Alberto Garcia-Martin

Background/Objectives: Loneliness in adult cancer survivors is a frequent and disruptive psychosocial sequela with important consequences for overall health. Psychosocial interventions designed to address this issue are crucial. This systematic review and meta-analysis aimed to examine the efficacy of various psychosocial interventions for reducing loneliness in adult cancer survivors. Methods: A systematic literature search was conducted across PubMed, Web of Science, Scopus, Cochrane Library, PsycINFO, CINAHL Complete and Psicodoc for studies published up to October 2025. Methodological quality was assessed using PRISMA, RoB 2, and the PEDro Scale. The protocol was prospectively registered in PROSPERO (CRD420251174610). Results: Psychosocial interventions showed a significant and moderate effect on reducing loneliness (SMD = 0.46; 95% IC: 0.16 to 0.75). Heterogeneity was high (Q = 30.01; p-value < 0.001; I² = 70%), and exploratory analyses suggested that differences in loneliness measurement instruments may contribute to this heterogeneity. Additional benefits were observed in anxiety, depression, well-being, and quality of life. Meaning-based and cognitive-behavioral approaches were found to be most effective. A large proportion of the studies showed a high risk of bias. Conclusions: Current evidence suggests that psychosocial interventions may reduce loneliness in adult cancer survivors. However, given the high risk of bias and heterogeneity, findings should be interpreted cautiously. Standardized tools and longitudinal designs remain essential.

Background/objectives: Chemotherapy-induced peripheral neuropathy (CIPN) is a frequent toxicity of neurotoxic agents commonly used in colorectal cancer (CRC) and has limited evidence-based management options. Exercise may help, but the optimal prescription during chemotherapy remains uncertain. To evaluate the effects of an eight-week exercise program on CIPN (primary outcome), cancer-related fatigue (CRF), handgrip strength, and physical activity in CRC patients receiving chemotherapy. Methods: This pilot parallel-group randomized controlled trial screened 44 CRC patients receiving chemotherapy; 40 were randomized (1:1) to an intervention group (supervised resistance training twice weekly plus home-based aerobic exercise) or a control group (home-based physical activity program only). Outcomes were assessed at baseline and after eight weeks. NCT06404359. Results: Twenty-seven participants completed follow-up (intervention n = 15; control n = 12). Baseline characteristics were comparable. No statistically significant between-group differences were observed for CIPN, CRF, or handgrip strength. Physical activity increased significantly in the intervention group compared with controls (p < 0.001). Adherence exceeded 80%, and no exercise-related adverse events were reported. Conclusions: In this pilot trial, an eight-week program combining supervised resistance training with home-based aerobic exercise was feasible and safe and increased self-reported physical activity, but did not demonstrate statistically significant improvements in CIPN, fatigue, or strength compared with home-based aerobic exercise alone. Larger adequately powered trials are warranted.

Objective: The primary objective of this pilot randomized clinical trial was to determine the effect of adding a supervised resistance exercise programme to a home-based physical activity plan on health-related quality of life in patients with colorectal cancer undergoing active treatment. The secondary objectives were to evaluate its effects on anxiety, depression, sleep quality, and inflammatory parameters. Methods: This is a pilot randomized clinical trial with parallel groups. Patients with CRC were recruited through the Oncology Department at the Salamanca University Health Care Complex in Spain. They were randomly allocated to receive either a home-based physical activity plus a supervised resistance training programme, or the home-based physical activity plan only. The primary outcome was health-related quality of life measures and the secondary outcomes included anxiety, depression and sleep quality evaluations. The supervised training lasted 8 weeks for each patient. Results: A total of 40 patients were recruited, 20 for each group. Adding a supervised resistance exercise programme to the home-based activity plan improved symptoms related to quality of life, such as fatigue (p = 0.040) and constipation (p = 0.015). However, no significant effect was found with regard to other health-related quality of life, anxiety, depression or sleep variables. Conclusions: Fatigue and constipation in patients with CRC receiving chemo- and/or immunotherapy may benefit from the introduction of supervised resistance exercise training programmes.

La enfermedad oncológica genera limitaciones físicas que requieren cuidados continuados, siendo la ayuda a domicilio un recurso clave para garantizar la calidad de vida. La ley de Dependencia regula este servicio según el grado de dependencia, pero su aplicación es insuficiente ante la complejidad y urgencia del paciente oncológico. Este estudio descriptivo analiza a 57 pacientes del Hospital Clínico (anonimizado), en su mayoría mujeres mayores con dependencia, que en gran parte financiaron el recurso de forma privada. El coste anual fue superior a 600€ en más de la mitad de los casos. La falta de respuesta administrativa motivó esta autofinanciación, evidenciando desigualdades en el acceso y una sobrecarga en las familias cuidadoras. Estos resultados plantean la necesidad de fortalecer las políticas sociales para asegurar el derecho a cuidados adecuados en este colectivo vulnerable.

