Psilocybin therapy has demonstrated efficacy for cancer-related anxiety and depression, but resource-intensive individual treatment models raise important questions for psychedelic public health about equitable access and scalability. In our prior Phase 1/2 study of group retreat psilocybin therapy for patients with metastatic cancer, we observed partial responders who did not achieve full therapeutic benefit. No published research has examined whether partial responders might benefit from a second psilocybin therapy experience.

We conducted a single-arm Phase 1 study to assess the safety of a second experience of Group Retreat Psilocybin Therapy for partial responders from our prior study. Protocol modifications addressed dose as a potential contributor to partial response: the initial dose was increased to 35 mg, and an optional 10 mg booster could be requested by participants who reported low subjective effect at 60-90 min and passed a safety check. Pre-retreat antidepressant tapering was not required. The intervention was delivered in a group retreat format with four primary facilitators and included three preparation sessions, a single psilocybin dosing day, and four integration sessions.

Thirteen participants (mean age 56 years, 70% female, 38% on concurrent antidepressants) completed the intervention. No serious adverse events occurred; mild adverse events included transient hypertension (n = 4), nausea (n = 3), and headache (n = 1). Seven participants (54%) received the booster dose. Mean Hospital Anxiety and Depression Scale (HADS) Total scores decreased from 15.08 (SD 4.35) at baseline to 9.00 (SD 4.62) at Day +8, with improvements maintained through 24-week follow-up (mean 10.42, SD 6.93); 69% achieved HADS scores below the clinical threshold. The proportion of participants with a "complete" mystical experience (Mystical Experience Questionnaire ≥ 60%) increased from 38% in the first experience to 77% in the second, without an increase in challenging experiences (Challenging Experiences Questionnaire). Social support, social identification, and group cohesion scores showed progressive improvements that persisted at 24 weeks.

A second experience of group retreat psilocybin therapy was safe and feasible for partial responders with metastatic cancer. The protocol modifications-higher dose, optional booster, and no antidepressant tapering requirement-did not introduce new safety concerns and were associated with substantially enhanced mystical experiences and preliminary efficacy signals. These findings support further investigation of retreatment protocols for partial responders and contribute to developing scalable group-based models relevant to psychedelic public health, where the resource intensity of individual treatment remains a fundamental barrier to population-level access.

Cancer awareness is vital for early detection and prevention; however, individuals with intellectual disabilities (ID) often face challenges in accessing health information. The Cancer Awareness Measure (CAM) has not been tailored for this population. This study aimed to adapt and validate the CAM for individuals with ID in Hungary and to assess their cancer literacy.

A cross-sectional study was conducted with 232 adults with mild and moderate ID living in community and residential settings. The CAM was simplified for cognitive accessibility, translated into Hungarian, and reviewed by the experts. The psychometric evaluation included internal consistency (Cronbach's α), content validity (I-CVI and S-CVI/Ave), and face validity through pilot testing. The associations between cancer knowledge, barriers, and demographic variables were analyzed using independent t-tests and one-way ANOVA.

The adapted CAM showed satisfactory reliability across subscales (Warning Signs: α = 0.842; Risk Factors: α = 0.785; Prevention: α = 0.714; Barriers: α = 0.842) and excellent content validity (S-CVI/Ave = 0.96). Participants' mean scores were 5.47/9 for Warning Signs, 36.41/55 for Risk Factors, 3.79/7 for Prevention, and 27.88/33 for Barriers to Seeking Help. Individuals living with family scored higher in warning sign knowledge (p = 0.022), while care home residents had higher barrier scores (p = 0.004). Those with a family history of cancer had higher warning sign (p = 0.002) and Prevention Knowledge (p = 0.047). Screening participation was associated with better warning sign knowledge (p = 0.02). Age ≥65 years, vocational education, and full-time employment were associated with higher knowledge scores. Sex differences were not observed.

The Adapted CAM is a reliable and valid tool for assessing cancer awareness among individuals with ID in Hungary. The findings highlight demographic and contextual disparities, emphasizing the need for tailored, inclusive educational interventions and caregiver support.

