Objective COVID-19 vaccines have shown efficacy and safety in healthy people. However, cancer patients under active immunosuppressive treatment were not included in the clinical trials conducted to test vaccines' efficacy and safety. This study aimed to evaluate the COVID-19 vaccine acceptance in cancer patients undergoing immunosuppressive therapy. Methods A total of 200 adult cancer patients received a questionnaire between March 8 and April 2, 2021, before the beginning of cancer patients' vaccination in Portugal. The questionnaire adapted from previously conducted studies included 11 close-ended items, evaluating variables such as patient sociodemographic and clinical characteristics, and the acceptance and underlying reasons to be or not to be vaccinated. The primary outcome was the intended acceptance of the COVID-19 vaccine in cancer patients. Multiple logistic regression was performed to identify factors associated with intended acceptance. Results Among the 200 delivered questionnaires, only 169 were included in this study. From those, 142 (84%) patients intended to be vaccinated against COVID-19. Only 27 participants (16%) had not yet decided or were reluctant to COVID-19 vaccination. High school degree (odds ratio (OR) 0.133, 95% confidence interval (C.I.) 0.031-0.579, p = 0.007], rural residence (OR 0.282, 95% C.I. 0.081-0.984, p = 0.047), and reluctance in believing in the vaccine efficacy (OR 0.058, 95% C.I. 0.016-0.204, p < 0.001] were identified predictors factor for COVID-19 vaccine hesitancy. Conclusion Most patients intended to be vaccinated against COVID-19, and specific factors such as education level, rural residence and the belief in vaccine efficacy were related to vaccine acceptance.

Background: Cancer p represent a high-risk population for severe COVID-19. Cancerassociated immunosuppression may hinder in the development of anti-SARS-CoV-2 antibodies.

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Conclusions:The majority of prostate cancer patients reported at least mild anxiety and mild depression. In this analysis of real-world evidence, cancer stage, PSA at diagnosis, treatments, and side-effects, were among the factors affecting patients in several ways. The multiple determinants of emotional wellbeing of prostate cancer patients warrant more research and offer the opportunity for personalised interventions.

Cervical carcinosarcoma is a very rare tumour, with less than 70 cases described in the literature. We report a case of a woman in her 60s, with an atypical presentation: a single episode of high volume serous vaginal discharge. A carcinosarcoma of the uterine cervix was diagnosed and, after exclusion of distant disease, the patient was submitted to radical surgery. Due to surgical complications adjuvant treatment was not performed.

Objective: To evaluate the prevalence of psychiatric disorders in a sample of Portuguese patients with metastatic breast cancer and assess the relationship between these disorders and the characteristics of the oncological disease.Methods: Cross-sectional, single-center study with female patients diagnosed with metastatic breast carcinoma and under palliative treatment between November 2020 and May 2021. Psychiatric disorders were screened by applying and filling-out the MMSE, HADS, BSI, and WHOQoL-Bref instruments at the outpatient daycare unit when patients were present for treatmen. Results: A total of 91 female patients were included, median age 59.79 years. None of the patients had cognitive impairment (MMSE). HADS scale: 18.7% of the patients scored for anxiety and 17.6% for depression. The anxiety subscale score of > 8 (HADS) was related to ovarian function suppression (p<0.001), neoadjuvant therapy (p<0.001), and type of second-line of palliative treatment (p=0.024). The depression subscale score >8 (HADS) was related to the type of surgery performed (p= 0.022), molecular subtype of the tumor (p=0.020), and occurrence of grade 3-4 toxicities in the first (p=0.018), and third-line treatments (p=0.031).Conclusion: The screening of psychiatric disorders through the application of these scales by the medical oncology team may be able to aid in diagnosis and potentially lead to psychiatric referral and intervention at an earlier stage.

Background: This study assessed the efficacy of immersive virtual reality (VR) as an adjunct in the management of treatment-related anxiety and depression among breast cancer outpatients undergoing chemotherapy at the University of the Philippines -Philippine General Hospital Cancer Institute. Methods:In this open-label phase II randomized control trial, participants were randomly assigned into two groups during their first cycle of chemotherapy e the intervention group who were subjected to immersive VR experience using VR Box 3D goggle sets plus standard-of-care and the control group who received standard-ofcare only. Anxiety and depression scores of at-risk breast cancer patients were measured using the Hospital Anxiety and Depression Scale -Pilipino (HADS-P) questionnaire before and after chemotherapy. The influence of clinico-demographic factors on the mean difference of HADS-P scores was explored. Pre-and postchemotherapy blood pressures, heart rates, and respiratory rates were also determined. Results:The investigators were able to screen 114 patients and 65.8% (n¼75) had a HADS-P score of 11. The proportion of patients who were at-risk to develop treatment-related anxiety and depression was 73.5% (n¼50) and 22.1% (n¼15), respectively. A total of 68 patients were included in the randomization. Statistically significant mean differences of j-2.71j and j-4.74j (p<0.05) in the pre-and postchemotherapy HADS-P scores between the control group and intervention group were reported. Changes in mean arterial pressures, heart rates, and respiratory rates pre-and post-chemotherapy were not statistically significant.Conclusions: In this study, the investigators observed that immersive VR could potentially decrease the level of treatment-related anxiety and depression of at-risk breast cancer outpatients undergoing chemotherapy.

IntroductionCancer patients on active treatment are at increased risk of developing coronavirus disease 2019 , making effective immunization of the utmost importance. However, the effectiveness of vaccination in this population is still unclear. This study aims to evaluate the response against COVID-19 in a cohort of patients with active cancer under immunosuppressive therapy. MethodsThis was a prospective, cross-sectional, single-center study that included patients with cancer under immunosuppressive therapy vaccinated against COVID-19 between April and September 2021. Exclusion criteria were: previous known severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection, single-dose vaccine or incomplete vaccination scheme. Immunoglobulin G (IgG) anti-SARS-CoV-2 antibody levels were assessed using 35.2 binding antibody units (BAU)/mL as the positive cut-off. Assessments were performed 14-31 days after the first and second dose and three months after the second dose. ResultsA total of 103 patients were included. The median age was 60 years. Most patients were being treated for gastrointestinal cancer (n=38, 36.9%), breast cancer (n=33, 32%) or head and neck cancer (n=18, 17.5%). At evaluation, 72 patients (69.9%) were being treated with palliative intent. The majority were being treated with chemotherapy (CT) alone (57.3%). At the first assessment, levels of circulating SARS-CoV-2 IgG consistent with seroconversion were present in 49 patients (47.6%). At the time of the second assessment, 91% (n=100) achieved seroconversion. Three months after the second dose, 83% (n=70) maintained levels of circulating SARS-CoV-2 IgG consistent with seroconversion. In this study, no SARS-CoV-2 infection was reported in the study population. ConclusionsOur findings suggest that this group of patients had a satisfactory COVID-19 immunization response. Although promising, this study should be replicated on a wider scale in order to validate these findings.