Nanotechnology has emerged as a promising frontier in the identification and treatment of skin cancer by offering innovative platforms for targeted drug administration, real-time imaging, and enhanced therapeutic efficacy. Though preclinical results are promising and scientific enthusiasm is rising, the shift of nanotechnological breakthroughs from research laboratories to clinical environments remains hampered. The main translational problems preventing the clinical acceptance of nanomedicine in skin cancer treatment are investigated in this chapter. It explores obstacles like manufacturing scalability, reproducibility, regulatory uncertainty, clinical trial design restrictions, financial limits, and intellectual property complexity. Moreover, the chapter describes strategic ways to get beyond these obstacles: multidisciplinary cooperation, regulatory harmonization, and the inclusion of digital technologies into development pipelines together with artificial intelligence (AI). This chapter seeks to give a complete knowledge of what it takes to propel nanotechnology beyond the bench and into pragmatic, patient-centred applications in oncology by closely analysing both the challenges and possible solutions.

Skin is the largest organ of the body, which comprises of 16 % of the body weight. It has layered structure which consists of epidermis and dermis and plays a crucial role in protection. Due to factors like UV exposure, there is rising global incidence and mortality of skin cancer and thus there is requirement for advanced treatment methods beyond current methods. So, leading to the exploration of nanotechnology-driven therapies that provide improved diagnostic capabilities, targeted drug delivery and minimized adverse effects. Photodynamic therapy (PDT) uses photosensitizers that is activated by specific light wavelengths and offers minimal invasive treatment with the help of production of reactive oxygen species that destroy cancer cells. The challenges faced by conventional PDT is overcome by advancements such as targeted delivery systems, nanocarriers and oxygen-enhancing strategies. Photothermal therapy (PTT) is also a minimally invasive cancer treatment that uses absorbing agents like nanoparticles which absorb near-infrared (NIR) light. It destroys the cancer cells whiles sparing the healthy tissue by generation of localized heat. Nanotechnology significantly enhances both photodynamic therapy (PDT) and photothermal therapy (PTT) by controlled drug release, precise tumour targeting and improved heat agent or photosensitizer stability. With the use of advanced nanocarriers and NIR-responsive systems greater efficacy in hypoxic environments, reduced side effects and deeper tissue penetration is achieved when compared to conventional approaches. While clinical translation faces challenges like scalability, standardization and safety ongoing advancements in theranostics, AI and biodegradable nanomaterials has the potential to enhance therapeutic outcomes by overcoming these drawbacks.

Skin cancer is considered one of the most significant malignancies worldwide, arising primarily from epidermal keratinocytes or melanocytes and influenced by genetic, environmental, and lifestyle factors. Conventional therapies, including chemical treatments, chemotherapy, radiotherapy, and antibody immunotherapy, though most effective in the early stages, often present significant limitations including such as systemic toxicity, recurrence, drug resistance, and cosmetic or psychological impacts. In recent years, nanotechnology has emerged as a promising strategy to overcome these challenges by enabling targeted, efficient, and minimally invasive therapeutic approaches. Nanoparticles, with their tunable size, surface properties, and biocompatibility, facilitate site-specific drug delivery, improve solubility of poorly soluble agents, and prolong drug circulation time while minimizing off-target effects. Diverse nanocarrier systems-liposomes, niosomes, dendrimers, micelles, nanospheres, nanoemulsions, and metallic nanoparticles-have been investigated for skin cancer therapy, offering improved penetration across the stratum corneum, controlled release, and enhanced drug retention. Functional modifications such as PEGylation and ligand attachment further optimize stability, immune evasion, and receptor-mediated targeting. Moreover, nanotechnology integrates diagnostic and therapeutic potential through theranostic applications, enabling simultaneous imaging, monitoring, and treatment of skin malignancies. Despite regulatory and translational challenges, advancements in nanoparticle-based therapeutics represent a paradigm shift in precision dermatologic oncology, offering safer, more effective, and patient-friendly interventions. This chapter highlights recent progress, clinical perspectives, and future directions in nanotechnology-enabled skin cancer therapies.

This chapter will thoroughly examine how the landscape of skin cancer therapeutics is changing with a particular focus on the fact that nanotechnology has resulted in a transformative advancement in drug delivery systems. It starts by providing a summary of the epidemiology of skin cancer, and the treatment difficulties that are associated with conventional modalities, including surgery, radiotherapy, and topical chemotherapy, and their shortcomings. The wide variety of nanocarriers, including lipid-based systems, polymeric nanoparticles, micelles, dendrimers, and inorganic platforms like gold nanoparticles and quantum dots, are then discussed along with their physicochemical properties, the mechanism of improved drug solubility, stability, bioavailability, and targeted activity. The hybrid and stimuli-sensitive delivery systems that are intended to be delivered on the site of action in response to internal (pH, redox, enzyme) or exterior (light, temperature, magnetic field) stimuli receive particular attention. The efforts to optimize therapeutic utility and reduce toxicity in the off-target tissues through enhanced permeability and retention (EPR) impact and ligand-based targeting are among the passive and active tumor targeting mechanisms that are taken into consideration.The chapter ends with a discussion on the recent research, combination therapies, theranostics, and future on clinical translation of nanotechnology-based methods in managing skin cancer.

