The study’s central methodological innovation is its comparison group. Most previous research on pediatric ECMO outcomes has either followed ECMO survivors alone or compared them to healthy children, making it impossible to separate the effects of the machine from the effects of the catastrophic illness that required it. Le Helleye and colleagues instead recruited a matched cohort of general pediatric intensive care unit survivors, matched for age, diagnosis, and admission year. This design allows researchers to ask a sharper question: does ECMO itself leave a distinctive mark on a child’s long-term health-related quality of life, or is the mark left by critical illness in general? The answer, it turns out, is nuanced and clinically important.

Across the full spectrum of health-related quality of life, ECMO survivors scored modestly lower than their critically ill peers. But when the researchers broke the measure into its component domains, a striking pattern emerged. Physical functioning showed a clear and robust deficit in the ECMO group, one that persisted even when compared against children who had endured comparable critical illness without extracorporeal support. This suggests that whatever ECMO uniquely contributes to long-term outcomes, it manifests primarily in the physical realm, plausibly reflecting the vascular complications, immobility, and prolonged rehabilitation that accompany cannulation and circuit support. The finding gives clinicians a concrete target for follow-up care rather than a vague expectation of global impairment.

Psychosocial functioning told a different story. ECMO survivors and non-ECMO critically ill survivors did not differ significantly in this domain, which encompasses emotional and social wellbeing. The implication is that the psychosocial struggles common among survivors of pediatric intensive care are driven more by contextual and family factors, such as the trauma of hospitalization, disrupted development, and family stress, than by any ECMO-specific injury to the brain or body. For families who have been told that the machine itself may have damaged their child’s emotional and social prospects, this reframing may come as a relief, and it redirects attention toward factors that are potentially more amenable to intervention.

Perhaps the most consequential finding concerns executive function. Roughly one-third of the entire cohort, both ECMO survivors and non-ECMO controls alike, showed clinically significant executive dysfunction, meaning difficulties with the cognitive processes that govern planning, working memory, impulse control, and flexible thinking. These are the mental tools children rely on to succeed at school, form relationships, and navigate daily life. The fact that this burden was shared across both groups points again to critical illness itself, rather than ECMO, as the driving force, consistent with a growing literature on post-intensive care syndrome in children, in which inflammation, sedation, hypoxia, and prolonged hospitalization are thought to injure the developing brain regardless of the specific technology used.

When the researchers modeled which factors best predicted poor health-related quality of life, executive dysfunction emerged as the strongest independent predictor across all domains, outweighing the effect of ECMO exposure itself. This is a remarkable result. It means that a cognitive measure, one that can be assessed with validated parent-report instruments such as the Behavior Rating Inventory of Executive Function, predicts a child’s long-term wellbeing better than whether or not they were placed on an artificial heart-lung machine. In practical terms, a child who never came near an ECMO circuit but leaves the intensive care unit with impaired executive function may face a harder road than a child who survived on the machine with intact cognition.

The second powerful predictor was parental stress, which acted as a mediator of child outcomes and, crucially, is modifiable. Research across pediatric critical illness and childhood cancer survivorship has repeatedly shown that parents’ psychological health is tightly linked to their children’s recovery and quality of life, and studies of parents in the first six months after a child’s critical illness document substantial physical, cognitive, emotional, and social burdens on the parents themselves. The new findings elevate this from an observation to a therapeutic imperative: supporting the family’s mental health is not a courtesy add-on to pediatric critical care but a direct route to improving the child’s own long-term outcomes.

Feder and Puligandla argue that these results demand a reframing of post-PICU follow-up. In many centers, follow-up clinics for survivors of pediatric critical care are unevenly resourced, and children who receive ECMO are often tracked more intensively than other critically ill children simply because the technology is visible and dramatic. The new data suggest that neurodevelopmental monitoring, including systematic screening for executive dysfunction, should be extended to all survivors of critical illness, not reserved for ECMO patients. Equally, structured family psychological support should be treated as a core component of critical care recovery, embedded in follow-up pathways rather than offered sporadically when families happen to ask for help.

The study also illustrates the value of rigorous study design in a field where dramatic interventions attract dramatic assumptions. By matching on age, diagnosis, and admission year, the investigators controlled for the severity and nature of the underlying illness, isolating the specific contribution of ECMO. The use of validated instruments for both quality of life and executive function, including psychometrically evaluated French-language versions of the BRIEF, strengthens confidence in the measurements. And by measuring outcomes prospectively rather than retrospectively reconstructing them from charts, the study avoids the recall biases that plague much of the survivorship literature. Earlier work on pediatric cardiac extracorporeal life support survivors and on children years after infant heart surgery had hinted at quality-of-life burdens, but without the controlled design needed to attribute them.

The broader message resonates far beyond ECMO. Pediatric intensive care has become extraordinarily good at saving lives, and the field’s frontier is increasingly about the quality of the lives that are saved. If executive dysfunction affects a third of critically ill children regardless of the technology used, and if it, together with parental stress, predicts long-term wellbeing more strongly than any single intervention, then the drivers of recovery are cognitive and familial as much as they are physiological. Hospitals that invest in neuropsychological screening, early rehabilitation targeting executive skills, and structured support for parents may improve outcomes in ways that no refinement of the ECMO circuit can achieve. For the children who survive the most frightening weeks of their lives, and for the parents who survive alongside them, the path to a good life may run not just through the intensive care unit, but through the months and years of monitoring and support that follow it.

Subject of Research: Long-term health-related quality of life and neurodevelopmental outcomes in pediatric ECMO and critical care survivors

Article Title: Beyond ECMO: rethinking drivers of long-term outcomes in critically ill children

Article References: Feder, J., & Puligandla, P. S. (2026). Beyond ECMO: rethinking drivers of long-term outcomes in critically ill children. Pediatric Research. https://doi.org/10.1038/s41390-026-05582-4

Image Credits: AI Generated

DOI: 10.1038/s41390-026-05582-4

Keywords: ECMO, pediatric critical care, health-related quality of life, executive function, neurodevelopment, parental stress, PICU follow-up, physical functioning, psychosocial outcomes, survivorship, Pediatric Research, Beyond

Gliomas, which arise from neuroepithelial cells, are the most common primary malignant tumors of the central nervous system, accounting for roughly 50 to 60 percent of all intracranial tumors. The World Health Organization’s 2021 classification divides them into four grades, with grades one and two considered low-grade and grades three and four high-grade. Even with standardized treatment combining surgery, concurrent chemoradiotherapy, and adjuvant chemotherapy, the median overall survival for patients with WHO grade IV malignant glioma remains under two years, and the five-year survival rate is only about ten percent. Because grading relies primarily on tumor morphology, patients with identical grades can still face markedly different prognoses, adding a layer of uncertainty that shadows every stage of care.

The study’s methodology was deliberately designed to capture change over time. Using a descriptive phenomenological approach grounded in the philosophical tradition of Husserl, the team conducted semi-structured interviews at three points: at initial diagnosis, one month after surgery, and three months after surgery. Twelve survivors, numbered P1 through P12, were recruited through purposive sampling at a large tertiary Grade A specialized cerebrovascular hospital in Central China between November 2024 and November 2025. The median age was 51 years, with a range of 31 to 69, and 58.4 percent were men. Data saturation was reached with the eleventh participant, and a twelfth was interviewed to confirm that no new themes were emerging. Interviews lasted between 30 and 60 minutes and were conducted in quiet, undisturbed spaces, with researchers recording nonverbal cues such as speech rate, tone, facial expressions, and body movements.

Transcripts were analyzed using Colaizzi’s method, a structured seven-step procedure in which researchers repeatedly read the records, extract meaningful statements related to symptom experience, condense them into units of meaning, and cluster similar content into themes. Transcripts were verified by a second researcher within 24 hours and sent back to participants for confirmation. Two researchers independently coded and analyzed the data, and regular team meetings compared interpretive approaches and examined subjective assumptions to minimize bias. The analysis yielded four core themes: self-perception and interpretation of the disease, differentiated coping with symptoms, practical dilemmas in symptom management, and core needs in symptom management.

The first theme traces how symptoms announce themselves and how patients make sense of them. Because glioma symptoms are dictated by tumor size, location, and growth rate, presentations varied widely. One 68-year-old man described a relentless headache paired with constant nausea that left him unable to eat, while a 60-year-old man spoke of a swollen left hand and foot, walking as if stepping on cotton, and a fear of falling that forced him to rely on family for basic care. Hospitalization added its own physiological challenges, with patients reporting pain during drainage tube removal, dressing changes, and wound suturing. Notably, despite this discomfort, most patients cooperated actively with nursing care, and some, like a 57-year-old man facing nasogastric tube insertion, recognized the clinical necessity of the intervention and chose to endure it.

