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This study aimed to explore oncological doctor-patients experiences concerning the neoplastic disease. The study involved 20 Polish doctors with cancer. Respondents answered open questions related to cancer management and opinions about themselves as oncological patients. The results of the study indicate that doctor-patients deny their susceptibility to illness, which leads to prophylaxis ignorance. Many doctors diagnosed themselves with the disease, but they needed a clear verbal confirmation of the diagnosis by another physician. Respondents well assessed professional skills of doctor-colleagues. However, communication competencies of their doctors were assessed critically. Medical narratives may become an incentive to deepen the discourse on the quality of the relationship between a doctor and a doctor-oncological patient. They may also lead to further research on the anthropological, psychological, and sociological understanding of disease. [ABSTRACT FROM AUTHOR]

Objectives: As general practice increasingly moves towards large group practices, there is debate about the relative benefits, safety and sustainability of different care delivery models. This study investigates the performance of single-handed practices compared to practices with multiple doctors in England, UK. Methods: Practices in England with more than 1000 patients were included. Workforce data and a quality control process classified practices as single-handed or multiple-handed. Outcomes were (i) GP patient survey scores measuring access, continuity, confidence in health professional and overall satisfaction; (ii) reported diabetes and hypertension outcomes; and (iii) emergency department presentation rates and cancer detection (percentage of cancers diagnosed by a 2-week wait). Generalised linear models, controlling for patient and practice characteristics, compared outcomes in single and multiple-handed practices and assessed the effect of GP age in single-handed practices. Results: Single-handed practices were more commonly found in areas of high deprivation (41% compared to 20% of multiple-handed practices). Single-handed practices had higher patient-reported access, continuity and overall satisfaction but slightly lower diabetes management and cancer detection rates. Emergency department presentations were higher when controlling for patient characteristics in single-handed practices but not when also controlling for practice rurality and size. Increased deprivation was associated with lower performance in seven out of eight outcomes. Conclusions: We found single-handed practices to be associated with high patient satisfaction while performing slightly less well on selected clinical outcomes. Further research is required to better understand the association between practice size, including increasing multidisciplinary working, on patient experience and outcomes. [ABSTRACT FROM AUTHOR]

Purpose: Substantial cancer burden may be prevented through lifestyle modifications. The purpose of this study was to determine the preliminary effectiveness of health coaching for the improvement of health, fitness, and overall well-being of cancer survivors in a community setting. Methods: Participants were recruited from Cancer Support Community Delaware locations. Health coaching was provided to people diagnosed with cancer anywhere along the survivorship continuum. Coaches provided 6 individual sessions. Surveys were sent pre- and post-intervention on topics including fitness, eating habits, sleep, perceived stress, anxiety, depression, and quality of life. Results were analyzed using multilevel modeling. Results: 48 participants completed an average of 85% of health coaching sessions. Coaching participants noted improvements in weekly physical activity frequency, including moderate–vigorous physical activity. Increases were found in healthy eating behavior. Participants reported improvements in the quality of their sleep, including changes in sleep duration and sleep efficiency. Significant reductions were found in perceived stress, anxiety, and depression. Importantly, participants reported improved quality of life, particularly in areas of physical and emotional well-being, as well as functional and total well-being. Conclusion: Preliminary findings indicate significant behavior change in measured outcomes and suggest health coaching may be an important tool for cancer survivorship. [ABSTRACT FROM AUTHOR]

As an important nutrient in the human body, cholesterol can not only provide structural components for the body's cells, but also can be transformed into a variety of active substances to regulate cell signaling pathways. As an important cholesterol synthase, DHCR24 participates in important regulatory processes in the body. The application of DHCR24 in tumor clinical diagnosis and treatment also attracts much attention. This article reviews the structure and regulatory characteristics of DHCR24, and the research of DHCR24 on tumor progression. We summarize the possible mechanisms of DHCR24 promoting tumor progression through reactive oxygen species (ROS), p53, Ras and PI3K-AKT pathways. Through our review, we hope to provide more research ideas and reference value for the application of DHCR24 in tumor prevention and treatment. [ABSTRACT FROM AUTHOR]

Background: Cancer often co-occurs with other chronic conditions, which may result in polypharmacy. Polypharmacy is associated with adverse outcomes, including increased health service utilization. Objectives: This study examines the overall prevalence of polypharmacy (5 or more medications) among adults with cancer and multimorbidity, as well as the association of both minor polypharmacy (5-9 medications) and hyper-polypharmacy (10 or more medications) on high use of emergency room visits and hospitalizations, while controlling for age, sex, and type and stage of cancer. Methods: This retrospective longitudinal study used linked health administrative databases and included persons 18 years and older diagnosed with cancer between April 2010 and March 2013 in Ontario, Canada. Data on the number of health service utilizations at or above the 90th percentile (high users), was collected up to March 2014 and multivariate logistic regression was used to determine the impact of polypharmacy. Results: The prevalence of polypharmacy was 46% prior to cancer diagnosis, and 57% one year after diagnosis. Polypharmacy prior to and after cancer diagnosis increased with the level of multimorbidity, increasing age, but did not differ by sex. It was also highest in persons with lung cancer (52.4%) and those diagnosed with stage 4 cancer (51.3%). Minor polypharmacy increased the odds of being a high user of emergency rooms (1.16; 99% CI: 1.09-1.24) and hospitalizations (1.03; 0.98-1.09) and the odds of high use was greater with hyper-polypharmacy (1.41; 1.33-1.51) and (1.23; 1.17-1.29) respectively. Conclusion: Polypharmacy is highly prevalent and is associated with high health service utilization among adults with cancer and multimorbidity [ABSTRACT FROM AUTHOR]

Young adults (YAs), defined as individuals between the ages of 18 and 39 years, experience unique challenges when diagnosed with advanced cancer. Using the social constructivist grounded theory approach, we aimed to develop a theoretical understanding of how YAs live day to day with their diagnosis. A sample of 25 YAs (aged 22–39 years) with advanced cancer from across Canada participated in semi-structured interviews. Findings illustrate that the YAs described day-to-day life as an oscillating experience swinging between two opposing disease outcomes: (1) hoping for a cure and (2) facing the possibility of premature death. Oscillating between these potential outcomes was characterized as living in a liminal space wherein participants were unsure how to live from one day to the next. The participants oscillated at various rates, with different factors influencing the rate of oscillation, including inconsistent and poor messaging from their oncologists or treatment team, progression or regression of their cancer, and changes in their physical functioning and mental health. These findings provide a theoretical framework for designing interventions to help YAs adapt to their circumstance. [ABSTRACT FROM AUTHOR]

