PurposeWe examined trends in emotional distress among survivors of childhood and adolescent and young adult (CAYA) cancers.MethodsWe analyzed the 2008–2018 National Health Interview Survey (NHIS) data among individuals (n = 6451) who were diagnosed with cancer between 0 and 39 years of age. Emotional distress was assessed using the validated Kessler 6-item scale. Respondents rated how often they felt nervous, hopeless, restless, or fidgety, so sad that nothing could cheer them up, that everything was an effort, and worthless in the past 30 days. Responses were scored and added to produce a range of 0–24. We classified emotional distress as mild/no (score of less <5), moderate (score between 5 and 12), or severe distress (≥ 13). Joinpoint regression estimated yearly increases/decreases in psychological distress using annual percent changes.ResultsOverall, the proportion of individuals experiencing mild/no psychological distress increased by 1.68% annually between 2008 and 2014 and then decreased by 1.34% annually between 2014 and 2018, although not statistically significant. The proportion of individuals experiencing moderate distress decreased by 3.06% annually between 2008 and 2014 and then increased by 4.18% annually between 2014 and 2018, although not statistically significant. The proportion of individuals experiencing severe distress remained stable between 2008 and 2014 and then decreased by 7.36% annually between 2014 and 2018, although not statistically significant. No statistically significant trend in emotional distress was observed when stratified by patients’ demographics and access to mental health services.ConclusionWe found that trends in emotional distress among survivors of CAYA cancers have not changed significantly over the 2008–2018 decade, overall and when stratified by gender, race/ethnicity, marital status, and visit to a mental health professional within the past year.Supplementary InformationThe online version contains supplementary material available at 10.1007/s00520-026-10580-7.

PurposeThe Multinational Association of Supportive Care in Cancer and the International Society of Oral Oncology (MASCC/ISOO) has published evidence-based international guidelines for the management of oral mucositis (OM). However, adherence to these guidelines has not been evaluated. This survey assessed OM management in hematopoietic cell transplantation (HCT) centers in Australia and New Zealand.MethodsSpecialist nurses in 41 transplant hospitals were invited to complete a survey. Questions covered general unit information, oral assessment (tools, assessors, frequency), prevention strategies (guidelines, oral care, cryotherapy, photobiomodulation, palifermin, and barriers to use), and treatment strategies (pain management and nutritional support).ResultsOf 41 hospitals, 24 (59%) responded. All but one responder were specialized nurses. Oral assessment was primarily conducted by nurses (100%) and doctors (80%). The most commonly used tools were the World Health Organization grading scale (42%), pain scores (46%), and EviQ (Australian online cancer resource) (42%). EviQ guidelines (67%), which exclude palifermin and photobiomodulation, followed by institutional guidelines (29%) and MASCC/ISOO guidelines (17%). Oral care (100%) and cryotherapy with melphalan (96%) were widely adopted, while photobiomodulation and palifermin were rarely used due to cost and access barriers. For OM-related pain, as-needed opioids (100%), patient-controlled analgesia (58%), and topical analgesics (46%) were common. When OM impaired oral intake, supportive measures included supplemental drinks (88%), enteral nutrition (50%), and parenteral nutrition (67%).ConclusionIn Australia and New Zealand, national EviQ guidelines are used more often than the MASCC/ISOO guidelines. Feasibility for implementing palifermin and photobiomodulation should be reassessed, and greater collaboration in developing guidelines is necessary.