Coping strategies diverged sharply along two paths. Some patients adopted a positive mindset, perceiving the illness as understandable and controllable, and proactively sought reliable resources. A 69-year-old man expressed complete confidence in his doctors’ expertise and the hospital’s advanced technology, certain that full cooperation would speed his recovery. Optimism proved contagious: the same ward’s patients, ranging from a six-year-old child to people over 80, inspired one another with their resilience. Others sank into negative coping. A 52-year-old woman sighed that her family’s business had been suspended, no one could care for the children, and everything now centered on her, making her feel like a burden to the whole family. Fear of seizures kept one participant from ever going out alone, while another lay awake each night terrified of recurrence, and a third avoided relatives and friends to escape gossip about her brain tumor, gradually losing all desire to interact with anyone.

The third theme exposed a web of practical dilemmas that the researchers describe as a vicious cycle of insufficient cognition, limited treatment, economic loss, and social isolation. Most patients had limited understanding of glioma prevention and management, relying predominantly on the internet for information rather than systematic, personalized guidance. One man worried aloud whether an injection or his pre-admission aspirin would interfere with upcoming surgery; another had read online that a second relapse would be serious and could not stop worrying. Diagnostic difficulties compounded the distress, with one patient reporting that different hospitals gave different test results and none could offer a definite diagnosis. Financial pressure was crushing: one 32-year-old father had already spent over 100,000 yuan on treatment in Beijing and expected to spend another 70,000 to 80,000 yuan. Work limitations followed, with one 41-year-old man reporting that no company would hire him for fear he would suddenly fall ill on the job.

Against these burdens, patients articulated two core needs. The first is for health-related information: personalized treatment plans, clear follow-up protocols, and home-based rehabilitation guidance. Patients asked whether they would receive follow-up care after discharge, what the specific process would be, and how to care for themselves at home. The second is for diverse, multi-level support: emotional comfort from family and peers, professional care from clinicians, and social and economic resources. One man described how chatting with friends eased his anxiety, while a woman said earnest family conversations left her feeling particularly at peace. Another participant noted that when her headache became unbearable, doctors and nurses patiently showed her what to do and even chatted to lift her spirits, after which the pain felt far less severe. Economic support emerged as the most urgent social demand, alongside hopes for mutual assistance among patients.

The discussion section argues that these findings, which extend the team’s earlier cross-sectional work, demand a fundamental reorientation of care. Because specialists typically provide only phased, targeted treatment, the authors contend that clinical nurses, who maintain uninterrupted contact across the entire disease course, are best positioned to lead a psychosocial oncology care system tailored to China’s conditions, coordinating multiple medical teams, integrating services into individualized care, and conducting continuous needs assessment and long-term follow-up. They recommend replacing one-size-fits-all education with bedside one-on-one guidance, short videos, and peer experience sharing, and optimizing bed reservation systems, multi-hospital information sharing, and standardized multidisciplinary team protocols to reduce delays. The sensitive transition from hospital to home, they emphasize, requires telephone calls, text messages, or home visits to track symptoms, offer professional advice, and sustain emotional companionship.

The authors acknowledge the study’s limitations candidly. All twelve participants were recruited from a single tertiary hospital in Henan Province, so the findings cannot be generalized to patients elsewhere in the world or treated at other hospitals, and most participants had low incomes and education levels, limiting representativeness for wealthier or more educated groups. Possible confirmation bias and missing data also qualify the results. Yet the study makes a significant contribution to the qualitative literature on Chinese glioma patients, illuminating how the disease reshapes not only bodies but family roles, social standing, and the very possibility of a normalized life. Its central message resonates far beyond one hospital: survivorship care must become longitudinal, patient-centered, and responsive to needs that change month by month, or patients will continue to navigate an evolving symptom burden largely alone.

Subject of Research: Longitudinal qualitative study of symptom trajectories and care needs in glioma survivorship

Article Title: From diagnosis to daily realities: longitudinal phenomenological exploration of symptom trajectories in glioma survivorship

Article References: Meng, X.-J., Zhang, Z.-C., Xiang, L., Min, G., & Li, L.-M. (2026). From diagnosis to daily realities: longitudinal phenomenological exploration of symptom trajectories in glioma survivorship. Supportive Care in Cancer, 34(10), Article 994. https://doi.org/10.1007/s00520-026-11200-0

Image Credits: AI Generated

DOI: 10.1007/s00520-026-11200-0

Keywords: glioma, brain cancer, survivorship, symptom management, phenomenology, qualitative research, quality of life, nursing, coping strategies, patient needs, longitudinal study, supportive care

The scientific case for resistance exercise in this population is substantial. Cancer and its treatments strip away lean mass and muscular strength while fat mass and frailty risk climb, and low muscle mass after treatment is linked to worse clinical outcomes. Structured strength training has been associated in prior work with reduced anxiety and fatigue, better sleep, improved physical function, higher self-esteem, greater strength capacity, and a lower risk of falls. Emerging data even suggest that more muscle-strengthening activity may be tied to reduced cancer mortality and recurrence. That is why the American College of Sports Medicine recommends that survivors perform full-body muscle-strengthening activity at least two days per week, a threshold only 19.2 percent of survivors report reaching, compared with roughly 31 percent of women and 40 percent of men without a cancer history.

To capture what survivors actually want, the researchers recruited participants from Northwestern Medicine electronic medical records, sampling in proportions similar to the U.S. survivor population by cancer type and age. Eligible participants were adults at least 18 years old with non-metastatic cancer, no more than five years since diagnosis, at least three months past the end of primary treatment, with internet access and English literacy. Of 759 people who consented, 556 provided complete data on the intervention preferences questionnaire. The average participant was 56.5 years old, 53.6 percent were female, and the most common diagnoses were breast, prostate, lung, colon, and endometrial cancers. Notably, 99.1 percent owned a smartphone, a detail that matters for the technology-supported programs the team had in mind.

Activity levels were measured with validated instruments. The short form of the Muscle-Strengthening Exercise Questionnaire captured frequency, duration, intensity, and the types of resistance work performed, with a test-retest reliability ranging from 0.76 to 0.91. A modified Godin Leisure-Time Exercise Questionnaire estimated weekly minutes of moderate-to-vigorous aerobic activity. In this sample, participants averaged 1.7 days per week of strength work for about 20 minutes per session and 174 minutes of weekly aerobic activity. About a third, 33.6 percent, met both the strength and aerobic guidelines, while 34.7 percent met neither, and 45.3 percent reported no muscle-strengthening activity at all. The sample was more active than population-based estimates, a limitation the authors acknowledge, since people drawn to a study about exercise are plausibly more active to begin with.

The preference data paint a detailed portrait of an ideal program. Participants wanted medium-intensity sessions, 70.3 percent favoring that level, mixing light weights with high repetitions and heavier loads with lower repetitions. Nearly half were willing to train three to four days per week for 20 to 39 minutes, and 68.7 percent preferred one longer daily session over several shorter ones. Free weights were the most popular modality at 65.3 percent, followed by combinations of free weights and resistance bands, yoga, resistance bands alone, and balance exercises. On timing, the highest endorsement, 92.6 percent, went to starting a program six months to one year after treatment, though more than 70 percent expressed interest at every point along the cancer care continuum.

Technology figured prominently in the results. Almost half of participants, 47.7 percent, preferred a hybrid intervention combining in-person and technology-supported elements, while the remainder split between fully in-person and fully remote formats. For digital delivery, on-demand video was the top choice at 47.8 percent, with a live-plus-on-demand combination close behind. Wearable devices such as fitness trackers were the most favored way to receive feedback on progress, and 57.7 percent wanted feedback on exercise form. Interest in commercially available connected strength equipment was surprisingly high: 65.1 percent were willing to try Tonal, 58.1 percent Peloton, and 55.8 percent Tempo. More than 94 percent said they would use a fitness app if given free access, and 35.8 percent were already using one. Willingness to pay, however, was modest, with 82.4 percent capping spending at zero to fifty dollars per month.

Regression analyses revealed that preferences were not uniform across the population. Women rated one-on-one and live group videoconference sessions, text messages, and emails as more helpful than men did. White participants and non-Hispanic participants generally rated in-person group sessions, activity trackers, electronic health record integration, and buddy systems as less helpful than their counterparts did. Older age predicted lower enthusiasm for nearly every digital feature, including apps, videos, trackers, and smart equipment. Higher income was associated with lower ratings of social networking integration and personalized messaging, while participants with lower household income valued those features more. Treatment history also mattered: surgery recipients rated one-on-one in-person sessions and smart equipment more favorably, and those who had radiation valued smart equipment and program buddies more than those who had not.

The qualitative arm added depth. Thirty participants, randomly selected and stratified so that half met the strength guidelines, completed semi-structured interviews lasting 20 to 45 minutes over Zoom. Transcripts were coded iteratively by multiple team members using consensus review in Dedoose, yielding five themes. Participants believed strength training could restore pre-diagnosis functioning and prevent further decline; they described multilevel barriers including motivation, unfamiliarity with equipment and technique, physical health issues, time, gym access, and cost; prior experience shaped what they were willing to try; they craved support and accountability, particularly from peers who understood the cancer experience; and they demanded flexible, convenient, personalized programming with clear instruction on modifications and progression to avoid overexertion and injury.