Accessory parotid gland (APG) tumors account for 1% to 7% of all parotid gland neoplasms but are more likely to be malignant than main parotid gland tumors. Management of APG neoplasms entails surgical excision. Four primary approaches to resection have been described in the literature with varying facial nerve outcomes. We report a case of a 4-cm APG pleomorphic adenoma utilizing a transoral approach for excision without postoperative facial nerve injury. A transoral approach is known to mitigate patients' cosmetic concerns; however, prior reports utilized endoscopic assistance on patients with smaller tumors. We conclude that large APG tumors can be excised through a transoral approach without undue risk to the distal facial nerves, though this transoral approach ultimately may not be appropriate for malignant neoplasms or difficult dissections. [ABSTRACT FROM AUTHOR]

Mental health problems were found to be more common than physical health problems in cancer caregivers in palliative care units. This is a quasi-experimental study planned to determine the effect of the meditation based mandala programme on distress, anxiety and depression in caregivers of cancer patients in a palliative care unit. Planned as a single-group pre-test/post-test design, with a total of 11 caregivers. Data were collected with the Caregiver Diagnosis Form, Distress Thermometer, Beck Depression Inventory, and Beck Anxiety Inventory. Caregivers participated in the Meditation Based Mandala Programme once a week, which lasted 2 hours for 5 weeks. The distress, depression and anxiety levels of the patients were measured before the programme started and at the end of the programme. Meditation based mandala programme is effective in reducing the distress, depression and anxiety levels of caregivers of cancer patients in the palliative care unit. [ABSTRACT FROM AUTHOR]

In recent years, the application of nanoimaging technology on standardize tumor diagnosis has become a new research hotspot, especially nanoprobes. Our research group has synthesized a kind of nanocarrier, mPEG2000-GPLGIAGQ-DSPE, which has the characteristic of matrix metalloproteinase-2 (MMP2) sensitive ability in tumor microenvironment. Meanwhile, the encapsulation method is adopted to prepare MMP2-sensitive tumor-targeted prussian blue fluorescent nanoprobe with mPEG2000-GPLGIAGQ-DSPE as the carrier. On the one hand, this novel nanoprobe not only can effectively improve the solubility of prussian blue, but is non-toxic and safe for cells. On the other hand, octapeptide (GPLGIAGQ) in mPEG2000-GPLGIAGQ-DSPE nanocarrier can specifically respond to MMP2 in tumor cells to release prussian blue, and achieve targeted intelligent imaging of tumor cells. [ABSTRACT FROM AUTHOR]

Background: Lenvatinib (LEN) is a first-line therapy for patients with hepatocellular carcinoma (HCC), but has a larger adverse effect profile. In this study, we developed a liposome with drug-carrying function and magnetic resonance imaging (MRI) imaging function to investigate the targeted drug-carrying function and MRI tracing ability of liposome for HCC. Methods: Magnetic nano-liposomes (MNL) with dual targeting function of epithelial cell adhesion molecule (EpCAM) and vimentin and capable of encapsulating LEN drugs were prepared. The characterization performance, drug loading efficiency and cytotoxicity of EpCAM/vimentin-LEN-MNL were tested, and the dual-targeting slow release drug loading function and MRI tracing ability were investigated in cellular and animal models. Results: EpCAM/vimentin-LEN-MNL has a mean particle size of 218.37 ± 5.13 nm and a mean potential of 32.86 ± 4.62 mV, and is spherical in shape and can be uniformly dispersed in solution. The encapsulation rate was 92.66 ± 0.73% and the drug loading rate was 9.35 ± 0.16%. It has low cytotoxicity, can effectively inhibit HCC cell proliferation and promote HCC cell apoptosis, and has specific targeting function and MRI tracing ability for HCC cells. Conclusions: In this study, an HCC-specific dual-targeted sustained-release drug delivery liposome with dual-targeted recognition and sensitive MRI tracer was successfully prepared, which provides an important scientific basis for maximizing the multiple effects of nano-carriers in tumor diagnosis and treatment. [ABSTRACT FROM AUTHOR]

Apocrine hidrocystoma is a cystic tumor originating from apocrine sweat glands. It is predominantly located in the eyelid margins. Here, we report a case of apocrine hidrocystoma of the parotid gland in a 19-year-old man who was referred to our outpatient clinic with a 5-year history of a gradual swelling in the left parotid region. The patient underwent left superficial parotidectomy. Histological examination confirmed the diagnosis of apocrine hidrocystoma. The case is original by the tumor's location: to the best of our knowledge, this could be the first case in English and French literature reporting an apocrine hidrocystoma affecting the parotid gland. The purpose of this article is to report our case and discuss its clinical and anatomopathological features as well as its differential diagnoses. [ABSTRACT FROM AUTHOR]

Introduction: Primary fallopian tube neoplasms are usually rare, and they are the rarest of all female genital tract neoplasms. According to the WHO classification, papillomas, adenofibroma, cystadenoma, cystadenofibroma, and metaplastic papillary tumors belong to the group of benign tumor masses that arise from the fallopian tubes. Methods: In our case, during an abdominal hysterectomy in a 45-yearold woman suspicious of endometrial adenocarcinoma, a right tubal mass was incidentally found. Results: Microscopic findings revealed features of serous papillary adenofibroma. Serous papillary adenofibroma is a very rare tumor. Till date, only a few cases have been reported worldwide, more so in the presence of endometrial malignancy. Conclusion: Serous papillary adenofibroma is often an incidental finding; thus, it is important to gross the specimen minutely to look for any such finding in the adnexa to avoid missing out on such rare neoplasm. [ABSTRACT FROM AUTHOR]

