The people most vulnerable to medical debt often face systemic barriers to health care that are further exacerbated by debt accumulation, creating a compounding effect leading to adverse health outcomes. This ecological panel study assessed associations among county-level medical debt and cancer screening, cancer mortality, and community-level health status. Medical debt data (from 2017, 2019, and 2021) from the Urban Institute Credit Bureau Panel were analyzed using generalized estimating equations with an exchangeable correlation structure and lagged exposure-outcome modeling. A total of 8,954 county-years were included. In multivariable analysis, each 5-percentage-point increase in medical debt was associated with a 0.43-percentage-point and a 1.35-percentage-point decrease in colorectal and breast cancer screening rates, respectively, and 10.9 per 100,000 population more deaths from cancers with guideline-recommended screening. Medical debt was consistently associated with worse health and cancer outcomes. Addressing this burden is important for improving population health and mitigating cancer-related disparities.

Although survival rates for pediatric cancer diagnoses have improved significantly, persistent health disparities prevent many children and adolescents in the United States from reaping equitable benefit from this progress. This review examines inequities related to race and ethnicity, language preference, socioeconomic status, and geographic location. A literature search identified 33 articles highlighting how these factors intersect to affect diagnosis, treatment access, clinical trial participation, and outcomes. Black patients and Hispanic patients face consistently poorer survival, while language barriers are linked to delayed care and increased mortality. Low socioeconomic status and lack of insurance contribute to late-stage diagnoses and treatment nonadherence. Residence in rural areas or historically marginalized urban neighborhoods are associated with increased mortality. Disparities in clinical trial enrollment further limit access to cutting-edge therapies and weaken the generalizability of research. Addressing these disparities requires systemic reform, culturally informed care, and inclusive research practices to ensure equitable outcomes.

Advances in cancer treatment and supportive care have resulted in more than 80% of pediatric cancer patients surviving into adulthood. This progress has prompted consideration of factors influencing long-term quality of life for patients, including fertility. The ability to have biological children is important to many survivors. Yet, gonadotoxic therapies, such as alkylating agents and radiation, can damage gonadal tissues and cause infertility. Since these treatments remain essential for cure, efforts have expanded to better understand fertility risks and preservation strategies. Prominent organizations, including the American Society for Reproductive Medicine, American Society of Clinical Oncology, American Academy of Pediatrics, Association of Pediatric Hematology/Oncology Nurses, and Children's Oncology Group, recommend all cancer patients receive comprehensive counseling on fertility risks and options. This review outlines current knowledge on fertility risk, preservation strategies, care barriers, and future directions to improve fertility preservation access and outcomes for pediatric cancer patients and survivors.

Surgical excision remains the cornerstone treatment for skin cancer, considered the gold standard in clinical practice. However, alternative methods such as laser therapy are being explored for their potential to achieve tumor control while minimizing tissue damage and improving cosmetic outcomes. This review analyzes the existing literature on the use of Nd: YAG laser in the management of non-melanoma and melanoma skin cancer, with the aim of evaluating clearance and recurrence rates, as well as gaining deeper insights into the efficacy, safety, and potential side effects linked to this treatment approach. A systematic literature search was conducted using Embase, PubMed, Google Scholar, and Cochrane with the keywords: "Nd: YAG laser," "skin cancer," and "treatment." The search encompassed studies published from 1985 to July 2023 and included prospective, retrospective, double-blind randomized controlled trials, and non-blinded clinical trials in English. Studies were selected based on their focus on the use of Nd: YAG laser for non-melanoma including basal cell carcinoma and squamous cell carcinoma and melanoma skin cancer treatment, specifically excluding those that investigated the combination of ND: YAG laser with other therapies. Only studies reporting on the direct application of ND: YAG laser in treating various forms of skin cancer or premalignant skin lesions were considered for inclusion. Across all identified Nd: YAG laser studies from 1985 to 2023 (n = 12), a total of 7,358 histologically confirmed skin malignancies were reported, including 6,846 basal cell carcinomas (BCCs), 185 squamous cell carcinomas (SCCs), 323 malignant melanomas, and 4 cases of Bowen's disease. BCCs accounted for the vast majority of treated lesions (93.0%), followed by malignant melanoma (4.4%), SCC (2.5%), and Bowen's disease (0.05%). In calculating these totals, only lesions explicitly reported in each study were included. For instance, Brunner et al. (1985) described four patients with nevoid basal cell carcinoma syndrome as having "hundreds" of lesions; however, because the exact number was not provided, only the 200 histologically confirmed BCCs from this cohort were counted to avoid overestimation. No overlapping patients between studies were assumed unless explicitly noted. Moskalik et al. (2009) treated 188 recurrent limited BCCs alongside 3,346 primary BCCs, while Moskalik and Kozlow (2010) treated 172 recurrent limited BCCs within a cohort of 2,837 patients. El Tonsy et al. (2004) included patients with previously treated lesions, emphasizing the clearance of 37 BCCs, some of which were recurrent. Sharmazan et al. (1996) and later studies (Ortiz 2015/2018; Ahluwalia 2019; Markowitz & Bressler 2021; Kranz 2023) mostly treated primary BCCs but some non-facial and challenging anatomical locations likely included previously treated lesions. SCCs and melanomas were treated less frequently, usually in early-stage or thin lesions, and Bowen's disease appeared rarely. Taken together, these results indicate that Nd:YAG laser therapy has been applied predominantly to BCCs, reflecting both the high prevalence of this tumor type and the favorable safety and cosmetic outcomes reported. SCCs and melanomas were treated less frequently but showed encouraging clearance and cosmetic results in early-stage or low-thickness lesions, while Bowen's disease appeared only rarely in the literature. Nd:YAG laser therapy represents a promising, minimally invasive option for selected cases of non-melanoma skin cancers, offering good cosmetic outcomes and reduced morbidity compared to surgery. Its effectiveness in low-risk BCC and SCC, especially in cosmetically sensitive areas or for non-surgical candidates, is supported by current evidence. However, limitations such as lack of margin control and variable results restrict broader use, and its application in melanoma remains experimental. Continued research through standardized, long-term studies is needed to confirm its oncologic safety and define its future role in dermatologic oncology.

