Current Issue : October-December Volume : 2025 Issue Number : 4 Articles : 5 Articles
Cervical cancer is a significant global health challenge, ranking as the fourth most common malignancy in women worldwide (age-standardized incidence: 13.3/100,000). In the UK, prevalence is markedly lower (7.6/100,000) compared to global averages, attributable to successful HPV vaccination and screening programs. post-treatment followup is critical for monitoring recurrence, managing complications, and addressing survivors’ psychosocial needs. However, follow-up care lacks standardization, especially for advanced-stage cervical cancer. This narrative review critically assesses existing guidelines, practices, and innovative approaches to follow-up care post-cervical cancer treatment, identifying inconsistencies and offering recommendations for standardization. This review synthesizes recommendations from 12 guidelines (NCCN, ASTRO, ESGO, BSCCP, BGCS, and ESMO) to evaluate follow-up strategies for cervical cancer survivors. Emerging evidence supports risk-stratified approaches combining Patient-Initiated Follow-Up (PIFU) for low-risk patients with intensive imaging (PET/CT/MRI) for advanced stages. Psychosocial interventions, particularly for sexual health and return-to-work challenges, remain underutilized despite ESGO recommendations. Follow-up recommendations vary significantly, focusing on clinical examination and symptom-based imaging. Patient-Initiated Follow- Up (PIFU) is a growing trend, though concerns persist regarding its appropriateness for high-risk groups. Most recurrences are symptomatic, supporting less-intensive protocols for low-risk patients. Imaging methods like FDG PET/CT provide prognostic insights but are not universally adopted. Psychosocial and psychosexual care needs remain under addressed. Standardized, evidence-based follow-up protocols are essential to address disparities in survivorship care. Holistic strategies incorporating psychosocial support and tailored plans will ensure comprehensive care. This is the first review to integrate NCCN imaging standards with ESGO psychosocial care in a risk-stratified model. Future research should refine PIFU models and imaging strategies to balance resource use with quality care. Critical clinical implications emerge: (1) Risk-stratified follow-up reduces unnecessary imaging by 31% (95% CI 24–38%) in low-risk patients while maintaining 98% 5-year survival; (2) mandatory psycho-oncology referrals (per ESGO guidelines) lower depression rates by 58% (OR 0.59); (3) PET/CT should be reserved for stage IIB+ patients with symptoms, saving EUR 2300 per avoided scan. These evidence-based thresholds enable personalized survivorship care....
Dihydrocapsaicin (DHC), a prominent capsaicinoid derived from red chili peppers, has shown cytotoxic effects against various cancer cell types. However, its role in modulating cytokine-induced survival and apoptotic signaling in cancer cells remains unclear. In this study, we investigated the effects of DHC on tumor necrosis factor-α (TNF-α)-induced cell cycle arrest and apoptosis in HeLa human cervical cancer cells. Our results demonstrate that DHC significantly enhances TNF-α-induced G1 phase cell cycle arrest and apoptosis by targeting the transforming growth factor-β-activated kinase 1 (TAK1)-mediated prosurvival pathways. DHC inhibited the phosphorylation of TAK1 and downstream effectors including IKKα, NF-κB p65, MAPKs (p38, JNK, ERK), Akt, and EGFR, thereby disrupting key signaling networks that typically confer resistance to TNF-α- induced cytotoxicity. Additionally, DHC suppressed the TNF-α-induced phosphorylation of EGFR at Ser-1046/1047 and Thr-669, sites critical for survival signaling. Co-treatment with DHC and TNF-α led to enhanced apoptotic features, including increased PARP-1 cleavage. These findings suggest that DHC sensitizes cervical cancer cells to cytokineinduced cell death by interfering with TAK1/NF-κB and EGFR signaling axes. Our study positions DHC as a promising candidate for combination therapies aimed at overcoming resistance in cancers with aberrant inflammatory and survival signaling....
Cancer patient navigation has emerged as a patient-centric intervention enabling equitable cancer care, by mitigating barriers patients encounter throughout their cancer journey. Cancer Care Alberta (CCA) implemented a professional navigation model over a decade ago and commissioned a program evaluation in response to evolving operational demands. The objectives were (1) to better understand the current state of CCA’s cancer patient navigation program; (2) to explore the need for other specialized streams; and (3) to provide key recommendations to strengthen and grow the program. A mixed methods approach, including a survey, administrative data, and semi-structured interviews, captured patient-, staff-, and system-level insights. Findings revealed difficulties in identifying complex patients needing navigation, along with inconsistencies regarding intake practices, program awareness, referral pathways, standardized workflows, and a lack of programmatic supports, which contributed to variability in service delivery. A need for enhanced palliative navigation support also emerged. Approximately 25% of surveyed patients reported being unable to access perceived needed support before their first oncology consultation. These findings underscore the importance of early, targeted navigation for equity-deserving populations. Recommendations include harmonizing program structure, refining navigator roles, expanding navigation streams, standardizing processes, and enhancing equity-focused competencies. These findings offer a roadmap with which to improve person-centered cancer care....
Background: Indigenous peoples nationally have seen a drastic increase in cancer diagnoses, often at later stages and with poorer survival rates than non-Indigenous Canadians. Colonization, assimilation policies, and racism within our healthcare system are contributors to these inequities. Methods: As a team, we have worked for over a decade to improve the cancer care journey of Indigenous patients in Labrador. We share learnings from a qualitative community-based project with Beneficiaries of the Labrador Inuit land claim agreement through sharing suggested improvements from participants to improve the cancer care journey. Objective: Acknowledging the diversity of Indigenous groups, we discuss suggestions as a guide and expand the discussion to provide interconnected suggestions for oncology nurses on enhancing care for their Indigenous patients. Conclusions: Oncology nurses play a crucial role in enhancing the cancer care journey for Indigenous peoples, necessitating a commitment to culturally safe environments, ongoing professional development, and advocacy for systemic changes....
Tumor cells and the tumor microenvironment (TME) produce factors, including neurotrophins, that induce axonogenesis and neurogenesis, and increase local nerve density. Proliferative growing cancer cell clusters and disseminated invasive tumor cells undergoing partial epithelial-to-mesenchymal transition (pEMT) can invade peripheral nerves. In the early stages of tumor–nerve interactions, Schwann cells (SCs) dedifferentiate, become activated and migrate to cancer cell nests; later, they induce pEMT in tumor cells and activate tumor cell migration along nerves. The SC–tumor–nerve interaction attracts myeloid-derived suppressor cells (MDSCs) and inflammatory monocytes, and the latter differentiate into macrophages. SCs and MDSCs are responsible for the activation of transforming growth factor-beta (TGF-beta) signaling. Intra-tumoral innervation is followed by perineural invasion (PNI), which has an unfavorable prognosis. What are the interventional options against PNI: local reduction in tumor nerves or inhibition of TGFbeta- related events, inhibition of downstream signaling of TGF-beta or immune activation, or intervention against immunosuppression? This systematic review is based on the Prisma 2009 search method and provides an overview of tumor–nerve interaction....
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