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Medical Complications and Supportive Care in Patients with Cancer (2nd Edition)

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A special issue of Cancers (ISSN 2072-6694). This special issue belongs to the section "Cancer Survivorship and Quality of Life".

Deadline for manuscript submissions: 31 December 2025 | Viewed by 7917

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Dr. Javier Marco-Hernández

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Department of Internal Medicine, Supportive and Palliative Care Unit in Cancer, Hospital Clinic, Villarroel 170, 08036 Barcelona, Spain
Interests: cancer; oncological emergencies; supportive care; autoimmune diseases; infectious diseases; critical care; vasculitis; immunotherapy; immune-related adverse events
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Special Issue Information

Dear Colleagues,

This Special Issue is the second edition of the previous one, entitled "Medical Complications and Supportive Care in Patients with Cancer" (https://www.mdpi.com/journal/cancers/special_issues/U18OO3N5CE).

The prevalence of cancer is increasing due to the aging population, early diagnosis and the therapeutic novelties that have appeared in recent years (targeted therapies or different modalities of immunotherapy, among others) and have led to improvements in the survival of patients with oncological diseases. However, this has also caused an increase in the complexity in the management of these patients, who present classic complications of cancer (oncological emergencies, thromboembolic disease or infectious diseases) but also pose new challenges for the professionals who provide them with medical care (new treatment toxicities such as immune-related adverse events, the adverse effects of CAR-T cell therapies or the need for intensive care). In addition, other challenges arise in parallel: older patients may be candidates for oncologic treatment (oncogeriatrics), and the palliative needs of patients are becoming more complex and require specialized attention.

For all these reasons, we believe that this Special Issue will be of great interest to professionals who work with cancer patients and strive to provide the best care for those experiencing medical complications of cancer and receiving supportive or palliative care. Papers related to these areas are welcome to be submitted to this Special Issue, whether they are about oncological emergencies, infectious diseases in cancer patients, treatment toxicities, immune-related adverse events, supportive care, palliative care or thromboembolic disease, among others.

Dr. Javier Marco-Hernández
Guest Editor

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Cancers is an international peer-reviewed open access semimonthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2900 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

cancer
oncological emergencies
immune-related adverse events
immunotherapy
supportive care
palliative care
infectious diseases
thromboembolic disease
treatment
toxicities
CAR-T cell therapy

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Published Papers (8 papers)

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Research

14 pages, 1131 KB

Open AccessArticle

Evaluating the Impact of Index Metastasis Resection in Patients with Multiple Brain Metastases

by Maria Goldberg, Luisa Mona Kraus, Cvetina Vatcheva, Denise Bernhardt, Stephanie E. Combs, Chiara Negwer, Bernhard Meyer and Arthur Wagner

Cancers 2025, 17(20), 3281; https://doi.org/10.3390/cancers17203281 - 10 Oct 2025

Viewed by 179

Abstract

Background: The impact of surgical resection on the survival and functional outcomes of patients with multiple brain metastases remains a critical question in neuro-oncology. Methods: This retrospective study involved 160 patients who underwent surgical resection of brain metastases from 2017 to 2020. Patients were classified by the number of metastases—single, oligometastatic, or multiple—and whether complete removal of the main symptomatic lesion was achieved. Outcomes such as survival rates, complications, and functional status were assessed. Results: Among the patients, 48.1% had a single metastasis, 21.9% were oligometastatic, and 30% had multiple metastases. Survival did not differ by number of metastases when the main lesion was completely resected and remaining lesions were radiated (p = 0.6172). Complete resection increased mean survival to 15.74 months compared with 4.5 months without it. Additionally, patients who underwent complete resection experienced fewer seizures (16.2% vs. 32.6%, p = 0.019), implying a lower seizure risk. Functional independence was maintained post-surgery. Conclusions: While multiple brain metastases are generally associated with poor outcomes, a trend toward longer survival was observed after complete resection of the index metastasis, though this was not statistically significant. Radiation of residual lesions remains important to support prognosis. Reducing the tumor volume is key to lowering seizure risk. This study supports the role of aggressive surgical interventions, paired with radiation, to potentially enhance outcomes in patients with multiple brain metastases. Full article

(This article belongs to the Special Issue Medical Complications and Supportive Care in Patients with Cancer (2nd Edition))