Introduction: Breast cancer is the most frequent malignancy in women and is curable in ~70-80% of patients with early-stage detection and without complication. Paraneoplastic neurologic syndrome of breast cancer is one such complication which is often hard to diagnose, severely debilitating, and also challenging to treat. Materials and Methods: A 57-year-old woman with no known co-morbidity presented with sudden onset altered sensorium. She was in status epilepticus when brought to emergency and progressed to super refractory status epilepticus in-spite of our efforts. MRI of the brain with contrast done revealed hyper intense signal in bilateral frontal, parietal, occipital, bilateral thalami, periaqueductal region and dorsal midbrain. Cerebrospinal fluid (CSF) study revealed only increased protein. The comprehensive infective panel of CSF was negative. The vasculitis marker, anti NMO and anti MOG antibody were absent. So, we suspected a possibility of autoimmune aetiology and started methylprednisolone along with intravenous immunoglobulin. Results: Her epileptic discharges settled in an electroencephalogram, and we weaned her off ventilation. We detected a right breast mass on clinical examination. The PET CT scan revealed metastasis in the liver, bones, right axillary lymph nodes, and bone marrow. Conclusion: Our patient, who had the first-time presentation, was diagnosed to have paraneoplastic encephalopathy in the background of breast cancer. The importance of proper clinical examination and whole-body PET CT scan, followed by a trial of immunomodulator therapy, is necessary in all patients with non-infective encephalitis. [ABSTRACT FROM AUTHOR]

Current evidence supporting antimicrobial stewardship programs focused largely in inpatient setting. With the shift in cancer management from inpatient to ambulatory setting, it is crucial to examine the prevalence and predictors of inappropriate antibiotics prescribing. This is a retrospective cross-sectional study conducted at the National Cancer Centre Singapore (NCCS). Patients at least 21 years, with an active or past cancer diagnosis and prescribed with at least one oral antibiotic by a NCCS physician from 1st July to 30th September 2019 were included. Antibiotic appropriateness was assessed using institutional antibiotic guidelines or published clinical practice guidelines. For cases where antibiotics appropriateness cannot be ascertained using these guidelines, an independent three-member expert panel was consulted. A total of 815 patients were screened; 411 (59.4% females) were included with mean age of 62.4 years. The top three cancer diagnoses were breast (26.5%), lung (15.6%) and head and neck (13.6%). More than half (58.6%) received appropriate antibiotic choice. Of which, 235 (97.5%), 238 (98.8%) and 194 (80.5%) received appropriate dose, frequency and duration respectively. The presence of non-oncologic immunosuppressive comorbidities (OR 4.890, 95% CI 1.556-15.369, p-value = 0.007), antibiotic allergy (OR 2.352, 95% CI 1.178-4.698, p-value = 0.015) and skin and soft tissue infections (OR 2.004, 95% CI 1.276-3.146, p-value = 0.003) were associated with a higher incidence of inappropriate antibiotic choice. This study highlighted that inappropriate antibiotic prescribing is prevalent in the ambulatory oncology setting. Predicators identified can aid in the design of targeted strategies to optimise antibiotic use in ambulatory oncology patients. [ABSTRACT FROM AUTHOR]

Introduction: Malignant mesothelioma (MM) of tunica vaginalis is a very rare tumor and it has a poor prognosis. It is not easy to diagnose the disease preoperatively because there is a lack of comprehensive studies and information about the disease. We would like to present our two cases with severe scrotal edema and hydrocele, which were debrided perioperatively due to scrotal necrosis, followed by radical inguinal orchiectomy and subsequently diagnosed as MM of tunica vaginalis. Case 1: A 74-year-old male patient with bilateral scrotal swelling for 6 months. Right radical inguinal orchiectomy was performed. The pathology result of right radical inguinal orchiectomy material was compatible with malignant mesothelioma of tunica vaginalis. Case 2: A 90-year-old male patient with complaints of right scrotal swelling for 3 years. A right radical inguinal orchiectomy was performed. The pathology result of right radical inguinal orchiectomy material was compatible with malignant mesothelioma of tunica vaginalis. Conclusion and discussion: MM has a very poor prognosis therefore early treatment plan should be made. Surgery is the main treatment for malignant mesothelioma of the testis. Although chemotherapy and radiotherapy play an active role in the treatment of metastatic disease, surgery is the first-line therapy in the treatment of the tumor. Also; long-term hydrocele, recurrent epididymitis, scrotal edema can make it harder to detect the tumor diagnosis. MM should be considered in such patients. Necrosis and abscess appearance was not mentioned before in published case reports. In this respect, it should not be ignored the long-term hydrocele situation and the appearance of abscess-epididymitis that cannot be treated properly. [ABSTRACT FROM AUTHOR]

The human papillomavirus (HPV) is the most common sexually transmitted infection in the United States despite most cases being preventable by vaccination. HPV vaccine efficacy varies in relationship to when the vaccine is administered, with greater efficacy obtained if administered prior to sexual debut. Historically, this vaccine was created to protect women from cervical cancer. As scientific knowledge of HPV-related cancers has advanced, it has become evident that HPV vaccination is a priority for both genders. HPV is known to contribute to male cancers of the mouth, throat, anus, and penis, as well as causing genital warts. This article aims to explain the benefits of HPV immunization for the gender the farthest from meeting vaccination goals, boys, and young men. This article expounds on the school nurses' role in promoting vaccination to prevent HPV infection and the sequela of related cancers. [ABSTRACT FROM AUTHOR]

In recent years, extracellular vesicles (EVs) have gained significant attention due to their tremendous potential for clinical applications. EVs play a crucial role in various aspects, including tumorigenesis, drug resistance, immune escape, and reconstruction of the tumor microenvironment. Despite the growing interest in EVs, many questions still need to be addressed before they can be practically applied in clinical settings. This paper aims to review EVs' isolation methods, structure research, the roles of EVs in tumorigenesis and their mechanisms in multiple types of tumors, their potential application in drug delivery, and the expectations for their future in clinical research. [ABSTRACT FROM AUTHOR]

The article presents the case of a 51-year-old female who was rushed to a hospital department due to ulcer in her preexisting discoid lupus erythematosus (DLE) lesions on her right cheek to discuss reconstruction of a large oncologic defect of the lower eyelid and infraorbital cheek using a modified supratrochlear artery forehead island (MSTAFI) flap. The flat is recommended to avoid the risk of necrosis and ectropion.