Diagnostic integration technology represents a significant advancement in cancer diagnosis and treatment. The combination of fluorescence probe-based imaging methods with photodynamic therapy (PDT) offers distinct advantages due to its high sensitivity and minimally invasive nature. However, the effective detection depth and spatial resolution of fluorescence imaging are limited by light scattering effects in biological tissues. Additionally, high concentrations of GSH in the tumor microenvironment (TME) neutralize reactive oxygen species (ROS) generated by PDT, directly inhibiting therapeutic efficacy. Therefore, developing a highly sensitive, high-resolution fluorescent probe to achieve integrated tumor diagnosis and treatment is of great significance. This study developed an activatable diagnostic-therapeutic probe, MB-2O-MB. In MB-2O-MB, methylene blue (MB) served as both the photosensitizer and signal reporting moiety, while a thiols-sensitive disulfide bond was introduced as the linker and response unit. When the probe reacted with GSH in tumor regions, the disulfide bond broke, causing structural dissociation and releasing free MB molecules. Experiments demonstrated that the probe exhibited strong interference resistance, and high sensitivity (LOD = 57.99 nM) for this reaction. Furthermore, the photoacoustic (PA) signal generated upon probe activation compensated for the limited tissue penetration depth of fluorescence imaging, enabling more precise spatial localization of tumor regions. Therapeutically, upon irradiation with 660 nm near-infrared (NIR) laser light, the released MB efficiently generated singlet oxygen, effectively inducing 4T1 tumor cell death. In vivo data further validated the significant tumor suppression effect of MB-2O-MB via PDT. In summary, MB-2O-MB achieves precise tumor localization and complete eradication through the synergistic combination of NIR fluorescence/PA dual-modality imaging and PDT. This strategy simultaneously overcomes the drug resistance bottleneck and imaging limitations of conventional photodynamic therapy, paving a new pathway for constructing highly selective and potent smart diagnostic and therapeutic systems, and significantly advancing precision medicine.

Adrenal disorders in pregnancy are rare but often clinically significant. Diagnosis is challenging owing to overlap with normal physiologic changes in pregnancy. Early diagnosis is often key, ideally before pregnancy. Cushing's syndrome and adrenal cortical carcinoma are often treated surgically, and primary aldosteronism is often treated medically. Pheochromocytoma can often be treated medically, but surgery remains an option in select cases. Adrenal insufficiency can be successfully managed medically, with adjustments in doses based on clinical signs and symptoms.

Adrenocortical carcinoma (ACC) is a rare, aggressive malignancy with symptoms arising from mass effect or hormonal excess, particularly hypercortisolism. Accurate diagnosis requires comprehensive clinical, hormonal, radiologic, and histopathologic evaluation. Surgical resection is the only curative treatment. Treatment decisions are guided by risk stratification based on stage, Ki67 index, and resection margin status. Mitotane, the only Food and Drug Administration-approved drug for ACC, is combined with etoposide, doxorubicin, and cisplatin as the standard treatment for patients with recurrent disease. Investigational therapies include tyrosine kinase inhibitors, immune checkpoint inhibitors, image-guided locoregional therapies, radiation therapy, and cell-based therapies.

PPGL are rare neuroendocrine tumors that secrete catecholamines. There are over 20 driver mutations associated with PPGL. All patients who have been diagnosed with PPGL need genetic testing. Diagnosis is made by checking either plasma or urine metanephrines. Localization studies include computed tomography, magnetic resonance imaging, and functional imaging such as positron emission tomography scans. Alpha-blockers are a central component for preparation prior to surgical removal of the tumor, which is the mainstay of therapy. For patients with metastatic disease, several different modalities can be employed from palliative surgery, chemotherapy, radionuclide therapy, HIF-2α inhibitor, and drugs in clinical trials.

Over the past several decades, the management of nonmetastatic nonsmall cell lung cancer (NSCLC) has centered on identifying patients eligible for upfront surgical treatment. This selection has traditionally relied on multidisciplinary assessments of clinical operability and oncologic resectability, with the latter depending primarily on mediastinal lymph node evaluation, a key prognostic factor in determining whether patients should be directed toward upfront surgery or definitive chemoradiotherapy. The recent incorporation of immune checkpoint inhibitors (ICIs) into standard neoadjuvant therapy has transformed this paradigm. By significantly enhancing pathologic response and improving survival across the full spectrum of N2 disease, neoadjuvant ICI therapy is reshaping the prognostic weight traditionally assigned to mediastinal nodal involvement, challenging long-standing staging practices. Rather than serving primarily to exclude patients from surgery, mediastinal assessment in the immunotherapy era may play a more selective role in baseline risk stratification while also potentially gaining new roles, such as in the evaluation of treatment response and nodal downstaging, which could support broader refinements in clinical decision-making. This update synthesizes emerging evidence and evolving clinical concepts to re-examine mediastinal assessment in the immunotherapy era, with implications for clinical decision-making and future trial design in nonmetastatic NSCLC.