Care Of Cancer Patients Research Articles

Characteristics of cancer patients dying at home during the COVID‐19 pandemic: A study based on vital statistics from 2015 to 2022 in Japan

AbstractBackgroundThe coronavirus disease 2019 (COVID‐19) pandemic has markedly affected end‐of‐life care, notably increasing home deaths among cancer patients in Japan. This study investigated the characteristics of cancer patients who died at home during the pandemic and the associated factors before and during the pandemic.MethodsVital statistics from January 2015 to December 2022 were analyzed to evaluate trends in home deaths among cancer patients aged 0 to 113 years, pre‐pandemic (January 2015 to March 2020) and during the pandemic (April 2020 to December 2022). Home deaths were assessed by demographics, including age, sex, marital status, and residential location. Multivariable modified Poisson regression analyses were performed to identify factors associated with home deaths in both periods.ResultsAmong 3,010,374 individuals, 11.6% (226,571/1,959,304) and 20.8% (218,429/1,051,070) died at home before and during the pandemic, respectively. In subgroup analysis depicting the trend of in‐home deaths by patient characteristics, only the age group showed a differential trend: the proportion of in‐home deaths was higher among older people before the pandemic, whereas it was higher among younger people during the pandemic. The multivariable analysis revealed the excess risk of in‐home deaths among people aged ≥65 years before the pandemic and among those aged <65 years during the pandemic.ConclusionsThe pandemic has increased home‐based end‐of‐life care for terminal cancer patients, particularly younger individuals, possibly due to hospital visit restrictions. Ensuring sufficient resources for both home and hospital care is vital to allow individuals to receive end‐of‐life care in their preferred settings.

Patterns and determinants of patient sharing in end-of-life health services: Empirical evidence from the Italian National Health Service

ABSTRACT End-of-life (EoL) care is critical for cancer patients, who tend to have high service needs that are dispersed across organizations and different levels of care. Although EOL has been widely studied, little is known about the patterns of coordination among EoL health care providers and how they contribute to the care of cancer patients. This study adopts a network perspective to examine the complex patterns of patient sharing among health care providers involved in EoL care, using data on the use of EoL health care services by 266 cancer patients in a large Local Health Authority in Italy. We conducted a social network analysis of the structural properties of the emerging network and used logistic regression-quadratic assignment procedures (LR-QAP) to explore how characteristics of health care providers, their collaborative network, and their distances predict the likelihood of observing patient sharing relationships. Our results show that complementarities in terms of medical specialization and co-location of services positively predict the likelihood of cancer patient sharing. This probability is also positively related to the difference in terms of eigenvector centrality as well as the degree of network transitivity. We discuss the policy implications of our findings.

Body image discontentment among head and neck cancer patients in Visakhapatnam district: An empirical study

Head and neck cancers, which comprise tumours of the oral cavity, throat, nasal cavity, and thyroid, pose substantial physical and psychological issues. These tumours frequently require harsh therapies such as surgery, radiation therapy, and chemotherapy, which can result in apparent changes in appearance and physical function. As a result, patients are frequently subjected to body image distress, low self-esteem, and overall unhealthy psychological well-being. This study aims to investigate head and neck cancer patients' self-perceptions and body image problems, with an emphasis on feelings of self-consciousness, physical attractiveness, and general body dissatisfaction amongst head and neck cancer out patients undergoing treatment in HCG cancer hospital in Visakhapatnam. This study was conducted on 50 head and neck cancer outpatients undergoing treatment at an oncology centre Healthcare Global Enterprises ltd (HCG) hospital Visakhapatnam during the period of (May 2023 to June 2023) who were willing to participate in the study and were 20 years of age and above. An interview schedule was prepared by the researcher and administered to the patients comprising section A (questions pertaining to the demographic and clinical details of the patient), section B (modified 6 item Body Image Scale). Majority of the patients were male (62%) while female constituted 38% with the majority aged between 20- 39 years (61%) and the most common cancer being that of oral cavity (58%). The findings reveal a sizable proportion of respondents reporting feeling self-conscious and less physically attractive as a result of their sickness or treatment. Many individuals are dissatisfied with their appearance and overall body image, with a significant percentage reporting that these issues interfere with their social relationships and sense of wholeness. These findings highlight the need of addressing psychological and emotional support in the treatment and care of head and neck cancer patients. Integrating mental health and body image counselling into cancer treatment programmes has the potential to greatly improve patients' overall well-being and quality of life.