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12 pages, 685 KB

Open AccessArticle

The Role of Perceived Benefits in Buffering Gastrointestinal-Symptom Burden Among Post-Operative Colorectal Cancer Patients: A Six-Month Longitudinal Study

by Ming-Wei Chang, Ashley Wei-Ting Wang and Cheng-Shyong Chang

Cancers 2025, 17(17), 2934; https://doi.org/10.3390/cancers17172934 - 8 Sep 2025

Viewed by 531

Abstract

Objectives: The goal of this longitudinal study was to explore how gastrointestinal-symptom distress and benefit finding together influence health-related quality of life (HRQOL) over time in colorectal cancer (CRC) survivors. Colorectal cancer (CRC) survivorship may differ from other cancer types due to the persistent burden of gastrointestinal symptoms. The highly visible and socially sensitive nature of these sequelae may influence the trajectory of benefit finding compared with other cancers. Specifically, we explored whether increases in symptom distress predicted declines in physical and mental HRQOL whether benefit finding was directly related to or buffered the negative impact of symptom distress on HRQOL. Methods: Participants were 73 Taiwanese women and men who underwent surgery for CRC. Using a three-time-point, multilevel framework, participants were assessed at 1, 3, and 6 months after surgery. Hierarchical linear modeling was used to investigate whether gastrointestinal-symptom distress and benefit finding covary over time with HRQOL. Results: The results indicated that increases in gastrointestinal-symptom distress were linked to declines in both physical and mental HRQOL. Benefit finding had no direct association with HRQOL but significantly moderated the symptom-HRQOL relationship, weakening the negative impact of symptom distress among those with higher benefit finding. Conclusions: Rises in a CRC survivor’s gastrointestinal-symptom distress went hand-in-hand with drops in both physical and mental HRQOL. This study adds to the literature in that benefit finding has a favorable effect on cancer adjustment when patients face higher symptom distress after the surgery and treatment. Further implications on possible mechanisms were discussed. Full article

(This article belongs to the Special Issue Medical Complications and Supportive Care in Patients with Cancer (2nd Edition))

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12 pages, 425 KB

Open AccessArticle

Adaptation and Implementation of Self-System Therapy for Older Adults with Advanced Lung Cancer: Pilot Trial Results

by Katherine Ramos, Aliza Ayaz, Jennie Riley, Kaylee Faircloth, Laura S. Porter and Timothy J. Strauman

Cancers 2025, 17(17), 2809; https://doi.org/10.3390/cancers17172809 - 28 Aug 2025

Viewed by 573

Abstract

Background/Objectives: Advanced lung cancer is a highly distressing disease that negatively impacts older adults. Supportive care interventions designed for this population are scarce and often inaccessible due to competing demands and transportation access. We adapted and refined an evidence-based treatment, Self-System Therapy (SST), to address the unmet needs of older adults with advanced cancer. Methods: Guided by principles of implementation science, we conducted patient interviews, focus groups, and user testing to refine our new SST for the lung cancer (SST-LC) protocol. We then conducted a single-arm pilot trial (clinicaltrials.gov NCT04057196) for patients aged 65+ and above with Stage III or IV lung cancer (N = 30). Benchmarks for acceptability, feasibility, and preliminary changes in outcome measures were assessed. Results: Our study met the desired recruitment goals and demonstrated high treatment adherence rates (89%) and satisfaction rates (85%), indicating that SST-LC was feasible and well-received. Participants also showed reductions in distress and depression, and improvements in emotional and functional well-being from baseline to post-intervention, with effects mostly maintained at follow-up. Physical well-being, social well-being, and quality of life showed smaller, non-significant changes. Feedback from participants also suggested that SST enhanced their resilience and ability to cope with cancer-related challenges, but also indicated a preference for fewer sessions. Conclusions: SST for older adults living with advanced lung cancer is feasible and acceptable. Moreover, this supportive care intervention shows promise in addressing psychological distress, emotional well-being, and functional well-being in older adults. Future research will include testing the efficacy of SST in a larger randomized controlled trial. Full article

(This article belongs to the Special Issue Medical Complications and Supportive Care in Patients with Cancer (2nd Edition))

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11 pages, 214 KB

Open AccessArticle

Ifosfamide-Induced Encephalopathy in Children and Young Adults: The MD Anderson Cancer Center Experience

by Shaikha Alqahtani, Sabrina D. Bitar, Maria Estela Mireles, Fernando F. Corrales-Medina, Cynthia E. Herzog, John Slopis and Najat C. Daw

Cancers 2025, 17(13), 2192; https://doi.org/10.3390/cancers17132192 - 29 Jun 2025

