To observe the clinical efficacy of moxibustion combined with Jianpi Wenshen formula in treating cancer-related anorexia of spleen-kidney yang deficiency.

A total of 80 patients with cancer-related anorexia of spleen-kidney yang deficiency were randomized into an observation group and a control group, with 40 cases in each group.Jianpi Wenshen formula was given orally in the control group. On the basis of the treatment in the control group, moxibustion was applied at bilateral Zusanli (ST36), Neiguan (PC6) and Zhongwan (CV12), Guanyuan (CV4), Mingmen (GV4) in the observation group, once daily for the first 15 days, then once every other day. Both groups were treated for 4 weeks. The scores of appetite, Karnofsky performance status (KPS), nutritional risk screening 2002 (NRS-2002), and patient-generated subjective global assessment (PG-SGA), as well as the serum levels of interferon-γ (IFN-γ) and C-reactive protein (CRP)were observed before and after treatment, and the clinical efficacy was evaluated after treatment in the two groups.

After treatment, the scores of appetite, NRS-2002, PG-SGA, and the serum levels of IFN-γ and CRP were decreased compared with those before treatment in the two groups (P<0.001, P<0.05, P<0.01), and the above indexes in the observation group were lower than those in the control group (P<0.05, P<0.001); the KPS scores were increased in the two groups compared with those before treatment (P<0.001, P<0.05), and the KPS score in the observation group was higher than that in the control group (P<0.001). The marked response rate was 57.5% (23/40) in the observation group, which was higher than 30.0% (12/40) in the control group (P<0.05).

Moxibustion combined with Jianpi Wenshen formula can effectively improve appetite and overall status, and reduce the levels of IFN-γ and CRP in patients with cancer-related anorexia of spleen-kidney yang deficiency.

Traditional social determinants of health measures rely on population-level data, limiting the ability to assess individual patient-level factors. This study explores the influence of a novel, patient-level social determinants of health measure on oncologic outcomes in patients with colon cancer.

Using a program developed within our integrated health network, which prospectively captures 13 specific patient-level social determinants of health components, we categorized patients as high-risk social determinants of health if they reported significant impairments in any social determinants of health domain. We evaluated the independent effect of high-risk social determinants of health on oncologic outcomes among patients with adenocarcinoma of the colon from 2020 to 2023.

Among 717 patients, the mean age was 67.9 ± 13.6 years, with 54.7% (n = 392) male and 90.8% (n = 651) White; 16.2% had a Charlson Comorbidity Index >2 and 21.3% (n = 128) had stage IV disease at diagnosis. Median overall survival for the cohort was 50.0 (28.0-55.0) months. Overall, 24.0% (n = 172) of patients presented with high-risk social determinants of health. Patients in the 2 cohorts were similar in sex, race, and Charlson Comorbidity Index (P > .050). On multivariable analysis, high-risk social determinants of health was an independent predictor of stage IV disease at diagnosis (odds ratio, 2.32; 95% confidence interval, 1.45-3.73; P < .001) and mortality among all patients (hazard ratio, 1.81; 95% confidence interval, 1.16-2.85; P = .010). Among early stage patients (stage I-II), high-risk social determinants of health was an independent predictor of mortality (hazard ratio, 4.61; 95% confidence interval, 1.67-12.69; P = .003).

Utilizing a novel prospective measure, patient-level social determinants of health independently predicts metastatic disease at diagnosis as well as stage-specific survival in colon cancer. This presents an opportunity to identify specific cancer patients at high risk for poor oncologic outcomes who may benefit from directed care measures.

Early and accurate diagnosis of chronic obstructive pulmonary disease (COPD) is essential to ensure correct management and minimise future morbidity. Therefore, case finding in symptomatic at-risk individuals is highly valuable. The C FIND COPD study invited symptomatic people at risk of COPD for a COPD case-finding diagnostic assessment. These individuals had undergone a previous lung cancer screening low-dose CT. The diagnostic assessment used a mobile research unit stationed in community car parks across Nottinghamshire. This current qualitative study aimed to gather participants' opinions about this research study and the associated lung assessment.

15 participants accepted an interview using a semi-structured interview guide by an independent researcher. At the visit, seven interviewees had been given a new diagnosis of COPD and eight had no current evidence of the condition. The interviews were transcribed verbatim and analysed in NVivo (V.14) using inductive thematic analysis.