Foundations for a Personalized Psycho-Oncology: The State of the Art.

Personalized psycho-oncology represents a major challenge for the holistic care of cancer patients. It focuses on individualized psychotherapeutic and psychiatric interventions to address specific psychological needs. This narrative review summarizes the current literature on personalized psycho-oncology and highlights the prevalence and impact of psychiatric/psychological disorders in cancer patients. Personalized approaches, including tailored interventions and interdisciplinary collaboration, have been shown to be effective in improving mental health and overall quality of life. The integration of inflammatory biomarkers into treatment plans is a promising but challenging way to alleviate mental health problems. In addition, there is a need for specific diagnostic tools and treatment guidelines that take into account the specific psychological impact of different types of cancer. Future research should aim to refine these personalized strategies, improve diagnostic accuracy, and evaluate the cost-effectiveness of these interventions to improve both the psychological well-being and treatment outcomes of cancer patients.

The assessment of care burden and influencing factors on family caregivers for cancer patients.

The family caregivers as primary caregivers play a crucial role regarding the care of cancer patients. As defined in the literature, the care burden encompasses the negative objective and subjective outcomes including psychological and physical health problems, economic and social issues, deterioration of family relationships and feelings of loss of control that arise from caregiving responsibilities. This study aims to assess the care burden and to evaluate the associated factors among family caregivers of cancer patients receiving treatment at a state hospital in Türkiye. This cross-sectional study was conducted with the family caregivers of patients undergoing treatment in the radiation oncology department of a state hospital in Türkiye. The study population consisted of 350 individuals, with a participation rate of 80%. Participants were administered a questionnaire concerning determining daily living activities and identifying the caregiving burden through their socio-demographic characteristics. The care burden among primary family caregivers while the delivery of health services was severe for 85.1% of them. The average ZBI score of caregivers was 55.92 ± 14.58. It was clarified that family caregivers' burden was influenced by several factors, including the duration of caregiving, difficulties experienced while caring for the patient, and the negative impact on their daily roles. Our study's findings indicate the need for health professionals to support caregivers of cancer patients while over half of the caregivers were identified as having a severe level of caregiving burden. It is important to raise awareness among nurses and the oncology team with a holistic approach. In the delivery of health services, caregivers' needs should be identified first, support mechanisms should be activated and interventions should be made to meet these needs. This study's findings highlight the need to identify and problems faced by family members during caregiving. This is important for sustainable and cost-effective holistic care. The results of this study are reported based on the guidelines of The Strengthening the Reporting of Observational Studies (cohort, case-control studies, cross-sectional studies) in Epidemiology (STROBE). Our study's findings indicate the need for health professionals to support caregivers of cancer patients. It is important to raise awareness among nurses and the oncology team with a holistic approach. In the delivery of health services, caregivers' needs should be identified first, support mechanisms should be activated and interventions should be made to meet these needs.

Supporting follow-up care in colorectal cancer patients: first experiences with the Assessment of Burden of ColoRectal Cancer (ABCRC)-tool.

