IntroductionVirtual consultations are increasingly being used in cancer rehabilitation, yet little is known about how the virtual consultation format shapes patients' sense of embodied presence and relational care. This study explores how women diagnosed with breast cancer or ductal carcinoma in situ experience rehabilitative virtual consultations with nurses and focuses on how virtual consultations influence bodily presence, body modalities, and relational interaction.MethodsAn exploratory qualitative study was conducted using semi-structured telephone interviews with fourteen women who had participated in a nurse-led rehabilitative virtual consultation one year after treatment. Using Braun and Clarke's Reflexive Thematic Analysis, we analysed the data with particular attention to how digital mediation reconfigured embodied presence and relational care.ResultsAcross the dataset, virtual consultations were experienced as altering body modalities and reducing embodied presence when bodily matters were addressed on-screen. Patients experienced vulnerability associated with the absence of physical co-presence and touch but also highlighted how the home environment created a sense of calm and safety. The analysis generated one overarching theme, The Body's Vulnerabilities in the Virtual Space, with four subthemes showing how virtual consultations continuously shifted between connection and disconnection, and how familiarity with the nurse supported relational grounding.DiscussionThe findings demonstrate that virtual consultations reconfigure embodied presence in cancer rehabilitation, which requires patients and nurses to negotiate new body modalities shaped by technology and by the environments from which they participate in the virtual consultation. These dynamics influence vulnerability, trust, and relational care, which underscores the need for digital health practices that recognize spatial embodiment and actively support embodied engagement at a distance.

BackgroundMaintaining activities of daily living is of great importance for patients who have cancer, and dependency is associated with psychological distress. However, evidence for rehabilitation remains scarce in this setting. The objective of this study was to evaluate the efficacy of a structured rehabilitation program for maintaining activities of daily living among patients with terminal cancer.MethodsThis multicenter randomized controlled trial across 19 Japanese inpatient hospices/palliative care units enrolled patients who had terminal cancer with an Eastern Cooperative Oncology Group performance status of 2–3, a life expectancy ≥3 weeks, and no severe symptoms. Participants were randomly assigned (1:1, stratified by performance status and site) to either a 3‐week structured rehabilitation program that incorporated key elements of rehabilitation for patients with terminal cancer or usual unstructured rehabilitation. The primary outcome was a change in the total modified Barthel Index from baseline to day 22. Secondary outcomes included the European Organization for Research and Treatment of Cancer Quality‐of‐Life Questionnaire Core 15–Palliative Care score and safety.ResultsBetween July 8, 2019, and February 20, 2024, 130 patients were randomized (59 to the intervention group, 71 to the control group; 56 patients [43.0%] were women). The primary analysis included 77 participants who had complete data available. The mean change in total modified Barthel Index was −1.31 (95% confidence interval [CI], −10.89, 8.08) in the intervention group and −15.51 (95% CI, −24.02, −7.01) in the control group. The between‐group difference was 14.21 (95% CI, 1.77–26.64; p = .026), exceeding the minimally clinically important difference (9.25). Patient‐reported physical functioning on the European for Research and Treatment of Cancer Quality‐of‐Life Questionnaire Core 15–Palliative Care instrument was also significantly higher in the intervention group than in the control group. No serious harms occurred.ConclusionsStructured rehabilitation maintained activities of daily living better than unstructured rehabilitation in patients with terminal cancer, supporting its integration into routine care even in the last stage of cancer.

