Despite legal advances and the depathologization of transgender identities, transgender individuals still face significant barriers and discrimination within healthcare systems. A pervasive lack of training in gender diversity among healthcare professionals often results in uncomfortable, even hostile, clinical encounters, exacerbating physical and mental health vulnerabilities. Consequently, fear of stigma and discrimination leads many transgender people to avoid seeking care, placing their wellbeing at further risk due to delayed or foregone medical attention. To explore transgender individuals' perceptions of healthcare professionals' awareness and responsiveness to their care and support needs in the Valencian Community (Spain). We conducted a descriptive qualitative study with a phenomenological approach in the Valencian Community. Using convenience sampling, we recruited 14 participants. Data were collected between April and June 2022 via in-depth, semi-structured, open-ended interviews. The study comprised 2 sequential phases: An initial focus group session, followed by individual interviews conducted using a snowball sampling technique. We identified 3 thematic domains: T1: Experiences of professional care among transgender individuals; T2: Impact of cisgender-centric regulations within the healthcare system; T3: Gender diversity education needs for healthcare professionals. The transformation of the health system is urgent to ensure inclusive and equitable care for transgender people. According to the interviews, they consider that better training of professionals will improve their care. In addition, they highlight the need to reduce bureaucratic barriers, create specific protocols, and improve access to specialized treatment. Implementing inclusive public policies will contribute to a fairer and more accessible system.

Background/Objectives: Malnutrition is highly prevalent in patients with advanced colorectal cancer (CRC) and is associated with poorer treatment tolerance, reduced quality of life, and worse clinical outcomes. Chemotherapy regimens incorporating irinotecan are commonly used in later treatment lines but present a distinct toxicity profile characterized mainly by gastrointestinal symptoms and functional decline, which may negatively affect nutritional status. This study aimed to evaluate the impact of irinotecan-containing chemotherapy regimens on nutritional status and functional capacity in patients with advanced CRC using the Patient-Generated Subjective Global Assessment (PG-SGA). Methods: A cross-sectional observational study was conducted in 91 adult patients with histologically confirmed stage III–IV colorectal adenocarcinoma undergoing active systemic chemotherapy between November 2023 and June 2024. Demographic and clinical variables, treatment regimens, and exposure to irinotecan were recorded. Nutritional status was assessed using the PG-SGA, and body composition was evaluated by multifrequency bioelectrical impedance analysis. Associations between irinotecan exposure and nutritional, functional, and symptom-related variables were analyzed using χ² or Fisher’s exact tests. Results: Thirteen patients (14.3%) received irinotecan-containing regimens, most frequently combined with FOLFOX. Patients exposed to irinotecan presented higher PG-SGA scores, indicating a greater nutritional burden. Although most gastrointestinal symptoms did not reach statistical significance, early satiety (p = 0.041) and functional deterioration (p = 0.039) were significantly associated with irinotecan administration, while nausea (p = 0.089) and vomiting (p = 0.087) showed trends toward significance. The subgroup treated with FOLFOX–irinotecan also demonstrated a higher frequency of functional impairment compared with those receiving FOLFOX alone. Conclusions: Irinotecan-containing chemotherapy regimens in advanced CRC may be associated with a distinct pattern of nutritional deterioration primarily driven by functional decline and gastrointestinal symptoms affecting food intake. Systematic nutritional assessment using validated tools such as the PG-SGA may allow early identification of vulnerable patients and support the implementation of timely multimodal interventions aimed at improving treatment tolerance and clinical outcomes.

Background: Body composition may be a relevant determinant of metabolic and functional vulnerability in patients with colorectal cancer. This study aimed to investigate the association between different therapeutic strategies and body composition parameters. Methods: An observational, analytical, cross-sectional study was conducted in adult patients with colorectal adenocarcinoma undergoing active oncological management at Hospital Universitario de Badajoz, Spain, consecutively recruited between February 1, 2024, and June 20, 2024. Nutritional status was assessed using the Patient-Generated Subjective Global Assessment (PG-SGA), and body composition was evaluated by multifrequency bioelectrical impedance analysis (BIA). Fat mass, fat-free mass, skeletal muscle mass, bone mass, protein mass, total body water, visceral fat, and basal metabolic rate were assessed. Patients were stratified according to treatment modality: surgery alone, FOREST protocol, neoadjuvant chemotherapy, adjuvant chemotherapy, and combined neoadjuvant-adjuvant chemotherapy. Between-group differences were assessed using one-way ANOVA, with additional Kruskal-Wallis tests performed as nonparametric sensitivity analyses for departures from normality. Statistical significance was set at p<0.05. Results: A total of 91 patients were included, with a mean age of 64.97±9.92 years; 56 (61.5%) were men. Significant differences between treatment modalities were observed in bone mass (p=0.023), protein mass (p=0.002), skeletal muscle mass (p=0.022), fat-free mass (p=0.022), and basal metabolic rate (p=0.039). Patients receiving adjuvant chemotherapy alone exhibited the lowest values for protein mass, skeletal muscle mass, fat-free mass, and basal metabolic rate, whereas those receiving combined neoadjuvant-adjuvant chemotherapy showed the highest values. No significant differences were observed in the remaining body composition parameters. Conclusions: Body composition parameters differed across therapeutic groups, particularly in parameters related to skeletal muscle mass and physiological reserve. These findings support incorporating body composition assessment into comprehensive clinical and nutritional evaluation. However, the cross-sectional design precludes determining whether the observed differences reflect treatment-related changes or pre-existing differences between therapeutic groups. In particular, the higher muscle-related values observed in the combined neoadjuvant-adjuvant group should not be interpreted as evidence of preservation or improvement of physiological reserve. Prospective longitudinal studies are warranted to determine changes in body composition over the course of treatment and their relationship with treatment-related toxicity and clinical outcomes.