The Assessment of Burden of ColoRectal Cancer (ABCRC)-tool is a unique tool that includes a PROM focused on health-related quality of life (HRQoL), functional outcomes and lifestyle assessment. Furthermore, it provides visualization of results and treatment advice. The tool aims to support follow-up consultations of colorectal cancer (CRC) patients. The purpose of this study was to evaluate the first experiences of patients and healthcare professionals (HCPs) with the ABCRC-tool. The ABCRC-tool was implemented in two Dutch hospitals and used by 25 patients and 5 HCPs during follow-up care. Consultations were audio-recorded and their content was analyzed independently by two researchers. Semi-structured interviews with patients and HCPs were conducted after the consultation. Interviews focused on the overall experience with the tool, ease of use, interpretation of the PROM and the visualized results and on the added value of the tool. Audio recording revealed that multiple topics, relevant to patients, were discussed during consultations with the ABCRC-tool. Patients and HCPs appreciated the ABCRC-tool as it added structure to the consultation, was helpful in the preparation of consultations and provided useful and convenient treatment options. The tool was easy to use, and the visualization was clear and informative. HCPs suggested that the tool is likely to be most relevant for patients in the first year of follow-up. This study implies that the ABCRC-tool is of added value for patients and their HCPs. Future research should focus on the evaluation of broad implementation, across a wide range of CRC patients. The ABCRC-tool is a valid tool to support CRC survivors and HCPs to monitor and visualize experienced burden of disease and lifestyle parameters in order to optimize personalized care.

Probing the killing potency of tumor-infiltrating lymphocytes on microarrayed colorectal cancer tumoroids

Immunotherapy has emerged as a new standard of care for certain cancer patients with specific cellular and molecular makeups. However, there is still an unmet need for ex vivo models able to readily assess the effectiveness of immunotherapeutic treatments in a high-throughput and patient-specific manner. To address this issue, we have developed a microarrayed system of patient-derived tumoroids with recreated immune microenvironments that are optimized for the high-content evaluation of tumor-infiltrating lymphocyte functionality. Here we show that this system offers unprecedented opportunities to evaluate tumor immunogenicity, characterize the response to immunomodulators, and explore novel approaches for personalized immuno-oncology.

Spiritual Care for Cancer Patients at the End-of-Life.

Spiritual care for patients at the end of life is an important element in their holistic care. The aim of this study is to assess the opinions of cancer patients with limited prognosis about the importance of faith in fighting illness and the factors contributing to a better adjustment to illness and to their self-reconciliation and spiritual well-being. This study used a specially designed questionnaire for cancer patients with limited prognosis. The 30 respondents were patients with an estimated prognosis of less than 1 month, cared for in a unit with palliative and home care beds. The patients emphasized the importance of family as a supporter in the fight against disease (90%), followed by faith (66.7%) and a care team (63.3%). The most common concerns expressed were related to the course of their disease, family distress, fear of death, and the Russian-Ukrainian war. Family and faith represent important factors in supporting and caring for a patient at the end-of-life. Patients who felt spiritually at peace and were supported in their faith by family and a priest had a better spiritual state.

Sociodemographic and Clinical Characteristics Associated with Genetic Testing among Cancer Survivors: Evidence from Three Cancer Registries.

Genetic tests, including germline and tumor (somatic) testing, can optimize the clinical care and outcomes for cancer patients and their family members. However, evidence on cancer patients' use of genetic testing and discussions about it with healthcare providers is limited. Study participants included cancer survivors aged 18 or older, drawn from the 2021 Health Information and National Trends Survey (HINTS)-Surveillance, Epidemiology, and End Results (SEER) linked database, which comprises three US cancer registries: Iowa, New Mexico, and the Greater Bay Area. Sociodemographic factors (e.g., age, sex, income, education) at the time of the survey and clinical characteristics (e.g., cancer site, stage) at the time of diagnosis were compared based on self-reported genetic testing status and provider discussions, using survey design-adjusted analysis. The weighted study sample comprised 415,978 cancer survivors with a mean age of 70.5 years at the time of the survey. Overall, 17.0% reported having germline testing, 8.5% having tumor testing, and 8.6% discussing tumor testing with their healthcare providers. Higher proportions of germline genetic testing were observed among survivors under age 65 at the time of the survey, females, holding college degrees, and with private insurance coverage compared to their respective counterparts - males, aged 65 or above when surveyed, with lower educational attainment, and with public insurance or uninsured. The proportion of those who reported tumor testing was greater for those diagnosed in recent years (2015-2017 vs. before 2002). Regarding clinical characteristics, survivors with ovarian and breast cancers had a 7.0-36.4% higher prevalence of both testing compared to those with other cancer types lacking germline indication. More cancer survivors diagnosed at distant stages (vs. regional) or between 2015 and 2017 (vs. 2003-2010) reported having provider discussions about tumor testing. Findings showed that the highest reports of germline testing were among young female cancer survivors and those with higher education and private insurance. Survivors diagnosed in recent years or with advanced-stage disease were more likely to report discussing tumor testing with providers. Further research is warranted to better understand the barriers and educational needs of cancer patients, caregivers, and providers to optimize genetic testing strategies.