Oncogenic neurotrophic tropomyosin receptor kinase gene fusions occur in less than 1% of common cancers. These mutations have emerged as new biomarkers in cancer genomic profiling with the approval of selective drugs against tropomyosin receptor kinase fusion proteins. Nevertheless, the optimal pathways and diagnostic platforms for this biomarker's screening and genomic profiling have not been defined and remain a subject of debate. A panel of national experts in molecular cancer diagnosis and treatment was convened by videoconference and suggested topics to be addressed in the literature review. The authors proposed a testing algorithm for oncogenic neurotrophic tropomyosin receptor kinase gene fusion screening and diagnosis for the Brazilian health system. This review aims to discuss the latest literature evidence and international consensus on neurotrophic tropomyosin receptor kinase gene fusion diagnosis to devise clinical guidelines for testing this biomarker. We propose an algorithm in which testing for this biomarker should be requested to diagnose advanced metastatic tumors without known driver mutations. In this strategy, Immunohistochemistry should be used as a screening test followed by confirmatory nextgeneration sequencing in immunohistochemistry-positive cases. [ABSTRACT FROM AUTHOR]

Parent-adolescent communication is important in the context of childhood cancer. However, we know little about the communication experiences between Korean adolescents and their parents. Here, we conducted a secondary analysis of interview data from a qualitative descriptive study to explore Korean parent-adolescent communication experiences as a unit. Specifically, our dyadic analysis of individual interviews with seven Korean adolescents with cancer and at least one parent included inductive analysis at the individual level and cross-analysis to generate themes. The main theme was “Experience the same thing, but see it differently,” along three subthemes: (1) different expectations for parent-adolescent communication, (2) different views on communication challenges, and (3) limited sharing and no progress in the conversation. Overall, our findings provide insights into different communication expectations and preferences between Korean adolescents and parents, and reasons for communication challenges, while emphasizing the individualized assessment of parent-adolescent communication between them. [ABSTRACT FROM AUTHOR]

Finding meaning in life is important for maintaining physical and mental well-being. Obtaining a deeper understanding of activities that patients with cancer find meaningful is essential in improving cancer care and increasing meaning in life in these individuals. The sample of the present study consisted of patients with cancer (N = 61) who reported their levels of financial strain and listed types of activities that they found most meaningful as a part of an online study. Participants engaged in activities that could be grouped into four broad domains (companionship, personal responsibility, recreation, and existential). In addition, results showed that financial strain was associated with higher preference for activities in the existential domain and lower preference for activities in the recreation domain. Future researchers could extend this study by exploring why certain activities are found to be more meaningful and how to combat the influence of financial strain in cancer. [ABSTRACT FROM AUTHOR]

Background: Enhancing Connections (EC) is an evidence-based intervention that promotes communication between cancer-diagnosed mothers and their school-age children. EC was validated with college-educated non-Latina White mothers of privileged socioeconomic status. Latina researchers culturally adapted EC for Latina mothers diagnosed with cancer and renamed it Conexiones. Following cultural adaptation guidelines, the next recommended step was to engage the new consumer group (Latina mothers) in evaluating the newly adapted educational materials. Purpose: The purpose of this study was to evaluate the cognitive and cultural fit of the newly adapted Conexiones educational materials for use with Latina mothers diagnosed with cancer. Method: Eighteen Latina mothers participated in focus groups evaluating the Conexiones educational materials. An inductive approach was used to identify problem areas and recommendations for corrections to the Conexiones program content. Results: Within the cognitive-informational dimension, recommendations were made to improve the ease of comprehension in the Spanish version of the program. Recommendations within the affective-motivational dimension described the cultural adjustments needed to more effectively engage cancer-diagnosed Latina mothers in the Conexiones program. Implications for Practice. Engagement of the new consumer group in evaluating the initial adaptation of Conexiones served to identify additional cognitive-informational and affective-motivational corrections needed to further refine the cultural adaptation of the Conexiones program. This study reinforced the importance of community engagement in evaluating and refining newly adapted evidence-based interventions. [ABSTRACT FROM AUTHOR]

In the scope of symptom cluster research, few investigators have obtained patients' perceptions of their symptom clusters, even though this information is central to designing effective interventions. In this cross-sectional study, 38 adults with cancer completed measures of demographics, health outcomes (functional status, well-being, quality of life) and a symptom cluster assessment that captured symptom occurrence, severity, distress, clustering, a priority cluster, causal attributions, duration, directional relationships, and cluster interference with daily life. Participants described 72 distinct symptom clusters. Symptoms were most frequently attributed to the cancer diagnosis. Participants' priority symptom cluster typically included two symptoms of continuous duration and one intermittent symptom. Temporal order and direction of symptom relationships varied, with 75 different relationships described among symptom pairs. Greater symptom cluster burden and interference were related to poorer health outcomes. This patient-centered view of symptom clusters revealed substantial variability in symptom cluster characteristics with important implications for symptom management. [ABSTRACT FROM AUTHOR]

Cancer incidence and mortality in Nigeria are increasing at an alarming rate, especially among Nigerian men. Despite the numerous public health campaigns and education on the importance of early cancer detection in Nigeria, there exist high rate of fatal/advanced stage cancer diagnoses among Nigerian men, even among affluent Nigerian men. However, there is limited information on patterns of cancer screening and psychosocial predictors of early cancer detection behaviors among Nigerian men. In this cross-sectional study, we examined demographic and psychosocial factors influencing early cancer detection behaviors among Nigerian men. Participants (N = 143; Mage = 44.73) responded to survey assessing: masculinity, attachment styles, current and future cancer detection behaviors, and sociodemographic characteristics. We found that among the participants studied, education, masculinity and anxious attachment were significantly associated with current cancer detection behaviors. Additionally, education and anxious attachment were significantly associated with future cancer detection behaviors. Our finding is best served for clinicians and public health professionals, especially those in the field of oncology in Sub-Saharan Africa. Also, the study may be used as a groundwork for future research and health intervention programs targeting men in Sub-Saharan Africa. [ABSTRACT FROM AUTHOR]

Objectives: tRNA-derived small non-coding RNAs (tsncRNAs) are one of mysterious small non-coding RNAs. Dysregulated tsncRNAs can led to all kinds of cancers. Recently, tsncRNAs were postulated to be potentially useful biomarkers for tumor diagnosis and prognosis. However, there were no systematic reviews of prognostic and diagnostic tsncRNAs in neoplasms. The study aimed to decipher the relationships between tsncRNAs expression, diagnostic and prognostic outcome in tumors. Methods: This study systematically searched Google Scholar, MEDLINE, Scopus, PubMed, Embase, ScienceDirect, Ovid-Medline, Chinese National Knowledge Infrastructure, WanFang and SinoMed databases for relevant articles published before September 21, 2020. Results: The study is registered in PROSPERO (CRD42020213863). Fourteen relevant studies were included in the meta-analysis: 12 on diagnosis and 5 on prognosis. The pooled add ratio, 95% confidence intervals (Cl) and hazard ratios (HR) of the studies were used to investigate the clinical parameters and overall survival (OS) of cancer patients. The area under the curve (AUC), sensitivity, and specificity was 0.79, 72%, and 73% in tumors, respectively. Though abnormally expressed tsncRNAs were associated with poor and unfavorable impacts on the OS time of cancer patients, the oncogenic tsncRNA may be a favorable impact on overall survival (OS: HR = 0.67, 95% Cl: 0.48-0.94, P = 0.02), and tumor-suppressor tsncRNA might have an unfavorable impact on overall survival (OS: HR = 1.41, 95% Cl: 0.84-2.37, P = 0.19). Conclusion: These results strongly suggested that tsncRNAs were potential novel prognostic and diagnostic indicators in tumors. [ABSTRACT FROM AUTHOR]