The purpose of this study was to identify implementation strategies and determine priorities for establishing a seamless cancer rehabilitation delivery system based on consensus among multidisciplinary stakeholders. An online modified-Delphi study was conducted. A total of 100 stakeholders (healthcare professionals, researchers, cancer survivors, and members of patient support groups) with experience in cancer rehabilitation were invited. Participants selected the top three barriers to cancer rehabilitation in the first survey. In the second survey, the implementation strategy list was provided, and the effectiveness of each strategy was rated using a 4-point Likert scale. In the third survey, participants evaluated the impact and cost of successful implementation using a 4-point scale to determine priority. Valid responses were obtained from 85 participants for the first survey, 64 for the second survey, and 59 for the third survey. Consensus was reached on all 35 implementation strategies as effective measures (agreement rate for each item ranged from 70.3% to 98.4%). Fourteen items were judged very effective. The assessment of priority considering impact and cost indicated that reinforcing multidisciplinary collaboration and improving access to information were high priorities. This study identified implementation strategies and priorities for cancer rehabilitation based on expert consensus. These findings demonstrate that improving inter- and intra- organizational processes is as crucial as institutional and structural enhancements. The identified strategies are expected to bridge the gap between evidence and clinical practice in Japan, contributing to the promotion of effective, continuous cancer rehabilitation delivery systems.

Bridging gaps to improve referrals to cancer rehabilitation and exercise services for older adults: Co-creation of a primary care referral process through qualitative interviews.

Postmenopausal women with breast cancer and coexisting metabolic syndrome are at increased risk of breast cancer-related lymphedema (BCRL) and chronic systemic inflammation. Medically supervised exercise (MSE) has emerged as a promising non-pharmacological intervention to mitigate these complications. This systematic review and meta-analysis aimed to evaluate the effects of MSE on BCRL severity, inflammatory biomarkers, and quality of life (QoL) in this high-risk population. A systematic search was conducted across PubMed, Cochrane Library, and Scopus up to May 2024 for randomized controlled trials (RCTs) involving postmenopausal breast cancer survivors with metabolic syndrome who participated in MSE programs. Outcomes of interest included BCRL severity, inflammatory markers (hs-CRP, IL-6, TNF-α), and QoL. Data extraction and risk of bias assessment were performed independently by two reviewers following PRISMA 2020 guidelines. Pooled effect sizes were calculated using a random-effects model. Heterogeneity was assessed with the I2 statistic, and evidence quality was evaluated using GRADE. Fifteen RCTs (n = 1,197) were included. MSE significantly reduced systemic inflammatory markers (mean difference = 0.31; 95% CI: 0.05 to 0.57; P = 0.02) with moderate heterogeneity (I² = 50.4%). Subgroup analyses showed moderate-quality evidence for reductions in IL-6 and TNF-α, though results varied across studies. Evidence for CRP reduction was very low due to high heterogeneity and risk of bias. Improvements in QoL and reductions in lymphedema volume were also reported in several studies. MSE appears effective in reducing systemic inflammation and improving QoL among postmenopausal breast cancer survivors with metabolic syndrome. However, evidence for specific biomarkers remains limited. Further high-quality, standardized RCTs are needed, especially in underrepresented regions such as sub-Saharan Africa, to guide global implementation of MSE in cancer rehabilitation.

Cancer rehabilitation improves function, quality of life, and symptom control, yet access to specialized programs is limited by geographic, financial, and systemic barriers. Telerehabilitation has emerged as a scalable alternative; however, its effectiveness across cancer types and intervention modalities remains heterogeneous. We conducted a systematic review of randomized clinical trials (RCTs) and nonrandomized comparative studies evaluating telerehabilitation in adults with cancer. Searches were performed in MEDLINE, LILACS, ScienceDirect, PEDro, Cochrane Central, Scopus, Springer, Taylor & Francis, and Google Scholar from January 1, 2010 to September 30, 2025. Two reviewers independently screened studies and extracted data. Risk of bias was assessed using the PEDro scale (RCTs) and the MINORS tool (nonrandomized studies). Given heterogeneity in measures and outcome definitions, we applied structured narrative synthesis with vote counting (SWiM/Cochrane), complemented by effect-direction and albatross plots. Thirteen studies (11 randomized controlled trials and 2 nonrandomized comparative trials) were included, encompassing populations with breast, lung, and esophageal cancers, hematologic malignancies, gliomas, and mixed cohorts. Interventions were categorized into three main delivery modalities: supervised synchronous exercise via videoconferencing, web- or app-based programs incorporating remote monitoring, and telephone-based counseling. Across studies, telerehabilitation consistently demonstrated improvements in physical function (e.g., walking capacity, muscular strength, and peak VO2) and reductions in fatigue. Effects on pain were modest and heterogeneous, while outcomes related to health-related quality of life (HRQoL) were mixed. The most pronounced benefits were observed in supervised synchronous interventions, whereas asynchronous or maintenance models exhibited diminished effects, indicating a lower likelihood of achieving functional improvement. Adherence, as reported by the primary study authors, ranged from moderate to high, and no serious adverse events attributable to the interventions were documented. Telerehabilitation is a safe and effective strategy to improve function and reduce fatigue in oncology, with less consistent evidence for HRQoL and pain. Supervised synchronous models provide the strongest benefits. Multicenter RCTs with standardized outcomes and longer follow-up are needed.