PurposeThis study aimed to evaluate the effects of a 12-week multicomponent intervention combining fixed-seat rowing (falucho) with targeted strength and flexibility exercises on physical and psychosocial outcomes in women with and without a history of breast cancer.MethodsA quasi-experimental, parallel-group design was employed. Nineteen breast cancer survivors and nineteen healthy women participated in a structured program consisting of twice-weekly open-water rowing sessions and gym-based conditioning exercises. Functional, psychological, and quality of life variables were assessed at baseline and post-intervention using validated tools (Hand Grip Strength, 30-Seconds Sit to Stand Test, QuickDASH, Piper Fatigue Scale, and WHOQOL-BREF). A multivariate repeated measures model and bootstrapping methods were used for statistical analysis.ResultsSignificant improvements over time were observed in all functional variables across both groups. Notably, breast cancer survivors showed greater reductions in upper limb disability (QuickDASH, p = 0.011) and cancer-related fatigue (Piper score, p < 0.001). Positive effects on quality of life were also found, particularly in the physical dimension. Group-based rowing in an outdoor maritime setting may have contributed to improved emotional well-being and social engagement, although psychological, social, and environmental domains showed only time-related effects. Attendance exceeded 80% of planned sessions, with no adverse events reported.ConclusionThis intervention appears to be a feasible and beneficial strategy to enhance physical function, reduce fatigue, and support psychosocial recovery in breast cancer survivors. The findings suggest that traditional rowing, especially when combined with complementary exercises, may be a valuable addition to oncology rehabilitation programs.Supplementary InformationThe online version contains supplementary material available at 10.1007/s00520-026-10361-2.

PurposeThis study aimed to evaluate the efficacy and potential pharmacological interaction of naldemedine and magnesium oxide (MgO) in the management of opioid-induced constipation (OIC) in cancer patients, with a particular focus on the impact of different MgO doses on treatment outcomes.MethodsA total of 171 patients who received opioid therapy were included in this study. The outcome variable was defecation. Daily defecation status during the observation period was extracted from electronic medical records. To assess the effects and potential interaction between naldemedine and MgO on defecation, a generalized estimating equations (GEE) model with a logit link function was used to account for within-patient clustering. Predicted probabilities of defecation were calculated based on the fitted GEE model.ResultsThe probability of defecation increased with higher doses of MgO. Among patients receiving both MgO and naldemedine, the likelihood of defecation was significantly higher at MgO doses ≤ 1500 mg compared to those receiving MgO alone. However, at doses > 1500 mg, naldemedine did not add further benefit. Naldemedine was independently associated with improved bowel movements, regardless of MgO use. The association between MgO and defecation also strengthened with increasing doses. No significant interaction between naldemedine and MgO was observed at any dose.ConclusionThe concomitant use of MgO and naldemedine was associated with improved defecation, although no statistically significant interaction was detected. However, the added benefit of naldemedine may be limited at higher MgO doses. Naldemedine may be particularly effective in patients with constipation during opioid therapy that is insufficiently responsive to conventional laxatives, especially when an increase in MgO is difficult due to risks such as hypermagnesemia.Supplementary InformationThe online version contains supplementary material available at 10.1007/s00520-026-10487-3.

PurposeThe increasing incidence of bone metastases frequently leads to skeletal-related events (SREs) and pain. While multidisciplinary management is recommended by scientific societies, a standardized model remains undefined. An example can be provided by the Osteoncology multidisciplinary outpatient clinic (OMC) of the Veneto Oncology Institute, created to offer support to patients with bone metastases.Patients and methodsPatients with bone metastases are evaluated by a multidisciplinary team since 2013. Access to the OMC is regulated by an internal protocol and a form filled out by the referring physicians, which establishes the priority of access and the specific query for the multidisciplinary team. We analyzed the characteristics and outcome of OMC visits of all patients who accessed between January 2018 and June 2023. All data were retrieved from a prospectively managed database.Results2,200 patients were evaluated at OMC, with a median age of 66 years. Breast (33.3%) and lung cancer (19.2%) were the most frequent primary sites. Most patients (85.1%) accessed the OMC in line with the priority indicated by their referral score, with a median waiting time of 6 days. Physicians most frequently asked the multidisciplinary team about the best treatment for bone metastases; 35% sent multiple requests. Following OMC visit, 31.5% of patients received two or more distinct indications. The most frequent were orthopedic corsets (28.3%) and radiotherapy (27.5%).ConclusionThis large series confirms the efficacy of a multidisciplinary approach for bone metastases. This method reduces patients' psychophysical stress through rapid and effective assessment and provide precise and tailored therapeutic indications.

