Patients' Experiences of a Sarcoma Diagnosis: A Process Mapping Exercise of Diagnostic Pathways

Factors Affecting Psychosocial Distress in Adolescents and Young Adults with Cancer: BRIGHTLIGHT Cross-Sectional and Longitudinal Cohort Study Results

BACKGROUND/OBJECTIVES

AYAs face unique psychosocial challenges compared to younger children and older adults. Little published data exists about symptoms of psychological distress in AYAs, particularly in large cohorts over time. This study aimed to (1) explore relationships between distress and variables known to impact mental health, (2) examine distress over time, and (3) consult with a patient and public involvement group (Young Advisory Panel, YAP) to contextualize the results.

METHODS

Secondary data analyses were conducted from a multicentre longitudinal cohort study, which recruited 830 participants aged 13-24 years newly diagnosed with different cancers. The mean age was 20.1 (SD 3.3) and 45% were female. Bespoke surveys, including a validated measure of psychosocial distress, were administered five times over 3 years following diagnosis. Participatory workshops were conducted with the YAP to gather their impressions of the study results and inform conclusions.

RESULTS

At the first time point, higher social support was associated with higher distress scores (β = 0.202, p < 0.001) and AYAs with higher depressive symptoms were more likely to see a mental health professional (p < 0.01). Over time, anxiety symptoms remained stable (p = 0.090); however, depressive symptoms improved (p < 0.001). The YAP highlighted the mixed effects of social support and the under-recognition and undertreatment of distress.

CONCLUSIONS

This information identifies key targets, such as social support, that can inform the design of personalized screening and intervention tools. It also highlights specific timepoints at which these efforts can be directed to mitigate distress and improve quality of life. Future research should include longer-term follow-up, qualitative explorations of distress along the disease trajectory, and ongoing co-production efforts.

Diagnostic work-up of an incidental ultra-rare tumour, epithelioid haemangioendothelioma, in a Danish diagnostic centre

In this case report we present a woman in her late 40s with dual clinical presentation. First, the patient presented to general practice with muscular symptoms over months, including pain and a palpable mass in her right leg. Then acute cerebral symptoms appeared that required emergency hospitalisation. MRI scan of the head, chest X-ray, upper-body 18F-FDG-PET/CT and CT scan were indicative of both a benign meningioma and malignant lung metastases. Subsequent diagnostic work-up at our diagnostic centre led to the final diagnosis; epithelioid haemangioendothelioma, with the primary site in the right leg and lung metastases, an ultra-rare type of cancer.

Nomenclature of the symptoms of head and neck cancer: a systematic scoping review

Introduction

Evolution of a patient-reported symptom-based risk stratification system to redesign the suspected head and neck cancer (HNC) referral pathway (EVEREST-HN) will use a broad and open approach to the nomenclature and symptomatology. It aims to capture and utilise the patient reported symptoms in a modern way to identify patients' clinical problems more effectively and risk stratify the patient.

Method

The review followed the PRISMA checklist for scoping reviews. A search strategy was carried out using Medline, Embase and Web of Science between January 1st 2012 and October 31st 2023. All titles, abstracts and full paper were screened for eligibility, papers were assessed for inclusion using predetermined criteria. Data was extracted pertaining to the aims, type of study, cancer type, numbers of patients included and symptoms, presenting complaints or signs and symptoms.

Results

There were 9,331 publications identified in the searches, following title screening 350 abstracts were reviewed for inclusion and 120 were considered for eligibility for the review. 48 publications met the eligibility criteria and were included in the final review. Data from almost 11,000 HNC patients was included. Twenty-one of the publications were from the UK, most were retrospective examination of patient records. Data was extracted and charted according to the anatomical area of the head and neck where the symptoms are subjectively and objectively found, and presented according to lay terms for symptoms, clinical terms for symptoms and the language of objective clinical findings.

Discussion

Symptoms of HNC are common presenting complaints, interpreting these along with clinical history, examination and risk factors will inform a clinician's decision to refer as suspected cancer. UK Head and Neck specialists believe a different way of triaging the referrals is needed to assess the clinical risk of an undiagnosed HNC. EVEREST-HN aims to achieve this using the patient history of their symptoms. This review has highlighted issues in terms of what is considered a symptom, a presenting complaint and a clinical finding or sign.

Current challenges and practical aspects of molecular pathology for bone and soft tissue tumors

This review shows the extraordinary change molecular pathology has induced in the classification, diagnosis, and clinical practice of molecular pathologists dealing with sarcomas. We have primarily focused on the practical aspects of molecular studies and the current and mid-term challenges for our subspecialty, ending with ten tips for the next generation of sarcoma molecular pathologists.