Cancer-related fatigue (CRF) affects the majority of cancer survivors and can negatively impact activities of daily living. Exercise training reduces CRF, but little is known about the immediate or "acute" association of exercise on CRF. This study examined changes in CRF from before to immediately after and several hours following an exercise session, and explored the relationship of exercise intensity. Observational longitudinal cohort study of cancer survivors enrolled in a 12-week outpatient cancer rehabilitation program. CRF was assessed before, immediately after, and 1-, 4-, and 7-h after one exercise session per week, and at the same clock time on one non-exercise day per week using a visual analog scale (0 = no fatigue, 10 = high fatigue). Exercise sessions consisted of aerobic and resistance training, and intensity was self-selected. Sessions were categorized as either light or moderate based on heart rate and rating of perceived exertion. Mixed effects models with random and fixed effects for time and exercise session intensity evaluated changes in CRF from before to after exercise sessions. Participants N = 25 (M = 62 ± 12years, 84% female, 48% Stage III/IV cancer) completed N = 187 exercise sessions (M = 7.0 ± 3.3). There was no change in CRF from before (3.19 ± 1.61) to immediately after exercise sessions (3.13 ± 1.61) (p = 0.62). CRF significantly increased from the post-exercise to the 7-h time point on both exercise (p = 0.001) and non-exercise days (p < .001). There was an increase in CRF (+ .35) following moderate-to-vigorous exercise sessions compared to a decrease following low-intensity sessions (-.21) (p = 0.02). There was no difference in CRF from before to immediately after exercise sessions, and CRF was highest at the 7-h time-point on both exercise and non-exercise days. These findings suggest that exercise had a minimal association with CRF, and exercise intensity was not related to this change in CRF.

ABSTRACT Background and Objective Children diagnosed with central nervous system (CNS) tumors frequently present with persistent motor impairments that compromise independence and participation. Although the Gross Motor Function Measure (GMFM-88) is widely used in pediatric neurology, evidence regarding its reliability and feasibility in pediatric neuro-oncology remains limited. Therefore, this study aimed to investigate the intra- and inter-rater reliability of the GMFM-88, its association with tumor volume, and evaluate the patient-centered clinical feasibility of the instrument. Methods This cross-sectional reliability study was conducted at a specialized cancer rehabilitation center. Participants were children with brain tumors confirmed by imaging and biopsy. Gross motor function was assessed using the GMFM-88 with all assessments video-recorded following a standardized protocol. Primary outcomes were intra- and inter-rater reliability. Intra-rater reliability was determined through the analysis of the video of the evaluation day, by the same rater after a four-week interval. Inter-rater reliability was assessed by a second, independent blinded rater who scored the same video recordings. Reliability was analyzed using intraclass correlation coefficients (ICC; two-way mixed-effects, absolute agreement). Secondary outcomes included the correlation between GMFM-88 total scores and tumor volume estimated via the ellipsoid method. To investigate the relationship between variables, Pearson’s correlation coefficient was calculated. Furthermore, patient-centered clinical feasibility was assessed using a 7-point Likert scale addressing safety, administration speed, and acceptability. Results Thirty-two children were included (mean age 10.2 ± 3.7 years; 50% female). The GMFM-88 demonstrated excellent reliability, with an intra-rater ICC of 0.997 (95% CI: 0.993–0.998) and an inter-rater ICC of 0.999 (95% CI: 0.998–0.999). No significant association was observed between tumor volume and GMFM-88 total scores (r = 0.085; 95% CI: −0.27 to 0.42; p = .64). Feasibility ratings were high for safety (aggregate score 76/96) and acceptability (91/96), though administration speed was variable (64/96). Discussion The GMFM-88 is a highly reliable and clinically applicable tool for assessing gross motor function in pediatric neuro-oncology. The lack of correlation between tumor size and motor capacity suggests that functional outcomes may be more closely related to lesion topography in eloquent areas than volume alone. Major limitations include the single-center design and small sample size. However, these findings support its use as a standardized and clinically applicable outcome measure in pediatric neuro-oncological

