Groin node dissection (GND) following uro-gynaecological cancer surgery has a very high incidence of lymphatic complications. These patients often suffer from prolonged wound healing due to high-output lymphatic discharge. Repeated debridement, sclerotherapy, embolisation are among the commonly used alternatives. These approaches tend to scar and obliterate the lymphatic system, leading to secondary lymphoedema.In recent years, there has been an exponential rise in the popularity and success of lymphovenous anastomosis as a prophylactic surgery following nodal dissection. It has been well-documented under the Lymphatic Microsurgical Preventive Healing Approach or as afferent lymphovenous anastomoses (LVAs), particularly after axillary lymph node dissection. Prophylactic LVAs in the lower limb following GND are not well explored, let alone managing immediate complications of lymphocele.With our case, we aim to demonstrate that the super-microsurgical procedure of multiple LVAs can be an excellent treatment option for managing high-output lymphatic complications, preventing long-term secondary lymphoedema and ensuring timely completion of adjuvant therapy.

Survival rates from lung cancer in the UK are inferior to those experienced in other high-income countries. Improving access to investigations for people with symptoms may offer some utility to address this. This pilot investigated the potential of community pharmacy to identify and signpost people with symptoms of possible lung cancer towards an existing self-request chest X-ray service (SRCXRS) in Leeds.

All community pharmacies across Leeds were invited to participate in this pilot. 27 completed necessary staff training and signposted people with symptoms of possible lung cancer towards the SRCXRS between March and September 2024. Eligibility was assessed using the existing SRCXRS criteria. Limited non-identifiable data were captured regarding the basic demographics, symptoms and medication history of people signposted. People who were signposted were provided with a unique numbered card to facilitate analysis of attendance data. Pharmacy data were used in conjunction with routinely collected attendance data from the SRCXRS.

491 people were signposted by community pharmacies (2.83 patients/pharmacy/month). 32 people signposted attended the SRCXRS. All fulfilled the eligibility criteria to receive a chest X-ray. Nine attended with the unique number card. There was no clear evidence of difference in likelihood to attend based on Index of Multiple Deprivation (IMD) status (IMD 1-5=6.06% vs IMD 6-10=6.92%, relative risk=0.88 p=0.7) or age (p=0.42). Route to attendance data was not collected in 34.9% (n=235) of all attendees of the SRCXR during the pilot period.

This pilot demonstrates that pharmacies were able to successfully identify and signpost people with symptoms of possible lung cancer. Results indicate that using community pharmacies in this capacity did not impact the likelihood of signposted patients to attend the SRCXRS based on age or IMD status. The reported outcomes are limited by a significant proportion of incomplete data regarding patients' route to attendance at the SRCXRS.

IntroductionFinancial toxicity (FT) is more prevalent among rural-dwelling cancer survivors who also face greater cancer care-related travel burdens. We sought to examine how FT and travel burdens may pose dual burdens for cancer survivors, and assess their effects on care experiences and subsequent cost-coping strategies.MethodsRapid qualitative analysis of semi-structured interviews with rural-dwelling cancer survivors who screened positive for FT per the COmprehensive Score for financial Toxicity (COST) measure. Our analysis was structured around three inductive themes: rural-dwelling patients' experiences of cancer treatment while navigating FT, patient perceptions of travel burdens undertaken in the course of accessing cancer care, and perceived implications of both FT and travel burdens for care on HRQoL.ResultsThe (n = 12) participants in our study were mostly women, with a median age of 60.1. The median COST score was 9.5, indicating a high degree of FT, and the median round-trip travel distance was 25.6 miles. Participants reported cost-coping strategies to reduce travel-associated costs, such as "stacking" appointments to reduce travel costs and taking advantage of non-medical assistance offered by health systems' financial assistance programs (e.g., gas cards). Participants also reported shared burdens with caregivers who also shouldered costs.ConclusionsEstimates of travel distances to cancer care likely understate travel burdens, because they do not capture the frequency of appointments and their associated indirect and opportunity costs for cancer survivors experiencing FT. Financial assistance for cancer survivors should be responsive to the dual and cumulative financial and travel burdens of cancer care.

Weight gain in adulthood is a common potentially modifiable breast cancer risk factor. Intermittent 5:2 diets (two low-calorie days/week) have proven efficacy for weight loss among people with overweight or obesity and can promote sustained awareness and mindfulness of diet choice and help appetite control.This trial aims to test whether a less intensive 6:1 intermittent diet programme (one low-calorie day/week) is a feasible intervention to promote healthy eating and prevent weight gain in women at increased risk of breast cancer.