Several findings distinguish strength training from general aerobic exercise preferences documented in earlier studies. While most prior preference research found survivors favor unsupervised, home-based activity, roughly half of this sample wanted some supervision, most often from an exercise specialist in person, and about half wanted instruction somewhere other than home, such as a fitness club or cancer center. Nearly 90 percent wanted some form of one-on-one coaching. The authors interpret this as evidence that resistance exercise, perceived as more complex and equipment-dependent than walking or running, may require more guidance to feel safe and feasible, especially for survivors with comorbid conditions worried about injury.

The study has limits worth noting. Recruitment came from a single academic medical center, the sample was highly educated, and although 38 percent of participants were non-White or Hispanic, consistent with national figures, the findings may not generalize to community settings or socioeconomically disadvantaged survivors. Self-reported activity measures carry misclassification risk, and the survey presented no visuals or prototypes, which may have affected how participants interpreted questions. Still, the central message is clear and actionable: survivors across activity levels want strength-training interventions that are accessible, encouraging, flexible, and tailored to their circumstances, and the wide variability in feature preferences argues for involving survivors directly in designing and testing programs. Only one intervention to date has incorporated connected strength equipment with survivors, so the space for innovation, from hybrid coaching models to app-based form feedback, remains wide open. Future work, the authors conclude, must determine which features are truly feasible, engaging, and cost-effective for raising adherence and improving health outcomes in this growing population, projected to exceed 22 million Americans within the next decade.

Subject of Research: Cancer survivors' interests and preferences for muscle-strengthening activity interventions

Article Title: Cancer survivors’ interests and preferences for muscle-strengthening activity interventions

Article References: Pincever, J., Frey, J., Solk, P., Reading, J. M., Wang, S., Freeman, H., Wolter, M., Hickey, B., Wang, L., Webb, F., Walker, F. M., Desai, R., & Phillips, S. M. (2026). Cancer survivors’ interests and preferences for muscle-strengthening activity interventions. Supportive Care in Cancer, 34(11), Article 1078. https://doi.org/10.1007/s00520-026-11312-7

Image Credits: AI Generated

DOI: 10.1007/s00520-026-11312-7

Keywords: cancer survivors, muscle-strengthening activity, resistance training, exercise preferences, survivorship, physical activity guidelines, technology-supported interventions, mixed methods, Supportive Care in Cancer, Northwestern University, behavioral medicine, rehabilitation

The study team, led by Therese Christensson of Karolinska Institutet, identified 2,576 cancer survivors within the SCAPIS cohort, a population-based sample of roughly 30,000 randomly selected Swedes aged 50 to 64 recruited between 2013 and 2018 at six sites across the country. By linking SCAPIS data to the Swedish National Patient Registry using ICD-9 and ICD-10 codes, the researchers identified survivors of breast, prostate, lung, colorectal, and urinary bladder cancers as well as malignant melanoma, excluding childhood and young-adult cancers by setting the year 2000 as a diagnostic cut-off. The median participant was 59 years old, 57 percent were women, and the median time since diagnosis was a remarkable 13 years, making this a genuinely long-term survivorship population rather than a recently treated one. Malignant melanoma dominated the sample at about half of all cases, followed by breast cancer at 25 percent and prostate cancer at 15 percent.

What sets this analysis apart technically is its measurement strategy. Physical activity was captured with tri-axial ActiGraph accelerometers worn on the hip for seven consecutive days, with valid days defined as at least 600 minutes of wear time and intensity thresholds set at counts per minute: below 200 for sedentary behaviour, 200 to 2,689 for light activity, 2,690 to 6,166 for moderate activity, and above 6,167 for vigorous activity. Meeting the physical activity recommendation was operationalized as at least 150 minutes per week of moderate-to-vigorous activity, equivalent to 22 minutes per day under national Swedish guidance. Diet was scored with the Swedish dietary guideline index, or SweDGI, a 12-component food-based index spanning encouraged items such as fruits, vegetables, legumes, nuts, whole grains, fish, and unsaturated fats, alongside discouraged items including red and processed meat, high-fat dairy, added sugar, alcohol, and salt, with a maximum score of 48 and a cut-off of 26 points marking good adherence. Alcohol was screened with the AUDIT-C questionnaire, smoking status by self-report, and sleep quality with a single item from the Basic Nordic Sleep Questionnaire.

The accelerometer data reveal a population that is, on the surface, reasonably active but profoundly sedentary. Most survivors met the weekly physical activity recommendation, with the lowest figure, 76 percent, appearing among the oldest lung cancer survivors. Yet on average, survivors spent eight hours per day, or 55 percent of wear time, sedentary, only 46 minutes in moderate activity, and less than a single minute, just 0.08 percent of the day, in vigorous activity. Prostate cancer survivors were the most sedentary group at 8.4 hours per day, while breast cancer survivors were the least at 7.6 hours. Men consistently sat more than women, accumulating at least eight sedentary hours daily across all cancer types, and younger survivors were significantly more likely than older ones to meet the activity target, although no sex difference emerged on that specific measure.

Diet was the clearest failure point. Only 41 percent of survivors met the dietary recommendation overall, and the sex gap was dramatic: 53 percent of women achieved good adherence compared with just 26 percent of men, a highly significant difference. Breast cancer survivors fared best at 56 percent, while male lung cancer survivors sat at the bottom with only 17 percent meeting the recommendation. This matters because prior research, cited by the authors, links diet quality to survival: good-quality diets are associated with improved survival in breast and colorectal cancer survivors, while Western-style diets high in fat, red meat, and processed foods have been tied to recurrence in colorectal cancer and to higher all-cause mortality across several cancer groups.

Alcohol told a similar story of quiet excess. Roughly a third of survivors consumed alcohol above recommended levels, with cut-offs set at more than five points on the AUDIT-C for men and more than four for women, based on Swedish national guidance. Prostate cancer survivors had the lowest proportion meeting the alcohol recommendation at 62 percent, while breast cancer survivors had the highest at 71 percent. Women were significantly more likely than men to stay within limits, 73 percent versus 62 percent. The authors caution that comparisons with general population data are imperfect, since Swedish population surveys typically define risk consumption by weekly standard drinks, whereas AUDIT-C also captures episodes of heavy drinking and cannot be directly translated into weekly intake. Still, the contrast is suggestive: only about 16 percent of the general Swedish population is estimated to drink above recommended levels, compared with roughly a third of these survivors.

Not all the news was grim. Smoking, often the most damaging modifiable factor after a cancer diagnosis, was largely under control: 88 percent of survivors were former or never smokers, mirroring the roughly 11 percent smoking prevalence in the general Swedish population. The glaring exception was lung cancer, where a full third of survivors still smoked, a finding with serious consequences given evidence that cessation after a lung cancer diagnosis reduces the risk of second primary lung tumours and that continued smoking raises both overall and cancer-specific mortality. Sleep quality was also broadly satisfactory, with 82 percent reporting good sleep and most sleeping seven to eight hours per night, though men outperformed women across nearly all cancer types, and close to a third of female urinary bladder cancer survivors and older colorectal cancer survivors reported poor sleep. Given that the median survivor was 13 years past diagnosis, the authors note this may indicate that sleep disturbances can persist for many years after treatment ends.

Perhaps the most consequential finding concerns combinations. Nearly everyone, 99 percent, met at least one recommendation, but only about half met four or more of the five, and just a small minority achieved all five. Meeting multiple recommendations differed significantly across cancer types, with breast cancer and malignant melanoma survivors doing best; 22 percent of breast cancer survivors met all five lifestyle recommendations. Women were significantly more likely than men to meet multiple recommendations. The steepest drop-offs came at the harder end of the spectrum: the transition from three to four recommendations coincided with a 32 percentage-point decline among lung cancer survivors, while prostate cancer survivors showed the largest fall, 17 percentage points, between two and three. Prior research suggests this stacking matters biologically, since meeting four or five lifestyle factors has been associated with lower incidence of cancer, cardiovascular disease, and diabetes compared with meeting none, and meeting multiple recommendations appears more protective for survival than meeting any single one.

The authors are candid about limitations. Dietary data were self-reported and vulnerable to underreporting, overreporting, and social desirability bias, which means the true proportion failing dietary recommendations could be still higher than observed. Dichotomizing each lifestyle factor into met or not met inevitably discards nuance, multimorbidity, cancer stage, and treatment information were unavailable, and the 13-year median time since diagnosis raises the possibility of survival bias, since survivors who lived long enough to participate may be healthier overall. The restriction to adults aged 50 to 64 also limits generalizability to younger or older survivors and to populations outside Sweden, although the cohort broadly resembles the Swedish population in education, activity level, and country of birth.