Background: When confronting a partner's diagnosis of advanced cancer, family caregivers are often protected against severe psychological illness by their mental resilience. However, the current COVID-19 pandemic endangers this resilience through the daily threat of contagion exposure, viral transmission, isolation, and fear of death. Aim: To examine the experiences of partners caring for a person with advanced cancer during the COVID-19 pandemic. Setting: Twelve partners (all under the age of 65) of persons newly diagnosed with advanced cancer immediately before or during the pandemic were interviewed. An interpretative phenomenological approach was used in analyzing the data. Findings: Partners experience the COVID-19 pandemic as "living in a double cage." Due to pandemic mandates and restrictions, the pace of their lives slows. However, COVID-19 does not slow the progression of the cancer, nor does it allow for an escape from the cancer. The pandemic has a significant impact on several elements of resilience. Nevertheless, the participants succeed in adapting and coping in a balanced and creative way despite the new challenges imposed by the pandemic. Conclusion: The COVID-19 pandemic challenges one's resilience, a process that, under normal circumstances, may evolve while caring for a partner diagnosed with advanced cancer. Although most partners seem to cope adaptively with both advanced cancer and COVID-19, healthcare professionals should be aware of the risk of exhaustion. Furthermore, it can be presupposed that threatened, contextual factors that may support resilience should be preserved to increase the chances for a resilient outcome. [ABSTRACT FROM AUTHOR]

Breast cancer is a malignant tumor, which has derived from cells of the breast. Further, a relatively rapid metastasis, and resistance development against all the conventional drug combinations are major clinical issues in breast cancer patients as well as limitations like toxicity, genetic mutation, and metastasis make difficult the use of conventional therapy methods such as chemotherapy, radiotherapy, and local surgery. Therefore, considering the urgent needs, and high death rate in breast cancer cases, the development of new diagnosis and treatment regimens which diagnosed at the early stage and protected normal tissues required for clinical applications. Recently, the combination of tumor diagnosis and treatment within a single platform is a novel perspective, and magnetic nanoparticles are potential candidate owing to their low toxic effect, biocompatibility, biological degradability, superior magnetic properties, and targeting ability to overcome the problems of conventional diagnosis and therapy techniques. Considering these restrictions and requirements, the goal of this research was to investigate the potential of an innovative theranostic agent, which is soybean oil-based polystyrene (PS)-g-soybean oil graft copolymer containing AgNPs (PS-Agsbox) for treatment and MRI-based diagnosis of cancer. Herein, we designed targeted magnetic PS-Agsbox nanoparticles carrying thymoquinone (TQ) that is known for its anticancer potential against breast cancer, and herceptin (HER), which is to bind to the HER2 receptor protein on the surface of HER2-positive tumor cells, and acts by blocking the effects of it. We have successfully demonstrated selective binding, effective uptake of HER-conjugated magnetic PS-Agsbox nanoparticles into MDA-MB-231 (human breast carcinoma cells, a HER2-underexpressing cell line) and SKBR-3 (human breast cancer cells, a HER2-overexpressing breast cancer cell line) cell lines while no effect against L929 (mouse fibroblast cell line). Moreover, the magnetic resonance (MRI) properties of HER-conjugated magnetic PS-Agsbox nanoparticles were also confirmed. [ABSTRACT FROM AUTHOR]

Background: Energy spectrum computed tomography (CT) has become a promising approach for the differential diagnosis of tumor subtypes. Purpose: To explore the value of energy spectrum CT parameters in the differential diagnosis of high-grade clear cell renal cell carcinoma (ccRCC) and type II papillary renal cell carcinoma (pRCC). Material and Methods: Forty-two cases of high-grade ccRCC and 28 cases of type II pRCC were retrospectively reviewed. All region of interest (ROI) measurements were maintained consistently between the two-phase contrast-enhanced examinations. The ROIs encompassed as much of the enhancing areas of the lesions as possible. Energy spectrum CT parameters of all cases, including the 70 keV (HU) value, normalized iodine concentration (NIC), and energy spectrum curve slope were recorded by two radiologists with over 10 years of experience in abdominal CT diagnosis. Results: In the cortical phase (CP) and parenchymal phase (PP), the 70 keV (HU) value, NIC, and slope value of the energy spectrum curve of high-grade ccRCC were significantly higher than those of type II pRCC. In the CP, NIC showed the highest differential diagnosis efficiency for the two group tumors, with a sensitivity of 78.9% and a specificity of 77.0%. There was no statistical difference in tumor hemorrhage, tumor envelope, tumor morphology, tumor border, lymph node metastasis, embolism, renal pelvis invasion, or tumor calcification between the two tumor types. However, there was significant difference in the number of tumors (P = 0.019). Conclusion: Energy spectrum CT parameters are valuable for the differential diagnosis of high-grade ccRCC and type II pRCC. [ABSTRACT FROM AUTHOR]

At present, metalloporphyrin compounds demonstrate three main uses as anticancer sensitizers: (1) photosensitizers, (2) photothermal conversion agents, and (3) ultrasound sensitizers. Developing efficient sensitizers for cancer with excellent controllability and biocompatibility is an important goal of oncology medicine. Because of the different structural diversity of anticancer sensitizers, such sensitizers are used for treating cancers by employing a variety of tumor treatment methods such as mature photodynamic therapy, commonly used clinically photothermal therapy and promising sonodynamic therapy. Among the many sensitizers, metalloporphyrin-complex sensitizers attract wide attention due to their excellent performance in tumor treatment and diagnosis. This review briefly describes some metalloporphyrin anticancer drugs and diagnostic agents related to photodynamic, photothermal and sonodynamic therapy, and discusses the roles of metal atoms in these drugs. [ABSTRACT FROM AUTHOR]

