Brain metastases (BM) are perceived as a rare complication of prostate cancer associated with poor outcome. Due to limited published data, we conducted a literature review regarding incidence, clinical characteristics, treatment options, and outcomes of patients with prostate cancer BM. A literature analysis of the PubMed, MEDLINE, and EMBASE databases was performed for full-text published articles on patients diagnosed with BM from prostate cancer. Eligible studies included four or more patients. Twenty-seven publications were selected and analyzed. The sources of published patient cohorts were retrospective chart reviews, administrative healthcare databases, autopsy records, and case series. BM are rare, with an incidence of 1.14% across publications that mainly focus on intraparenchymal metastases. Synchronous visceral metastasis and rare histological prostate cancer subtypes are associated with an increased rate of BM. Many patients do not receive brain metastasis-directed local therapy and the median survival after BM diagnosis is poor, notably in patients with multiple BM, dural-based metastases, or leptomeningeal dissemination. Overall, prostate cancer BM are rare and associated with poor prognosis. Future research is needed to study the impact of novel prostate cancer therapeutics on BM incidence, to identify patients at risk of BM, and to characterize molecular treatment targets.

Background/Objectives: Many Canadians experience challenges navigating the healthcare system during their cancer care. Nurse navigators are uniquely positioned to support patients with their clinical expertise in oncology and patient care, but they have not been widely implemented. This study aimed to examine the impact of nurse navigators and barriers to successful implementation of a nurse navigator program. Methods: MEDLINE, EMBASE, and Web of Science databases were searched for articles examining the role of nurse navigators in cancer care. The data was extracted on study design, patient characteristics, nurse navigators’ responsibilities, outcomes, barriers to success, and recommendations for implementing nurse navigator programs. Content analysis was used to identify common themes. Results: Of 1787 articles identified, 44 articles met the inclusion criteria and underwent data extraction. Nurse navigator responsibilities included patient education, psychosocial support, clinical assessment, care coordination, patient advocacy, and improving workflows. Most studies reported significant benefits from nurse navigator programs, including patient-centered care, satisfaction with the healthcare system, reduced patient distress, healthcare provider support, and enhanced patient monitoring. Barriers included a lack of understanding of the role, overwhelmed nurse navigators, and inefficient healthcare system workflows. Recommendations for future nurse navigator programs include providing personalized support to patients, encouraging integrated healthcare teams, and permanent funding. Conclusions: Nurse navigator programs improve cancer patients’ experiences and the efficiency of cancer care delivery. Implementation necessitates integration into the healthcare team and longitudinal financial and professional support of nurse navigators.

PURPOSE: Many Natural Language Processing (NLP) methods achieve greater performance when the input text is preprocessed to remove extraneous or unnecessary text. A technique known as text segmentation can facilitate this step by isolating key sections from a document. Give that transformer models—such as Bidirectional Encoder Representations from Transformers (BERT)—have demonstrated state-of-the-art performance on many NLP tasks, it is desirable to leverage such models for segmentation. However, transformer models are typically limited to only 512 input tokens and are not well suited for lengthy documents such as cancer pathology reports. The Longformer is a modified transformer model designed to intake longer documents while retaining the positive characteristics of standard transformers. This study presents a Longformer model fine-tuned for cancer pathology report segmentation. METHODS: We fine-tuned a Longformer Question-Answer (QA) model on 504 manually annotated pathology reports to isolate sections such as diagnosis, addenda, and clinical history. We compared baseline methods including regular expressions (regex) and BERT QA. However, those methods may fail to correctly identify section boundaries. Model performance was evaluated using sequence recall, precision, and F1 score. RESULTS: Final test results were obtained on a hold-out test set of 304 cancer pathology reports. We report sequence F1 scores for the following sections: diagnosis (0.77), addenda (0.48), clinical history (0.89), and overall (0.68). CONCLUSION: We present a fine-tuned Longformer model to isolate key sections from cancer pathology reports for downstream analyses. Our model performs segmentation with greater accuracy.

Dietary intake and obesity are established risk factors for cancer. The retail food environment, which comprises the settings where individuals access and purchase food, is a factor that shapes diet and body weight, prompting investigation into whether these food environmental exposures correlate with cancer risk. The aim of this scoping review was to synthesize the evidence of associations between the retail food environment and cancer, including incidence, mortality, and survival. A systematic search for relevant articles was conducted in 4 databases; Embase, Medline, Web of Science, and Scopus. Studies were included if they were published in English, examined retail food environment exposures in a high-income country, and assessed cancer, incidence, mortality, or survival in adult populations. Of 1277 articles identified in the search, 21 were included in the scoping review. Colorectal and breast cancer were the most frequently studied cancer types. All the studies originated from the United States. Of the 10 articles that examined cancer incidence, 5 reported that areas with limited access to healthy food were associated with increased cancer incidence. Similarly, of the 14 studies on cancer mortality or survival, 11 found that areas with limited access to healthy foods or high access to fast-food outlets were associated with higher mortality and/or lower survival, with statistically significant hazard ratios between 1.15 and 5.12. Associations between the food environment and cancer risk were particularly evident for obesity-related cancers. Comparisons across studies are, however, limited by the heterogeneous retail food environment exposures used, and should be replicated in other settings to understand generalizability. This scoping review highlights the potential importance of the food environment as a population-level target for cancer-prevention strategies, particularly obesity-related cancers.