Background: Cancer is a leading cause of morbidity and mortality globally. Dyspnea, affecting up to 60% of cancer patients, exacerbates physical and psychological distress, reducing quality of life. This study aims to explore the relationship between dyspnea and factors such as age, sex, clinical diagnosis, and treatment lines in cancer patients, with the goal of improving understanding and management of this debilitating symptom to enhance patient care and quality of life. Methods: This study employed an observational, cross-sectional, and descriptive approach to investigate patients with oncological disease at the University Hospital of Salamanca between March 2021 and April 2024. A convenience sample was selected, including patients over 18 years old with a pathological diagnosis of cancer, experiencing any degree of dyspnea, and who consented to participate by signing the informed consent. Exclusion criteria included lack of consent and clinical conditions that prevented an interview. The studied variables encompass sociodemographic (age, gender, diagnosis, tumor stage, number of treatment lines) and clinical aspects (daily activities, degree of dyspnea, functional capacity, physical performance), evaluated using the Barthel Index, the mMRC Dyspnea Scale, the ECOG Scale, and the Short Physical Performance Battery (SPPB). Data were collected through semistructured interviews and medical records, and analyzed using specialized software. This research has ethical approval CEiM Code 2023 12 1472, Reference 2024/01. Results: The mean age was 66.82 years. Lung cancer was predominant (60.2%), with most patients in stage 3 (65.7%) and receiving three treatment lines (68.7%). Higher age, advanced disease stage, and more treatment lines correlated with lower Barthel and SPPB scores, and higher ECOG and mMRC scores, indicating worse functionality, physical performance, and greater dyspnea. No significant correlations were found between gender or pathological diagnosis and the studied variables. Conclusions: Advanced age, higher disease stage, and more treatment lines are associated with decreased functionality, poorer physical performance, and increased dyspnea in cancer patients. Gender and specific cancer diagnosis do not significantly affect these relationships. Addressing dyspnea is crucial to improving the quality of life and physical performance in this population. Future studies should explore additional factors like treatment types and nutritional status.

Background: Colorectal cancer is a leading cause of morbidity and mortality worldwide, with chemotherapy being a crucial treatment despite its significant side effects, such as chemotherapy-induced peripheral neuropathy (CIPN). Physical exercise has shown potential benefits in mitigating these side effects and improving patients’ overall well-being. Objective: This study aims to evaluate the efficacy of a strength exercise program in reducing CIPN in patients with colorectal cancer undergoing chemotherapy, along with secondary objectives including impacts on quality of life, body mass index, oxygen consumption, anxiety and depression, fatigue, sleep quality, and various analytical parameters. Methods: A double-blind randomized controlled trial was conducted with 44 participants, divided into an intervention group (supervised resistance training twice a week and home exercises) and a control group (home exercises only). The primary outcome measure was CIPN, assessed using the EORTC QLQ-CIPN20 questionnaire. Secondary outcomes included assessments using the EORTC QLQ-C30, the 6-minute walk test, HADS, FACT-F, and MISS, along with various blood parameters. Results and Conclusions: The study will provide insights into the effectiveness of physical exercise in managing CIPN and improving various health parameters in colorectal cancer patients. By developing tailored exercise protocols, this research aims to enhance patient quality of life, optimize treatment outcomes, and reduce the incidence of debilitating side effects, thereby supporting the integration of physical exercise into standard oncological care.

Introduction: Breast cancer is among the most frequently diagnosed cancers worldwide, with 2.3 million new cases reported annually. The condition causes a social and economic impact known as financial toxicity of cancer. The study aims to explore the extra expenses borne by patients and their families on being diagnosed with breast cancer.Methodology: An observational, descriptive, cross-sectional study was conducted. The data was collected between November 2021 and March 2022 at the Medical Oncology Service in Complejo Asistencial Universitario de Salamanca, Spain. The variables under investigation were additional economic costs, physical disability (as measured by the Barthel Index), instrumental activities of daily living (as measured by the Lawton-Brody Scale), and caregiver burden (measured using the ZARIT scale).Results: The final sample size was N = 107. The study yielded the following outcomes: the median age was 55 years old and the majority of participants were female, with a proportion of 99.1%. The incidence rates for stage I and II were 31.8 and 35.5%, respectively. The median Barthel score was 100 points, while the Lawton and Brody score were 8 points and the ECOG score was 2 points. The analysis of primary caregiver burden resulted in a median ZARIT score of 15 points. The expenses related solely to the cancer diagnosis totaled 1511.22 euros per year (316.82 euros for pharmaceuticals; 487.85 euros for orthopedic equipment; 140.19 euros for home help; and 566.36 euros for housing adaptation or transfer to a hospital). The average annual income before diagnosis was 19962.62 euros. However, after being diagnosed with breast cancer, there is a significant income decrease of 15.91%, resulting in a reduced average annual income of 16785.98 euros. Additionally, a significant correlation was found between total expenditure and the level of dependency (p = 0.032) and functional status (p = 0.045).Conclusion: These findings indicate that breast cancer patients experience a considerable economic burden, which worsens as their functional status deteriorates. Therefore, we believe policies should be implemented to help control this economic deterioration resulting from a serious health condition.

Subtle loss of functionality in healthy older adults is considered one of the most important predictors of cognitive decline. Neurocognitive interventions are increasingly being used, from a preventive maintenance approach to functional capacity. This study evaluates the effectiveness of different neurocognitive approaches on the functionality of healthy older adults. In this systematic review (CRD42023473944), an extensive search was conducted for articles published in the last 10 years (2013–2023) in the following databases: Medline, Scopus, and Web of Science. A total of 809 trials were identified, of which 18 were considered to be eligible for inclusion in the review. The data revealed heterogeneity in sample size, measures of functional assessment, neurocognitive interventions used, number of sessions, session duration, and time. Traditional cognitive stimulation is shown to have no significant functional benefit, while other less commonly used neurocognitive interventions, such as those based on everyday cognition, are associated with more significant benefits. Moreover, it is demonstrated that although the Instrumental Activities of Daily Living scale (IADL) is the most used test in similar studies, it is not sensitive enough to detect changes in functionality in healthy elderly individuals, with other tests such as the Timed Instrumental Activities of Daily Living (TIADL) being more advantageous. Therefore, a new guideline is proposed for its use in clinical practice and research, using homogeneous study protocols and neurocognitive interventions that allow for the transfer and generalization of results in daily life.