Cancer rehabilitation in Denmark is publicly funded and framed as a universal and ongoing element of the cancer pathway, aimed at restoring everyday functionality after diagnosis. Yet participation remains uneven, particularly among citizens marked by social vulnerability. This article examines how such inequality unfolds in practice by focusing on moments of misalignments: situations where users' bodies call attention to themselves by not aligning with the spatial orders of rehabilitation. Drawing on ethnographic fieldwork in two rehabilitation units, we explore how such misalignments become visible in small gestures of hesitation, partial participation, or strategic withdrawal. By tracing moments of misalignment, we show how spaces of rehabilitation are structured by normative expectations of movement, progress, and improvement, while also containing cracks where alternative bodily logics surface. Attention to misalignment, we argue, offers a new lens on health inequality: shifting attention from formal access to the question of which bodies, rhythms, and ways of being are recognized and sustained within contemporary healthcare.

To explore occupational perspectives of patients with elevated risk of non-return to work (RTW) in cardiac, cancer, and orthopedic rehabilitation. What themes are relevant when patients in medical rehabilitation reflect on their occupational future, and to what extent are identified themes specific to medical specialty? Face-to-face interviews were conducted with 51 patients (63% female, median age 55) of elevated risk of non-RTW in post-acute rehabilitation after hospital stay for an acute cardiac (n = 20), cancer (n = 15), or orthopedic disease (n = 16). Six months after rehabilitation discharge, 41 (80%) participants were interviewed again, to analyze the significance and relevance of the collected themes after return to daily life. The transcripts of audio-recorded interviews were analyzed by a combination of flexible pattern matching and thematic analysis. In their occupational reflections, patients considered seven themes related to health (perception of health / health behavior and lifestyle), work (characteristics of professional career/reintegration options/motives for (non) RTW), and personhood (uncertainty about the future/perception of the environment). Disease-specific aspects were found in heart-related anxiety for cardiac patients, perceived uncertainty about the future for cancer patients, and workplace/work characteristics for orthopedic patients. 61% of the participants did not RTW within six months after rehabilitation discharge. Occupational reflections of all patients were characterized by the same set of themes, with some themes having more relevance depending on participants' medical specialty. Perceived uncertainty, health issues and expected barriers led to missing plans for future health-management and RTW-strategies and highlight the need for an occupational planning tool.