Patient perspective on adapting to bowel dysfunction after rectal cancer surgery.

Bowel dysfunction continues to be a clinically significant consequence of rectal cancer surgery, affecting quality of life. Rectal cancer patients value self-empowerment and adaptation to change to improve their quality of life in the context of bowel dysfunction. There are limited qualitative data addressing patients' perspectives on adapting to bowel dysfunction. The aim of this study is to evaluate patients' perspectives on adapting to bowel dysfunction after rectal cancer surgery. Adult patients who underwent rectal cancer surgery with sphincter preservation at a single colorectal referral centre from July 2017 to July 2020 were included. Patients were excluded if they had surgery <1 year since recruitment, received a permanent stoma or developed recurrence or metastasis. Semistructured interviews were held by phone and transcribed verbatim. Bowel dysfunction was assessed via the low anterior resection syndrome (LARS) score. Thematic analysis was used to identify adaptations which patients found helpful for improving bowel dysfunction after rectal cancer surgery. A total of 54 patient interviews were included. The distribution of patients with no, minor and major LARS was 39%, 22% and 39%, respectively. Four main themes were conceived from the analysis: implementing lifestyle changes, fostering supportive relationships and self-compassion, communication and access to resources, and adapting to social and cultural challenges. Associated subthemes were identified, namely forward planning, self-compassion and addressing social stigma. Patients' valuable perspective on adapting to bowel dysfunction involve subtle themes which expand the existing literature. These themes inform a patient-centred approach, which may improve outcomes and quality of care for rectal cancer patients.

Low molecular weight 35 kDa hyaluronan fragment HA35 in the treatment of bone metastasis pain: A case report.

Late-stage cancer patients often experience severe pain due to bone metastasis, caused by structural damage and cancer-induced inflammation. Hyaluronan, known to alleviate pain by blocking the TRVP1 calcium channel, faces limitations due to its high molecular weight. However, 35 kDa low molecular weight hyaluronan fragment (HA35) have shown promise in relieving various pains, including cancer-related pain. Nonetheless, evidence regarding their efficacy in bone metastasis pain remains scarce. A 52-year-old female with a rectal malignant tumor and multiple secondary tumors in the sacrum and lungs, accompanied by bone metastasis pain. Despite undergoing radiotherapy, her pain relief was unsatisfactory. Before treatment with HA35, her numerical rating scale score was 10, severely affecting her sleep, appetite, and daily activities. The patient was diagnosed with rectal malignant tumor with multiple metastases, presenting symptoms such as sacral metastasis pain, anal pain, lower limb pain, and anterior abdominal pain. Sacral metastasis pain and lower limb pain indicated a clear diagnosis of bone metastasis pain. Treatment involved subcutaneous injection into the deep fat tissue layer of the abdomen. A subcutaneous injection of 100 mg/5 mL of HA35 was administered once into the deep fat tissue of the abdomen, with subsequent injections repeated every 3 days. Following 1 injection, the patient's pain score decreased to 6 points within 20 minutes, providing 40% pain relief. After 40 minutes, the score further dropped to 4 points, with 60% pain relief. After 50 injections, pain was consistently controlled at around 3 points. Subcutaneous injection of HA35 into the abdominal fat tissue effectively alleviates pain in cancer and bone metastasis patients resistant to conventional treatments. Additionally, it helps alleviate anxiety and fatigue, and improves diet and sleep, thereby offering crucial palliative care for advanced cancer patients.