Single arm prospective feasibility trial in 30 healthy weight women aged 18-40 years, at moderate or high risk of breast cancer (≥17% lifetime risk and/or ≥3% 10 year risk at 40 years), body mass index 20-25 kg/m². Participants will be entered to a 16-week 6:1 diet programme involving 1 day consuming 1000 kcal and healthy eating for 6 days a week. Participants will also be advised to meet physical activity recommendations for health (≥150 min of moderate intensity physical activity/week and resistance exercise two times per week). The programme will be supported remotely by dietitian calls at baseline, week 1, 4, 8, 12 and 16. Participants will also be provided access to a trial-specific private monitored Facebook group which includes information and the opportunity for peer support.Co-primary outcomes are: (a) uptake to the trial, (b) retention rate, (c) adherence to the 6:1 diet and (d) participant feedback on acceptability of the programme. Secondary outcomes include characteristics of those recruited and completing the programme and a preliminary evaluation of benefits and harms. This includes changes in body weight and body composition (bioelectrical impedance), diet quality, physical activity, binge eating, sleep quality (Pittsburgh Sleep Quality Index), menstrual cycle length and potentially diet-related adverse events, that is, fatigue, constipation, dizziness, headache, indigestion. Exploratory outcomes include the impact of low-calorie days on dietary intake and physical activity across the week and any differences in adherence to the low calorie days across the menstrual cycle.

This trial has been approved by South Central-Berkshire B Research Ethics committee (rec reference 24/SC/0321). Findings will be disseminated via peer-reviewed journals, national and international cancer prevention and obesity conferences and cancer prevention charitable bodies.

ISRCTN14330469.

This study aims to assess palliative care service utilization among adult patients with cancer and examine how sociodemographic and clinical characteristics and patients' perceptions of palliative care influence this behaviour.

A facility-based cross-sectional study design using the multivariate logistic regression model was employed to identify sociodemographic characteristics, clinical characteristics and perceptions of patients determining palliative care service utilization among adult patients with cancer.

Jimma University Medical Center, Jimma, Southwestern, Ethiopia.

A total of 409 participants were able to complete the interviewer-administered questionnaires from 20 February to 25 December 2024.

The primary outcome of the study was utilisation of palliative care services, defined by the proportion of patients who actually used the service. The independent variables included sociodemographic and clinical characteristics and patients' perceptions of palliative care utilisation, measured by Perception of Palliative Care Instrument constructs.

39.4% of the participants used palliative care services. Female gender (adjusted OR (AOR)=0.5, 95% CI 0.3 to 0.8), diploma and above educational level (AOR=1.5, 95% CI 1.2 to 3.6), employed occupational status (AOR=2.2, 95% CI 1.1 to 4.3), having five or more family members (AOR=3.4, 95% CI 2.0 to 5.7), being diagnosed at Stage IV (AOR=0.6, 95% CI 0.3 to 0.8) and having a good perception of palliative care needs (AOR=1.3, 95% CI 1.0 to 1.5) were identified as being significantly associated with the utilization of palliative care services at p<0.05.

The utilization of palliative care services was suboptimal among our participants. Being female and receiving a cancer diagnosis at an advanced stage contributed to the underutilisation of palliative care services. Conversely, higher educational level, being employed, increased family size and positive perception increased utilisation. Therefore, a family-centred approach to palliative care services, early integration into the care process and addressing gender inequities are highly recommended.

Navigation programs for patients with cancer improve access and continuity of care, yet their digital transformation is often limited by poor usability and inadequate uptake. Applying user-centered and human-centered design (UCD/HCD) principles may close this gap, but the extent to which such design methods are used and evaluated in oncology navigation tools remains unclear.

This scoping review identifies how UCD/HCD principles have been, and should be, applied in developing and implementing digital health tools for navigation for patients with cancer.

A scoping review was conducted following PRISMA-ScR (Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews) and Joanna Briggs Institute guidance. A total of 7 databases (PubMed/MEDLINE, Scopus, IEEE Xplore, Web of Science, Embase, ACM Digital Library, and CINAHL) were searched for English-language articles published between January 2015 and July 2025. Eligible studies reported original, peer-reviewed research on digital or mobile health interventions linked to cancer navigation and documented at least 1 UCD/HCD activity. Two reviewers independently screened records and charted data on context, target users, functions, tool modality, design phase, methods, and outcomes. Findings were synthesized descriptively and thematically.