In this descriptive case study, we aimed to understand the experiences of cancer diagnosis, treatment, and palliative care in Pakistan. The case was limited to a hospital for cancer and hospice care in Karachi, Pakistan. Data collection included interviews with patients who had a cancer diagnosis, family members, healthcare providers, and unstructured observations. Two themes of suffering and late diagnosis were developed to describe the experiences of people with cancer. Suffering occurred as a result of poverty, social ideas about cancer, and physical suffering. Late diagnosis happened because of cultural ideas about health, low health literacy, and healthcare challenges, although both themes are interconnected. The findings illuminate three key pathways that will improve cancer diagnosis and palliative care in Pakistan: specifically, the need to (a) educate healthcare providers about cancer and palliative care, (b) eradicate corruption in healthcare, and (c) develop policies for universal access to health. [ABSTRACT FROM AUTHOR]

This study examined whether emotional distress among U.S. adults diagnosed with cancer was influenced by death rates, survival rates, and new cases based on cancer type and individual-level variables (health efficacy, perceived health, and use of information and communication technologies and social media for health-related reasons). Health Information National Trends Survey 5 data from cycle 1 and cycle 2 were used to examine emotional distress among individuals who had experienced 1 of 17 different types of cancer diagnoses. A multilevel model and follow-up one-way ANOVA indicated a small statistically significant difference in emotional distress across cancer types. To investigate the influence of individual-level variables on emotional distress, a hierarchical regression analysis indicated that, after controlling for perceived health and health efficacy, using social media in a greater number of health-related ways significantly predicted greater emotional distress, while using information and communication technologies in a greater number of health-related ways did not. [ABSTRACT FROM AUTHOR]

Intraductal biliary lesions can involve the main hepatic confluence. Assessment of the extension of pedunculated biliary lesions during per-oral cholangioscopy (POCS) can optimize and personalize the surgical strategy. Four consecutive cases of pedunculated biliary lesions were analysed. Cholangioscopy was performed with a disposable single-operator cholangioscope. POSC was successfully performed in four patients (three female, mean age 50 years), showing involvement of the main biliary confluence in three of four pedunculated biliary lesions; direct biopsy sampling was diagnostic in two of three cases (in one patient, biopsy were not performed due to the smooth appearance of the intrabiliary lesion). No adverse events occurred after POCS. Surgery required excision of the main hepatic confluence in two of three cases (one patient was not resectable). POCS can diagnose intrabiliary extension of protruding biliary lesions, providing important information to plan the surgical intervention. [ABSTRACT FROM AUTHOR]

Background: Adrenal sarcomas are rare malignant tumors with structural and clinical similarities to sarcomatoid adrenocortical carcinoma. Preoperative diagnosis of tumors of the adrenal gland can be challenging and often misleading thus detaining patients from appropriate oncological strategies. Objective: This analysis of a case series evaluated the predictive capability of the primary clinical diagnosis in case of malignancies of the adrenal gland. Methods: Thirty two patients were treated from 2009 to 2015 at our clinic and analyzed retrospectively. All patients had computed tomography and/or magnet resonance imaging and a primary histopathological examination at our institution after surgery. Ten questionable cases were surveyed by a reference pathologist. Results: Twelve out of 32 diagnoses had to be revised (37.5%). Only 15 out of 24 tumors primarily classified as adrenocortical carcinoma were finally described as primary adrenal cancer. We found two leiomyosarcomas, one liposarcoma, one sarcomatoid adrenocortical carcinoma, and one epitheloid angiosarcoma among 12 misleading diagnoses. Other tumors turned out to be metastases of lung, hepatocellular, and neuroendocrine tumors. Larger tumors were significantly more often correctly diagnosed compared to smaller tumors. Four patients of the group of revised diagnoses died whereas all patients with confirmed diagnoses survived during the follow-up. Conclusion: Preoperative assessment of tumors of the adrenal gland is still challenging. In case of wrong primary diagnosis, the prognosis could be impaired due to inadequate surgical procedures or insufficient preoperative oncological treatment. [ABSTRACT FROM AUTHOR]

During the last 100 years, musculoskeletal radiology has developed from bone-only radiography performed by everyone to a dedicated subspecialty, still secure in its origins in radiography but having expanded into all modalities of imaging. Like other subspecialties in radiology, it has become heavily dependent on cross-sectional and functional imaging, and musculoskeletal interventions play an important role in tumor diagnosis and treatment and in joint diseases. All these developments are reflected in the pages in Acta Radiologica, as shown in this review. [ABSTRACT FROM AUTHOR]

Objective: Mucinous carcinoma is a rare, special subtype of breast carcinoma associated with a good prognosis. It often presents a confusing appearance with a benign process. For all these reasons, differential diagnosis could be challenging. Case Report: Eighty years-old woman with a soft, lobulated, and well circumscribed mass at the left breast mimicking a benign process. Pathological examination of a core needle biopsy showed pure mucinous carcinoma. Discussion: It is a disease of elderly patient, over 60 years, and usually occurs in postmenopausal women. It accounts for only 2% of total breast carcinomas. On pathologic analysis, to be defined as pure mucinous carcinoma, a carcinoma must be made up of at least 90% intracellular or extracellular mucin. Conclusion: Examination of core biopsy material should be done carefully respecting this criteria to confirm the diagnosis of this rare entity and eliminate differential diagnosis. [ABSTRACT FROM AUTHOR]

Cancer is a leading cause of death in Samoa, with cancer patients presenting late and experiencing poor outcomes. Barriers to early diagnosis are complex, and cultural factors play an important part. This qualitative study explored the barriers to cancer diagnosis in Samoa through semistructured interviews conducted with 19 Samoan patients. Thematic data analysis was informed by socioecological theory and yielded 4 themes: knowledge and beliefs about cancer; pain as a trigger for health care–seeking behavior; follow-up issues; and communication and trust. Cancer knowledge and attitudes toward pain were strongly influenced by culture and community beliefs. Lack of follow-up resulted in significant delays, and ineffective patient-doctor communication triggered feelings of uncertainty and mistrust in the health care system. Efforts to address knowledge gaps will not be effective unless they are accompanied by broader strategies addressing local health care capacity issues. Adopting a socioecological framework lens within a regional collaborative approach provides a way forward. [ABSTRACT FROM AUTHOR]