Even with those caveats, the message for clinical practice is pointed. With roughly 600,000 people in Sweden living with cancer as of 2022 and survivor numbers rising worldwide as treatment improves, secondary prevention is becoming a central task of oncology follow-up. The World Cancer Research Fund encourages survivors to adhere to lifestyle recommendations as much as possible, and evidence continues to accumulate that structured exercise can improve survival and functioning, as a recent phase III trial in colorectal cancer demonstrated. This study suggests that follow-up care should move beyond single-issue advice and toward integrated interventions that target multiple behaviours simultaneously, with particular urgency around diet and alcohol, and with tailored outreach to the groups falling furthest behind, including male survivors, lung cancer survivors who continue to smoke, and prostate cancer survivors whose sedentary hours and drinking habits may quietly erode the survival their treatment won.

Subject of Research: Adherence to lifestyle recommendations among long-term cancer survivors

Article Title: Meeting lifestyle recommendations among cancer survivors – a cross-sectional descriptive analysis from the Swedish CArdioPulmonary BioImage study (SCAPIS)

Article References: Christensson, T., Hagströmer, M., Algurén, B., Bergman, F., Bäck, M., Drake, I., Porserud, A., Rossen, J., & von Rosen, P. (2026). Meeting lifestyle recommendations among cancer survivors – a cross-sectional descriptive analysis from the Swedish CArdioPulmonary BioImage study (SCAPIS). Journal of Cancer Survivorship. https://doi.org/10.1007/s11764-026-02140-z

Image Credits: AI Generated

DOI: 10.1007/s11764-026-02140-z

Keywords: cancer survivors, lifestyle recommendations, SCAPIS, physical activity, diet quality, alcohol consumption, smoking cessation, sleep quality, secondary prevention, accelerometry, survivorship, Sweden

JMIR Cancer is an open access, peer-reviewed journal indexed in PubMed Central, PubMed, MEDLINE, Scopus, DOAJ, and the Emerging Sources Citation Index maintained by Clarivate. That indexing footprint places the journal within the core literature that oncologists, health services researchers, and digital health scientists consult when tracking how technology is reshaping cancer care. The new theme collection is intended to gather work that evaluates how technological, educational, and participatory innovations can improve screening accuracy, streamline treatment protocols, optimize teleoncology workflows, and enhance long-term survivorship. In practical terms, the editors are looking for studies that do more than describe a new app or algorithm; they want evidence about whether and how these tools change measurable outcomes for patients and health systems.

The scope of the call is deliberately broad, reflecting the reality that digital health now touches nearly every stage of the breast cancer care continuum. Among the high-impact areas the journal highlights are mobile health applications designed to monitor treatment side effects, artificial intelligence and machine learning models for risk prediction and mammography analysis, virtual decision-support tools that assist clinicians and patients in shared decision-making, and digital platforms targeting post-treatment fatigue and psychosocial well-being. Each of these domains represents an active research frontier. Mobile applications, for example, can capture symptom reports in near real time between clinic visits, giving oncology teams earlier warning of chemotherapy toxicity or post-operative complications. Machine learning models applied to mammography have demonstrated the potential to flag subtle imaging patterns that human readers may miss, while risk prediction tools increasingly incorporate diverse data streams to stratify patients for enhanced surveillance.

Teleoncology has emerged as another central theme of the collection. The rapid expansion of remote care delivery in recent years transformed how many patients access oncology consultations, follow-up visits, and supportive care services, but questions about efficacy, equity, and patient experience remain active areas of investigation. The journal is explicitly inviting evaluations of the effectiveness and patient experience of telehealth and remote monitoring in breast cancer care, a request that signals interest in rigorous comparative studies rather than anecdotal reports. Researchers examining video consultations, remote symptom tracking, wearable sensor data, and hybrid models of care that blend in-person and virtual encounters will find their work squarely within the scope of the theme collection.

Education and support represent a third pillar of the call. The editors welcome submissions on novel educational platforms, virtual reality training for clinicians, and online support communities for patients and families. Virtual reality and simulation-based training have gained traction in surgical and procedural education, offering trainees opportunities to rehearse complex tasks without risk to patients. Online communities, meanwhile, have become a lifeline for many people navigating a breast cancer diagnosis, providing peer support, information exchange, and a sense of shared experience that complements formal clinical care. Studies that evaluate the reach, engagement, and clinical or psychological impact of these platforms are of particular interest to the journal’s readership.

Notably, the call does not limit itself to internet-based technologies. JMIR Cancer is also encouraging evaluations of non-internet, offline, and community-based participatory interventions designed to reduce disparities and broaden equitable access to breast cancer screening and survivorship programs. This emphasis acknowledges a persistent challenge in digital health research: the populations who stand to benefit most from improved screening and survivorship support are often those with the least reliable connectivity, the lowest digital literacy, or the greatest structural barriers to care. Offline strategies, community health worker programs, and participatory approaches that co-design interventions with the people they serve can reach patients whom purely digital solutions may leave behind. By welcoming this work alongside cutting-edge technology evaluations, the journal is signaling that equity of access is as much a part of the digital health conversation as the technology itself.

Perhaps the most distinctive element of the call is the journal’s special invitation to patients themselves. Under the heading of the Patients’ Corner, JMIR Cancer is encouraging patients with breast cancer, previvors, and survivors to submit original viewpoints and personal narratives. The journal states that it believes the most vital voices in oncology are those of the patients, and the invitation covers a wide range of lived-experience content: individual experiences with therapeutic regimens, navigation across healthcare systems, experiences using digital health tools including teleoncology solutions and mobile applications, and constructive perspectives on how breast cancer clinical workflows and patient care can be enhanced. In a research landscape where patient engagement is increasingly recognized as essential to meaningful science, giving patients a formal publication venue for first-person accounts is a concrete step toward elevating those voices.

The accessibility of that invitation is reinforced by a significant financial provision: submissions to the Patients’ Corner are entirely exempt from article processing fees. Article processing charges are a well-known barrier for authors who lack institutional funding, and this is especially true for patients writing outside of academic employment. By waiving these fees entirely for the Patients’ Corner, the journal is removing a practical obstacle that might otherwise prevent patients from sharing their perspectives with a global readership of researchers and clinicians. The stated goal is to ensure there are no barriers to contributing these invaluable viewpoints to the scientific record.

The timing of the call aligns with Breast Cancer Awareness Month, an annual campaign each October that has historically driven public attention, fundraising, and screening promotion around the disease. For a journal focused on the digital transformation of health care, the awareness month provides a natural moment to consolidate research on how technology can serve patients across the entire continuum of care, from risk assessment and screening through diagnosis, treatment, and the often-overlooked survivorship phase. The editors’ framing emphasizes that integration of digital health, innovative technology, and patient-centered strategies is essential across that full continuum, not merely at the point of diagnosis or during active treatment.

Researchers, clinicians, computational scientists, and health care leaders interested in contributing to the theme collection can find the full call for papers and submission details on the JMIR Cancer website, where the dedicated breast cancer theme section is hosted. JMIR Publications, the journal’s publisher, describes itself as a leading open access publisher of digital health research and a champion of open science, with a portfolio of peer-reviewed journals that includes the renowned Journal of Medical Internet Research. For investigators working at the boundary of oncology and technology, and for patients whose experiences can illuminate where that technology succeeds and where it falls short, the call represents an open door to a journal that has made the meeting of those two worlds its central mission.

Subject of Research: A call for breast cancer research submissions to JMIR Cancer's digital health theme collection during Breast Cancer Awareness Month

Article Title: JMIR Publications’ JMIR Cancer invites submissions on breast cancer

Article References: JMIR Publications’ JMIR Cancer invites submissions on breast cancer. (n.d.). Original publication

Image Credits: AI Generated

DOI: Not provided

Keywords: breast cancer, JMIR Cancer, digital health, teleoncology, artificial intelligence, mHealth, mammography, survivorship, patient narratives, open access, Breast Cancer Awareness Month, health equity

The research team, led by investigators at Sungkyunkwan University School of Medicine and Samsung Medical Center, recruited 44 patient-caregiver dyads, a total of 88 participants, between October 2021 and March 2022. Every participant completed both a quantitative survey and a separate, semi-structured in-depth interview, with patients and their caregivers interviewed individually rather than together. This dyadic design is methodologically important. Much of the existing literature on cancer caregiving relies on either patient reports or caregiver reports, which risks missing the interpersonal dynamics within a household. By interviewing both members of each pair and analyzing their accounts side by side, the researchers could compare not just what challenges each person faced, but why they faced them, and whether the two members of a dyad understood each other’s struggles. The final analytic sample included 41 patients and 38 caregivers, of whom 21 were spouses and 17 were adult children, reflecting the typical structure of family caregiving in Korea.