The national cancer strategy includes guidelines for rehabilitation as part of a collaborative team for cancer care. Interprofessional engagement is a critical attribute of a rehabilitation team. Thus, exposing students to live case scenarios in physiotherapy (PT), occupational therapy (OT) and speech-language pathology (SLP) provides development of Interprofessional Education Collaborative (IPEC) core competencies. To evaluate students' acquisition of interprofessional competencies (Values and Ethics; Roles and Responsibilities; Interprofessional Communication; and Teams and Teamwork) in cancer rehabilitation and explore their qualitative experiences of interprofessional engagement. A cross-sectional survey design with open-ended questions was administered to final year rehabilitation students (PT, OT and SLP) post interprofessional education (IPE) session with a cancer survivor (CS). Of 140 enrolled final year students, 64 completed the IPEC survey on Redcap. Descriptive and qualitative data analysis were conducted. High levels of agreement across all IPEC domains were observed, with the highest seen in Teams and Teamwork. Three themes, (1) Scope of practice, (2) Teamwork, (3) Experience of the IPE activity, emerged from the open-ended questions. High agreement across IPEC domains indicates enhanced collaborative attitudes and role clarity, despite limited exposure to oncology in participants' undergraduate curricula. The presence of a CS added authenticity, fostering empathy and ethical practice. Students gained insight into professional boundaries, effective communication strategies and teamwork in complex care settings. Findings support integrating authentic, condition-specific IPE into curricula to strengthen collaboration and professional identity formation. Undergraduate Health Sciences students can gain exposure to national cancer policies through IPE sessions. Future research can explore if the skills learnt translate to clinical teamwork post-graduation.

BackgroundSurgery is considered the primary treatment for lung cancer, but postoperative complications and functional limitations lead to longer recovery and hospitalization times. Although electrical stimulation (ES) is considered a promising intervention for overcoming these challenges, existing research findings on ES have limitations due to small sample sizes and incomplete outcome measurements. This systematic review aims to evaluate ES on five important aspects: postoperative pain, complications, exercise capacity, length of stay, and respiratory functions.MethodsDatabases searched included PubMed, Web of Science, Cochrane Library, Embase, China National Knowledge Infrastructure (CNKI), VIP Chinese Science and Technology Journal Database (VIP), Wanfang, and China Biomedical Literature Database (CBM) up to September 2025. Inclusion criteria consisted of randomized controlled trials (RCTs) of ES post-surgery, including both analgesic and functional ES, in adult patients undergoing resection of lung cancer. Comparison interventions included standard care, sham stimulation, or conventional rehabilitation. Pain intensity was the main outcome of interest. Secondary outcomes included complication rates, exercise capacity, hospital stay duration, and pulmonary functions. Methodological quality of the included RCTs was assessed using the Cochrane Risk of Bias 2 tool. Certainty of evidence for the outcomes of interest was assessed using the Grading of Recommendations Assessment, Development and Evaluation (GRADE) approach. Results are presented as mean difference (MD) or risk ratio (RR) with 95% confidence interval (CI).ResultsAnalysis of 23 RCTs (n=2,232) indicated that ES reduced postoperative pain (MD: 0.39–0.41 points), although this effect failed to meet the minimum important difference (MID) of 1.0 points. In postoperative morbidity, the ES reduced the incidence of complications and exercise capacity, increasing the 6-minute walk distance (6MWD) by 33.8 m, exceeding the MID of 25 m. Consequently, hospital stay was reduced by 3.2 days. In addition, the improvement in respiratory function, indicated by the increase in forced vital capacity (FVC) (0.25 L), exceeded the MID of 0.15–0.20 L, although the improvement in forced expiratory volume in 1 second (FEV1) (0.13 L) was limited. The quality of evidence for these outcomes, as classified in the GRADE approach, ranged from moderate to low.ConclusionsAfter lung cancer surgery, ES mainly facilitates functional recovery instead of significant early analgesia. ES can increase cardiopulmonary capacity, lower complication risk, and reduce hospital stay. Being a promising passive technique, its clinical importance is obvious; however, in consideration of current heterogeneity in studies, large-scale standardized RCTs are warranted to optimize ES.