Across five themes, highlights included praise for the clinical research staff, the accessibility and atmosphere of the research unit, convenience of appointment and opportunity of case finding. Subsequent suboptimal communication with general practitioner surgeries was flagged as a key issue in the weeks following the assessment.

Overall, case finding of COPD after lung cancer screening as part of the C FIND COPD study was considered a valuable assessment and experience. Interviewees were grateful for the service and aside from some practical aspects, people supported a wider roll-out.

Spiritual well-being is an essential component of holistic palliative care. However, patients' lived experiences of spirituality in advanced cancer remain underexplored in low- and middle-income settings. This study aimed to explore spiritual well-being from the perspectives of patients with advanced cancer receiving palliative care in a tertiary cancer centre in Kerala.

Qualitative descriptive study using face-to-face, in-depth, semistructured interviews and conventional content analysis conducted between November 2022 and December 2024.

Outpatient palliative care services of a tertiary cancer centre in Kerala, India.

20 adults with advanced cancer receiving palliative care were recruited using purposive sampling. Interviews were conducted in Malayalam. Data were audiorecorded, transcribed verbatim, translated into English and analysed using conventional qualitative content analysis as described by Graneheim and Lundman. Data collection continued until saturation was achieved. Trustworthiness was ensured through credibility, dependability, confirmability and authenticity.

A total of 127 codes were identified and organised into 18 subthemes and four overarching themes: (1) multidimensional suffering and reflection in advanced cancer, encompassing physical suffering, psycho-existential distress, social concerns, financial burden and moral reflection; (2) healing through social support and relationships, emphasising the supportive roles of family, community and healthcare professionals; (3) coping mechanisms and inner strength, including acceptance, peer inspiration, prior life experiences and adaptive psychological and physical strategies and (4) spiritual beliefs and practices, where faith, prayer, rituals and spiritual questioning contributed to meaning-making and emotional regulation.

Spiritual wellbeing in advanced cancer extends beyond religious practices and is shaped by interconnected experiences of illness, relationships, spiritual beliefs and cultural context. Addressing these dimensions through holistic and culturally sensitive palliative care may enhance emotional resilience and overall quality of life.

To assess the feasibility and acceptability of delivering risk-stratified low-dose CT (LDCT) lung cancer screening across diverse geographical and socioeconomic settings in Scotland and to characterise uptake, participant profile and screening outcomes.

Prospective, multicentre pilot feasibility study with descriptive analysis.

Primary and secondary care interface across four regional Health Boards in Scotland, encompassing urban, rural, remote and socioeconomically deprived populations.

2801 individuals aged 50-74 years, identified from primary care electronic medical records (EMRs), with a history of smoking were invited (current or within 15 years where available); 668 (23.8%) responded. Of 608 assessed for eligibility (50.8% female; median age 63 years), 503 (82.7%) met at least one predefined high-risk criterion.

Invitation to a lung health check, followed by telephone-based risk assessment using US Preventative Services Task Force, Liverpool Lung Pathway version 2 and the Prostate, Lung, Colorectal and Ovarian Screening Trial criteria. High-risk participants were offered a one-off LDCT scan at local centres.

Primary: feasibility indicators including uptake, risk eligibility and scan completion. Secondary: prevalence of lung cancer, pulmonary nodules and incidental findings (eg, coronary artery disease, emphysema).

Response rate was 23.8% (668/2801), varying from 17.8% to 38.1% across practices and lower in more deprived areas. Of 503 eligible participants, 436 (86.7%) underwent LDCT. Abnormal findings were present in 83.3% of scans. Lung nodules were detected in 25.7% (112/436), with 11.8% requiring follow-up. Lung cancer was diagnosed in 1.15% (5/436; 95%), alongside five additional malignancies. Coronary artery disease was identified in 56.4% (246/436) and emphysema in 33% (144/436). Non-responders were more likely to be current smokers (69.3% vs 49.8%).

Recruitment of people for lung cancer screening using the smoking history recorded in their primary care EMR is feasible. This approach identifies a high-risk population with a high burden of both malignant and non-malignant disease, and with substantial undiagnosed disease burden. However, uptake was modest and socially patterned, highlighting the need for equity-focused implementation strategies, including repeated invitations and targeted engagement. These findings are particularly relevant as Scotland considers implementation of a national lung cancer screening programme within a health system characterised by marked geographical and socioeconomic inequalities. Further research should evaluate long-term outcomes, cost-effectiveness and strategies to improve equitable participation.

