Emerging digital technologies in cancer treatment, prevention, and control

Transforming women's health, empowerment, and gender equality with digital health: evidence-based policy and practice

We evaluated the effects of digital health technologies (DHTs) on women's health, empowerment, and gender equality, using the scoping review method. Following a search across five databases and grey literature, we analysed 80 studies published up to Aug 18, 2023. The thematic appraisal and quantitative analysis found that DHTs positively affect women's access to health-care services, self-care, and tailored self-monitoring enabling the acquisition of health-related interventions. Use of these technologies is beneficial across various medical fields, including gynaecology, endocrinology, and psychiatry. DHTs also improve women's empowerment and gender equality by facilitating skills acquisition, health education, and social interaction, while allowing cost-effective health services. Overall, DHTs contribute to better health outcomes for women and support the UN Sustainable Development Goals by improving access to health care and financial literacy.

Patient and Provider Perspectives of a Web-Based Intervention to Support Symptom Management After Radioactive Iodine Treatment for Differentiated Thyroid Cancer: Qualitative Study

Background

Patients diagnosed with differentiated thyroid cancer (DTC) who receive radioactive iodine (RAI) treatment experience acute, medium, and late treatment effects. The timing and severity of these effects vary by individual; common posttreatment effects include dry mouth, salivary gland swelling, dry eyes, and nose bleeds. The nature of symptoms that patients experience after RAI treatment can significantly and negatively impact health-related quality of life. Adequate information during the postprimary treatment phase remains an unmet need among the population of patients diagnosed with DTC.

Objective

This qualitative study aimed to identify and understand self-management strategies for RAI-specific symptom burden from the perspectives of patients and stakeholders (cancer care providers and patient advocates). An additional aim included assessing features and functionalities desirable in the development of a web-based intervention to engage patients in their self-management and thyroid cancer survivorship care.

Methods

Following the Social Cognitive Theory framework and person-based principles, we conducted six focus groups with 22 patients diagnosed with DTC who completed RAI treatment and individual interviews with 12 stakeholders in DTC care. The interviews focused on participants' perspectives on current self-management strategies and mockups of a symptom management web-based intervention. Before focus groups and interviews, participants completed a demographics survey. Focus group discussions and interviews were transcribed and coded using content analysis. Interrater reliability was satisfactory (ɑ=.88).

Results

A total of 34 individuals (patients and stakeholders) participated in the study; the mean age was 45 (SD 13.4) and 45.3 (SD 13) years, respectively. Three domains emerged from qualitative interviews: (1) difficult-to-manage RAI symptoms: short, medium, and late treatment effects; (2) key intervention structure and content feedback on mockups; and (3) intervention content to promote RAI symptom management and survivorship care. Focus group participants identified the most prevalent RAI symptoms that were difficult to manage as: dry mouth (11/22, 50%), salivary gland swelling (8/22, 36%), and changes in taste (12/22, 55%). Feedback elicited from both groups found education and symptom management mockup videos to be helpful in patient self-management of RAI symptoms, whereas patients and stakeholders provided mixed feedback on the benefits of a draft frequently asked questions page. Across focus groups and stakeholder interviews, nutrition-based symptom management strategies, communication with family members, and practical survivorship follow-up information emerged as helpful content to include in a future web-based supportive care intervention.

Conclusions

Results suggest education and symptom management videos can empower patients with DTC to self-manage mild to moderate RAI symptoms on a web-based platform. Findings emphasized the need for additional information for patients related to ongoing care following RAI treatment including social support and thyroid cancer surveillance. The findings provide insights for theoretically informed interventions and recommendations for refinements in thyroid cancer survivorship from patient and provider perspectives.

Digital Health Technology & Cancer Care: Conceptual Framework Leading Comprehensive Fruitfulness