Cancer rehabilitation is increasingly recognized as a core component of cancer care, yet little is known about how people with cancer perceive its ethical dimensions. This study explored how patients experience autonomy, safety, equity, and relational care within physiotherapy-led cancer rehabilitation. We conducted a qualitative interview study using reflexive thematic analysis (RTA). Twenty adults with a previous cancer diagnosis who had received physiotherapy related to cancer rehabilitation within the past three years were purposively sampled to maximize variation in age, gender, diagnosis, stage, care setting, and geographical area. Interviews were conducted online, audio-recorded, transcribed verbatim, anonymized, and analyzed inductively from a constructionist, experiential perspective. Five themes captured ethically salient aspects of rehabilitation experiences: (1) struggles for meaningful participation, where involvement in decisions was sometimes limited despite rhetoric of autonomy; (2) balancing safety and control, where professional caution was experienced as both protective and at times over-restrictive; (3) unequal access as systemic injustice, with geography, logistics, and poor information affecting access to services; (4) empathy and emotional presence, which fostered trust, dignity, and motivation; and (5) limits of standardized care, where rigid protocols and time pressure risked depersonalization unless offset by flexibility. Participants did not view rehabilitation as a merely technical intervention, but as an ethically charged practice shaped by everyday interactions, organizational contexts, and opportunities for agency. People with cancer experience rehabilitation as an ethical as well as clinical practice. Flexible, dialogic, and equitable models of care may better support dignity, participation, and shared decision-making.

This study systematically reviews the current application of digital health interventions in cancer patients, clarifies their implementation characteristics and intervention effects in managing economic toxicity, and provides a reference for intervention programs to reduce the economic toxicity of patients. Relevant studies were systematically retrieved from PubMed, Web of Science, Cochrane Library, Embase, CINAHL, CNKI, CBM, WanFang Database, and VIP Database from their inception to February 6, 2026. Data from the included literature were extracted and analyzed. A total of 22 studies were included. Digital health technologies are applicable to multiple stages of cancer patient diagnosis, treatment, and rehabilitation. Among these, remote financial navigation or consultation is the most commonly used intervention method. Existing research has shown positive results in improving cost communication skills, facilitating financial assistance, and enhancing intervention feasibility, but evidence regarding improvements in economic toxicity scales and the alleviation of long-term financial difficulties exhibits some heterogeneity. Digital health technologies, with their high accessibility, scalability, and ease of remote access and follow-up, offer unique advantages in managing the economic toxicity of cancer patients. Current research in this field has gradually shifted from single-stage interventions to comprehensive intervention pathways. Future research should focus on the dynamic evolution of economic toxicity at different stages of diagnosis and treatment, promote the standardization of intervention procedures and outcome evaluations, and develop personalized digital intervention strategies to mitigate the economic toxicity of cancer patients. https://doi.org/10.17605/OSF.IO/4DYN3.

This study aimed to evaluate the performance of ChatGPT in responding to patient-centered queries related to cancer rehabilitation. It examined the accuracy, completeness, and overall quality of ChatGPT's responses across major domains of cancer rehabilitation from a physical therapy perspective. Fifteen representative patient queries covering eight domains of cancer rehabilitation-including general exercise, fatigue, bone metastasis, neuropathy, balance and falls, breast cancer, women's health, and pediatric cancer-were developed by two licensed physical therapists. Each query was input into ChatGPT-4, and responses were independently evaluated for accuracy, completeness, and global quality based on established clinical practice guidelines and expert consensus. ChatGPT demonstrated a mean accuracy score of 3.93 (SD = 1.10) on a 5-point scale, a mean completeness score of 2.13 (SD = 0.83) on a 3-point scale, and a mean global quality score of 3.60 (SD = 1.12) on a 5-point scale. Responses were generally accurate and clinically relevant but often lacked details regarding exercise dosage, safety precautions, and guideline-concordant recommendations. ChatGPT shows potential as an accessible tool for general cancer rehabilitation education but requires refinement to ensure accuracy, contextual relevance, and safety. AI-driven conversational models may improve patient access to rehabilitation information and self-management support when used under professional oversight and guided by evidence-based frameworks.