The quantitative backbone of the study came from two well-validated instruments. Psychological distress was measured with the Distress Thermometer, a simple self-report tool on which respondents rate their distress from 0 to 10, with scores of 4 or higher generally indicating clinically significant distress that warrants psychosocial intervention. Quality of life was assessed with the WHOQOL-Brief, the World Health Organization’s abbreviated instrument covering physical, psychological, social, and environmental domains. The results showed that patients and their spousal caregivers reported strikingly similar levels of distress, with mean Distress Thermometer scores of 4.2 for patients and 3.9 for spouses, both accompanied by wide standard deviations of 2.5 and 2.8 respectively, indicating substantial variability across individuals. Both groups hovered around the conventional threshold for significant distress, a signal that the emotional toll of multiple myeloma is shared almost symmetrically within couples.

The qualitative interviews, however, revealed that this numerical similarity conceals a profound asymmetry. Patients described a cascade of challenges flowing directly from the disease itself: reduced physical function, diminished psychological resilience, weakened spiritual well-being, and strained relationships with family and friends. Because multiple myeloma relapses and recurs, patients live in a cycle of treatment, remission, and relapse, never reaching the stable survivorship that patients with some other cancers may achieve. Bone pain, fatigue, anemia, and infection risk, all hallmarks of plasma cell malignancy, erode the ability to work, exercise, and maintain social roles. Each relapse forces patients to confront mortality again, restart treatment, and renegotiate their expectations for the future. The interviews captured how this uncertainty seeps into daily life, making long-term planning feel precarious and turning routine follow-up appointments into moments of renewed anxiety.

Caregivers reported facing almost exactly the same list of challenges: physical exhaustion, psychological strain, spiritual questioning, and social isolation. But when the researchers probed the underlying reasons, the picture diverged sharply. For caregivers, the dominant driver was not the cancer itself but the burden of caring for the patient and managing the needs of the wider family. Spouses, in particular, described absorbing the logistics of treatment schedules, medication management, transportation to the hospital, dietary adjustments, and the emotional labor of staying optimistic while privately fearing the next relapse. Adult children, who in the Korean context often balance caregiving with employment and their own young families, described the competing demands of filial duty and modern working life. Financial stress emerged as a distinctly caregiver-centered concern, encompassing both direct treatment costs and the indirect losses that follow when a patient can no longer work and a family member reduces paid hours to provide care.

This divergence, similar symptoms with different roots, is the study’s central and most consequential finding. It means that a household affected by multiple myeloma can appear, from the outside, to be coping coherently, while the two people inside it are suffering for reasons the other may not fully grasp. A patient’s irritability may stem from bone pain and steroid side effects; a caregiver’s withdrawal may stem from exhaustion and financial worry. Without explicit communication, each can misread the other’s distress as lack of understanding or lack of effort, compounding the strain on the relationship precisely when the relationship is the main source of support. The authors argue that this mutual misunderstanding is itself a modifiable target for intervention, one that current clinical practice rarely addresses because supportive care is typically organized around the patient, with caregivers assessed, if at all, as an afterthought.

The clinical implications are significant. As survival in multiple myeloma continues to extend, the cumulative demand on family caregivers grows in parallel, and the study suggests that caregiver distress is not a secondary phenomenon that resolves when the patient stabilizes; it tracks the patient’s distress closely and persists across the relapsing course of the disease. Supportive care programs that treat the patient and caregiver as a dyad, rather than as separate and unequal participants, could screen both members for distress at each clinical milestone, offer psychoeducation tailored to each role, and facilitate structured communication between them. For patients, interventions might focus on symptom management, uncertainty, and meaning-making; for caregivers, on respite care, financial counseling, and practical caregiving skills. The study’s authors conclude that tailored support systems fostering mutual understanding are essential for improving overall well-being throughout the myeloma journey, a formulation that moves beyond the generic call for more psychosocial services toward a specific, testable model of dyadic care.

The study also carries broader lessons for oncology as a whole. Multiple myeloma is an early example of a wider transformation: as novel therapeutics convert once-fatal malignancies into long-term chronic conditions across many cancer types, the supportive care needs of patients and families will increasingly define the quality of cancer care. Survivorship research has historically centered on the patient, and caregiver science has often been siloed within gerontology or palliative care. Dyadic designs like this one, pairing patients and caregivers within the same study and comparing their accounts directly, offer a template for understanding how illness is experienced as a shared but asymmetric enterprise. The Seoul team’s work was approved by the Samsung Medical Center Institutional Review Board and conducted in accordance with the Declaration of Helsinki, with informed consent from all participants, and it was supported by a grant from Janssen Korea, with the authors reporting no competing interests.

What lingers after reading the study is the image suggested by its title: two people traveling parallel journeys through the same landscape, encountering the same obstacles, for entirely different reasons. Modern hematology has become remarkably good at extending the length of that journey. The challenge now, this research makes clear, is to make sure that both travelers are seen, understood, and supported along the way, not only the one with the diagnosis. For the millions of households worldwide living with multiple myeloma, and for the growing number living with other cancers transformed into chronic diseases, that shift in perspective, from treating a patient to caring for a relationship, may prove as important as any drug in the pipeline.

Subject of Research: Life challenges and supportive care needs of multiple myeloma patients and their family caregivers

Article Title: Parallel journeys, similar challenges, and different reasons: navigating life challenges in multiple myeloma from the perspectives of patients and caregivers

Article References: Kim, S., Park, Y., Kim, N., Park, J., Bang, G., Kim, K., Yoon, S. E., Kang, D., Kim, S. J., & Cho, J. (2026). Parallel journeys, similar challenges, and different reasons: navigating life challenges in multiple myeloma from the perspectives of patients and caregivers. BMC Cancer. https://doi.org/10.1186/s12885-026-17045-4

Image Credits: AI Generated

DOI: 10.1186/s12885-026-17045-4

Keywords: multiple myeloma, caregivers, quality of life, psychological distress, dyadic study, supportive care, survivorship, caregiving burden, oncology, qualitative research, family caregiving, BMC Cancer

The study, led by Hiroto Ishiki of the Department of Palliative Medicine at the National Cancer Center Hospital in Tokyo and published in the journal Supportive Care in Cancer, examined a program the researchers call multimodal Japanese-style acupuncture and moxibustion, abbreviated MJAM. Unlike a single-technique acupuncture session, MJAM is a composite intervention that weaves together several distinct components: filiform needle acupuncture, in which fine needles are inserted into the skin; non-insertive needle therapy using a Teishin, a blunt instrument pressed against the skin without puncturing it; motion-style acupuncture, in which needling is combined with guided movement of the affected limb; indirect moxibustion, which applies the gentle heat of burning mugwort above the skin; hot pack application; and structured self-care instruction that patients continue at home.

The rationale for testing such a program rests on a substantial body of evidence suggesting that acupuncture can modulate chronic pain. Individual patient data meta-analyses have shown that acupuncture outperforms both sham procedures and usual care for chronic musculoskeletal pain, and systematic reviews have associated acupuncture and acupressure with improved cancer pain outcomes. Yet the picture for CIPN specifically has remained murky. Randomized trials of acupuncture for CIPN, including a large sham-controlled trial published in JAMA Network Open, have produced mixed results, and international guidelines from ASCO and ESMO currently offer few validated options for treating established CIPN, with duloxetine being one of the only pharmacological approaches supported by randomized evidence.

To explore whether the Japanese multimodal approach might help, the researchers conducted a single-center, single-arm study at the National Cancer Center Hospital. They enrolled women who had completed curative treatment for stage I to III breast cancer at least three months earlier and who were experiencing moderate to severe taxane-related CIPN pain, defined as a score of 4 or greater on item 5 of the Brief Pain Inventory, a validated instrument that asks patients to rate their average pain on a scale from 0 to 10. Between October 2022 and April 2024, 30 women with a median age of 58.0 years joined the study. On average, these patients were not fresh out of chemotherapy: the median time since completing treatment was 2.47 years, meaning their neuropathy had become a chronic, entrenched problem rather than a transient side effect.

Each participant received 12 weekly sessions of the standardized MJAM program, delivered over roughly three months. The researchers then tracked outcomes through week 16, four weeks after the final session, to see whether any benefit would persist beyond the treatment period itself. The primary endpoint was the change in the Brief Pain Inventory item 5 score, the patient’s rating of average pain, from baseline to week 16. At the start of the study, the mean baseline score was 5.3, with a standard deviation of 1.7, indicating that most participants were living with pain that was more than moderate on a daily basis.

The results showed a clear and statistically significant decline in pain over the course of the program. At week 4, after roughly a month of sessions, the mean change from baseline was only −0.1 points, a difference that could easily have arisen by chance, with a 95 percent confidence interval ranging from −0.6 to 0.3 and a p-value of 0.56. But by week 8, the mean reduction had grown to −0.7 points, a change that reached statistical significance. By week 12, the mean reduction was −1.1 points, and at the primary endpoint of week 16 it stood at −1.2 points, with a 90 percent confidence interval of −1.7 to −0.8 and a p-value below 0.0001. Notably, the benefit continued to accrue after the final session, suggesting that the effects of the program did not evaporate the moment treatment stopped.