Sanitation workers face chronic occupational exposure to ambient air pollution and traffic-related particulate matter; however, the prevalence of high-risk lung nodules in this vulnerable population remains unclear. Furthermore, the potential association between physical health-related quality of life (HRQoL) and nodule risk, along with its sex-specific patterns, has not been adequately investigated.

This cross-sectional study included 1,018 outdoor sanitation workers in Hohhot, Inner Mongolia Autonomous Region, China. All participants underwent low-dose computed tomography (LDCT) screening and completed the SF-8 Health Survey. Lung nodules were assessed by two independent radiologists in a blinded manner. High-risk lung nodules (Lung-RADS Category 4) were confirmed by at least two senior specialists. Multivariate logistic regression and interaction analyses were employed to evaluate the association between Physical Component Summary (PCS) scores and high-risk lung nodules, adjusting for age, sex, smoking status, and socioeconomic factors.

A total of 16 participants (1.57%) were identified with high-risk lung nodules, of whom 9 (56.3%) were never-smoking females. The fully adjusted model included 994 participants. Multivariable logistic regression revealed an inverse association between PCS and high-risk lung nodules. Treated as a continuous variable, PCS showed a marginal inverse association after adjusting for sex, age, smoking, education, and residence (OR = 0.92, 95% CI: 0.84-1.00, P = 0.0505). When dichotomized at a cutoff of 50, a significantly decreased risk was observed in the PCS ≥ 50 group vs. the PCS < 50 group, which persisted after full adjustment (OR = 0.29, 95% CI: 0.10-0.83, P = 0.0211). Generalized additive models indicated a significant, nearly linear relationship (P = 0.027). Furthermore, subgroup analyses showed this protective effect was accentuated in females (OR = 0.87, 95% CI: 0.79-0.96, P = 0.0065) and highly educated individuals (OR = 0.81, 95% CI: 0.70-0.94, P = 0.0042), both yielding significant interactions (P for interaction = 0.0407 and 0.0319, respectively). Interactions for age, income, smoking, BMI, and residence were non-significant.

A higher PCS is inversely associated with high-risk lung nodules, demonstrating a generally approximate linear relationship. This inverse association is more pronounced in females and individuals with higher educational levels, suggesting potential effect modification by sex and education.

The role of bronchial sleeve resection for centrally located pulmonary metastases remains poorly defined, as surgery in metastatic disease is often perceived as excessively aggressive. However, in selected patients, this parenchyma-sparing technique may offer durable local control and significant symptomatic relief. This study reports a single-center experience with sleeve resections performed for metastatic, centrally located pulmonary lesions.

All consecutive patients undergoing bronchial sleeve resection for metastatic disease at Padua University Hospital between January 2000 and August 2025 were retrospectively reviewed. Clinical characteristics, operative details, perioperative outcomes, and follow-up data were collected. Patients treated with sleeve resections for primary lung cancer were excluded.

Eighteen patients were included. Most had good performance status, and 66% received preoperative systemic therapy. Single sleeve resections were performed in 72% and double sleeves in 28%. Surgical access was thoracotomy in 72% and VATS in 28%. No in-hospital, 30-day, or 90-day mortality occurred. Postoperative symptom resolution was achieved in 94% of patients. The most frequent histology was colorectal adenocarcinoma. Median follow-up was 26 months, with a median disease-free survival of 22 months. Local recurrence occurred in only one case, and no bronchial stump recurrences were observed.

Bronchial sleeve resection for centrally located pulmonary metastases can be feasible and safe in a carefully selected subset of patients. It provides effective restoration of airway patency, good local control, and acceptable long-term outcomes. Larger multicenter studies are needed to further clarify its role within multidisciplinary management.