Satisfaction with in-person and teleconsultationoutpatient care in breast cancer patients at aPeruvian cancer center

Satisfaction with in-person and teleconsultationoutpatient care in breast cancer patients at aPeruvian cancer center

Impact of comprehensive geriatric assessment on treatment strategies and complications in older adults with colorectal cancer considering surgery.

This study aimed to assess the effectiveness of Comprehensive Geriatric Assessment (CGA) in customizing care for elderly cancer patients, specifically focusing on colorectal cancer. The research compared treatment strategies and outcomes in older adults considered for surgery before and after the initiation of a Geriatric Oncology Service (GOS). Conducting a comparative study, two cohorts of consecutive colorectal cancer patients aged 75 or older were examined: the control group (n = 156) and the GOS group (n = 158). Upon the treating surgeon's GOS consultation request, a geriatrician and an oncologist performed CGA, guiding treatment decisions and perioperative interventions. Postoperative complications were compared using propensity score matching (PSM). In the GOS group, 91% (n = 116) underwent CGA consultations, influencing decisions to forego surgery in 12 patients. After PSM for surgical cases (controls n = 146, GOS n = 146), each group comprised 128 patients. Perioperative physical therapy and pharmacist referrals were more frequent in the GOS group. The GOS group exhibited a significantly lower incidence of postoperative complications (22%) compared to the control group (33%) (p = 0.0496). Patients undergoing colorectal surgery post-GOS implementation experienced a notable reduction in postoperative complications, highlighting the positive impact of personalized geriatric assessment on surgical outcomes in the elderly.

Tube feeding in patients with head and neck cancer undergoing chemoradio-/radio therapy: A systematic review and meta-analysis based on the GRADE approach

ScopeThe scope of this systematic review (SR) was to determine whether a nasogastric tube (NGT) or percutaneous endoscopic gastrostomy (PEG) is a more useful supportive therapy in patients with oral cancer undergoing chemoradio-/radio therapy. MethodsFor the review, two authors searched MEDLINE, Cochrane CENTRAL and Ichushi-Web to identify clinical practice guidelines, SRs and randomised controlled trials (RCTs) according to pre-determined criteria. RevMan Web was used to combine trials and analyse the data. We evaluated the certainty of the evidence using the Grading of Recommendations, Assessment, Development and Evaluation system approach. ResultsIt was not possible to perform a meta-analysis of only treatment completion based on the included RCTs; therefore, we performed a meta-analysis of treatment breaks as a surrogate outcome. A meta-analysis of potential treatment breaks, including treatment discontinuation, revealed no superiority between PEG and NGT (risk ratio=0.64 [0.23, 1.79]). A meta-analysis was conducted on two RCTs regarding the harms of infection. There does not appear to be a significant increase in the risk of infection with either PEG or NGT (risk ratio=1.18 [0.45, 3.08]). The certainty of the evidence for two outcomes was judged to be very low. Further, meta-analyses of quality of life and nutritional status were not possible because of differences in assessment methods. ConclusionWe could not determine the superiority of NGT or PEG in the supportive care of oral cancer patients who received chemoradio-/radio therapy. The effect of PEG feeding is uncertain, and it is necessary to consider indications for each case.

Best practices in wound care for gastrointestinal stoma and colorectal cancer patients from a nursing perspective: A meta-analysis.