Chronic inflammation and immune dysfunction are significant concerns for cancer survivors. Exercise has been proposed as a promising intervention; however, further clarification is needed regarding its effectiveness, optimal modalities, and appropriate exercise prescription.

This study aims to explore the effects of different exercise modalities and doses on chronic inflammation and immune function in cancer survivors.

A comprehensive search across five major databases was conducted to identify randomized controlled trials (RCTs) examining exercise interventions on four immune parameters in cancer survivors (leukocyte types, lymphocyte subsets, immune cell functions, soluble inflammatory mediators). The search spanned from the inception of each database until January 2025. The quality of studies was independently evaluated by two reviewers, and network meta-analyses (NMAs) and dose-response analyses were performed using a random-effects model.

Forty RCTs involving 4048 participants were included. The network meta-analysis revealed that only resistance training (RT) demonstrated a significant effect, ranking the highest (SMD = - 1.42; 95% CrI: - 2.76 to - 0.17). Furthermore, a nonlinear dose-response relationship was observed between exercise interventions and chronic inflammation and immune function. The minimum effective dose was identified as 550 MET-min per week, with an optimal dose of 800 MET-min per week and a maximum safe dose of 960 MET-min per week.

Exercise is an effective approach to modulating chronic inflammation and immune function in cancer survivors, with an optimal dose of 800 MET-min per week, and RT demonstrating significant effects among different exercise modalities. Future large-scale RCTs are needed to validate the effects of RT across different cancer types and to further refine the dose-response relationship, particularly within the effective dose range.

We develop here a semiparametric Gaussian Mixture Model (SGMM) for unsupervised learning with valuable spatial information taken into consideration. Specifically, we assume for each instance a random location. Then, conditional on this random location, we assume for the feature vector a standard Gaussian Mixture Model (GMM). The proposed SGMM allows the mixing probability to be nonparametrically related to the spatial location. Compared with a classical GMM, SGMM is considerably more flexible and allows the instances from the same class to be spatially clustered. To estimate the SGMM, novel EM algorithms are developed and rigorous asymptotic theories are established. Extensive numerical simulations are conducted to demonstrate our finite sample performance. For a real application, we apply our SGMM method to the CAMELYON16 dataset of whole-slide images for breast cancer detection. The SGMM method demonstrates outstanding clustering performance.

This study identified psychological empowerment profiles of women with breast cancer to provide a clinical care framework.

This multicenter cross-sectional qualitative study used an interpretative phenomenological approach with semi-structured in-depth interviews. Participants were selected from five tertiary hospitals in northeast (Harbin and Shenyang), east (Nanjing), and northwest (Xi'an) China. Each participant underwent a face-to-face interview lasting 30-60 min. Data were collected between September and December 2024 and thematically analyzed. Forty-six women (33-72 years old) with breast cancer were interviewed; the rehabilitation timeframe spanned three days after surgery to 19 years after initial diagnosis.

The psychological empowerment profile comprised 25 subthemes and six themes. Themes 1 (Informed and Stress) and 2 (Ambivalence and Distress) reflect the negative profile; Theme 3 (Challenge and Confrontation) marks the turning point between negative and positive coping modes; Themes 4 (Adjustment and Buffer), 5 (Rationality and Acceptance), and 6 (Insight and Growth) reflect positive profiles. Participants receiving treatment (n = 36) showed higher counts in Themes 1, 3, and 4. Those from Harbin and Shenyang had higher counts across themes than those from Nanjing and Xi'an. Survivors (n = 10) dominated Theme 6, with Nanjing survivors exhibiting greater counts across themes than their Xi'an counterparts.