Digital technologies are now integral to daily life. However, their applications for the health of populations remain largely untapped. Increasing cancer incidence, and it being the leading cause of death in every country in the world, justifies the need for increasing healthcare. Digital health technology is a promising field. Digital health means different things to different people. Thus, the need for a concrete, distinctive, comprehensive action plan. Conceptual frameworks represent ways of thinking about a problem and how complex things work. We elaborate on the latest evidence with examples for the role of Digital Health Technology (DHT) as a comprehensive multi-faceted 'Conceptual Framework -5Ps' comprising: (i) DHT for Proper assessment: right from history taking to digital biopsies. (ii) DHT for Pertinent treatment: including genomic data analysis for precision treatment. Artificial Intelligence-based digital pathology approaches are practical and are increasingly improving selective cancer treatments. Digital self-management interventions improve symptom outcomes in adult cancer patients. Digital health can help cancer patients gain more autonomy, self-acceptance, and personal growth. (iii) DHT for Progress monitoring: comprehensively and remotely. The concept "hospital at home" feasible with DHT. (iv) DHT for Prevention applications: reaching all rewardingly. (v) DHT for Professional standards: education excellence. Proficiency is desirable when using DHTs fast-advancing applications. Doctors may not have the information they need to use a given DHT. General Medical Council, UK, and Medical Council India have been proactive in technology training. Regulations & ethics rigour are required energetically. All new technologies must meet the same bar for clinical evidence as other clinical interventions. Digital Health Academy is required to meet the highest standards, energizing and ensuring excellence. In the current state of healthcare and growing demands, good developments in DHT seem the solution. A conceptual framework is a good start for generous success. We hope our work progresses mindsets, practices, and policies majorly.

Investigation and analysis of the status of cancer health popularization in China, 2023

BACKGROUND

Cancer presents a significant public health challenge in China, necessitating broad collaboration across society. The Chinese government has articulated a goal to increase the overall five-year survival rate for cancer by 15% by 2030. Achieving this objective requires not only advances in medical technology, but also an improvement in the dissemination of knowledge pertaining to cancer prevention and treatment.

AIM

To provide a comprehensive understanding of the status of cancer prevention and level of popularization in China in 2023.

METHODS

From January 2023 to May 2023, online questionnaires were distributed to 3000 participants, including medical personnel, patients with cancer, their families, and the general public. There were 2711 valid responses, covering the entire nation.

RESULTS

A total of 1020 medical personnel and 1691 patients with cancer, their family members, and the general public participated in the survey. Among medical personnel, 93.2% had popularized cancer health. Commonly addressed topics included cancer prevention (85.9%) and cancer screening (77.8%). Primary challenges included time constraints (73.9%), insufficient personnel and material support (66.7%), and uncertainty as to where to begin (49.3%). Among patients with cancer, their family members, and the general public, 93.4% reported reading or watching cancer science popularization materials and 56.9% expressed a desire for deeper understanding. The most sought-after topics in cancer science popularization included cancer screening (80.2%) and cancer prevention (75.8%). The greatest challenge encountered in accessing cancer health popularization was an abundance of misinformation (67.5%).

CONCLUSION

Most clinical doctors, patients, family, and the general public wish to participate in cancer education. However, improvement in the quality of content in cancer prevention and treatment education is required.

Increasing Colorectal Cancer Screening Among Black Men in Virginia: Development of an mHealth Intervention

BACKGROUND

In the United States, colorectal cancer (CRC) is the third leading cause of cancer death among Black men. Compared to men of all other races or ethnicities, Black men have the lowest rates of CRC screening participation, which contributes to later-stage diagnoses and greater mortality. Despite CRC screening being a critical component of early detection and increased survival, few interventions have been tailored for Black men.

OBJECTIVE

This study aims to report on the multistep process used to translate formative research including prior experiences implementing a national CRC education program, community advisory, and preliminary survey results into a culturally tailored mobile health (mHealth) intervention.

METHODS

A theoretically and empirically informed translational science public health intervention was developed using the Behavioral Design Thinking approach. Data to inform how content should be tailored were collected from the empirical literature and a community advisory board of Black men (n=7) and reinforced by the preliminary results of 98 survey respondents.

RESULTS

A community advisory board identified changes for delivery that were private, self-paced, and easily accessible and content that addressed medical mistrust, access delays for referrals and appointments, lack of local information, misinformation, and the role of families. Empirical literature and survey results identified the need for local health clinic involvement as critical to screening uptake, leading to a partnership with local Federally Qualified Health Centers to connect participants directly to clinical care. Men surveyed (n=98) who live or work in the study area were an average of 59 (SD 7.9) years old and held high levels of mistrust of health care institutions. In the last 12 months, 25% (24/98) of them did not see a doctor and 16.3% (16/98) of them did not have a regular doctor. Regarding CRC, 27% (26/98) and 38% (37/98) of them had never had a colonoscopy or blood stool test, respectively.

