Editorial: Supportive care in cancer patients: a constantly evolving field No abstract available

Fertility, sexuality and cancer in young adult women Purpose of review To provide an up-to-date overview on indications, efficacy and safety of the existing fertility preservation strategies as well as on the features and management of sexual dysfunction in young adult women with newly diagnosed cancer. Recent findings Because of the improved life expectancy of cancer survivors, a growing attention should be given to the side effects of anticancer treatments. Among young cancer patients, risk of infertility and sexual dysfunction are of great concern. Summary As advocated by guidelines, patients need to be thoroughly informed of potential side effects of treatment before starting them. On this regard, efforts should be made to improve the counseling of young adult patients around fertility and sexuality. Fertility preservation strategies should be properly and extensively explained to all young patients, weighting the pros and cons to choose the more appropriate options for each situation. In addition, discussing sexual dysfunction and delivering sexual rehabilitation for cancer survivors not only allows for renewal of sexual function but can also promote increased quality of life and help women create a new and satisfying chapter in their life for many years after cancer.

Multicultural approaches of cancer pain Purpose of review Pain continues to be a prevalent symptom in cancer patients. Patient's ethnicity may influence the experience of pain with variations in pain outcomes among different ethnic groups. The objective of this thematic review is to investigate the relationship between ethnicity and cancer pain experience, assessment and management. Recent findings Cancer pain is not only a biophysiological construct but is rather a multidimensional concept of physiological and psychosocial responses, including the biocultural dimension. Culture can significantly affect patients’ cancer pain-related beliefs and behaviors and patient's ethnicity may influence the experience of pain. We found a scarcity of data and an inconsistent literature that highlights gaps in knowledge, research and clinical practice concerning effective cancer pain management in a multicultural context. Summary To face disparities among ethnic minorities in cancer pain management, well-designed randomized controlled trials and robust qualitative research on cancer pain-related issues should inform good clinical practice. A close worldwide collaboration between researchers and clinicians and professional organizations is warranted.

Cannabinoids: a new approach for pain control? Purpose of review To analyze available data related to the use of cannabinoids in medicine, with a special focus on pain management in cancer. The use of cannabis for medical purposes is growing but there are still numerous questions to be solved: effectiveness, safety, and specific indications. Recent findings There is considerable variation between countries in the approaches taken, reflecting a variety of historical and cultural factors and despite few randomized controlled studies using natural cannabinoids, there is a trend to state that the use of cannabis should be taken seriously as a potential treatment of cancer-related pain. Cannabidiol, a nontoxic phytocannabinoid with few side-effects is promising in various indications in medicine. Summary The endocannabinoid system is a potential therapeutic target. Cannabinoids may be considered as potential adjuvant in cancer-related pain management. Cannabidiol appears to be the drug of choice. Analgesic trial designs should evolve to get closer to real-life practice and to avoid biases.

Side effects of immunotherapy: a constant challenge for oncologists Purpose of review Immunotherapeutic strategies have become the new paradigm of cancer care, through their new targeting and safety profile approach, and, de facto, their new monitoring and safety management challenges. Recent findings Generalities and specificities of the toxicity management related to immune checkpoint inhibitors (ICIs) are highlighted. Predictive factors of safety are issue of research and the challenge of prevention as well as monitoring are huge to alleviate toxicities and enhance safety and efficacy. Particular situations like steroids association and cost-effectiveness approach are summarized. Summary Patients as well as general practitioners, including health-caregivers, should be informed before ICI initiation of the different alert symptoms which should precede immune-related adverse events.

Cancer cachexia, a clinical challenge Purpose of review The aim of this article is to review the metabolic background of the cachectic syndrome and to analyze the recent therapeutic approaches designed to counteract the wasting suffered by the cancer patient with cachexia. Recent findings The main changes associated with the development of this multiorganic syndrome are glucose intolerance, fat depletion and muscle protein hypercatabolism. Among the most promising approaches for the treatment of cachexia include the use of ghrelin agonists, beta-blockers, beta-adrenergic agonists, androgen receptor agonists and antimyostatin peptides. The multitargeted approach seems essential in these treatments, which should include the combination of both nutritional support, drugs and a suitable program of physical exercise, in order to ameliorate both anorexia and the metabolic changes associated with cachexia. In addition, another very important aspect for the design of clinical trials for the treatment of cancer cachexia is to staging cancer patients in relation with the degree of cachexia, in order to start as early as possible, this triple approach in the course of the disease, even before weight loss can be detected. Summary Cancer cachexia has two main components: anorexia and metabolic alterations and both have to be taken into consideration for the treatment of the syndrome.

Photobiomodulation therapy for acute radiodermatitis Purpose of review The number of clinical trials on the use of photobiomodulation therapy (PBMT) for the management of cancer therapy-related complications is growing steadily. One of the side-effects that is under investigation is acute radiodermatitis (ARD), an inflammatory skin reaction caused by radiotherapy. In this review, an overview is given on the state of art of the application of PBMT for the prevention and management of ARD. Recent findings Up to now about seven clinical trials have been performed, investigating the use of PBMT in the prevention and/or management of ARD. Results demonstrate that PBMT can effectively reduce the incidence of severe ARD, decrease the accompanying pain, and improve the patients’ quality of life. Moreover, the technique seems to be well tolerated in oncologic patients. Summary On the basis of the available evidence, there could be a strong recommendation to use PBMT in the prevention and management of ARD in cancer patients.

Current opinion about antimicrobial therapy in palliative care: an update Purpose of review The review englobes the latest studies published regarding the problem of antimicrobial usage with palliative intent. Recent findings In the advanced stages of illness like cancer, dementia, or neurodegenerative diseases, important decisions have to be made concerning the global treatment plan. Infections are very common among this kind of patients as they typically have multiple comorbidities and are incapacitated. These infections, in a majority of the cases, will be treated with antimicrobial therapy because this is a standard medical procedure. For a health professional, the decision of whether to treat, withhold, or withdraw a treatment can be difficult. In fact, in palliative care, the challenge is to balance compassionate care for people suffering from end-of-life diseases with the need for responsible antibiotic usage. Antimicrobial treatment could alleviate symptoms from an infection and make patients more comfortable, on the other hand, its overuse of it could bring a broader public health risk. Summary On the contrary, in 18 months there are few studies about this problem, what reveals no concern about the use of antimicrobians in end-of-life patients.

Editorial: Customizing sarcoma management and treatment No abstract available