The magnitude of the improvement matters as much as its statistical significance. In chronic pain research, the consensus recommendations from the IMMPACT initiative suggest that a reduction of roughly one point on a 0-to-10 pain scale can be clinically meaningful, and a drop of about 1.2 points on the Brief Pain Inventory average pain item approaches the thresholds often considered clinically important. For patients whose pain had persisted for more than two years after chemotherapy, a sustained reduction of this size, achieved without adding any new medication, represents a meaningful shift in daily comfort, even if it does not amount to a cure.

Safety and feasibility were equally central to the study’s conclusions. Twenty-eight of the 30 participants, or 93.3 percent, completed all 12 sessions, an adherence rate that speaks to the tolerability of the program and the practicality of weekly visits. Adverse events were uncommon and uniformly mild: nine participants, or 30.0 percent, experienced grade 1 events, the lowest severity category, with no serious harms reported. For a population of cancer survivors who are often wary of adding further interventions to their care, this safety profile is an important part of the story.

The researchers are careful to frame these findings as preliminary rather than definitive. Because the study was single-arm, with no control group, there is no way to rule out explanations such as the natural course of the condition, regression to the mean, or a strong placebo response, all of which are particularly relevant in pain research, where patient expectations can powerfully shape reported outcomes. The relatively small sample of 30 women and the single-center design further limit how far the results can be generalized. What the study does establish is that MJAM is safe, feasible, and associated with a reduction in pain severe enough to justify the confirmatory randomized clinical trial that the authors say is warranted.

Even so, the trial occupies an important position in a growing research landscape. Electroacupuncture trials for taxane-induced neuropathy are underway, pragmatic trials of acupuncture added to standard care have shown signals of benefit, and dose-response meta-analyses are beginning to explore how the timing and frequency of acupuncture sessions influence outcomes in CIPN. Integrative oncology guidelines from the Society for Integrative Oncology and ASCO already encourage the consideration of acupuncture for pain management in cancer care. If a rigorous randomized trial confirms what this exploratory study suggests, a centuries-old Japanese practice, refined with modern standardization and delivered alongside self-care education, could become a genuine option for the many breast cancer survivors whose nerve pain has, until now, had nowhere to go.

Subject of Research: Multimodal Japanese-style acupuncture and moxibustion as a treatment for taxane-related chemotherapy-induced peripheral neuropathy in breast cancer survivors

Article Title: Multimodal Japanese-style acupuncture and moxibustion for taxane-related chemotherapy-induced peripheral neuropathy in breast cancer survivors

Article References: Ishiki, H., Satomi, E., Matsuoka, H., Arakawa, S., Kawasaki, N., Horiguchi, Y., Takahashi, A., Takagi, T., Kobayashi, S., Oyamada, S., Ariyoshi, K., Kihara, K., Suto, A., Murata, T., & Takayama, S. (2026). Multimodal Japanese-style acupuncture and moxibustion for taxane-related chemotherapy-induced peripheral neuropathy in breast cancer survivors. Supportive Care in Cancer, 34(10), Article 997. https://doi.org/10.1007/s00520-026-11237-1

Image Credits: AI Generated

DOI: 10.1007/s00520-026-11237-1

Keywords: chemotherapy-induced peripheral neuropathy, breast cancer, acupuncture, moxibustion, taxanes, pain management, survivorship, integrative oncology, clinical trial, non-pharmacological therapy, Brief Pain Inventory, Japan

The research, led by Adam Biran of Newcastle University together with colleagues from NHS trusts and academic institutions across the United Kingdom, set out to explore how survivors of pelvic cancers access and receive information about chronic bowel symptoms after radiotherapy, and to build a framework that could guide improvements in how such information is provided. The team conducted semi-structured interviews with 28 cancer survivors, 14 treated for prostate cancer, 10 for gynecological cancers and 4 for anal or rectal cancers, all of whom had experienced chronic bowel symptoms following pelvic radiotherapy. They also interviewed 19 health professionals involved in the care of these patients. Participants were recruited through UK cancer charities and five NHS hospital trusts, and interviews took place remotely between November 2021 and September 2022, lasting up to 90 minutes for survivors and 60 minutes for clinicians.

The interviews were recorded, transcribed and analyzed thematically using NVivo software, with the researchers adopting a subtle realist approach that treats participants’ accounts as meaningful reflections of their experiences while acknowledging the influence of context and perspective. From this analysis, the researchers organized the data into three temporal categories reflecting the cancer journey, pre-treatment, recognizing symptoms, and managing symptoms, plus two cross-cutting themes covering information sources and the challenges of information provision. This structure then informed a provisional framework for information provision, which was reviewed and refined by five public and patient representatives with personal experience of bowel symptoms after cancer.

One of the most striking findings concerns the period before treatment. Health professionals reported that they routinely warn patients about possible short- and long-term effects of radiotherapy as part of the consent process, and some survivors recalled receiving printed material to this effect. Yet not everyone remembered being told about possible late effects, and even those who received the information often could not absorb it. As one 48-year-old woman put it, her priority at the time was simply survival: she wanted not to die, and details about potential long-term problems went to the back of her mind. Another survivor noted that the hospital gave information at the start but never highlighted that there could be an ongoing problem caused by the radiotherapy. Many patients also perceived no meaningful choice about the treatment itself, with one explaining that she could not make an informed decision because there was no decision to make, she had to have the radiotherapy.

The consequences of this information gap became apparent when symptoms emerged, sometimes months or years after treatment. Because late effects are unexpected, delayed in onset and often multiple and disparate in nature, survivors frequently failed to attribute them to their radiotherapy, misattributing them to other causes instead. Some described being alarmed by symptoms such as incontinence or anal bleeding, with clinicians noting that bleeding in particular could be frightening for the unprepared. Others described a sudden moment of realization upon stumbling across relevant information. One 65-year-old woman recounted scrolling a news feed when the Pelvic Radiation Disease Association popped up; having never heard of pelvic radiation damage, she read on and described it as a light bulb moment, realizing that the description matched her own experience exactly. Such chance discoveries, the researchers argue, highlight how fragile the current pathway to understanding is.

Once symptoms were recognized, survivors sought information to help manage them, most commonly around diet, since many suspected that what they ate and drank influenced their symptoms. But this information proved hard to find. In the absence of guidance, some survivors experimented on their own, potentially imposing unnecessary dietary restrictions, while others wondered whether further changes might help. One woman described being passed to a hospital dietitian who, upon hearing her history, said there was nothing she could do for her, leaving the patient to devise her own dietary approach. Health professionals themselves acknowledged the importance of dietary advice, both to prevent over-restriction and to help patients find appropriate alternatives, but the study suggests that access to such support is inconsistent at best.

The study also mapped where survivors turned for information. Beyond health professionals, participants commonly cited cancer charities and the NHS website, with academic literature, support groups and word-of-mouth mentioned less often. The internet was the dominant gateway, and participants were well aware of the risk of misinformation, naming the NHS, Macmillan and Jo’s Trust as trusted sources with up-to-date, reliable material. Support groups offered valuable peer learning and a point of comparison, but not everyone wanted to join them, and one participant noted that groups could themselves spread misinformation. The researchers caution that hearing other survivors’ personal experiences carries further risks: learning that others have more severe symptoms may deepen a sense of gratitude that inhibits care-seeking, and salient anecdotes may carry undue weight in treatment decisions compared with rigorous evidence, a concern that is particularly pertinent amid the rapid growth of medical misinformation online.

Underlying all of these accounts was a structural dilemma about timing. Information given before treatment may never be absorbed, because patients’ attention is consumed by the diagnosis itself. Information given at the end of treatment may not be retained until symptoms appear, which for some survivors is years or even decades later. One clinician highlighted the problem of so-called legacy patients, treated long ago and now difficult to reach, and suggested that checking and repeating information over time may be needed rather than one-off provision. Survivors themselves proposed that the end of radiotherapy might be a better moment to explain the possibility of long-term effects and what to look out for. Gaps in content were also identified, including information on discussing late effects with employers, tailored material for young adults who have left home but not yet started a family, and better education for health professionals, some of whom appeared slow to absorb improved guidance.

From these findings, the team built a provisional framework that maps the purpose of information, the channels through which it can be delivered, survivors’ needs at different time points, and the challenges and considerations for implementation. It deliberately combines patient-level solutions, such as layering information for better retention, web apps and clinically endorsed videos of lived experience, with systems-level measures, such as clinical checklists, integration with electronic record systems and clearer roles for primary and secondary care. The framework is intended to complement existing survivorship initiatives, including survivorship care plans, electronic symptom self-reporting and nurse-led clinics, and the authors believe its elements could apply more broadly to survivors of other treatments such as endocrine therapy and immunotherapy, with appropriate tailoring.

