PurposeWomen with breast cancer face many psychosocial problems. This study aims to determine the spiritual experiences of women diagnosed with breast cancer and the effect of these experiences on their psychosocial well-being.MethodsThe study was conducted with thematic analysis approach, and the sample consisted of women diagnosed with breast cancer (n = 15). The findings were obtained through individual semi-structured interviews, guided by the interview form presented in the Supplementary Materials. The thematic approach was employed to analyze data.ResultsThe main themes identified in this study were ‘spiritual empowerment and coping strategies during the breast cancer process’, ‘the impact of spirituality on social bonding and emotional support’, ‘empowerment and identity building through spirituality’, and ‘integration of spirituality into holistic cancer care’.ConclusionFindings of the present study revealed that spirituality contributes to strengthening the emotional and social support mechanisms of patients, helping them develop coping strategies, and improving their psychosocial well-being. Raising the sensitivity of healthcare professionals to spiritual care and integrating it into patient care can help address the psychosocial needs of patients more comprehensively. Furthermore, promoting spiritual counselling services may improve the psychosocial well-being of patients.Supplementary InformationThe online version contains supplementary material available at 10.1007/s00520-026-10569-2.

ObjectiveThis study aimed to clarify the topological structure, core symptoms, and inter-symptom association patterns of the symptom network in lung cancer patients receiving taxane-based chemotherapy and to provide a basis for formulating precise symptom management strategies.MethodsA convenience sampling method was used to enroll 315 hospitalized lung cancer patients who received taxane-based chemotherapy (paclitaxel, albumin-bound paclitaxel, docetaxel) in a Grade III-A hospital in Shanghai from January 2023 to June 2024. Data on demographics, physiological, psychological, and symptomatic variables were collected using a general information questionnaire, the Chemotherapy-Induced Peripheral Neuropathy Assessment Tool (CIPNAT), the Pittsburgh Sleep Quality Index (PSQI), the Psychological Capital Questionnaire (PCQ), and the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire-Core 30 (EORTC QLQ-C30). A symptom network was constructed using the graphical LASSO (least absolute shrinkage and selection operator) based on the Extended Bayesian Information Criterion (EBIC) (EBIC-glasso) algorithm. Centrality analysis was conducted to identify core symptoms; the bootstrap method was used to verify the network accuracy and stability, and the Network Comparison Test (NCT) was applied to analyze differences in network structure between two age groups (≤ 65 years vs. > 65 years).ResultsAmong the 315 patients, 86.35% were male, with a median age of 68 years (interquartile range (IQR): 60.50–72.00 years), and 58.73% were aged over 65 years. Three pairs of strongly correlated symptoms were identified in the symptom network: optimism and hope (r = 0.625), symptom frequency and bothersomeness (r = 0.603), and sleep efficiency and sleep duration (r = 0.522). The network was dominated by positive connections and exhibited high global connectivity, indicating that symptoms tended to co-occur and mutually reinforce each other. Centrality analysis showed that fatigue (QLQ7) was the key hub node in the network, with the highest strength centrality (2.735), closeness centrality (2.078), and betweenness centrality (3.944). The frequency of chemotherapy-induced peripheral neuropathy (CIPNAT3) was the driver node of the network, with the highest expected influence (EI = 1.417). The network showed good stability, with a correlation stability (CS) coefficient of 0.673 for strength centrality and expected influence. Subgroup analysis by age revealed no significant differences in network structure (M = 0.240, p = 0.347) or global connectivity (12.516 vs. 12.418, p = 0.802) between the two age groups.ConclusionThe symptom network of lung cancer patients receiving taxane-based chemotherapy exhibits a tightly interconnected characteristic. Fatigue is the core hub symptom, and the frequency of chemotherapy-induced peripheral neuropathy is the key driver symptom. Additionally, the network structure shows age universality. Clinically, interventions can be prioritized for the aforementioned core symptoms to achieve efficient management of the overall symptom cluster.