CONCLUSIONS

Working with a third-party developer, a prototype mHealth app that is downloadable, optimized for iPhone and Android users, and uses familiar sharing, video, and text messaging modalities was created. Guided by our results, we created 4 short videos (1:30-2 min) including a survivor vignette, animated videos about CRC and the type of screening tests, and a message from a community clinic partner. Men also receive tailored feedback and direct navigation to local Federally Qualified Health Center partners including via school-based family clinics. These content and delivery elements of the mHealth intervention were the direct result of the multipronged, theoretically informed approach to translate an existing but generalized CRC knowledge-based intervention into a digital, self-paced, tailored intervention with links to local community clinics.

TRIAL REGISTRATION

ClinicalTrials.gov NCT05980182; https://clinicaltrials.gov/study/NCT05980182.

Determinants of the implementation of eHealth-based long-term follow-up care for young cancer survivors: a qualitative study

BACKGROUND

eHealth may help closing gaps in the long-term follow-up care of former young age cancer patients. While its introduction to medical aftercare appears promising, it also faces obstacles in the course of its implementation. This study explored what prospective eHealth applications have to achieve and what facilitating and hindering factors are associated with the implementation of them.

METHODS

A qualitative, explorative-descriptive design involving semi-structured interviews was used in this study. General practitioners (GPs) from urban and rural areas as well as former cancer patients were recruited and interviewed. The interview guide focused on expectations of telemedical care services for the patient group of children and adolescents as well as potential facilitating and hindering factors of the implementation of telemedical care services for former cancer patients. Interviews were recorded, transcribed and analyzed on the basis of qualitative content analysis as described by Kuckartz.

RESULTS

Empiric saturation was reached after 25 interviews, respectively. The age of the physicians surveyed at the time of the interviews ranged from 27 to 71 years, with an average of 42 years. The former patients ranged in age from 21 to 43 at the time of participation, with an average age of 34. The age at diagnosis ranged from 3 to 31 years. eHealth services were considered an effective way to maintain continuity of care and improve the health literacy of cancer survivors. Cooperation with health insurance companies and gamification-elements were regarded as beneficial for the introduction of eHealth structures. Poor interface compatibility, insufficient network coverage and lack of digital literacy were valued as potential barriers.

CONCLUSIONS

If properly introduced, eHealth shows the potential to provide stakeholders with tools that increase their self-efficacy and ability to act. As the technology continues to advance, our data provides application-oriented factors for tailored implementation strategies to bring eHealth into the field.

Design and evaluation of a colon cancer mobile application

BACKGROUND

Colorectal cancer (CRC) is the third leading cause of cancer and the second cause of cancer-related deaths in the world. Despite the infrastructure and the availability of organized screening programs, participation in their screening programs is less than the set goals. Considering the importance of informing the society about the prevention and early detection of colorectal cancer symptoms and the positive impact of mobile health technologies, the present research was conducted with the aim of designing and evaluating a colon cancer mobile application.

METHODS

The present research was conducted in two phases: software design and evaluation. In the first phase, the software was prepared using the cascade method. First, all the educational content related to colorectal cancer was collected through an expert panel with the participation of 10 specialists. Then the software was evaluated with alpha and beta testing, and the initial version was approved by users in terms of simplicity and usability. In the second phase, a parallel clinical randomized trial study was conducted with the aim of investigating the effect of a colon cancer mobile application on the early detection of colorectal cancer. In this stage, 204 volunteers participated; inclusion criteria were age 18-85 years, owning a smartphone and the ability to read and write. Participants were randomized into control and intervention groups. The intervention group was educated with the colon cancer application for education about colorectal cancer, and the control group was educated with a pamphlet. After education, both groups were screened for colorectal cancer symptoms, and the results were compared.

RESULTS

In the software evaluation phase, the application was used by 204 users. In this stage, 84 (41.2%) women and 120 (58.8%) men, with an average (Standard Deviation) age of 47.53 (13.68) participated. Participants were randomized in two groups, 103 people with an average (Standard Deviation) age of 47.62 (14.65) in intervention group and 101 people with an average (Standard Deviation) age of 47.44 (12.70) in control group. There were no significant differences between the demographic characteristics of age, gender, marriage, occupation, instruction level, digestive disease history, cancer history, cancer risk factors, and family history of cancer between the two groups (P > 0.05). The Mann-Whitney U test indicated that there is a significant difference between the two groups of participants in self-assessment, willingness to do the screening, and the results of the assessment of colorectal cancer (P < 0.05).

