Objective Chronic pain is one of the most detrimental symptoms exhibited by cancer patients, being an indication for opioid therapy in up to half of the patients’ receiving chemotherapy and in 90% of advanced cases. Various successful non-pharmacological integrative therapy options have been explored and implemented to improve the quality of life in these patients. This review aims to highlight the mechanisms implicated; assessment tools used for cancer pain and summarize current evidence on non-pharmacological approaches in the treatment of chronic cancer pain. Data sources A review of the literature was conducted using a combination of MeSH keywords including “Chronic cancer pain,” “Assessment,” “Non-pharmacological management,” and “Integrative therapy.” Data summary Data on the approach and assessment of chronic cancer pain as well as non-pharmacological integrative options have been displayed with the help of figures and tables. Of note, non-pharmacological integrative management was divided into three subcategories; physical therapy (involving exercise, acupuncture, massage, and transcutaneous electric nerve stimulation), psychosocial therapy (e.g. mindful practices, supportive therapy), and herbal supplementation. Conclusions The use of non-pharmacological integrative therapy in the management of chronic cancer pain has been grossly underestimated and must be considered before or as an adjuvant of other treatment regimens to ensure appropriate care.

Background The association between heart failure (HF) patients and the incidence of cancer is not well understood, with conflicting results to date. Objective The aim of this meta-analysis was to evaluate whether patients with HF have a higher risk of developing cancer. Material and Methods We performed a systematic literature search using PubMed, Embase, and Scopus for relevant articles from inception until 10th December 2022. Primary clinical outcomes were the incidence of cancer. Secondary endpoints were the incidence of breast cancer, lung cancer, hematological cancer, colorectal cancer, and prostate cancer. Results A total of 10 articles with 7,335,834 (518,105 Heart Failure vs. 6,817,729 non-Heart Failure) patients were involved in the analysis. The mean age of the patients with HF and the non-HF group was 70.0 and 69.2 years. The median follow-up duration was 5.1 years. The most common Comorbidity among both groups includes DM (27.67% vs. 14.53%) and HTN (81.88% vs. 57.5%). Patients with HF were associated with a significant increase in the incidence of cancer, [HR, 1.43 (95%CI: 1.22-1.68), P<0.001], breast cancer [HR, 1.28 (95%CI: 1.09-1.50), P<0.00], lung cancer [HR, 1.89 (95%CI: 1.25-2.85), P<0.001), hematological cancer [HR, 1.63 (95%CI: 1.15-2.33), P=0.01), colorectal cancer [HR, 1.32 (95%CI: 1.11-1.57), P<0.001) compared with patients without HF. However, the incidence of prostate cancer was comparable between both groups [HR, 0.97 (95%CI: 0.66-1.43), p=0.88]. Conclusion This meta-analysis confirms that the state of heart failure is associated with a higher risk for incident cancer. These data may aid in raising awareness with physicians that cancer may develop in patients with prevalent heart failure and that early screening and evaluation may be useful in an early diagnosis of cancer.

Background: Egypt as part of the Eastern Mediterranean region is facing a growing HIV epidemic. Developments in the National HIV Program are associated with an increase in survival of HIV-positive persons. This study aimed to assess health-related quality of life (HRQOL) of healthy children/adolescents of HIV-positive parents compared with healthy children/adolescents of healthy HIV-negative parents. Participants and Methods: A cross-sectional comparative study was conducted. Healthy children aged 3-17 years old of all HIV-positive parents registered in the national HIV treatment center in Alexandria Fever Hospital during the year 2016 were enrolled (n=33) and compared with a comparable group of children of healthy parents (n=33). The HRQOL of studied groups was assessed by interviewing parents using Kinder Lebensqualität Fragebogen questionnaire revised parents' version. Results: Among the HIV-positive persons, 54.5% of their children had poor to fair HRQOL compared with only 9.1% of children of healthy parent group. They had significantly lower HRQOL scores in ; the physical, mental, family, and friends domains (P<0.05). Adolescents of HIV-positive parents had significantly lower HRQOL score compared with children (P=0.028). Parents' education was the only independent predictor of daughter/son's HRQOL (b=13.073, P=0.014). Conclusion: HIV-positive status of parents negatively affects the HRQOL of their children. Development of organized social and mental support services to families with HIV-affected member/s within the Egyptian National HIV program is highly recommended with specific focus on adolescents and children, especially those having lower educated parents.

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