Cited by 1 | Viewed by 1524

Abstract

Background: Ifosfamide, an alkylating agent used for treating various cancers, can cause encephalopathy in 10–30% of adults and 8% of children. Methylene blue has been used to treat ifosfamide-induced encephalopathy (IIE). This study aimed to describe our institutional experience with IIE in children and young adults with cancer, including its clinical manifestations, treatment, and outcomes. Methods: We reviewed the clinical records of patients with cancer aged up to 30 years who developed IIE over 10 years. Results: Twenty-four patients (median age: 17.6 years, range: 4–30 years) were included; 54% were male, and 71% had bone/soft tissue sarcomas. Ifosfamide was administered alone or with other drugs (dose range: 1.5–3.3 g/m²/day). Twelve patients developed IIE after short intermittent infusions (1–3 h), and twelve developed it after continuous infusions (12–24 h). IIE occurred at a median cumulative ifosfamide dose of 18 g/m². Symptoms appeared within hours to five days and resolved within 24–120 h. An altered mental status was present in all except one patient. Twelve patients had grade 3 IIE (severe somnolence, agitation, and confusion), and five had grade 4 IIE (coma and seizures). Twenty patients (83%) received methylene blue, with symptom resolution in nineteen patients (83%). Imaging studies showed nonspecific findings. Ten patients were re-challenged with ifosfamide; five received prophylactic methylene blue treatment, of whom three had recurrence. Conclusions: IIE can occur with both short intermittent and continuous ifosfamide infusions and presents as an altered mental status, seizures, and, rarely, hemiparesis. Symptoms are transient, and methylene blue may help alleviate this neurotoxicity, but it does not completely prevent its recurrence. Full article

(This article belongs to the Special Issue Medical Complications and Supportive Care in Patients with Cancer (2nd Edition))

10 pages, 839 KB

Open AccessArticle

Atrial Fibrillation Risk in Relation to the Clinical Staging of Gastric Cancer: A Nationwide Population-Based Cohort Study

by Mi Jin Oh, Yoon Jin Choi, Jin-Hyung Jung, Seunghan Lee, Kyungdo Han and Soo-Jeong Cho

Cancers 2025, 17(12), 2054; https://doi.org/10.3390/cancers17122054 - 19 Jun 2025

Viewed by 638

Abstract

Background/Objectives: Patients with gastric cancer (GC) have an elevated risk of atrial fibrillation (AF) and cardiovascular mortality, compared with the general population. However, the effect of the cancer stage on the development of AF remains unclear. This study aimed to evaluate the relationship between the risk of AF and GC stage based on the Surveillance, Epidemiology, and End Results (SEER) stage classifications. Methods: This retrospective population-based cohort study enrolled patients diagnosed with GC between 2012 and 2019, using anonymized data from the Cancer Public Library Database of South Korea. Patients were followed up until 2020. The risk of AF was assessed in relation to the SEER stage of GC (localized, regional, distant) using adjusted hazard ratios (aHRs) with 95% confidence intervals (CIs). Subgroup analyses were performed according to age, sex, year of diagnosis, and comorbidities. Results: Of the 211,500 patients enrolled in this study, 7266 were diagnosed with AF during follow-up. The risk of AF increased progressively with cancer stage, with aHRs of 2.00 (95% CI 1.81–2.22) for the distant stage and 1.32 (95% 1.25–1.41) for the regional stage, compared with the localized stage. Subgroup analyses showed a consistent association between advanced cancer stage and a higher AF risk; the association was stronger in the younger, female, and non-hypertensive subgroups. Conclusions: The risk of AF in patients with GC is associated with the initial stage, highlighting the need for the closer monitoring and management of AF to improve the survival of patients with advanced-stage GC. Full article

(This article belongs to the Special Issue Medical Complications and Supportive Care in Patients with Cancer (2nd Edition))

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12 pages, 586 KB

Open AccessArticle

A Prognostic Symptom Model Incorporating Patient-Reported Symptoms for Transplant-Ineligible Patients with Multiple Myeloma

by Amaris K. Balitsky, Rinku Sutradhar, Hsien Seow, Anastasia Gayowsky, Alissa Visram, Jason Tay, Irwindeep Sandhu and Hira Mian

Cancers 2025, 17(3), 489; https://doi.org/10.3390/cancers17030489 - 1 Feb 2025

Viewed by 1088

Abstract

Introduction: Patients with transplant-ineligible (TIE) multiple myeloma (MM) have high rates of symptom burden. The aim of this study was to develop and validate a prognostic model to predict symptoms in patients with TIE MM. Methods: In this population-based, retrospective cohort study, using multiple administrative health care databases linked using a unique encrypted patient identifier in Ontario, Canada, symptoms were identified using the patient self-reported Edmonton Symptom Assessment System (ESAS) at each clinic visit. The primary outcome was the presence of moderate-to-severe (ESAS score 4–10) symptoms (specifically symptoms of pain, tiredness, depression, and impaired well-being) within one year from the index date. Using the entire cohort, a multivariable logistic regression model with baseline covariates was developed to predict the risk of experiencing each of the above symptoms, categorized as moderate to severe within 1 year post-index date. Internal validation of the model was assessed via bootstrap validation methods. Results: A total of 1535 TIE adults with MM met the inclusion criteria. The median age was 75, with 25.2% of patients aged 80 years or older. In the multivariate analysis, baseline symptoms continued to be most associated with future symptom burden. Baseline severe pain (OR 9.84, 95% CI 6.29–15.7) was most associated with patients experiencing moderate–severe pain one year post-index date. Similarly, baseline severe tiredness (OR 17.34, 95% CI 9.00–33.42), baseline severe depression (OR 28.07, 95% CI 15.96–49.38), and baseline severely impaired well-being (OR 4.12, 95% CI 2.30–7.37) were the biggest predictors of patients experiencing moderate–severe tiredness, depression, and impaired well-being, respectively, at one year after the index date. Conclusions: Patients with MM experience persisting symptoms of pain, tiredness, depression, and impaired well-being, with baseline symptoms being the biggest predictor of future symptom burden. Full article