Background/Objectives: Malnutrition is highly prevalent in patients with advanced colorectal cancer (CRC) and is associated with poorer treatment tolerance, reduced quality of life, and worse clinical outcomes. Chemotherapy regimens incorporating irinotecan are commonly used in later treatment lines but present a distinct toxicity profile characterized mainly by gastrointestinal symptoms and functional decline, which may negatively affect nutritional status. This study aimed to evaluate the impact of irinotecan-containing chemotherapy regimens on nutritional status and functional capacity in patients with advanced CRC using the Patient-Generated Subjective Global Assessment (PG-SGA). Methods: A cross-sectional observational study was conducted in 91 adult patients with histologically confirmed stage III–IV colorectal adenocarcinoma undergoing active systemic chemotherapy between November 2023 and June 2024. Demographic and clinical variables, treatment regimens, and exposure to irinotecan were recorded. Nutritional status was assessed using the PG-SGA, and body composition was evaluated by multifrequency bioelectrical impedance analysis. Associations between irinotecan exposure and nutritional, functional, and symptom-related variables were analyzed using χ² or Fisher’s exact tests. Results: Thirteen patients (14.3%) received irinotecan-containing regimens, most frequently combined with FOLFOX. Patients exposed to irinotecan presented higher PG-SGA scores, indicating a greater nutritional burden. Although most gastrointestinal symptoms did not reach statistical significance, early satiety (p = 0.041) and functional deterioration (p = 0.039) were significantly associated with irinotecan administration, while nausea (p = 0.089) and vomiting (p = 0.087) showed trends toward significance. The subgroup treated with FOLFOX–irinotecan also demonstrated a higher frequency of functional impairment compared with those receiving FOLFOX alone. Conclusions: Irinotecan-containing chemotherapy regimens in advanced CRC are associated with a distinct pattern of nutritional deterioration primarily driven by functional decline and gastrointestinal symptoms affecting food intake. Systematic nutritional assessment using validated tools such as the PG-SGA may allow early identification of vulnerable patients and support the implementation of timely multimodal interventions aimed at improving treatment tolerance and clinical outcomes.

Background/Objectives: Colorectal cancer and its chemotherapeutic treatment may be associated with gastrointestinal toxicity and nutritional deterioration. This study evaluated the association between exposure to 5-fluorouracil (5-FU) or capecitabine and eating-related symptoms and nutritional status. Methods: We conducted an observational, cross-sectional study of 91 patients with colorectal cancer receiving active chemotherapy. Clinical, anthropometric, and treatment-related variables were collected. Nutritional status was assessed using the Patient-Generated Subjective Global Assessment (PG-SGA), and body composition was evaluated by multifrequency bioelectrical impedance analysis. Associations between exposure to 5-FU or capecitabine and symptomatic and nutritional variables were analyzed. Results: Ninety valid observations were available for the pharmacological analysis. Loss of appetite was more frequent among patients treated with 5-FU than among those not exposed to 5-FU (31.6% vs. 11.5%; p = 0.006), as was nausea (26.3% vs. 5.8%; p = 0.037). Among patients treated with capecitabine, diarrhea was less frequent than among those not exposed to capecitabine (23.5% vs. 51.3%; p = 0.048). Conclusions: Exposure to 5-FU and capecitabine was associated with distinct symptom profiles that may be clinically relevant to nutritional status. Multidimensional nutritional assessment using the PG-SGA may facilitate the early identification of nutritional risk during chemotherapy. However, the observational and cross-sectional design precludes causal inference; therefore, these findings require confirmation in prospective, longitudinal studies.