Breast cancer is often accompanied by significant psychological and physical symptoms during chemotherapy, which have a considerable impact on quality of life. Music therapy is a non-pharmacological intervention that can support psychological well-being but the way individuals respond to the treatment can vary considerably. Traditional group-based studies do not allow such variability to be captured. N-of-1 trials, which are based on repeated intra-individual comparisons, offer an innovative way to assess personalised effects. This pilot study aims to evaluate the feasibility of this approach in patients with breast cancer.

This multicentre pilot study uses an N-of-1 design combined with a crossover design involving 24 patients with breast cancer who are undergoing adjuvant chemotherapy. Participants will be randomised into alternating sequences of phases with and without music therapy each lasting 4 weeks. The intervention consists of weekly 60-minute group sessions incorporating receptive and active techniques as well as personalised playlists. The primary outcomes focus on feasibility, including dropout rate and missing data as well as acceptability. The secondary outcomes include measures of psychological and physical well-being as assessed using validated instruments (State-Trait Anxiety Inventory, Self-Rating Depression Scale, Quality of Life, Emotion Thermometers, Visual Analogue Scale and Pittsburgh Sleep Quality Index). The analysis will be primarily descriptive, exploring individual trajectories and intra- and inter-patient variability using mixed-effects models.

The study protocol was approved by the Research Ethics Committee of AOU Maggiore della Carità Novara (Protocol No. 590/CE/2025) and the Research Ethics Committee of Palermo 2 (Protocol No. 137/2025) and will be conducted in accordance with the principles of the Declaration of Helsinki. Written informed consent will be obtained from all participants. The results will be disseminated through peer-reviewed scientific publications and presentations at national and international scientific conferences.

NCT07549685.

The effectiveness of cervical cancer screening as a preventive strategy for cervical cancer substantially depends on timely and consistent adherence to recommended follow-up screenings. This study aimed to determine adherence to the recommended follow-up cervical cancer screening, characterise the timing of adherence and determine its associated predictors among women living with HIV (WLHIV) who undertook their first screening between 2019 and 2021 in Moshi Municipality, northern Tanzania.

We conducted a retrospective cohort study between 2019 and 2021.

Healthcare facilities in Moshi municipality, Kilimanjaro region, northern Tanzania.

2030 WLHIV who undertook their first screening in healthcare facilities in Moshi municipality between 2019 and 2021.

Adherence to a follow-up cervical cancer screening, defined as the subsequent screening test conducted to detect precancerous development in the cervix carried out after the first screening. For the sub-analysis assessing the timing of adherence to a follow-up screening, this outcome was further categorised into four distinct categories: early adherence, good adherence, poor adherence, extremely poor adherence based on the time elapsed between the first screening and subsequent follow-up screening. Predictors of adherence were assessed using multivariable Poisson regression models with robust SEs and reported as adjusted risk ratios (ARR) with 95% CIs.

Among 2030 WLHIV who undertook the first screening, only 33.2% adhered to a follow-up screening. Among these, only 21.4% (95% CI 18.4% to 24.7%) demonstrated good adherence, meaning they attended a follow-up within a month after the scheduled date. Also, adherence was higher in private healthcare facilities (ARR=1.57; 95% CI 1.35 to 1.82), lower for WLHIV who had their first screening at outreach facilities (ARR=0.28; 95% CI 0.19 to 0.39) and higher for those who were diagnosed with an abnormal screening outcome in their first screening (ARR=2.62; 95% CI 2.26 to 3.05). Adherence also increased with age and parity.

Adherence to follow-up cervical cancer screening among WLHIV in Moshi municipality was suboptimal, with only one-third of WLHIV adhering to these screenings. Strengthening recall systems particularly in public and outreach facilities and implementing targeted interventions for younger WLHIV, those with no or fewer children and those who had normal screening outcomes in the first screening is essential to improve adherence to recommended follow-up screening.

The proportion of women diagnosed with metastatic breast cancer (mBC) in Southern Thailand has remained stable at 10.5-11.7% over the past decade. Healthcare system-level and provider-level barriers contributing to these delays remain poorly understood.