Women with breast cancer showed a negative-positive psychological empowerment trajectory during rehabilitation. Geographic differences revealed the impact of healthcare infrastructure and culture, with northeastern cities (Harbin/Shenyang) engaging more themes (5/6) than eastern and northwestern cities (Nanjing/Xi'an), indicating the need for regional support programs.

Cancer patients who receive the information that they need may experience better quality of life and emotional wellbeing, and be more equipped to engage in shared decision-making. Our review explores the information needs of haematological malignancy patients specifically, and their experience of the information process.

Integrative review with data extraction and narrative synthesis (PROSPERO#: CRD42024543507). We searched PubMed, Web of Science, COCHRANE, CINAHL and APA PsycINFO for articles published before 21 May 2024. Two reviewers extracted the data; a third resolved disagreements. Quality was appraised using the Mixed Methods Appraisal Tool.

Our search yielded 920 articles; 60 met the inclusion criteria. We identified three categories: Type of Information: Medical and Psychosocial Information Needs; Patient Information Experience; and Information Needs of Specific Populations. Information needs varied across patient groups and along the cancer pathway. The most common information needs were related to treatment (options and side effects) and disease (evolution and prognosis). Patients who receive clear, tailored information from healthcare professionals may be better able to engage in treatment decision-making. Information preferences varied, as did patient satisfaction and the emotional impact of the information they received.

Haematological malignancies are heterogeneous diseases, which further complicates the provision of information to patients. The information patients receive must be tailored to their specific disease and stage. Patient satisfaction with the information they receive varies, suggesting that the method and manner of communication is just as important as the content of the information itself.

Hyperspectral imaging is a non-invasive imaging modality showing potential in delineating tumour margins preoperatively. This pilot study evaluated the feasibility of using hyperspectral imaging to demarcate lateral margins of high-risk facial basal cell carcinomas (BCC) prior to Mohs micrographic surgery. Thirty patients with high-risk BCCs were recruited from the Department of Dermatology, Sahlgrenska University Hospital, Sweden. Lesions were initially demarcated using dermoscopy, followed by hyperspectral imaging scans. During the first stage, a superficial vertical incision was performed along the demarcation line before adding a 3-mm clinical margin for the bowl-shaped excision of the tumour. Hyperspectral imaging-based tumour margins were compared with histopathologically verified borders, serving as ground truth. The data analysis used supervised learning; 2 complementary validation strategies were employed: a half-split approach where the left half of each annotated image was used for training and the right half for testing, and a leave-one-out cross-validation at the image level. A pixel-wise classification approach was used, treating each pixel as an independent sample. Hyperspectral imaging achieved a pixel-wise classification accuracy of 0.76, sensitivity of 0.75, specificity of 0.78, and an area under the receiver operating characteristic curve of 0.84. Hyperspectral imaging demonstrated potential for tumour demarcation, providing a basis for future research.

Colorectal cancer (CRC) is one of the most common cancers globally. The burden continues to grow globally, exerting tremendous physical, emotional and financial strain on individuals, families, communities and health systems.CRC patients undergoing chemotherapy frequently experience considerable depression. The objective of the study was to develop, implement, and evaluate the effectiveness of the developed module for pharmacists in reducing depression among CRC patients undergoing chemotherapy.

A systematic, single-blinded study involving 98 patients receiving chemotherapy was carried out at the National Cancer Institute (NCI). The estimated sample size was 98 participants (49 in each group). A selfadministered validated questionnaire was used to collect data on the sociodemographic characteristics of the respondents. The validated PHQ-9 (Patient Health Questionnaire-9) and the Multidimensional Scale of Perceived Social Support (MSPSS) were used to assess the depression level and social support of the patients. The intervention group received chemotherapy counselling using the newly developed module during their first, second, and third follow-up. The control group received the standard practice chemotherapy counselling upon their initial visit and during the first cycle. Data were analysed using the Statistical Package for Social Sciences (SPSS) version 26. Independent t-test and two-way repeated measures analysis of variance (ANOVA) were used to analyse the effectiveness of the intervention. A p-value <0.05 was considered significant, and partial eta squared was used to measure effect size.

All participants completed the questionnaire at baseline and followed the first, second, and third chemotherapy counselling sessions, giving a response rate of 100%. No significant difference was detected between the intervention and control groups at the baseline concerning sociodemographic characteristics, depression and social support. The depression scores of the intervention group recorded significant decrements at the third follow-up (p= 0.043), indicating the effectiveness of repetitive counselling in addressing the psychological issues faced by CRC patients.

The newly developed counselling module was effective in reducing depression among colorectal cancer patients undergoing chemotherapy. This study provided evidence-based data on repetitive counselling in improving the psychological and social support of chemotherapy in CRC patients by pharmacists.