PurposePatient navigation programs have demonstrated intervention efficacy associated with barrier reduction and health outcome improvements in the context of cancer care. Greater characterization of barriers and barrier resolution likelihoods may support program optimization.MethodsA 3-month longitudinal, non-comparative community-focused (i.e., lay navigator) patient navigation program was implemented at an NCI-designed cancer center between 2018 and 2021. Barriers to cancer care were reported by patients (n = 207) at pre-intervention and re-assessed at post-intervention. Descriptive analyses examined patient-level associations among pre-intervention barriers and post-intervention rates of barrier resolution. Logistic regressions were conducted at the barrier level and patient level to estimate the likelihood of barrier resolution associated with Health Access, Financial, and Psychosocial barrier domains.ResultsParticipants reported an average of 3.54 distinct barriers to cancer care. Barriers associated with Health Access and Financial domains were most frequently endorsed. Post-navigation, barriers were found to differ in their resolution rates. At the barrier domain level, resolution rates differed significantly (X2(2) = 7.826, p = 0.02), with Financial barriers significantly less likely (OR = 0.61; 95% CI = 0.41, 0.89) to be resolved. For participants who reported barriers exclusively within the Financial domain, the odds of any of their barriers being “resolved” were approximately 77% lower compared to participants who reported barriers in other domains.ConclusionIn this community-focused patient navigation program, barriers in the Financial domain proved to be the most difficult to resolve. The amenability of specific barriers to resolution via patient navigation can guide program tailoring and optimization.

ObjectiveTo explore the potential profiles of cancer-related fatigue (CRF) in colorectal cancer patients and their relationship with exercise adherence.MethodsA cross-sectional study was conducted with 329 patients with colorectal cancer in Wuhan, Hubei Province China from March to September 2024. Data were collected using general information questionnaires, the Cancer Fatigue Scale, and the Exercise Adherence Scale. Latent profile analysis was applied to explore the latent profiles of CRF. Multivariate logistic regression was used to analyze the sociodemographic variables in each profile, and ANOVA was used to explore the relationships between CRF profiles and exercise adherence.ResultsCRF in colorectal cancer patients can be categorized into three profiles: low CRF cognitively clear group (n = 138, 41.9%), moderate CRF balanced group (n = 165, 50.2%), and high CRF severe physical group (n = 26, 7.9%). Multivariate logistic regression analysis showed that living arrangements, recurrence and/or metastasis, the number of chemotherapies, and BMI were influencing factors for the profiles of CRF in colorectal cancer patients. There were statistically significant differences in the scores of various dimensions and the total score of exercise adherence among colorectal cancer patients with different profiles of CRF (P < 0.05).ConclusionCRF in colorectal cancer patients can be divided into three profiles, and there are differences in exercise adherence among colorectal cancer patients with different profiles of CRF. It is recommended that healthcare professionals develop targeted interventions based on the different profiles of colorectal cancer patients to improve their exercise adherence and enhance their quality of life.

PurposeOral supportive care is essential in comprehensive cancer management, particularly for patients with head and neck cancer and those with hematologic cancers, who experience significant oral complications. While supportive care has been extensively explored in medical oncology, dentists’ knowledge and practices regarding oral supportive care for cancer patients remain understudied. This study aimed to assess French dentists’ knowledge, practices, and training needs regarding supportive care for cancer patients.MethodsA cross-sectional survey was distributed electronically to dental surgeons across France through Departmental Councils of the Order of Dental Surgeons. The questionnaire investigated practitioners’ knowledge of cancer patient management, care modalities, encountered difficulties, knowledge of supportive care, and training needs.ResultsAmong 165 respondents, 96% reported treating cancer patients, with head and neck cancers being significantly over-represented compared to general population incidence. Among respondents, 89% expressed concern about supportive care in oncology, while 73% rated their knowledge in this area below 5/10, and 27% were unaware of risks associated with cancer therapies. Head and neck cancers (54%) and hematological malignancies (15%) presented the greatest management challenges. The most common difficulties included performing invasive procedures (46.7%), writing prescriptions (45.8%), and completing medical questionnaires (40.2%). Only 29% of dentists reported having knowledge of supportive care in oncology, with 89% expressing a need for further training.ConclusionFrench dentists demonstrate concern about their role in cancer patient care, yet face significant knowledge gaps and training deficiencies. Enhanced educational programs, improved interprofessional communication, and clear clinical guidelines specifically designed for dental professionals are needed to optimize supportive care delivery for cancer patients.Supplementary InformationThe online version contains supplementary material available at 10.1007/s00520-026-10392-9.