Multiple myeloma outcomes vary widely, with risk stratification typically based on baseline characteristics. Functionally high-risk multiple myeloma (FHRMM), defined by early relapse within 12 months of initial therapy or autologous stem cell transplant, is associated with poor prognosis. However, the continued prognostic impact of baseline high-risk features within the FHRMM cohort remains unclear. This study analyzed 181 FHRMM patients from the CoMMpass dataset, categorized into standard-risk (SRG) and high-risk (HRG) groups based on baseline cytogenetics and ISS stage. Despite SRG patients possessing more favorable baseline risk profiles, including lower SKY92 scores, their overall survival (OS) was not significantly different from HRG patients (20.7 vs. 18.1 months, p = 0.059). Treatment regimens and response rates were comparable between groups. Within the FHRMM cohort, only baseline ISS stage I retained prognostic significance for OS. In conclusion, FHR status overrides traditional baseline risk factors in determining prognosis. Patients experiencing early relapse should be considered uniformly high-risk, highlighting the need for effective salvage therapies and consideration of novel treatments like CAR T-cell therapies.

Metabolic dysregulation may contribute to kidney cancer development through shared biological mechanisms and/or as an independent risk factor. However, evidence on this association in the US population remains limited.

This study identifies associations between metabolic syndrome (MetS) and kidney cancer risk in the United States.

This case-control study using administrative claims data from the MarketScan database (2007-2022) identified adult kidney cancer cases and 1:10 frequency-matched controls by age, index year, sex, insurance duration, and region. Metabolic exposures (obesity, hypertension, diabetes, and dyslipidemia) were assessed using diagnoses and prescriptions, with binary classification (MetS: ≥3 conditions; non-MetS: <3). Secondary analyses examined pre-MetS (1-2 conditions), metabolically healthy, dose-response relationships, combinations of conditions, and interaction between obesity and MetS. Multivariable logistic regression models were used to estimate odds ratios (ORs) and 95% confidence intervals (CIs).

A total of 48,587 kidney cancer cases and 480,714 controls were included. MetS was associated with an increased risk of kidney cancer compared with non-MetS (OR, 1.43; 95% CI, 1.39-1.47). MetS (OR, 1.83; 95% CI, 1.77-1.88) and pre-MetS (OR, 1.47; 95% CI, 1.44-1.50) were associated with a higher risk compared with metabolically healthy. Each additional condition was associated with a 22% increase in the odds (95% CI, 1.21-1.23). Multiple conditions had higher odds than a single condition. Metabolically healthy obesity (OR, 1.48) and metabolically unhealthy obesity (OR, 1.77) showed stronger associations than metabolically healthy nonobesity.

MetS was associated with an increased risk of kidney cancer, highlighting the importance of overall metabolic health in its prevention.

There is inconsistent data on cancer risk in people with intellectual disability. Our primary objective was to compare the incidence of cancer in people with and without intellectual disability.

A cohort study using linked population-based administrative and cancer registry data in New South Wales, Australia 2001-2018. We compared the incidence of cancer in people with intellectual disability and a comparator group without intellectual disability matched for age, sex and residential postcode. We also compared cancer incidence in people with Down syndrome and people with intellectual disability without Down syndrome. We used a flexible parametric survival model accounting for competing risks.

People with intellectual disability had a slightly higher risk of developing any cancer (sub-hazard ratio, SHR 1.07 [95% CI 1.03 to 1.12]) compared to those without intellectual disability. An increased risk was evident in the 0-14 year (SHR 2.19, 95% CI 1.85 to 2.59) and 15-49 year (SHR 1.34, 95% CI 1.23 to 1.46) age groups, and a decreased risk was observed for those aged 50 years and above (SHR 0.93, 95% CI 0.88 to 0.98). People with intellectual disability had a higher risk of colorectal cancer (SHR 1.32, 95% CI 1.15 to 1.51) and a lower risk of prostate cancer (SHR 0.45, 95% CI 0.38 to 0.53) and melanoma (SHR 0.75, 95% CI 0.64 to 0.88). People with Down syndrome had a significantly higher risk of childhood cancer (SHR 7.94, 95% CI 5.72 to 11.04) compared to those with other intellectual disability, and a similar risk as an adult.

These findings underscore the need for targeted health promotion campaigns and, for adults, customised cancer screening programmes to improve access, acceptability and outcomes for people with intellectual disability.