Colorectal cancer, a type of colon or bowel cancer, poses a major challenge in the treatment of colorectal lesions. Colorectal endoscopic mucosal resection (EMR) is a minimally invasive technique, but the risk of wound infections remains a significant concern. These infections can impede the healing process, affecting daily activities and patient satisfaction. To mitigate the risk of wound infections, various prophylactic measures have been explored, including medication, vaccines, lifestyle adjustments and hygiene practices. This study aims to investigate the prevention of wound infections through prophylactic measures in colorectal EMR. A comprehensive literature review was conducted to identify prophylactic measures that can prevent wound infections. A systematic literature search was conducted using both free words and search terms. The data extraction was performed after a comprehensive literature screening. The meta-analysis was performed using the metabin function of the meta library in R to evaluate the infection incidences in intervention and control groups. A total of 599 infection incidences were considered, with 267 in intervention and 332 in the control group. The results of meta analysis demonstrated significant reduction of wound incidences following the prophylactic measures (risk ratio [RR] = 0.77, 95% confidence interval [CI]: 0.6747; 0.9016, I2 = 78.5%, p < 0.01). The wound infection ratio analysis also exhibited an approximate 6.6% less infection rate in the intervention group, demonstrating significantly less wound infection following the implementation of prophylactic measures. This study highlights the crucial significance of prevention of wound infections by prophylactic measures in colorectal EMR.

Prostate Cancer Related Sexual Dysfunction and Barriers to Help Seeking: A Scoping Review.

Despite available support, sexuality needs are the most frequently reported unmet need among men with prostate cancer, which may be due to low help-seeking rates. Using the Ecological Systems Framework as a theoretical foundation, we conducted a scoping review of the available literature to understand what factors impact help-seeking behaviour for sexual issues after prostate cancer treatment among men who had received treatment. Following PRISMA guidelines, a systematic search on Medline, PsychInfo, Embase, Emcare, and Scopus was conducted to identify studies of adult prostate cancer patients post-treatment, which reported barriers and/or facilitators to help-seeking for sexual health issues. Quality appraisals were conducted using Joanna Briggs Institute appraisal tools, and results were qualitatively synthesised. Of the 3870 unique results, only 30 studies met inclusion criteria. In general, studies were considered moderate to good quality, though only six used standardised measures to assess help-seeking behaviour. Barriers and facilitators for sexual help-seeking were identified across all five levels of the Ecological Systems Framework, including age, treatment type, and previous help seeking experience (individual level), healthcare professional communication and partner support (microsystem), financial cost and accessibility of support (meso/exosystem), and finally embarrassment, masculinity, cultural norms, and sexuality minority (macrosystem). Addressing commonly reported barriers (and inversely, enhancing facilitators) to help-seeking for sexual issues is essential to ensure patients are appropriately supported. Based on our results, we recommend healthcare professionals include sexual wellbeing discussions as standard care for all prostate cancer patients, regardless of treatment received, age, sexual orientation, and partnership status/involvement.

Facing the COVID-19 pandemic: An Italian feasibility study of a mixed in-person/telerehabilitation intervention for cancer patients.

The COVID-19 pandemic impacted healthcare organizations, necessitating a rapid transition from in-person to virtual care. Our study explored the feasibility of a mixed in-person/telerehabilitation intervention for cancer patients and its effects on cancer-related fatigue (CRF), quality of life (QoL), physical function, patient satisfaction, and perceived usefulness. TRACE 2020 is an observational prospective study that enrolled adult cancer patients, between January 2021 and March 2023, who were eligible for a rehabilitation program to be provided also in telerehabilitation. Patients were assessed at baseline and after the rehabilitation program. Adherence to sessions, reasons for non-adherence and adverse events were collected. Of the 23 patients enrolled, 87% received a mixed intervention, with an average of 60% in-person sessions and 40% telerehabilitation sessions. Adherence was very high (91%). Evaluation scales showed an improvement in CRF, QoL, and lower limb strength and a relevant increase in patients' level of physical activity (PA). Most patients reported good satisfaction; the few criticisms mainly concerned difficulties in connectivity, lack of physical contact and difficulties in understanding how to perform exercises during telerehabilitation sessions. The physiotherapist underlined the usefulness of the innovative approach and suggested ways to facilitate future implementation. A mixed intervention including telerehabilitation is feasible and accepted by cancer patients. It may have a positive effect on their CRF, QoL, and level of PA and render patient care more flexible. The findings suggest what characteristics the target population for telerehabilitation should have, in order to integrate telerehabilitation in standard care for cancer patients.