CONCLUSION

The results of the research indicated the positive impact of the Colon Cancer Application on the abilities of the users of self-assessment of colon cancer. Therefore, based on the findings, it can be concluded that the use of the colon cancer mobile application is effective for colon cancer prevention and self-care.

TRIAL REGISTRATION

This study was registered in the Iranian Registry of Clinical Trials ( https://irct.behdasht.gov.ir ) on 13/2/2024, with the IRCT ID: IRCT20210131050189N9.

Implementation of Health IT for Cancer Screening in US Primary Care: Scoping Review

BACKGROUND

A substantial percentage of the US population is not up to date on guideline-recommended cancer screenings. Identifying interventions that effectively improve screening rates would enhance the delivery of such screening. Interventions involving health IT (HIT) show promise, but much remains unknown about how HIT is optimized to support cancer screening in primary care.

OBJECTIVE

This scoping review aims to identify (1) HIT-based interventions that effectively support guideline concordance in breast, cervical, and colorectal cancer screening provision and follow-up in the primary care setting and (2) barriers or facilitators to the implementation of effective HIT in this setting.

METHODS

Following scoping review guidelines, we searched MEDLINE, CINAHL Plus, Web of Science, and IEEE Xplore databases for US-based studies from 2015 to 2021 that featured HIT targeting breast, colorectal, and cervical cancer screening in primary care. Studies were dual screened using a review criteria checklist. Data extraction was guided by the following implementation science frameworks: the Reach, Effectiveness, Adoption, Implementation, and Maintenance framework; the Expert Recommendations for Implementing Change taxonomy; and implementation strategy reporting domains. It was also guided by the Integrated Technology Implementation Model that incorporates theories of both implementation science and technology adoption. Reporting was guided by PRISMA-ScR (Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews).

RESULTS

A total of 101 studies met the inclusion criteria. Most studies (85/101, 84.2%) involved electronic health record-based HIT interventions. The most common HIT function was clinical decision support, primarily used for panel management or at the point of care. Most studies related to HIT targeting colorectal cancer screening (83/101, 82.2%), followed by studies related to breast cancer screening (28/101, 27.7%), and cervical cancer screening (19/101, 18.8%). Improvements in cancer screening were associated with HIT-based interventions in most studies (36/54, 67% of colorectal cancer-relevant studies; 9/14, 64% of breast cancer-relevant studies; and 7/10, 70% of cervical cancer-relevant studies). Most studies (79/101, 78.2%) reported on the reach of certain interventions, while 17.8% (18/101) of the included studies reported on the adoption or maintenance. Reported barriers and facilitators to HIT adoption primarily related to inner context factors of primary care settings (eg, staffing and organizational policies that support or hinder HIT adoption). Implementation strategies for HIT adoption were reported in 23.8% (24/101) of the included studies.

CONCLUSIONS

There are substantial evidence gaps regarding the effectiveness of HIT-based interventions, especially those targeting guideline-concordant breast and colorectal cancer screening in primary care. Even less is known about how to enhance the adoption of technologies that have been proven effective in supporting breast, colorectal, or cervical cancer screening. Research is needed to ensure that the potential benefits of effective HIT-based interventions equitably reach diverse primary care populations.

Quality assessment of mobile applications on postpartum hemorrhage management

OBJECTIVE

To assess mobile application quality on the management of postpartum hemorrhage available in the digital stores of the main operating systems.

METHOD

A descriptive evaluative study, carried out from January to February 2023 on the App Store® and Google Play Store®. The Mobile Application Rating Scale was used to assess quality (engagement, functionality, aesthetics, information and subjective quality). Information extraction and assessment on postpartum hemorrhage was carried out using a table with information based on official documents, containing stratification, prevention, diagnosis and treatment.

RESULTS

Seven applications were included; of these, three were in English, six had an Android operating system. The quality mean was 3.88. The highest means were for functionality, reaching 5.0 (n = 6), and the lowest were for engagement, less than 3.0 (n = 4). The majority of applications presented less than 50% of the information on postpartum hemorrhage management.