The authors are candid about the study’s limitations. Nearly all participants identified as White British, recruitment through charities may have skewed the sample toward more engaged individuals more likely to have sought information, and memories of events years past may have been colored by subsequent experiences. Even so, the central message is difficult to ignore: access to timely, relevant and accurate information was a problem across the entire cancer journey for this group, and individual information needs are so disparate that they cannot be fully known at the outset and change over time. As healthcare systems shift away from hospital-based follow-up toward supported self-management, the ability of survivors to recognize delayed symptoms and seek help becomes critical. The researchers’ next step is to refine the framework with survivors, particularly those from marginalized groups not represented in this study, and with practitioners, before co-developing the information resources that could finally close a gap that has left too many survivors, in the words of the study’s earlier work, cast adrift.

Subject of Research: Information access and provision for cancer survivors with chronic bowel symptoms after pelvic radiotherapy

Article Title: A qualitative exploration of information access and provision for cancer survivors experiencing chronic bowel symptoms after pelvic radiotherapy: informing a framework to guide improvements to information provision

Article References: Biran, A., Dobson, C., Maybury, J., Rees, C. J., Brooks-Pearson, R., Cunliffe, A., Durrant, L., Hancock, J., Neilson, L. J., Wilson, A., & Sharp, L. (2026). A qualitative exploration of information access and provision for cancer survivors experiencing chronic bowel symptoms after pelvic radiotherapy: informing a framework to guide improvements to information provision. Supportive Care in Cancer, 34(10), Article 999. https://doi.org/10.1007/s00520-026-11040-y

Image Credits: AI Generated

DOI: 10.1007/s00520-026-11040-y

Keywords: cancer survivors, pelvic radiotherapy, chronic bowel symptoms, pelvic radiation disease, information provision, qualitative research, supportive care, self-management, late effects, health communication, survivorship, NHS

The study’s clinical backdrop is a quiet epidemic. HPV-associated oropharyngeal cancer has been rising steadily in high-income countries, and although HPV vaccines will eventually blunt the trend, the long lag between infection and malignancy means case numbers will keep climbing for decades. The encouraging flip side is that these tumours respond well to treatment: in this cohort, 80 percent of patients had p16-positive disease, a marker of HPV-driven cancer, and their survival outcomes were dramatically better than those with HPV-negative tumours. Median overall survival for the entire group reached 15 years, with five-year overall survival of 85 percent and five-year disease-free survival of 81 percent. For patients with p16-positive tumours, five-year overall survival was 90 percent, compared with just 52 percent for those with p16-negative disease, and the hazard of death was 85 percent lower in the HPV-positive group.

Because so many patients now live for years or decades after curative-intent radiotherapy, the late effects of that treatment have become a survivorship problem in their own right. Modern techniques such as intensity-modulated radiotherapy and image-guided radiotherapy, delivered here with daily cone-beam CT verification and PET-based treatment planning, have steadily reduced collateral damage, but permanent side effects still affect the majority of head and neck cancer survivors. These can include difficulty swallowing, altered taste, dental problems, trismus, neck fibrosis, lymphedema and speech changes. For oropharyngeal cancers specifically, symptom scores tend to be more severe than for other head and neck sites, with higher rates of serious swallowing dysfunction, and the heaviest burden has been linked to trimodality treatment combining surgery, chemotherapy and radiation.

The research team identified all patients treated with curative-intent radiotherapy, with or without prior surgery, at their institution between January 2007 and May 2023. Most received the standard definitive regimen of 70 Gy in 35 fractions over seven weeks, with dose levels tiered to high-, intermediate- and low-risk target volumes, and 84 percent received chemotherapy, nearly all of it concurrent weekly cisplatin. In 2023, the team contacted every living patient and invited them to complete a comprehensive quality-of-life survey built around the European Organisation for Research and Treatment of Cancer QLQ-HN43 module, plus the global health status scale from the QLQ-C30. Of 232 patients contacted, 186—80 percent—completed the survey in full, a remarkably high response rate for a survivorship study, with a median of 6.3 years elapsed between radiotherapy and questionnaire completion.

The headline quality-of-life results were strikingly positive. The median global health status score was 83.3 on a 100-point scale, with a mean of 81.3—more than ten points above published general-population reference values, a difference considered clinically significant, though the authors caution that only survivors well enough to respond were surveyed. Ninety-three percent of respondents reported no treatment regret at all, and 77 percent had a fully normal performance status. Only 16 percent reported severe side effects requiring major interventions such as surgery, hyperbaric oxygen or hospitalisation. Many domains of the head-and-neck-specific questionnaire, including body image, social contact, shoulder problems, coughing and neck swelling, had median scores of zero, indicating no symptom burden at all for the typical respondent.

But one symptom stood out. Dry mouth and sticky saliva—xerostomia—was the most affected domain, with a median score of 33.3 and a mean of 41.9 on the 100-point scale where higher means worse. More than a quarter of patients described their health as somewhat or much worse than before treatment, and of those, roughly two-thirds attributed the decline directly to radiotherapy. For a cancer whose treatment is increasingly successful, this persistent oral dryness represents the principal unfinished business of curative therapy: it impairs taste, chewing, swallowing, dental health and sleep, and it rarely resolves completely once high doses have been delivered to salivary tissue.

The study’s most technically valuable contribution lies in its dosimetric analysis. Rather than testing every radiation parameter against every symptom, the researchers prespecified eleven organ-at-risk and target-volume pairings and applied false-discovery-rate correction to guard against spurious findings. The result was unambiguous: each 10 Gy increase in mean dose to the contralateral parotid gland—the salivary gland on the side of the neck opposite the tumour—was associated with a 10.1-point worsening in dry mouth and sticky saliva scores, an association that remained statistically significant after adjustment for age, smoking, stage, chemotherapy and time since treatment, and after multiple-comparison correction. Ipsilateral parotid dose showed a weaker, non-significant trend in the same direction. Notably, mean parotid doses in this cohort were already lower than those achieved in the landmark PARSPORT trial of parotid-sparing IMRT, suggesting that even more aggressive salivary sparing is technically feasible.

Other dosimetric hypotheses did not survive scrutiny. Mean doses to the pharyngeal constrictor muscles and larynx were not associated with swallowing or speech scores after adjustment, and the volumes of tissue receiving high, intermediate or low radiation doses showed no significant relationship with global quality of life. On the clinical side, older age predicted worse global health status, with a 4.9-point decline per decade of age, and worse swallowing scores, while current smoking showed a possible association with poorer global quality of life that narrowly missed statistical significance. One clinically meaningful finding was that patients whose necks were irradiated on one side only reported dry mouth scores 14 points better than those treated bilaterally—supporting unilateral neck treatment for well-lateralised tonsil tumours where oncologically safe. Longer time since radiotherapy was linked to marginally worse speech scores, an unexpected signal the authors suggest warrants prospective confirmation.

The authors are candid about their study’s limits. Because no baseline quality-of-life assessment existed, the symptom scores capture a single post-treatment snapshot and cannot cleanly separate radiation effects from pre-existing conditions. Survivorship bias looms large: patients who died or were too unwell could not respond, and survey completers were younger, more often p16-positive, earlier stage and treated with lower dose volumes than non-completers, meaning the reported quality of life is likely more optimistic than that of the treated population as a whole. The near-universal p16 positivity among respondents also made it impossible to analyse HPV status as a predictor of late quality of life. Still, the long median follow-up, high completion rate and standardised treatment protocols across nearly two decades give the findings unusual weight for a single-centre study.

The practical message for radiotherapy planning is clear: sparing the contralateral parotid gland deserves continued priority, and unilateral irradiation should be pursued wherever the tumour’s location allows it. The results also provide a real-world baseline against which the many ongoing de-escalation trials for HPV-positive oropharyngeal cancer can be judged—including the institution’s own trial using FMISO PET imaging to identify patients suitable for reduced radiation doses. As the population of long-term throat cancer survivors grows, studies like this one shift the question from whether patients survive to how well they live, and point to precisely which milligrays of radiation, delivered to which glands, make the difference between a comfortable recovery and a lifetime of dry-mouth discomfort.

Subject of Research: Long-term quality of life and dosimetric predictors after curative-intent radiotherapy for oropharyngeal squamous cell carcinoma

Article Title: Long‐Term Patient‐Reported Outcomes and Dosimetric Predictors of Quality of Life After Curative‐Intent Radiation Therapy for Oropharyngeal Squamous Cell Carcinoma: A Cross‐Sectional Study

Article References: Lawless, A., Jayamanne, D., Parker, L., Duruchukwu, E., Macleod, P., Venkatesha, V., Brown, C., Guminski, A., Lee, A., Back, M., Eade, T., & Bergamin, S. (2026). Long‐Term Patient‐Reported Outcomes and Dosimetric Predictors of Quality of Life After Curative‐Intent Radiation Therapy for Oropharyngeal Squamous Cell Carcinoma: A Cross‐Sectional Study. Cancer Reports, 9(10), Article e70712. https://doi.org/10.1002/cnr2.70712

Image Credits: AI Generated

DOI: 10.1002/cnr2.70712

Keywords: oropharyngeal cancer, HPV, radiotherapy, quality of life, xerostomia, parotid gland, dosimetry, IMRT, survivorship, EORTC QLQ-HN43, p16, dry mouth

The study, published in the journal Supportive Care in Cancer, drew on data from the Prospective Observational Cohort study of Oesophageal-gastric Cancer Patients, known as POCOP, a nationwide Dutch registry that routinely collects patient-reported outcomes and links them to the Netherlands Cancer Registry. Researchers led by Yipei Lee of the Netherlands Comprehensive Cancer Organization and Amsterdam UMC analyzed 1,896 patients with nonmetastatic esophageal or gastric cancer diagnosed between 2013 and 2024 who underwent either an esophagectomy, the removal of all or part of the esophagus, or a gastrectomy, the removal of all or part of the stomach. Of these, 1,462 patients, or 77.1 percent, had an esophagectomy, while 434, or 22.9 percent, underwent gastrectomy. Because POCOP participants have been shown to broadly resemble the overall Dutch population of patients with these cancers, the findings are likely to generalize beyond a single hospital or region.