Ethical Dilemmas and Coping Experiences of Nurses Caring for Patients With Hematologic Cancer: A Phenomenological Study.

The study aimed to evaluate the ethical dilemmas faced by nurses who provide care to patients with hematologic cancer and determine their coping mechanisms using a phenomenological approach. This qualitative study was conducted with 35 nurses employed in clinics specializing in hematologic cancer patient care, living in diverse regions of Turkey, using semistructured, in-depth interviews through the WhatsApp mobile application. The snowball sampling technique was utilized to identify participants, and interviews continued until data saturation was achieved. All interviews were recorded and subsequently transcribed. Data analysis was conducted using Colaizzi's phenomenological analysis method, with the study adhering to the COREQ (Consolidated Criteria for Reporting Qualitative Research) checklist for reporting. In the analysis of the data, 2 categories (ethical dilemma situations and coping experiences) and 6 subthemes (treatment, care, professional values and beliefs, emotions, struggling with emotional burdens, and psychosocial approach) emerged. According to the results, nurses responsible for hematologic cancer patients struggle with ethical dilemmas in healthcare delivery and face challenges in effectively addressing them, which could potentially impact the quality of healthcare provided by nurses.

Nomograms for prognosis prediction in esophageal adenocarcinoma: realities and challenges.

Prognostic assessment is of great significance for individualized treatment and care of cancer patients. Although the TNM staging system is widely used as the primary prognostic classifier for solid tumors in clinical practice, the complexity of tumor occurrence and development requires more personalized probability prediction models than an ordered staging system. By integrating clinical, pathological, and molecular factors into digital models through LASSO and Cox regression, a nomogram could provide more accurate personalized survival estimates, helping clinicians and patients develop more appropriate treatment and care plans. Esophageal adenocarcinoma (EAC) is a common pathological subtype of esophageal cancer with poor prognosis. Here, we screened and comprehensively reviewed the studies on EAC nomograms for prognostic prediction, focusing on performance evaluation and potential prognostic factors affecting survival. By analyzing the strengths and limitations of the existing nomograms, this study aims to provide assistance in constructing high-quality prognostic models for EAC patients.

Enhancing Breast Cancer Detection: Leveraging Convolutional Neural Networks

Abstract: Breast cancer continues to be a critical health concern, necessitating early detection and accurate classification for effective treatment. This study presents a comparative analysis between a custom-designed Convolutional Neural Network (CNN) and the pre-trained DenseNet121 model for breast cancer detection and classification. We compiled a comprehensive dataset of breast cancer images and applied appropriate preprocessing techniques to optimize the input for the models. The dataset was divided into training, validation, and testing sets to evaluate the models' performance. The CNN model comprises multiple convolutional and pooling layers followed by fully connected layers for classification, while the DenseNet121 model is fine-tuned specifically for breast cancer detection. The models were evaluated based on metrics such as accuracy, precision, recall, F1 score, and AUC-ROC. The DenseNet121 model outperformed the custom CNN model, achieving higher accuracy and reliability. For wider accessibility, we integrated the superior DenseNet121 model into a user-friendly web-based interface using Python Flask, enabling real-time breast cancer predictions. Ethical considerations were paramount, ensuring data privacy, security, and transparency in all model predictions. This study highlights the effectiveness of the DenseNet121 model and contributes to improved breast cancer diagnosis and patient care.