PurposeStandardized quality metrics are critical to evaluate guideline adherence and outcomes, yet these are rarely tracked outside of time-limited research studies in resource-constrained settings. We describe the early implementation of the Global Fever Registry (FEVEREG), an electronic registry designed to collect local quality indicators and support implementation of a clinical guideline for fever with neutropenia in children with cancer.MethodsBetween 2021 and 2023, the registry was introduced at six referral hospitals in Central America and the Caribbean. We assessed the feasibility of a cohort-based implementation model through descriptive analysis of the duration of key implementation steps, delays in data entry, completion of required data fields, and center participation.ResultsOver 2 years, 619 febrile episodes from 472 children were recorded. The all-site median delay from episode onset to database entry was over 30 days, but two centers had median delays of > 4 months; one subsequently discontinued registry use. Audits at 14 and 24 months after registry activation demonstrated 89% completion of required fields at both time points. ConclusionA heterogeneous group of centers successfully implemented a common registry and achieved high data completeness. However, workforce shortages and competing clinical demands contributed to intermittent registry use and delayed entry, highlighting the need for institutional investment in data management. Registry data have already informed local quality improvement projects; future work should identify factors that sustain long-term use.Supplementary InformationThe online version contains supplementary material available at 10.1007/s00520-026-10539-8.

PurposeWhat are the perceptions and practices regarding protein energy malnutrition (PEM) screening and assessment for patients with cancer among health professionals working in the cancer setting, and how have these perceptions and practices changed since the COVID-19 pandemic?MethodsA repeated cross-sectional study was conducted in 2018 (pre-COVID-19) and 2024 (post-COVID-19) using a study-specific online 24-item questionnaire. Qualified health professionals working as clinicians in the cancer setting were eligible. The survey was disseminated via professional associations internationally. Data were analysed in Stata/MP 18.5. ResultsOf N = 282 participants included (n = 197 pre-COVID-19, n = 85 post-COVID-19), most were dietitians (39%) from Oceania (29%). The reporting of workplace nutrition screening policies increased between pre- and post-COVID-19, especially in North America (56% to 100%, p = 0.013). Barriers to nutrition screening remained consistent pre- and post-COVID-19 except in North America where limited awareness increased (50% to 93%, p = 0.019) and in Oceania where there was a decrease in incorrect use of a screening tool (63% to 36%, p = 0.027). Nutrition screening and assessment implementation remained mostly unchanged, except for an increase in patient self-screening (15% to 28%; p = 0.029) and fewer non-admission assessments conducted in Oceania.ConclusionWhile some positive changes were observed between the pre- and post-COVID-19 period, nutrition screening and assessment continue to face many barriers. This has led to a lack of improvement or decline in nutrition screening and assessment practices in most regions and settings. PEM identification must evolve to ensure early detection for best patient care and in preparedness for future global health events.Supplementary InformationThe online version contains supplementary material available at 10.1007/s00520-026-10338-1.

Chemotherapy-induced peripheral neuropathy (CIPN) is a prevalent and debilitating side effect of neurotoxic chemotherapeutic agents. Patient-reported outcome (PRO) measures are widely utilized to assess CIPN severity; however, they are subject to bias and variability. This prospective case series investigates whether gait parameters provide an objective measure of CIPN severity. This pilot study consisted of 27 patients: 9 active CIPN, 9 CIPN resolved, and 9 healthy controls. Gait parameters including velocity, ambulation time, cadence, distance, and number of steps were assessed using GAITRite®. Treatment-Induced Neuropathy Assessment Scale (TNAS) pain and PROMIS® 29 + 2 Profile v2.1 (PROPr) scores were collected and correlated with gait measures. Patients with active CIPN exhibited significant gait impairments compared to both CIPN-resolved and healthy control groups. Active CIPN patients exhibited significantly slower velocity, greater step count, shorter walking distance, and longer ambulation time as compared to both CIPN-resolved and healthy control groups. Active CIPN patients also had higher cadence than healthy controls. TNAS pain scores were significantly negatively correlated with velocity and positively correlated with ambulation time in active CIPN patients. PROPr domains (pain intensity, pain interference, and physical function) were significantly correlated with velocity and ambulation time. Our preliminary findings demonstrate the potential for gait parameters to serve as an objective and relatively quick method for assessing CIPN severity. Further studies with a larger and more diverse sample will be necessary to establish gait as a clinical tool for evaluating severity, functional decline, and recovery in cancer survivors.