A total of 36 studies met the inclusion criteria. Findings were organized into 4 domains: study characteristics, navigation functions and digital modalities, design processes and methods, and UCD/HCD application. Iterative prototyping and usability testing were the most common, while participatory design and implementation evaluation were underused.

UCD/HCD approaches enhance usability and patient relevance of digital cancer navigation tools. However, their application remains limited across cancer types, regions, and functions. Broader stakeholder participation and evaluation beyond usability are needed to strengthen coordination, equity, and sustainability in cancer care.

Myeloid neoplasms (MNs) are most frequently diagnosed among adults aged 60 years and older. Cancer and chemotherapy can cause gait disturbances and increase fall risk in older adults with MNs. Exercise may improve gait, but there is a lack of research among older adults with MNs undergoing active chemotherapy.

We explored gait changes following a home-based mobile health exercise intervention during 2 cycles of outpatient chemotherapy (8-12 weeks).

In a single-arm pilot study, we included adults aged 60 years and older with MNs undergoing chemotherapy. Geriatric Oncology-Exercise for Cancer Patients intervention integrates a progressive aerobic walking and resistance exercise program with a mobile app. We assessed gait by using a waist-worn G-Walk motion sensor during a 6-minute walk at the preintervention and postintervention time points. Spatiotemporal outcomes included cadence (steps per minute), velocity (meters per minute), normalized stride (stride length normalized over height), and swing duration (percentage of the gait cycle during which a foot is in the air when walking). Regularity outcomes that measure gait rhythm included variability of normalized stride and variability of swing duration. Variability for both outcomes was quantified as the SD across all gait cycles. We calculated Cohen d effect sizes (ESs) for change in gait outcomes and used the Spearman rank correlation to correlate changes in daily steps and resistance exercise duration with gait outcomes.

We included 13 patients (mean age 71, SD 4.8 years); most were male (n=8, 61.5%), White individuals (n=12, 92.3%), and non-Hispanic individuals (n=13, 100%). Average daily steps were 3084 (SD 1765.5) at the preintervention time point and 3757 (SD 2623.6) at the postintervention time point. Patients performed resistance exercises for 25 minutes per day, 4 days per week at low intensity (mean rating of perceived exertion 3/10, SD 1.3). At the postintervention time point, we observed numerical changes in gait outcomes, including increased cadence (mean +4.6, SD 14.6 steps per minute; P=.24; ES=0.38) and decreased variability in normalized stride (mean -1.4%, SD 8.5%; P=.34; ES=-0.18) and swing duration (mean -0.1%, SD 1.1%; P=.54; ES=-0.15), although these improvements were not statistically significant. Increased daily steps significantly correlated with decreased swing duration variability (r=-0.72; P=.01). Resistance exercise duration significantly correlated with increased cadence (r=0.54; P=.06) and velocity (r=0.56; P=.05).

In our exploratory analyses, better adherence to exercise correlated with improved gait outcomes. Our ongoing pilot randomized controlled trial (ClinicalTrials.gov identifier: NCT04981821) will further examine the effects of the Geriatric Oncology-Exercise for Cancer Patients intervention on gait outcomes in this population.

Prostate cancer is the second leading cause of cancer-related mortality in men worldwide. Prostate-specific membrane antigen (PSMA)-targeted radioligand therapy (RLT) has emerged as a theranostic strategy for metastatic castration-resistant prostate cancer (mCRPC), with [177Lu]Lu-PSMA-617 demonstrating survival benefits in the VISION trial. However, clinical responses are heterogeneous, and resistance mechanisms remain poorly understood. Liquid biopsy (LBx), particularly circulating tumor DNA (ctDNA), may provide a minimally invasive approach to assess tumor heterogeneity, monitor response, and detect emerging resistance.

The LOOPS (Liquid Biopsy as a Biomarker in Patients Treated with PSMA Radioligand Therapy) study aims to prospectively investigate the prognostic and predictive value of ctDNA in patients undergoing PSMA RLT.

LOOPS is a prospective, multicenter observational biomarker trial recruiting 100 patients with mCRPC eligible for PSMA RLT across 3 Bavarian cancer research centers in Germany. Patients will undergo up to 6 cycles of [177Lu]Lu-PSMA-617. Blood samples for ctDNA analysis will be collected longitudinally (at baseline and after cycles 1, 2, 4, and 6) and processed according to standardized protocols. Imaging with PSMA positron emission tomography-computed tomography and clinical and biochemical data will be systematically collected. The primary end points are the prognostic and predictive value of baseline ctDNA for treatment response, defined by imaging- and prostate-specific antigen (PSA)-based response criteria after 2 cycles of PSMA RLT. Predictive performance will be evaluated using receiver operating characteristic analyses, including the determination of optimal ctDNA cutoffs, sensitivity, specificity, positive and negative predictive values, and multivariable logistic regression models adjusting for relevant clinical confounders. Secondary end points assess the concordance and correlation between ctDNA dynamics, systematically assessed PSMA positron emission tomography-computed tomography response, and PSA changes, as well as associations between ctDNA and clinical or laboratory (eg, age, Gleason score, and other) characteristics at baseline and during follow-up. Exploratory analyses will investigate early molecular response patterns based on short-term ctDNA changes and will characterize clonal dynamics and potential resistance mechanisms under therapy.

