among prostate cancer survivors, significantly affecting quality of life for patients and their partners. The True North Sexual Health and Rehabilitation eClinic (SHAReClinic) is a virtual, biopsychosocial intervention developed to improve access to sexual health support for prostate cancer survivors and their partners. This study used a qualitative descriptive design to examine barriers and facilitators influencing the integration of SHAReClinic into oncology care across nine Canadian health care centres. Semi-structured interviews were conducted with 17 knowledge users, including health care providers and institutional leaders. Data were analyzed using a hybrid deductive-inductive thematic approach guided by the Consolidated Framework for Implementation Research (CFIR) 2.0. Participants described SHAReClinic as a much-needed resource, particularly in the absence of standardized sexual health pathways in oncology care. The virtual format was seen as accessible and well suited to addressing sensitive topics. However, limited funding, lack of institutional support, and workflow integration challenges emerged as primary barriers to implementation. Findings offer practical, theory-informed guidance for integrating SHAReClinic into oncology care and highlight key considerations for developing sustainable and scalable survivorship care models.

Bladder cancer (BC) is the ninth most common malignancy worldwide. Squamous cell carcinoma (SqCC), a rare histological variant, accounts for approximately 2-5% of all BC cases. Compared to urothelial carcinoma, the predominant subtype, research on SqCC remains limited and shows inconsistent findings regarding prognosis. This study aimed to compare survival outcomes between patients with SqCC and those with pure urothelial carcinoma (PUC).

This retrospective, observational study analyzed pathology reports from 2549 transurethral resections of bladder tumors and 632 cystectomies performed at our institution between 1 December 2010 and 31 December 2023. Following pathological re-evaluation, 33 patients with SqCC and 132 with PUC were identified. After 1:3 propensity score matching, 20 patients with SqCC and 58 with PUC were included in the final analysis. Demographic, clinicopathological features, and survival outcomes were compared between groups.

The median follow-up was 2.31 years (range: 0.17-13.50). No significant differences in baseline demographic or clinical characteristics were observed, except for the type of surgery. Kaplan-Meier analysis demonstrated no significant differences in disease-free survival (DFS; p = 0.961) or overall survival (OS; p = 0.847) between SqCC and PUC groups. Multivariate Cox regression analysis identified T stage, nodal involvement, and adjuvant chemotherapy (CT) as independent predictors of DFS, while sex and metastasis at diagnosis were significant predictors of OS.

Survival outcomes (DFS and OS) did not significantly differ between patients with SqCC and patients with PUC. Prognosis was more closely associated with disease stage at diagnosis, sex, and adjuvant CT. Further large-scale studies are warranted.

This retrospective study aimed to assess the effectiveness of prophylactic hepatoprotective therapy in decreasing the incidence of drug-induced liver injury (DILI) among patients with cervical cancer undergoing chemotherapy. The analysis was performed on patients with cervical cancer who received chemotherapy at a tertiary hospital between September 2019 and August 2020. Propensity score matching (PSM) was utilized to equilibrate baseline characteristics between the treatment group, which received prophylactic hepatoprotective drugs, and the control group, which did not receive prophylaxis. The incidence and severity of liver injury were evaluated using the Common Terminology Criteria for Adverse Events (CTCAE) version 5.0. Out of the 609 patients initially screened, 299 were included following PSM, with 105 in the treatment group and 194 in the control group. There were no significant differences in the incidence of liver injury (21.90% vs. 18.04%, p = 0.420) or its severity (p = 0.348) observed between the groups. Furthermore, none of the subgroups exhibited a significant reduction in DILI risk with prophylaxis. However, the number of patients experiencing an increase in their grade of liver injury was significantly higher in the treatment group (18.10% vs. 13.40%, p = 0.002), with these patients also exhibiting increased levels of alkaline phosphatase (ALP) and direct bilirubin (DBIL) post-chemotherapy (p < 0.05). Hepatoprotective drugs are not associated with a reduced risk of DILI and may in fact increase risk.

The prevalence of cancer is rising both in Canada and across the world, with approximately 35 million new cases predicted by 2050. Cancer immunotherapy is a form of treatment that harnesses the body's immune system to fight cancer cells, increasing life expectancy beyond what traditional treatments offer. Immunotherapy may cause immune-related adverse events that differ from the toxicities of traditional treatments. While these events can be detrimental to health, it is critical that they are caught early. This perspective paper examines the evolving role of oncology nurses within the cancer care continuum in caring for patients receiving cancer immunotherapy, specifically immune checkpoint inhibitors. Oncology nurses provide care in many areas, specifically in educating patients on the early detection of side effects to prevent negative outcomes, assessing and monitoring patient symptoms through a variety of means, including nurse-led clinics, and providing support to patients undergoing therapy. This work helps identify gaps in the literature. Future research is required for advancing cancer immunotherapies and better detecting early signs of side effects for nurses practicing in different settings, ensuring timely care.

A single measurement or a summary of a limited number of measurements of CA125 was considered in the prediction of clinical outcomes for patients with ovarian cancer. We aimed to identify the classes of patients with advanced ovarian cancer based on their CA125 trajectory and to investigate the heterogeneity of clinical outcomes among the patients in the different classes.