(This article belongs to the Special Issue Medical Complications and Supportive Care in Patients with Cancer (2nd Edition))

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11 pages, 718 KB

Open AccessArticle

High Rate of Thromboembolic Events in the Last Year of Life of Cancer Patients: A Registry Study

by Peter Strang and Torbjörn Schultz

Cancers 2024, 16(23), 4031; https://doi.org/10.3390/cancers16234031 - 1 Dec 2024

Cited by 1 | Viewed by 1272

Abstract

Background/Objectives: Venous thromboembolism (VTE) is associated with cancer, but we wanted to show VTE data for the last year of life, adjusting for age, sex, socioeconomic status and comorbidities. We also wanted to study the possible increase in VTE month by month, as well as time trends from 2015 to 2023. Methods: A cohort of 27,423 deceased people with cancer were analyzed with t-tests, chi-square tests and binary logistic regression models. Results: In total, 13.6% had at least one VTE episode during the last year of life and the VTE rate increased month by month (p < 0.0001). In adjusted models, higher VTE rates were associated with younger age and being a woman (p < 0.0001), both for all VTE as well as separately for pulmonary embolism (PE). The VTE rate increased by 47% from 11.1% in 2015 to 16.3% in 2023, and with significant differences for the pre-COVID-19 and COVID-19 years (i.e., 2015–2019 compared to 2020–2023, p < 0.0001). Conclusions: VTE is common in the last year of life and increases month by month. Higher frequencies are associated with female sex but especially with being younger, or having certain cancer forms such as pancreatic, gynecologic or lung cancer. The rate of VTE increased from 2015 to 2023. This is of interest as VTE has been associated with higher treatment intensity and with poorer prognosis and should be considered in the decision-making process. Full article

(This article belongs to the Special Issue Medical Complications and Supportive Care in Patients with Cancer (2nd Edition))

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11 pages, 899 KB

Open AccessArticle

Decrease in Primary Caregivers’ Quality of Life During the Care of a Relative with Palliative Care Needs: A Prospective Longitudinal Study

by Rodica Sorina Pop, Bianca Olivia Cojan Minzat, Cristina Paula Ursu, Ștefan Ursu and Aida Puia

Cancers 2024, 16(21), 3570; https://doi.org/10.3390/cancers16213570 - 23 Oct 2024

Viewed by 1394

Abstract

Background/Objectives: The quality of life is a complex concept that is insufficiently assessed in clinical practice. It is influenced by different factors, as follows: the individual’s characteristics, personal values and beliefs, physical and mental state, and relationship to other members of their community. The quality of life of the primary caregiver influences their health and the quality of their care interventions. This study aims to investigate how the quality of life of caregivers changes during palliative patients’ care. Methods: This is a prospective longitudinal study that assesses the different aspects of the quality of life of primary caregivers who care for patients with palliative needs. The tool used in this study was the Medical Outcomes Scale-Short Form 36 (MOS-SF36). Results: This study included 140 caregivers, of which 63 were involved in the care of patients with cancer and 77 were involved in the care of patients with non-oncological diseases. Almost 9 out of 10 caregivers were a family member of the patient and over two-thirds of these were women. The caregivers of patients with non-malignant diseases had a decreased quality of life in the following aspects: limitations in their usual role due to emotional problems, social functioning, energy, and their perception of their general health. In the group of oncological patients, the caregivers displayed limitations in their daily role due to physical health, emotional problems, and social functioning. Conclusions: The large number of responsibilities, the long time spent caring, and the uncertainty about the evolution of the disease as well as the marginalization and lack of time for oneself are some of the elements that increase caregiver burden. Along with this, the quality of life of caregivers decreases significantly in different aspects, such as physical, psycho-emotional, and social, with the perception of deteriorating general health. Full article

(This article belongs to the Special Issue Medical Complications and Supportive Care in Patients with Cancer (2nd Edition))

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