Lung cancer, colon cancer, breast cancer, and prostate cancer are the leading causes of death in developed countries. Many cancers display non-specific signs in the early stage of the disease, thus making early diagnosis often difficult. We focused on nestin as a new biomarker of possible clinical importance in the early diagnosis and monitoring of cancer. The expression of nestin takes place at an early stage of neural differentiation, but no expression of the nestin gene can be revealed in normal, mature adult tissues. Nestin plays an important role in the development of the central nervous system and contributes to the organization and maintenance of cell shape. Nestin was found to be a marker of microvessel density, which in turn has proven to be a reliable prognostic factor for neoplastic malignancies in patients. Nestin expression correlates with an increased aggressiveness of tumor cells. The role of nestin in cancers of the colon and rectum, liver, central nervous system, lung cancer, breast cancer, melanoma, and other cancers has been reviewed in the literature. Associations between nestin expression and prognosis or drug-resistance may help in disease management. More research is needed to understand the molecular mechanisms of nestin expression and its role in possible targeted therapy. [ABSTRACT FROM AUTHOR]

Objective: Venous thromboembolism is a major cause of morbidity, mortality, and increased medical costs in tumor patients. In the current review, we summarize the progress made in the study of cancer-associated venous thromboembolism.Methods: By searching cancer-associated venous thromboembolism-related literature on PubMed, the epidemiology, pathological mechanisms, risk factors, risk prediction models, and prevention and treatment of cancer-associated venous thromboembolism were reviewed.Results: The pathophysiological mechanisms of cancer-associated venous thromboembolism are multifactorial. Various blood cell counts (such as platelets and white blood cells) and biomarkers (such as D-dimer and sP-selectin) were considered predictors of thrombosis in cancer patients and were incorporated into the venous thromboembolism risk stratification models. Thromboprophylaxis is currently recommended for all hospitalized cancer patients. In addition, outpatient thromboprophylaxis can be used for selected high-risk patients. Low-molecular-weight heparin was the preferred treatment for cancer-associated venous thromboembolism, but some issues arose in the long-term treatment. In this case, direct oral anticoagulants were a treatment option for tumor patients. The efficacy of direct oral anticoagulant in treating cancer patients is not inferior to low-molecular-weight heparin, but is associated with a higher risk of bleeding. Therefore, there were concerns regarding their safety.Conclusion: Since thrombocytopenia, thrombosis recurrence, and bleeding are common in tumor patients, the selection of anticoagulants in this circumstance is a considerable challenge for clinicians. [ABSTRACT FROM AUTHOR]

Background: In recent years, there has been significant research on the mental health effects of classic psychedelic use, but there is very little evidence on how classic psychedelics might influence physical health.Aims: The purpose of the present study was to investigate the associations between lifetime classic psychedelic use and markers of physical health.Methods: Using data from the National Survey on Drug Use and Health (2015-2018) with 171,766 (unweighted) adults aged 18 or above in the United States, the current study examined the associations between lifetime classic psychedelic use and three markers of physical health (self-reported overall health, body mass index, and heart condition and/or cancer in the past 12 months) while controlling for a range of covariates.Results: Respondents who reported having tried a classic psychedelic at least once in their lifetime had significantly higher odds of greater self-reported overall health and significantly lower odds of being overweight or obese versus having a normal weight. The association between lifetime classic psychedelic use and having a heart condition and/or cancer in the past 12 months approached conventional levels of significance, with lower odds of having a heart condition and/or cancer in the past 12 months for respondents who had tried a classic psychedelic at least once.Conclusion: The results of the present study suggest that classic psychedelics may be beneficial to physical health. Future research should investigate the causal effects of classic psychedelics on physical health and evaluate possible mechanisms. [ABSTRACT FROM AUTHOR]

Women in underserved communities are disproportionately affected by chronic diseases such as cardiovascular disease and cancer. The Connecticut Early Detection and Prevention Program (CEDPP) has taken a streamlined approach to improve access to comprehensive preventive health services for minority women and those with incomes below the federal poverty threshold. The CEDPP has implemented Wellness Days to improve outreach in the community and offer opportunities for health assessments, screenings, and education around chronic disease prevention and management. CEDPP contractors coordinated 47 Wellness Days in 2019, reaching 2,509 women and successfully enrolling 107 (4.3%) in the CEDPP. While the majority of Wellness Day events offered health education to participants, only 10.6% offered mammograms and 6.4% offered Papanicolaou (Pap) tests onsite. Through ongoing evaluation efforts, the CEDPP and its contractors have identified opportunities to enhance the success of Wellness Days to connect women with essential preventive services. By expanding its reach, the CEDPP will have a more widespread impact on women's health across Connecticut. [ABSTRACT FROM AUTHOR]

The article presents the discussion on considering cancer procoagulant (CP) as diagnostic and therapeutic target in clinical oncology or oncology pharmacy. Topics include neoplastic cells in bloodstream inducing the platelet activation and triggering the coagulation cascade through the expression and releasing of the well-known thrombus forming factors; and anticoagulants with chemotherapeutic activity, chemotherapies with anti-coagulating properties, and natural products.

Background: This study examined the accuracy and pitfalls associated with frozen section diagnosis of primary ovarian tumors and ovarian metastases based on the 2014 World Health Organization classification (WHO) criteria and proposed improvements from a pathologist's perspective. Methods: We microscopically reviewed 871 cases of primary ovarian tumor (N = 802) and ovarian metastasis (N = 69) and compared the results of frozen sections with the final diagnosis. Malignant potential concordance (benign, borderline, or malignant) and specific discordant diagnosis rates were analyzed. Finally, we conducted a unique literature review of specific diagnostic errors in the frozen section diagnosis of primary ovarian tumors. Results: Of 802 primary ovarian tumors, 50 (6.2%) cases showed discordant diagnoses in which mucinous carcinoma (40.5%), low-grade serous carcinoma (LGSC; 31.3%), and mucinous borderline tumor (18.4%) were frequently misinterpreted. Of 69 ovarian metastases, all 4 cases of low-grade appendiceal mucinous neoplasm (LAMN) were misdiagnosed as primary ovarian mucinous tumor. A literature review revealed that mucinous/serous borderline tumor or carcinoma accounted for approximately 70% of 217 reported discordant diagnoses. Conclusion: In the present study, the concordance rate of malignant potential of the tumor was comparable to that previously reported. Even in the 2014 WHO classification, primary ovarian mucinous borderline tumor/carcinoma and LGSC still comprised the majority of discordant cases. Grossing methods that reduce sampling error are required. LAMN was frequently misinterpreted as a benign or borderline ovarian mucinous tumor. To prevent this error, a differential algorithm integrating clinical information and gross findings should be developed. [ABSTRACT FROM AUTHOR]