Taxane-induced neuropathic pain (TINP) is a debilitating condition and represents a significant therapeutic challenge in the treatment of breast cancer. The objective of this critical review is to initially explore the molecular and cellular mechanisms in the peripheral and central nervous systems associated with TINP, including mitochondrial dysfunction, oxidative stress, axonal degeneration, maladaptive neuroplasticity, and neuroimmune activation. The review then proposes to present clinical and experimental interventions that target these peripheral and central pathways, such as pharmacological treatments, invasive and non-invasive neuromodulation techniques, physical activity, manual therapies (including acupuncture and massage), and cryotherapy. Although clinical trials investigating these strategies have shown promising results, several methodological limitations must be considered, such as small sample sizes, heterogeneity in study designs, and the frequent classification of taxane-induced neuropathic pain as a secondary outcome. Therefore, it is concluded that there is a clear need for more methodologically rigorous studies, particularly those involving mechanism-oriented interventions, in the context of TINP rehabilitation in breast cancer.

ABSTRACTBackgroundImmunotherapy has rapidly become part of lung cancer care, however the ability of people to participate in rehabilitation in conjunction with immunotherapy remains largely unknown. The aims of this study were to (a) understand stakeholder perspectives of lung cancer immunotherapy treatment and (b) co‐design a rehabilitation programme for people with lung cancer during and following immunotherapy.MethodsExperience‐based co‐design, involving three distinct online phases: (1) patient, carer and healthcare professional interviews to understand immunotherapy and rehabilitation experiences; (2) separate workshops for healthcare professionals and patients/carers, to identify priority areas for future rehabilitation programme design; and (3) combined workshops to refine the draft programme. Transcripts were analysed by two researchers, guided by the Consolidated Framework for Implementation Research.ResultsSeventeen stakeholders were involved in the interviews and/or workshops: seven patients, one carer and nine exercise healthcare professionals. Key themes included: immunotherapy side effects varied but were generally more tolerable than chemotherapy; rehabilitation information was lacking, and access varied; healthcare professional training in immunotherapy was limited. Rehabilitation enablers included supervision and monitoring from healthcare professionals with expertise in cancer; routine rehabilitation discussion with oncologists and nurses; dedicated funding. Lack of education about symptom control when exercising was a barrier for patients. Essential rehabilitation elements included individualised programmes, group‐based, flexibility for centre‐ or home‐based programmes. Programme components included education, aerobic and strength exercise and screening for nutrition and psychology needs.ConclusionsThis research has furthered understanding of the lung cancer immunotherapy treatment journey and identified key design requirements of a rehabilitation programme.Patient or Public ContributionTwo patient advocates contributed to this study as members of the project steering committee. Their contributions for this study included reviewing and providing feedback on the proposed study design and the interview and workshop topic and question guides. Patient, carer and healthcare professionals co‐designed the rehabilitation programme through individual interviews and a series of small‐group workshops.

The effect of structured patient-to-patient communication on fear of cancer recurrence in total laryngectomy patients: A randomized controlled trial.