The scale of the problem the team set out to quantify is considerable. Globally, roughly 1.49 million new cases of esophageal and gastric cancer were diagnosed in 2022, and for many of these patients, surgical resection combined with chemotherapy or radiotherapy before or after the operation offers the best chance of a cure. But that cure reshapes the gastroesophageal tract in ways the body struggles to compensate for. Previous research has shown that more than one-third of patients experience persistent gastrointestinal symptoms at nine to twelve months after surgery, and around 20 percent of esophagectomy patients and 15 percent of gastrectomy patients report two or more severe symptoms. These symptoms, which include eating restrictions, loss of taste, reflux, diarrhea, and appetite loss, are not merely uncomfortable. Having two or more gastrointestinal symptoms has been linked to clinically meaningful declines in quality of life, physical functioning, and daily activity, with work productivity impairment reported to be 29.3 percent higher among esophagectomy patients with multiple symptoms compared with those who have none.

To capture how these symptoms cluster and evolve, the researchers turned to an unsupervised machine learning technique called k-means clustering. Rather than treating each symptom in isolation, the method groups patients based on the overall pattern and intensity of their reported symptoms. The team extracted gastrointestinal symptom data from two validated quality-of-life instruments: the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire Core 30, or EORTC QLQ-C30, and the EORTC QLQ Oesophageal-Gastric Cancer Module 25, known as QLQ-OG25. Together, these questionnaires covered a broad spectrum of complaints, including dysphagia, or difficulty swallowing; eating restrictions; reflux; odynophagia, or painful swallowing; nausea and vomiting; constipation; diarrhea; appetite loss; dry mouth; trouble with taste; trouble with coughing; trouble swallowing saliva; and trouble talking. Every item is scored on a four-point scale and transformed linearly to a value between 0 and 100, with higher scores indicating worse symptoms.

The clustering was performed separately at five time points: a pre-resection baseline, which for most patients fell before or during neoadjuvant therapy, and then at zero to three, three to six, six to nine, and nine to twelve months after surgery. To decide how many patient groups existed at each point, the researchers used the Elbow method, which calculates the within-cluster sum of squares for candidate solutions ranging from one to ten clusters and identifies where the improvement in fit begins to level off. The answer was consistent: three profiles at every time point, for both surgery types. Crucially, these profiles did not represent distinct symptom patterns, in which one group might suffer mainly from reflux while another struggled primarily with diarrhea. Instead, the groups differed almost entirely in overall severity, forming what the researchers described as mild, moderate, and severe symptom profiles.

The composition of those profiles was revealing. The mild profile was the most common throughout the year, accounting for between 42.5 and 60.5 percent of esophagectomy patients and between 53.9 and 73.5 percent of gastrectomy patients across the assessment periods. Moderate profiles comprised roughly 24 to 42 percent of patients depending on surgery type and timing, while severe profiles, the smallest group, ranged from as few as 2.3 percent to as many as 15.7 percent. For esophagectomy patients, the most frequently reported symptoms across all time periods were eating restrictions, dysphagia, and appetite loss, with dry mouth and coughing problems also rising above baseline levels after surgery. For gastrectomy patients, the picture shifted over time: early on, severe-profile patients reported high scores for dysphagia, eating restrictions, appetite loss, and pain, but by six months after resection, the moderate profile was distinguished by eating restrictions, diarrhea, appetite loss, trouble with taste, and dry mouth, while the severe profile showed broader elevations including nausea, vomiting, and trouble swallowing saliva.

Perhaps the most clinically consequential finding concerns stability. When the researchers tracked how patients moved between profiles from one three-month period to the next, most stayed exactly where they started. Among esophagectomy patients who began in the mild profile, only 0.7 to 2.5 percent ever jumped directly to the severe profile in any postoperative interval. Gastrectomy patients in the mild profile were similarly anchored, with 63.2 to 92.0 percent remaining there between consecutive assessments. There was a general drift toward improvement in the early months: from the first to the second postoperative period, 51.4 percent of esophagectomy patients in the moderate profile moved down to mild, and among gastrectomy patients, roughly half of those in the moderate or severe profiles shifted to mild between baseline and three months. But the dominant pattern was persistence, which means that a patient’s symptom burden shortly after surgery is a strong signal of what the rest of the year will look like.

The statistical models also identified who was most at risk. Using generalized linear mixed models with a random intercept to account for repeated measurements in the same patient, the team found that female sex nearly doubled the odds of landing in a moderate or severe profile after esophagectomy, with an odds ratio of 1.67, and raised the odds by about 54 percent after gastrectomy, at 1.54. Receiving neoadjuvant chemotherapy was an even stronger predictor, with an odds ratio of 1.91 for esophagectomy patients and 2.39 for gastrectomy patients. Other risk factors after esophagectomy included an American Society of Anesthesiologists physical status classification of III or higher, transthoracic rather than transhiatal surgical approach, and a prolonged hospital stay, defined as more than twelve days. After gastrectomy, subtotal removal of the stomach was associated with better outcomes than total removal, with an odds ratio of 0.33 for moderate or severe symptoms. Interestingly, adjuvant chemotherapy or immunotherapy after esophagectomy was linked to a lower likelihood of severe profiles, an association the authors note warrants further investigation.

The researchers are candid about the limits of their approach. The Silhouette scores, a standard measure of how well-separated clusters are, ranged from 0.12 to 0.36, values the authors themselves describe as low and consistent with the exploratory nature of the analysis. Clinical symptom data are notoriously difficult to cluster because most features are highly correlated, and comparable studies of cancer symptom clustering have reported similarly modest scores. The team deliberately avoided principal component analysis, a common dimension-reduction technique, because compressing symptoms into abstract components would obscure direct clinical interpretation. They also acknowledge that the EORTC questionnaires summarize symptoms over the preceding week and may miss day-to-day fluctuations, that lower gastrointestinal symptoms were underrepresented, and that patients who complete questionnaires tend to be younger and healthier, potentially understating the true symptom burden.

Even with those caveats, the study’s implications for survivorship care are hard to ignore. Follow-up care for gastrointestinal symptoms after esophagectomy or gastrectomy is not fully standardized in the Netherlands, and existing approaches largely target single symptoms even though patients experience multiple co-occurring problems. The authors argue that targeting symptom profiles rather than individual complaints could make treatment strategies more effective and improve communication between clinicians and patients, and that patients clustered in higher-severity groups might benefit from earlier multidisciplinary support, including nutritional and rehabilitation care. Because profile membership tends to persist, baseline symptom burden could serve as an early warning system, allowing clinicians to identify high-risk patients before surgery and to set realistic expectations about recovery. The authors emphasize that the findings are exploratory and that future studies using alternative longitudinal modeling approaches are needed before the profiles can be deployed in the clinic. But the core message is already clear: for a substantial minority of patients cured of esophageal or gastric cancer, the hardest part of the journey may begin the moment the operation ends, and the first year is when their trajectory is written.

Subject of Research: Longitudinal gastrointestinal symptom profiles after esophagectomy or gastrectomy for esophageal or gastric cancer

Article Title: Gastrointestinal symptom profiles after resection of esophageal or gastric cancer

Article References: Lee, Y., Katsimpokis, D., van Erning, F. N., Nieuwenhuijzen, G. A. P., van Laarhoven, H. W. M., Gisbertz, S. S., Klarenbeek, B. R., Jeene, P. M., Pouw, R. E., Noteboom, L., Verhoeven, R. H. A., & Vissers, P. A. J. (2026). Gastrointestinal symptom profiles after resection of esophageal or gastric cancer. Supportive Care in Cancer, 34(10), Article 1069. https://doi.org/10.1007/s00520-026-11293-7

Image Credits: AI Generated

DOI: 10.1007/s00520-026-11293-7

Keywords: esophageal cancer, gastric cancer, esophagectomy, gastrectomy, gastrointestinal symptoms, symptom profiles, k-means clustering, patient-reported outcomes, quality of life, supportive care, longitudinal study, survivorship