CA125 trajectory classes were identified by latent-class mixed models based on values collected within 3 and 6 months post-treatment for 819 women with advanced ovarian cancer enrolled in a randomized trial.

Based on their CA125 values during the first 6 months of treatment, the patients with low CA125 levels at baseline that remained low during treatment had the best clinical outcome (a median survival of 83 months and a progression-free survival of 34 months). In contrast, the patients with high CA125 values at baseline with a modest decrease during treatment had the highest risk of death and progression (hazard ratio [95% confidence interval]: 4.83 [3.56, 6.54] for overall survival and 5.15 [3.87, 6.87] for progression-free survival).

Longitudinal trajectories of CA125 may provide more direct information for the prognoses of patients with advanced ovarian cancer undergoing chemotherapy treatment.

Among adult advanced cancer patients already accessing palliative care, symptoms can contribute to unplanned acute care utilizations, which can disrupt care and worsen patient outcomes. We examined how a novel symptom complexity algorithm, using patients' ratings of the nine Edmonton Symptom Assessment System-Revised (ESAS-r) symptoms to assign "low", "medium", or "high" complexity, predicts acute care utilizations. This retrospective observational cohort study used electronic medical record data from the Durham Regional Cancer Centre in Ontario, Canada, comprising adult advanced cancer patients who completed at least one ESAS-r report between 1 January 2022 and 31 December 2023. We applied chi-squared tests, Kruskal-Wallis H tests, and multivariable binary logistic regressions to evaluate factors associated with higher odds of acute care utilization within seven and fourteen days of patients' first ESAS-r reports after their first palliative care interaction. Of 559 included patients, 125 (22.4%) exhibited low complexity, 180 (32.2%) exhibited medium complexity, and 254 (45.4%) exhibited high complexity on their first ESAS-r report. In total, 61 (10.9%) patients accessed acute care within seven days and 108 (19.3%) patients accessed acute care within fourteen days of their first ESAS-r report. Controlling for sociodemographic and clinical covariates, compared to low-complexity patients, high-complexity patients had higher odds of acute care utilization within seven days (aOR = 2.83, 95% CI: 1.18-6.77), but not within fourteen days (aOR = 1.78, 95% CI: 0.97-3.28). Accordingly, as a clinical decision-making tool, ESAS-r symptom complexity may help identify patients who would benefit from more intensive follow-up and potentially reduce unnecessary acute care utilizations.

Radiation therapy, including external-beam radiation therapy (EBRT) and brachytherapy, is curative for localized prostate cancer. Hydrogel spacer (HS) placement between the rectum and prostate is popular for reducing radiation-related complications. Criteria to identify patients who benefit from HS placement would be clinically valuable. In a retrospective analysis of 430 patients with localized prostate cancer treated between November 2010 and March 2023 with ≥2 years of follow-up, we evaluated the incidence of rectal hemorrhage and its association with the median distance at the midpoint between the prostate and the rectum (mDPR) on pretreatment MRI. Rectal hemorrhage occurred in 6% of HS cases and 18% of non-HS cases (p < 0.001). Among 268 patients who received EBRT (±brachytherapy), the incidence was 9% with HS and 30% without HS (p < 0.001). In non-HS cases, the rate in patients with mDPR ≤ 1.62 mm was higher than in those with mDPR > 1.62 mm (24% vs. 12%, respectively; p = 0.04). In patients with EBRT and mDPR ≤ 1.62 mm, HS significantly reduced hemorrhage (9% vs. 39%, respectively; p < 0.001). Multivariate analysis identified mDPR and HS as independent predictors of rectal hemorrhage (both p = 0.02). Thus, HS placement may be safely omitted in non-EBRT cases with mDPR ≥ 1.62 mm.

This retrospective cohort study evaluated characteristics, treatment patterns, and clinical outcomes in adults with locally advanced/metastatic urothelial carcinoma (la/mUC) receiving first-line (1L) systemic treatment with or without avelumab 1L maintenance (1LM) between January 2020 and July 2023. The index date was the first date with a claim for 1L systemic therapy after a la/mUC diagnosis. Patients with continuous health plan enrollment for ≥6 months before and ≥1 month after the index date were identified from Carelon Research's Healthcare Integrated Research Database. Of 2820 patients receiving 1L treatment, 37.0% received platinum-based chemotherapy (PBC); 39.0%, immuno-oncology (IO) monotherapy; and 24.0%, other therapies. Renal disease and other comorbidities influenced 1L regimen choice. Healthcare resource utilization (HCRU) and costs were reported for patients receiving second-line (2L) treatment. HCRU was high in 32.8% of patients (926 of 2820) who received 2L treatment. Median all-cause direct medical costs per patient per month were USD 15,859, USD 19,781, USD 11,346, and USD 9516 for 1L PBC, 1L PBC + avelumab 1LM, 1L IO monotherapy, and 1L other therapies, respectively. Most direct healthcare costs were attributed to all-cause outpatient visits.