Advanced pancreatic cancer is often a rapidly progressing malignancy causing high symptom burden. The objective of this study was to assess the association of specialist palliative care (SPC) and its timing with healthcare resource utilisation at the end of life.

This nationwide retrospective study which covers the whole population of Finland included all 1199 patients who died of pancreatic cancer in 2019. Data were obtained from national registries. Patients were categorised into two groups based on the timing of their first contact with SPC: Group I (> 30 days before death), and Group II (≤ 30 days before death or no contact).

Among 1199 patients, 438 (36%) had a SPC contact, and median time from the first contact to death was 51 days. Contact with a SPC occurred > 30 days before death for 22.5% of the patients (n = 270). Having an earlier contact with SPC (Group I) was significantly associated with fewer secondary care hospitalisations (25% vs. 56%, p < 0.001) and fewer emergency department (ED) contacts (50% vs. 61%, p < 0.001) during the last month of life. In addition, patients in Group I were more likely to receive hospital-at-home services (44% vs. 9%, p < 0.001) and to receive care in SPC wards (23% vs. 5%, p < 0.001). Most of the patients died in hospital (56% vs. 79%, p < 0.001), but death in SPC ward (22% vs. 5%, p < 0.001) or at home (19% vs. 13%, p < 0.014) was more likely for patients in Group I.

Lower secondary healthcare utilisation and ED contacts during the last month of life, and higher probability of dying in SPC ward or at home, were observed in patients who had an earlier SPC contact. Integration of SPC in time should be ensured for all patients with advanced pancreatic cancer.

Both fruquintinib and TAS-102 monotherapies are guideline-recommended for third-line treatment of metastatic colorectal cancer (mCRC). This study aimed to analyze the preliminary outcomes of fruquintinib combined with TAS-102, with or without stereotactic body radiation therapy (SBRT), as a third- or later-line therapy for mCRC. This prospective, two-arm, phase II study planned to enroll 66 patients with mCRC who were unresponsive to at least two prior lines of therapy. Patients were allocated to either the FTS (fruquintinib + TAS-102 + SBRT) or FT (fruquintinib + TAS-102) group. Eligible patients received fruquintinib (4 mg, qd, days 1-21) and TAS-102 (30 mg/m², bid, days 1-5; 15-19) orally every 4 weeks until disease progression or intolerable toxicity. The primary endpoint was progression-free survival (PFS, per RECIST 1.1); secondary endpoints included overall survival (OS), objective response rate (ORR), disease control rate (DCR), and adverse events (AEs, graded using CTCAE v5.0). By January 20, 2025, 40 patients were enrolled (FTS group, 11; FT group, 29), with a median follow-up of 8.48 months. In 20 (50%) patients, the number of metastatic organs was ≥ 3. However, the number of metastatic lesions was > 5 in 32 (80%) patients. For the 36 eligible patients, the ORR and DCR were 19.4% and 88.9%, respectively. The median PFS was 8.58 months; however, the median OS has not been attained. The most common treatment-related AE was decreased white blood cell count (92.5%); grade 3-4 AEs included decreased lymphocyte count (12.5%). No treatment-related death occurred. Fruquintinib combined with TAS-102, with or without SBRT, showed promising preliminary efficacy and acceptable safety as third- or later-line treatment of mCRC.

Pilonidal sinus disease typically occurs in the sacrococcygeal region, with the intermammary location being exceptionally rare. We report the first documented case of an intermammary pilonidal sinus from eastern India in a 14-year-old Asian female.

A 14-year-old Asian female presented with 1-year history of intermammary swelling that evolved into a discharging sinus after 11 months. Physical examination revealed multiple sinus tract openings in the intermammary region with surrounding induration. Complete excision of the sinus tract with primary closure was performed under general anesthesia. Histopathological examination confirmed chronic inflammatory tissue consistent with the pilonidal sinus. The patient had an uncomplicated recovery with no recurrence at follow-up.

Inclusion of intermammary pilonidal sinus in the differential diagnosis of chronic intermammary lesions should be considered, particularly in young females with large, pendulous breasts. Early recognition and complete surgical excision remain the gold standards for treatment, with excellent outcomes.