PurposeLimited research has evaluated the success criteria and priorities for symptom improvement of patients with cancer to inform patient-centered care. In this study, we adapted and tested a measure of these constructs, the Patient-Centered Outcomes Questionnaire (PCOQ), for patients with advanced prostate cancer. We compared acceptable symptom severity levels following symptom treatment across 10 symptoms and identified patient subgroups based on symptom importance.MethodsPatients with advanced prostate cancer (N = 99) participated in a one-time survey, which included a modified version of the PCOQ, standard symptom measures, and additional clinical characteristics.ResultsThe modified PCOQ demonstrated construct validity through its correlations with related theoretical constructs. There was a moderate correlation between symptom severity and importance. Acceptable symptom severity levels were generally low, with sexual dysfunction having a higher acceptable severity than most other symptoms. Three patient subgroups were identified: (1) those who rated all symptoms as low in importance (n = 43); (2) those who rated all symptoms as moderately important (n = 33); and (3) those who rated all symptoms as highly important (n = 18). Subgroups were associated with functional status, fatigue, sleep problems, pain, and emotional distress.ConclusionThe modified PCOQ demonstrated preliminary evidence of construct validity. Patients generally considered low symptom severity to be acceptable, with variations across symptoms. Results suggest that symptom severity and importance are related but distinct aspects of the symptom experience in advanced prostate cancer. Patients’ diverse priorities for symptom improvement point to the need for individualized treatment plans.Supplementary InformationThe online version contains supplementary material available at 10.1007/s00520-025-10299-x.

BackgroundWith rising cancer survival rates and an increasing number of cancer survivors, the sustainability of secondary care follow-up care is under pressure. Transferring certain follow-up tasks to primary care is suggested as a potential solution, but there is no consensus on the optimal strategy for this.PurposeTo identify preferences of primary and secondary healthcare providers regarding the transfer of follow-up care for breast, colorectal, and prostate cancer, using a discrete choice experiment (DCE).MethodA DCE was conducted among 153 primary and secondary healthcare professionals in the Netherlands. Attributes related to patient and follow-up characteristics included: type of cancer, age, time post-treatment, any protocolled care for comorbidities, recurrence risk, and types of check-up protocols. A conditional logit model and latent class analysis were used to assess preferences and identify subgroups.ResultsHealthcare providers favored the transfer of follow-up care to primary care for prostate cancer patients. Across all cancer types, preferences for substitution were greater in patients aged above 75 years, longer post-treatment, a low recurrence risk, and who were already enrolled in protocolized chronic care. Transfer of basic check-up care was preferred, while extensive check-up was negatively valued, especially by GPs.ConclusionFuture follow-up should focus on patient groups and tasks for which consensus exists that primary care involvement is feasible and appropriate, forming the basis for sustainable, collaborative, and patient-centered models of care.Supplementary InformationThe online version contains supplementary material available at 10.1007/s00520-026-10538-9.

PurposeThis study was conducted to evaluate the impact of the ONKOSIS mobile application, developed within the scope of the study, on the management of chemotherapy-related symptoms and quality of life.MethodsThis randomized controlled, single-blind experimental design study was carried out with the participation of 199 patients at the Kocaeli University Semahat Aracı Oncology and Palliative Care Center, Outpatient Chemotherapy Unit. In the study, which used simple randomization, the intervention group consisted of 98 patients and the control group consisted of 101 patients. During chemotherapy treatment, in addition to standard care for symptom management, the intervention group used the ONKOSIS mobile application, while the control group used a demo mobile application. The study data were obtained through the Diagnostic Form, Nightingale Symptom Assessment Scale, Coping with Chemotherapy Symptoms Form, and patient satisfaction survey. The follow-up frequency was planned according to the type of treatment protocol applied to the patients. Patients who received four cycles of treatment were followed up after the 2nd, 3rd, and 4th cycles, while patients who received six cycles of treatment were followed up after the 2nd, 4th, and 6th cycles.ResultsThe study group had a mean age of 47.18 ± 13.83; 74.4% were female. Treatment cycles of 2, 3, or 4 weeks were provided for 26.6% of patients receiving treatment for gastrointestinal cancer, 21.6% for breast cancer, and 17.1% for lung cancer. Sociodemographic and clinical characteristics were similar between groups. Although the intervention group exhibited greater initial symptom burden (higher N-SAS scores at T1/T2), their symptom trajectory improved significantly over time compared to the control group, supporting the role of mHealth in enhancing outcomes. The use of ONKOSIS improved quality of life and patient satisfaction but did not reduce unscheduled healthcare visits.ConclusionThe ONKOSIS mobile application was found to be an effective tool in supporting symptom management and improving the quality of life for cancer patients during the treatment process. It was determined that the widespread adoption of the mobile application in cancer care could contribute to improving patient outcomes and enhancing care quality.Trial registrationClinicalTrials.gov ID: NCT05946070. Registered on June 22, 2023