CONCLUSION

The applications assessed achieved an acceptable quality mean and, according to health organizations' current protocols, did not contain the necessary information for complete postpartum hemorrhage management.

Development and Promotion of an mHealth App for Adolescents Based on the European Code Against Cancer: Retrospective Cohort Study

BACKGROUND

Mobile health technologies, underpinned by scientific evidence and ethical standards, exhibit considerable promise and potential in actively engaging consumers and patients while also assisting health care providers in delivering cancer prevention and care services. The WASABY mobile app was conceived as an innovative, evidence-based mobile health tool aimed at disseminating age-appropriate messages from the European Code Against Cancer (ECAC) to adolescents across Europe.

OBJECTIVE

This study aims to assess the outcomes of the design, development, and promotion of the WASABY app through a 3-pronged evaluation framework that encompasses data on social media promotion, app store traffic, and user engagement.

METHODS

The WASABY app's content, cocreated with cancer-focused civil society organizations across 6 European countries, drew upon scientific evidence from the ECAC. The app's 10 modules were designed using the health belief model and a gamification conceptual framework characterized by spaced repetition learning techniques, refined through 2 rounds of testing. To evaluate the effectiveness of the app, we conducted a retrospective cohort study using the WASABY app's user database registered from February 4 to June 30, 2021, using a 3-pronged assessment framework: social media promotion, app store traffic, and user engagement. Descriptive statistics and association analyses explored the relationship between sociodemographic variables and user performance analytics.

RESULTS

After extensive promotion on various social media platforms and subsequent traffic to the Apple App and Google Play stores, a sample of 748 users aged between 14 and 19 years was included in the study cohort. The selected sample exhibited a mean age of 16.08 (SD 1.28) years and was characterized by a predominant representation of female users (499/748, 66.7%). Most app users identified themselves as nonsmokers (689/748, 92.1%), reported either no or infrequent alcohol consumption (432/748, 57.8% and 250/748, 33.4%, respectively), and indicated being physically active for 1 to 5 hours per week (505/748, 67.5%). In aggregate, the app's content garnered substantial interest, as evidenced by 40.8% (305/748) of users visiting each of the 10 individual modules. Notably, sex and smoking habits emerged as predictors of app completion rates; specifically, male and smoking users demonstrated a decreased likelihood of successfully completing the app's content (odds ratio 0.878, 95% CI 0.809-0.954 and odds ratio 0.835, 95% CI 0.735-0.949, respectively).

CONCLUSIONS

The development and promotion of the WASABY app presents a valuable case study, illustrating the effective dissemination of evidence-based recommendations on cancer prevention within the ECAC through an innovative mobile app aimed at European adolescents. The data derived from this study provide insightful findings for the implementation of Europe's Beating Cancer Plan, particularly the creation of the EU Mobile App for Cancer Prevention.

Enhancing head and neck tumor management with artificial intelligence: Integration and perspectives

Head and neck tumors (HNTs) constitute a multifaceted ensemble of pathologies that primarily involve regions such as the oral cavity, pharynx, and nasal cavity. The intricate anatomical structure of these regions poses considerable challenges to efficacious treatment strategies. Despite the availability of myriad treatment modalities, the overall therapeutic efficacy for HNTs continues to remain subdued. In recent years, the deployment of artificial intelligence (AI) in healthcare practices has garnered noteworthy attention. AI modalities, inclusive of machine learning (ML), neural networks (NNs), and deep learning (DL), when amalgamated into the holistic management of HNTs, promise to augment the precision, safety, and efficacy of treatment regimens. The integration of AI within HNT management is intricately intertwined with domains such as medical imaging, bioinformatics, and medical robotics. This article intends to scrutinize the cutting-edge advancements and prospective applications of AI in the realm of HNTs, elucidating AI's indispensable role in prevention, diagnosis, treatment, prognostication, research, and inter-sectoral integration. The overarching objective is to stimulate scholarly discourse and invigorate insights among medical practitioners and researchers to propel further exploration, thereby facilitating superior therapeutic alternatives for patients.