The study has been funded by the German Research Foundation (Deutsche Forschungsgemeinschaft) since July 2025. Patient recruitment has already commenced, and in January 2026, a total of 63 patients have been enrolled. Analysis of LBx samples was initiated in January 2026, while recruitment and data collection are ongoing.

The LOOPS study will provide the first prospective, systematic evaluation of ctDNA as a biomarker in PSMA RLT. By integrating molecular, imaging, and clinical data, it aims to clarify the role of LBx in response monitoring and the early identification of resistance. The results could pave the way toward personalized therapeutic strategies in mCRPC.

We assessed progress toward WHO 2030 Cervical Cancer (CC) elimination targets including 70% coverage for CC screening and 90% of precancerous lesions treated according to HIV status in Côte d'Ivoire during the 2010-2021 period.

A national CC screening registry was initiated in Côte d'Ivoire since 2010, collecting individual-level data from all health facilities offering visual inspection with acetic acid (VIA). The CC screening coverage was estimated based on the 2021 population census and the HIV national database in women aged 25-49 years from the general population and in women with HIV (WLHIV). CC screening and care cascade indicators were documented over time and compared according to HIV status. Access to same-day cryotherapy and associated factors were analyzed through a logistic regression model.

A total of 66,268 women received CC screening, with 11,251 (17.0%) being WLHIV. The estimated CC screening coverage was 4.4% (2.6-5.2), rising to 13.9% (13.5-15.3) in WLHIV. Overall, VIA positivity was 6.4% (6.2-6.5) and was higher in WLHIV (9.1% [8.6-9.7]), P < .001. Among VIA-positive women, 3,500 (83.1%) were eligible for same-day cryotherapy. Access to cryotherapy was 59.1%, declining over time from 71.7% before 2015 to 51.9% in 2021. Access to cryotherapy was higher in WLHIV (aOR, 1.55 [95% CI, 1.32 to 1.84]) and women screened in secondary-level (aOR, 1.82 [95% CI, 1.49 to 2.23]) or tertiary-level facilities (aOR, 1.79 [95% CI, 1.54 to 2.09]) versus primary level.

Despite major achievements in this 11-year implementation of the CC screening program in Côte d'Ivoire, performances remained low regardless of HIV status and far from elimination targets in 2021. These findings underline the need to endorse new screening strategies based on HPV testing and thermal ablation treatment at a national level.

This study examined the determinants of breast and cervical cancer screening and quantified socioeconomic inequalities in service use.

We analyzed data from women age 15-49 years from the 2023 Tajikistan Demographic and Health Survey. The outcomes were self-reported ever having received a clinical breast examination for breast cancer and ever having been tested for cervical cancer. The prevalence was estimated using weighted descriptive statistics and Rao-Scott chi-square tests. Determinants were examined with multivariable logistic regression, reporting adjusted odds ratios (AORs), and 95% confidence intervals. Socioeconomic inequality was assessed using concentration curves and concentration indices, accounting for the complex survey design.

The final sample size was 9,824. Breast and cervical cancer screening prevalence was 6.2% and 9.3%, respectively. Uptake increased with age (25-34 years: breast AOR = 2.68; cervical AOR = 2.41; 35-49 years: breast AOR = 3.54; cervical AOR = 3.27, v 15-24 years) and with household wealth (richest v poorest, cervical AOR = 1.95). Higher screening odds were associated with parity, recent health care visits, contraceptive use, and media exposure, whereas lower odds were associated with nonmotorized transport use. The prevalence was greater in urban areas. Concentration indices showed significant pro-rich inequality for both screening services (breast = 0.05; cervical = 0.05; P < .001).

Strategies prioritizing integrating screening into reproductive and primary care, expanding outreach to poorer households, ensuring financial protection, and delivering community-based services in rural areas, alongside monitoring equity indicators, are critical to advancing universal access to breast and cervical cancer screening in Tajikistan.