To identify patient-related and healthcare system-related factors influencing referral delays for mBC in Southern Thailand, and to co-design implementation strategies with stakeholders to address these barriers.

This co-produced qualitative study, developed in partnership with a breast cancer survivor support group, employed Force Field Analysis to identify barriers and facilitators influencing mBC referral in Health Region 12. Data were generated through semi-structured interviews with 8 women living with mBC and 13 medical interns, documentary analysis of 3 national policy documents and a stakeholder co-design workshop. Reflexive thematic analysis was undertaken, with findings synthesised across macro, organisational and micro levels.

Four barriers and three facilitators were identified. At the macro level, inequities in insurance scheme restrictions and the incomplete implementation of national guidelines created structural filters that delayed access to specialist care. At the organisational level, limited diagnostic resources, fragmented medical information systems and a culture of caution surrounding referral further compounded delays. At the micro level, socioeconomic constraints and reliance on traditional medicine interacted with system-level barriers, indicating that late presentation is more reflective of systemic dysfunction than of individual health literacy deficits. Facilitators were informal, fragile and largely dependent on individual clinician initiative.

Referral delays are driven by cumulative and reinforcing structural barriers rather than patient-level factors alone. Through co-design, stakeholders prioritised two key interventions: a regional integrated queue system to enable urgency-based access, and a digital health platform to enhance care coordination. Future research should focus on feasibility testing and pilot implementation of these interventions to evaluate improvements in timeliness, equity and sustainability of cancer care.

Programmed cell death evasion fuels malignant progression and undermines therapeutic efficacy across diverse neoplasms. Ferroptosis, an iron-driven membrane lipid oxidation that culminates in catastrophic membrane integrity loss, has emerged as a metabolically distinct liability amenable to therapeutic exploitation through radiotherapy and immunotherapy combinations. Ionizing radiation overwhelms cellular antioxidant buffering capacities within the tumour microenvironment, shifting the redox balance toward peroxidative membrane injury and bypassing resistance mechanisms active in treatment refractory tumours. Ferroptotic corpses release alarmins and lipid peroxidation products, triggering immunogenic cell death that reshapes immune surveillance, draws in antigen presenting cells, and reduces activation barriers for immune checkpoint inhibitors and adoptive cellular therapies. At the same time, radiotherapy triggered metabolic reprogramming of the tumour microenvironment marked by glutamine dependence, lipid peroxidation accumulation, and cystine limitation aligns with immunomodulatory effects to strengthen anti-tumour immunity. This Review deconstructs the enzymatic cascades and metabolic checkpoints that govern ferroptotic vulnerability, mapping how radiation induced metabolic rewiring links cytotoxic and immune stimulatory therapeutic goals. We examine whether ferroptosis serves as a central node connecting radiotherapy and immunotherapy, assessing preclinical data on radio immunotherapy combination strategies that leverage this dual functionality. Translational barriers remain. Constrained therapeutic windows, lack of validated pharmacodynamic markers, and unclear toxicological consequences in normal tissues require careful evaluation prior to clinical application. We outline a conceptual framework for deploying ferroptosis as a mechanistic bridge between radiotherapy and immunotherapy, suggesting that its targeted induction under tumour specific metabolic conditions could reshape multimodal treatment strategies and enhance cancer treatment outcomes beyond the marginal gains achievable with single agent approaches.

National cancer control plans and non-communicable disease strategies are key instruments to guide cancer policy and resource allocation. However, the extent to which these frameworks explicitly address older adults remains unclear.

We conducted a structured content analysis of national cancer control plans and non-communicable disease strategies identified through the International Cancer Control Partnership database. Plans were screened for inclusion of older adult-specific provisions, including explicit mention, age-specific interventions, geriatric assessment, workforce training, and access considerations. Plans were further classified based on the depth of inclusion. Descriptive analyses and Fisher's exact tests were used.

Among 156 plans, 18 (11.6%) included older adult-specific policies. These were more frequently observed in Europe. Only seven plans contained a dedicated chapter on older adults, and six included specific geriatric oncology implementation components. In most cases, older adults were mentioned only as a vulnerable population without detailed strategies. No significant differences were observed based on plan type, region, or income level.

Older adults are infrequently and inconsistently incorporated into national cancer policy frameworks. Greater attention to aging within cancer control strategies is needed to ensure alignment with demographic trends and evolving care needs.