Applications of digital Medicine in oncology: Prospects and challenges

The current state of oncology medical services is not encouraging and is unable to fully meet the needs of patients with cancer. In recent years, rapidly developing artificial intelligence technology and gradual advancements in mobile phones, sensors, and wearable devices, which have made these more compact, affordable, and popular, have greatly expanded the development of digital medicine. Digital medicine refers to clinical evidence-based technology and products with a direct impact on disease management and research. Integrating digital medicine into clinical practice has the advantages of broader applicability, greater cost-effectiveness, better accessibility, and improved diagnostic and therapeutic performance. Digital medicine has emerged in different clinical application scenarios, including cancer prevention, screening, diagnosis, and treatment, as well as clinical trials. Additionally, big data generated from digital medicine can be used to improve levels of clinical diagnosis and treatment. However, digital medicine also faces many challenges, including security regulation and privacy protection, product usability, data management, and optimization of algorithms. In summary, the application and development of digital medicine in the field of cancer face numerous opportunities and challenges.

Rapid systematic review on developing web-based interventions to support people affected by cancer

OBJECTIVE

To systematically identify and explore the existing evidence to inform the development of web-based interventions to support people affected by cancer (PABC).

DESIGN

A rapid review design was employed in accordance with the guidance produced by the Cochrane Rapid Reviews Methods Group and reported using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses checklist. A rapid review was chosen due to the need for a timely evidence synthesis to underpin the subsequent development of a digital resource (Shared Lives: Cancer) as part of an ongoing funded project.

METHODS AND OUTCOMES

Keyword searches were performed in MEDLINE to identify peer-reviewed literature that reported primary data on the development of web-based interventions designed to support PABC. The review included peer-reviewed studies published in English with no limits set on publication date or geography. Key outcomes included any primary data that reported on the design, usability, feasibility, acceptability, functionality and user experience of web-based resource development.

RESULTS

Ten studies were identified that met the pre-specified eligibility criteria. All studies employed an iterative, co-design approach underpinned by either quantitative, qualitative or mixed methods. The findings were grouped into the following overarching themes: (1) exploring current evidence, guidelines and theory, (2) identifying user needs and preferences and (3) evaluating the usability, feasibility and acceptability of resources. Resources should be informed by the experiences of a wide range of end-users taking into consideration current guidelines and theory early in the design process. Resource design and content should be developed around the user's needs and preferences and evaluated through usability, feasibility or acceptability testing using quantitative, qualitative or mixed methods.

CONCLUSION

The findings of this rapid review provide novel methodological insights into the approaches used to design web-based interventions to support PABC. Our findings have the potential to inform and guide researchers when considering the development of future digital health resources.

TRIAL REGISTRATION NUMBER

The review protocol was registered on the Open Science Framework (https://osf.io/ucvsz).

Expanding access to cancer peer support: development of a website to deliver written peer support that meets patients' individual emotional and informational needs while reducing potential harms

Cancer patients often want information from "peers" with the same diagnosis or treatment. To increase access to this valuable resource, we developed a website to deliver written peer support to cancer patients undergoing stem cell transplant. Because little evidence describes how to optimize benefits or reduce potential harms of written peer support, we gathered multiple forms of stakeholder feedback to inform the website's ethical approach, personalization, design, function, and content: a Community Advisory Board; a longitudinal study of patients' written peer support needs and motivations; focus groups; semi-structured interviews; and usability testing. Findings provide a rich foundation for website development.

Behavioral medicine, cancer control, and NCI: reflections on a fruitful past and auspicious future

Cancer prevention and control has benefited substantially from behavioral medicine research over the last several decades. The National Cancer Institute's (NCI) Division of Cancer Control and Population Sciences, ably led by Barbara Rimer and then Bob Croyle since being established in 1997, has been a primary supporter of this research. NCI has made significant investments in many of the topics featured in this special section and will continue to do so. These include research on basic behavioral processes such as affect as well as optimal approaches to health communication. A key and enduring focus has been the support of behavioral interventions, particularly for tobacco, diet, physical activity, and sun exposure. The success of such interventions will be amplified to the extent that they leverage novel research designs, emerging digital technologies, evidence gleaned from the burgeoning field of implementation science, and lessons learned from greater attention to the impact of health disparities and inequities. Moreover, as the cancer survivor population continues to grow given the rapid development of diagnostic and therapeutic science, it will be even more essential to devote attention to understanding and addressing the health care and other needs of survivors such as cognitive dysfunction and financial toxicity. The field of behavioral medicine should be both applauded for its many contributions to reducing the cancer burden and encouraged to continue developing new research ideas in these critical areas.