Dear Editor, We read with great interest the recent article titled “A novel approach to cancer rehabilitation: assessing the influence of exercise intervention on postoperative recovery and survival rates”[1] published in the International Journal of Surgery. This article investigates how exercise intervention affects cancer patients’ postoperative recovery and survival rates. Exercise therapy before and after surgery has been shown to significantly improve patients’ physical capabilities, reduce postoperative complications, shorten hospital stays, and enhance overall quality of life. However, future research must address a number of important challenges. First, there are insufficient individualized criteria for exercise prescriptions. Although existing literature emphasizes the importance of developing individualized exercise regimens, it fails to provide a clear and actionable set of specific criteria. There is a lack of stratified or quantified guidance on how to dynamically adjust exercise types, intensity, frequency, and duration based on factors such as cancer type, stage, treatment phase (e.g. chemotherapy cycles, radiotherapy site), patient physical baseline, complications (e.g. bone metastases, lymphedema), and age[2]. For instance, current research remains vague regarding how core training for patients undergoing abdominal surgery with stoma should be performed safely while mitigating risks. This results in clinical practice where “individualization” still largely relies on the experiential judgment of rehabilitation physicians, lacking a standardized framework based on evidence-based medicine. Consequently, this affects the reproducibility of intervention protocols and the stability of therapeutic outcomes. Second, the article lacks an in-depth exploration of the mechanisms integrating psychological intervention with exercise[3]. While it acknowledges the impact of psychological factors (e.g. anxiety, depression) on rehabilitation and mentions that exercise can improve psychological states, it provides insufficient elaboration on the critical pathway of “how exercise influences physiological rehabilitation outcomes through psychological mechanisms.” For instance, the neuroendocrine mechanisms by which exercise alleviates anxiety (e.g. reducing cortisol levels and modulating the hypothalamic-pituitary–adrenal axis) are not systematically explained, nor is it clarified how these effects translate into faster wound healing, enhanced immune function, or improved treatment adherence. Psychological rehabilitation and exercise interventions are discussed in parallel rather than being deeply integrated. The article fails to adequately explore specific models for integrating structured psychological interventions (e.g. cognitive behavioral therapy, mindfulness-based stress reduction) with exercise regimens, either temporally or content-wise, to achieve synergistic effects. Third, the literature review on special populations and complex conditions remains insufficient. The covered cancer types are predominantly common malignancies (e.g. breast cancer, colorectal cancer, and lung cancer), while evidence on the safety and efficacy of exercise rehabilitation for low-incidence or poor-prognosis cancers (e.g. pancreatic cancer, biliary tract cancer, glioblastoma) and patients with special complex conditions (e.g. advanced age, multiple metastases, severe treatment-related adverse effects such as severe peripheral neuropathy, refractory cancer-related fatigue) is virtually nonexistent. The recommendations in Table 1 (page 9) remain overly generalized. For these populations, there is a lack of targeted research on which exercises are absolutely contraindicated, which exercises require close monitoring, and how to establish an extremely low but effective exercise threshold. This results in an overly conservative approach in clinical practice for patients who most urgently need rehabilitation support. In conclusion, this study systematically reviews the positive impact of exercise intervention on postoperative cancer rehabilitation, yet reveals several limitations in the depth and precision of clinical translation. Future research should focus on strengthening long-term efficacy evidence while developing refined, stratified clinical decision support tools, exploring integrated intervention programs based on the biopsychosocial model, and actively leveraging digital technologies to establish sustainable multidisciplinary collaborative implementation frameworks. These efforts will ultimately realize the true value of exercise rehabilitation in the comprehensive management of cancer throughout its entire lifecycle. All of this is related to the Transparency in the Reporting of Artificial Intelligence (TITAN) guideline, which mandates openness in artificial intelligence reporting[4].

To explore how cancer survivors experience work-related well-being and aspects influencing their experience of it, one year after cancer treatment. During the development of a work-related intervention, cancer survivors (n = 22, 67% was female, age md 56years) were interviewed using purposive sampling one year post chemo-/radiotherapy for breast, prostate or colorectal cancer. Inductive content analysis was applied. The first year after treatment was described as a transition period in which cancer survivors strove to regain their general well-being but were able to experience work-related well-being even when their general well-being was limited. Their work-related experiences were characterised by a balance between personal readiness for work participation and workload. Daily life and working life were described as interdependent, requiring strategies to maintain balance. There was a vulnerability in handling the demands of work. Both general well-being and work-related well-being were promoted by the absence of side effects and the availability of guidance and responsiveness from caregivers and employers. One year after treatment, cancer survivors considered participation in work life to be important for their well-being. At the same time, the need for enhanced preparation was expressed for balancing work and private life, managing remaining side effects, and navigating ongoing rehabilitation. Our results suggest that the interplay between personal preparedness and work-related stress is central to work-related well-being, highlighting the importance of addressing work-related aspects early in treatment. The findings also indicate that available resources in cancer rehabilitation are underused relative to patients' individual needs. Cancer survivors desired a more holistic rehabilitation, as both general well-being and work-related well-being encompass life after illness as well as the process of returning to work. Strengthening and clearly defining the role of contact nurses regarding work-related issues, and establishing early collaboration between thecancer survivor, employer, and rehabilitation coordinators, can improve support for return to work. Further research is needed to investigate how these discussions and support efforts can be structured and how models and theories can be applied to contribute to increased focus on issues related to work-related well-being after cancer.