PurposeThis longitudinal study explored the prevalence and cumulative incidence of pain among rural cancer survivors, assessed the prevalence of persistent pain over time, and identified sociodemographic, clinical, and psychological factors associated with worse outcomes.MethodsThis study was a secondary analysis of data from the Travelling for Treatment study. Adult cancer survivors living in Queensland, Australia, who had travelled ≥ 50 kms for cancer treatment were included (N = 659). Pain outcomes (intensity, interference, frequency) were assessed at baseline, three months, 12 months, and annually for up to five years using the Adjusted Quality of Life 8-Dimension Tool (AQoL-8D). Sociodemographic, clinical, and psychological factors were assessed at baseline. Prevalence and cumulative incidence of pain, and the proportion of cancer survivors reporting persistent pain was calculated. Cumulative link mixed models and binary logistic regression explored factors associated with pain outcomes and likelihood of experiencing persistent pain.ResultsAcross follow-up (median 3 years), 84% of rural cancer survivors reported moderate to unbearable pain, 64% reported serious pain at least weekly, and 66% reported that pain interfered with activities at least sometimes. Higher psychological distress was associated with worse pain intensity (aOR = 2.80, CI 2.24, 3.49), interference (aOR = 3.09, CI 2.56, 3.74) and more frequent serious pain (aOR = 2.46, CI 2.44, 2.47). Persistent pain was reported by 21% of rural cancer survivors and was also associated with increased psychological distress (aOR = 1.18, CI 2.56, 3.74).ConclusionPain is common among rural cancer survivors. Comprehensive interventions that address co-occurring mental and physical health comorbidities and facilitate open communication about pain are needed to ensure effective pain management and support for this population.Supplementary InformationThe online version contains supplementary material available at 10.1007/s00520-026-10622-0.

BackgroundSystematic collection of sexual orientation and gender identity (SOGI) data has been promoted by national organizations to identify and address LGBTQ+ (i.e., lesbian, gay, bisexual, transgender, queer, etc.) health disparities across the cancer care continuum. The purpose of this study was to identify key difference-making pathways distinguishing cancer care settings that systematically collect SOGI data from those that partially collect or do not collect SOGI data in oncology practice settings.MethodsFrom September 2022 to August 2023, interviews (n = 62) were conducted in oncology practices (n = 23) diverse in geographic location, affiliation, patient mix, size, and setting. Interviews were scored using a 5-point scale ranging from +2 to −2, with +2 representing a strong positive effect and −2 a strong negative effect based on the influence of each construct on SOGI data collection at the practice level. Coincidence analysis was conducted to identify difference-making facilitators and barriers to SOGI data collection.ResultsTwo metafactors involving three constructs consistently distinguished practices with systematic, partial, or no SOGI data collection. One metafactor acted as a facilitator (a “metafacilitator”) that was found across all seven sites reporting systematic SOGI data collection and consisted of the presence of either the maximum level of training or the maximum level of information technology (valence of +2). One metafactor served as a barrier (a “metabarrier”) that was found in four of five sites reporting no SOGI data collection and represented the combined presence of negative values (−1 or −2) for both training and leadership support. The pathway that accounted for 10 of the 11 sites with partial SOGI data collection was the absence of both the metafacilitator and the metabarrier: that is, neither having a +2 score for the training construct or the information technology construct nor having negative values for both the training construct and the leadership support construct.ConclusionsThis analysis identified a difference-making metafacilitator and metabarrier that consistently distinguished between three levels of SOGI data collection. The training construct appeared in both the metafacilitator and the metabarrier at different values, underscoring its crucial importance for SOGI data collection initiatives.Trial registrationNot applicable.