PurposeCancer-related fatigue (CRF) is a common and debilitating symptom in palliative care, with limited effective treatments. This study evaluated the efficacy and safety of K-style contact needle technique (CNT), a non-invasive form of traditional Japanese acupuncture, for alleviating CRF.MethodsIn this multicenter, single-blind randomized controlled trial, 119 patients with stage III or IV cancer and moderate to severe fatigue (≥ 4 on a Numerical Rating Scale [NRS]) were randomized to receive either CNT or sham CNT weekly for 4 weeks. The primary outcome was change in fatigue NRS scores. Secondary outcomes included the Cancer Fatigue Scale (CFS), Support Team Assessment Schedule-Japanese version (STAS-J), Palliative Prognostic Index (PPI), Palliative Performance Scale (PPS), salivary amylase activity (SAA), and adverse events.ResultsAlthough no significant difference was observed in the primary outcome between groups by t test, multiple regression analysis at Week 4 revealed a significant treatment effect for CNT (β = 1.548, p = 0.029). CNT also improved STAS-J scores (β = 1.758, p = 0.044) and reduced SAA at Week 2 and final evaluation (p < 0.05). No serious adverse events occurred.ConclusionsCNT may be a safe, gentle, and potentially effective intervention for managing fatigue and distress in palliative care patients with advanced cancer. Further research is warranted to confirm these findings and assess long-term outcomes.Trial registration UMIN000028304, registered on July 21st, 2017; https://upload.umin.ac.jp/cgi-open-bin/ctr_e/ctr_view.cgi?recptno=R000032401Supplementary InformationThe online version contains supplementary material available at 10.1007/s00520-026-10430-6.

PurposeGiven the impact of place of death (PoD) on end-of-life quality and policy planning, this study examined the distribution and determinants of PoD among older adults receiving palliative care in Taiwan, with a focus on service models and referral-to-death intervals.MethodsThis population-based study analyzed linked data from the Health and Welfare Data Science Center in Taiwan for 177,403 decedents aged ≥ 65 years who received palliative care and died between 2010 and 2020. Multivariable logistic regression was employed to examine associations between PoD and individual characteristics, hospital attributes, palliative care models, and referral-to-death intervals.ResultsHospital was the most common PoD (61.5%), followed by home (35.8%). Home death was more likely among females (OR 1.08, 95% CI 1.05–1.10), those aged 75–79 years (OR 1.29, 95% CI 1.25–1.34), cancer decedents (OR 1.40, 95% CI 1.36–1.45), and those receiving palliative care in private hospitals (OR 1.31, 95% CI 1.28–1.34). Use of home palliative care (OR 3.93, 95% CI 3.71–4.16) or home care combined with shared-care services during admission (OR 3.89, 95% CI 3.72–4.06) was strongly associated with home death. Referrals longer than 180 days were associated with a lower likelihood of hospital death (OR 0.84, 95% CI 0.79–0.90).ConclusionAmong older palliative care recipients, early referral and access to home-based and shared-care services play a significant role in promoting home death. Optimizing end-of-life care may require integrating these elements into palliative care policy and service planning.Supplementary informationThe online version contains supplementary material available at 10.1007/s00520-026-10408-4.