In recent years, the organisation of healthcare in many welfare states is gradually moving towards an individualised and responsibility-driven self-care and use of healthcare services. Departing in this restructuring of care, this article explores how bodies are experienced and how care is sough, by socially disadvantaged cancer patients. Based on repeated ethnographic interviews with 10 socially deprived cancer patients in Denmark, the article illustrates that socially disadvantaged cancer patients often experience their bodies and move between feeling fine and feeling sick in a disjunctive manner engulfed by the practicality of getting through the day. From a critical phenomenological perspective, we argue that this way of being in the world appears counterfactual to welfare expectations of proactive attention to the body, and contemporary moves towards increased individual responsibility for preventing serious disease and monitoring the body. [ABSTRACT FROM AUTHOR]

Immune-checkpoint blockade (ICB) demonstrated inspiring effect and great promise in anti-cancer therapy. However, many obstacles, such as drug resistance and difficulty in patient selection, limited the efficacy of ICB therapy and awaited to be overcome. By timely identification and intervention of the key immune-suppressive promotors in the tumor microenvironment (TME), we may better understand the mechanisms of cancer immune-escape and use novel strategies to enhance the therapeutic effect of ICB. Myeloid-derived suppressor cell (MDSC) is recognized as a major immune suppressor in the TME. In this review, we summarized the roles MDSC played in the cancer context, focusing on its negative biologic functions in ICB therapy, discussed the strategies targeted on MDSC to optimize the diagnosis and therapy process of ICB and improve the efficacy of ICB therapy against malignancies. [ABSTRACT FROM AUTHOR]

Background: Cancer is the second leading cause of death in the United States. Lifestyle choices such as substance abuse can impact a survivor's health and overall quality of life. Methods: We used longitudinal data from the Wave 1-3 Population Assessment of Tobacco and Health data to examine sociodemographic characteristics and substance use behaviors (current cigarette, e-cigarette, alcohol, and marijuana use) by cancer diagnosis status. A generalized estimating equation model was used to examine the population-averaged effects of sociodemographic factors on substance use. Results: Among 1527 participants diagnosed with cancer, 14.5% used cigarettes, 3.8% used e-cigarettes, 49.1% used alcohol, and 4.2% used marijuana in the prior 30 days in Wave 1. While the prevalence of cigarette use among those with no cancer history decreased significantly between Wave 1 (21.9%) and Wave 3 (20.2%), it increased significantly among participants diagnosed with cancer from 14.5% to 16.0%. E-cigarette use decreased for both groups, whereas alcohol and marijuana use increased. Results showed that substance use among people diagnosed with cancer significantly varied by sociodemographic characteristics. Age, sex, race-ethnicity, education, income, and region of residence were significantly associated with substance use among patients diagnosed with cancer. Conclusion: Overall, substance use is lower among participants diagnosed with cancer than those with no cancer history. Substance use varies by sociodemographic characteristics among people diagnosed with cancer. More focus on substance use prevention among patients diagnosed with cancer could be beneficial in terms of improving the overall well-being of this population. [ABSTRACT FROM AUTHOR]

A cross-section correlational study was conducted to evaluate the overall quality of life in young adults (AYAs) diagnosed with cancer, and the impact of health-related and non-health-related factors on their quality of life. Fifty-six AYA cancer survivors were recruited to elicit the impact of biological function (cancer type and comorbidity), symptoms, functional status, general perception of health status, gender, and characteristics of the environment on quality of life. Participants experienced higher than average quality of life. Symptoms, functional status, and general perception of health status were significant predictors of quality of life in this group of AYAs diagnosed with cancer. In delivering quality cancer care, nurses must be able to thoroughly assess symptom status, AYA cancer survivors' perception of their health status, and functioning in order to implement supportive measures to help improve their quality of life. [ABSTRACT FROM AUTHOR]

Gastrointestinal tumors are common tumors in the digestive system. Early diagnosis of gastrointestinal tumors is the key to improve prognosis and curative effect of patients with tumors. Compared with other methods of examination and diagnosis, ultrasound examination has the advantages of simple operation, non-invasive, economical, and repeatable operation. With the advancement of ultrasound technology and the development of ultrasound contrast agents, ultrasound examination is more and more applied to gastrointestinal examination. Ultrasound cannot only observe the gastrointestinal wall, but also evaluate the surrounding lesions and metastases, as well as preoperative analysis and postoperative follow-up of gastrointestinal tumors. We reviewed the diagnostic applications of ultrasound in gastrointestinal tumors. [ABSTRACT FROM AUTHOR]

Introduction: Intractable and persistent cough is experienced by more than a third of patients with advanced cancer, with a significant negative impact on quality of life. Pharmacological treatment has been of little help in some patients. Limited evidence suggests novel agents such as paroxetine may reduce cough severity. This retrospective study aimed to assess effectiveness and tolerability of paroxetine for the treatment of intractable cough in patients with cancer. Methods: Single-centre medical record review of paroxetine use in patients with advanced malignancy and cough treated at an Australia tertiary referral cancer centre between 1 October 2012 and 1 October 2017. Data relating to cough type and severity, response and adverse events were extracted from medical records. Cough type was described as non-productive dry cough, productive chesty cough or cough exhibiting both non-productive and productive features (mixed cough). Results: Overall, 24/34 patients (71%) experienced a major or moderate reduction in their cough severity after treatment with paroxetine. Nearly half (47%) described a major improvement and a quarter (24%) moderate improvement. Of the 34 patients, nearly half had a lung primary cancer (16/34, 47%) and nearly all (17/18) of those without lung cancer had lung metastases from another primary cancer. Patients with dry cough reported greater benefit from paroxetine. Of the 56% (19/34) of patients with non-productive dry cough, 80% (15/19) reported an improvement in symptoms post paroxetine. The remaining 15 patients, 44% of the group, presented with either a productive chesty cough (9/34, 27%) or mixed cough (6/34, 18%). Of these patients, 60% (9/15) reported an improvement in symptoms. Two thirds of patients were commenced on paroxetine 10 mg (22/34, 65%), with the remainder starting at 20 mg (14/34, 35%). Conclusion: Paroxetine may be an effective, novel, off-label treatment for intractable and persistent cough in patients with advanced cancer. [ABSTRACT FROM AUTHOR]