Cancer Research and Treatment

Original Articles

Palliative medicine

Exploring Oncologists’ Perspectives on the Early Integration of Specialty Palliative Care in Korea: Challenges, Needs, and Clinical Implications: Shin Hye Yoo, Yu Jung Kim, Ye Sul Jeung, Jung Sun Kim, Kwonoh Park, Eun Mi Nam, Si Won Lee, Jun Ho Ji, Jwa Hoon Kim, Joon Young Hur, Song Ee Park, Jung Lim Lee, Su-Jin Koh; Cancer Res Treat. 2026;58(1):339-348. Published online April 10, 2025; DOI: https://doi.org/10.4143/crt.2025.158

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Purpose
This study aimed to explore the practices, perceptions, and barriers related to specialty palliative care (SPC) referrals among oncologists in Korea, highlighting the clinical implications of early integration.
Materials and Methods
A cross-sectional online survey targeting board-certified hemato-oncology specialists was conducted between August 1-25, 2024. The survey assessed referral practices, attitudes toward early SPC integration, referral criteria, barriers, and institutional characteristics.
Results
A total of 227 oncologists participated (response rate, 36.7%). Among them, 68.7% reported frequent SPC referrals, with higher referral rates observed among younger physicians, those in tertiary hospitals, and institutions with in-house SPC teams (p < 0.001). Although 74.9% supported early SPC integration, referrals were often inconsistently timed, frequently occurring after disease progression or at the discontinuation of chemotherapy. For time-based referrals, the most commonly endorsed triggers were disease progression despite palliative second-line treatment and a prognosis of expected mortality within 6-12 months. Need-based referral triggers such as patient or family requests (96.5%), psychological distress (89.9%), or uncontrolled symptoms (83.3%), were also widely endorsed. The major barriers to early SPC integration included patient and family resistance (70.0%) and limited availability of SPC teams (34.4%).
Conclusion
This study emphasizes the importance of systematic efforts to promote timely SPC integration in Korea, including education to raise patient awareness, improved referral systems, and enhanced infrastructure. The positive attitudes toward early SPC among oncologists reflect a growing recognition of its value, highlighting the need for strategies that align with international standards.

Citations

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Intensivists’ Perspectives and Practices on Palliative Care in the ICU: A Nationwide Survey in Korea
Tae Jung Kim, Yoon Sun Jung, Ye Sul Jeung, Woo Hyun Cho, Shin Hye Yoo, Jae Young Moon
Journal of Korean Medical Science.2026;[Epub] CrossRef
Improving Quality of End-of-Life Care Through the K-HOPE Consultative Palliative Care Model: A Prospective Study in a Tertiary Hospital
Yoo Jeong Lee, In Cheol Hwang, Eun Jeong Lee, Soon-Young Hwang, Youn Seon Choi
Current Oncology.2026; 33(4): 213. CrossRef
Association between the timing of palliative care consultation and end-of-life outcomes in patients with cancer
Jung Sun Kim, Wan Taek Lee, Bhumsuk Keam, Jin-Ah Sim, Shin Hye Yoo
Supportive Care in Cancer.2026;[Epub] CrossRef

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General

Associations of Financial Toxicity with Employment Concerns and Cancer-Related Distress: A Cross-Sectional Survey among Korean Working-Age Cancer Survivors: Hyun-Ju Seo, Dal-Lae Jin, Young Ae Kim, Su Jung Lee, Seok-Jun Yoon; Cancer Res Treat. 2025;57(3):659-668. Published online December 3, 2024; DOI: https://doi.org/10.4143/crt.2024.090

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Purpose
Although South Korea’s health insurance has a co-payment-decreasing policy for cancer survivors, information on the extent of financial toxicity and its related factors is limited. We assessed the level of financial toxicity and the association of high levels of financial toxicity with employment concerns after diagnosis and cancer-related distress in working-age cancer survivors.
Materials and Methods
A cross-sectional study was conducted. Study participants were recruited from the National Cancer Survivorship Center between November and December 2022. Financial burden was assessed using the Korean version of the Comprehensive Score for Financial Toxicity, and cancer-related distress was measured using the National Comprehensive Cancer Network Distress Thermometer. Multivariate logistic regression analyses were used to explore the associations between high financial toxicity, cancer-related distress, and changes in employment status after cancer diagnosis.
Results
Of 1,403 working-age cancer survivors, approximately 62% reported high levels of financial distress. Survivors reporting early retirement and taking time off work with the intent to return were more likely to report high financial toxicity (adjusted odds ratio [OR], 1.69; 95% confidence interval [CI], 1.14 to 2.5; and adjusted OR, 2.82; 95% CI, 1.24 to 6.43, respectively) than those with a full-time or part-time job. Moreover, cancer survivors with high distress levels were more likely to report high financial toxicity than those with low distress levels (adjusted OR, 4.36; 95% CI, 3.17 to 5.99).
Conclusion
High financial toxicity is associated with adverse employment concerns and cancer-related distress among working-age cancer survivors. Therefore, developing cancer survivorship interventions within the healthcare system is necessary to ensure improvements in financial well-being.

Citations

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Effect of early integration of supportive care in addition to standard care in patients with breast cancer: A randomised controlled trial
Himanshu Varshney, Prateek Maurya, Nishkarsh Gupta, Atul Batra, Ajay Gogia, Brajesh Kumar Ratre, Sachidanand Jee Bharati, Vinod Kumar, Rakesh Garg, Rajiv Kumar Malhotra, Seema Mishra, Sushma Bhatnagar
Supportive Care in Cancer.2026;[Epub] CrossRef
Complementary and alternative medicine use among elderly cancer patients: a cross-sectional study in South Korea
Hyunyem Chang, Soo Jeung Choi, Hyea Bin Im, Dain Choi, Dongwoon Han
Frontiers in Oncology.2026;[Epub] CrossRef
Chronic Disease and Future Perceptions of Financial Control
Victoria H. Davis, Guanghao Zhang, Minal R. Patel
Medical Care.2025; 63(5): 353. CrossRef
Disparities in the Diagnosis and Treatment of Breast Cancer Among People With Disabilities
Hea Lim Choi, Jin-Hyung Jung, Hwa-Young Lee, Kyungdo Han, Dong Wook Shin
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Raymond Javan Chan, Reegan Knowles, Carolyn Taylor, Nirmala Bhoo Pathy, Ke Yu, Karolina Lisy, Julia Lai-Kwon, Miyako Tsuchiya, Yan Lou, Wendy Lam, Michael Jefford
The Lancet Regional Health - Western Pacific.2025; 65: 101749. CrossRef
Direct and Indirect Costs of Cancer in Adult Population of Poland in the Period 2021–2023
Izabela Gąska, Aleksandra Czerw, Monika Pajewska, Olga Partyka, Dorota Charkiewicz, Andrzej Deptała, Anna Badowska-Kozakiewicz, Katarzyna Sygit, Ireneusz Dziubek, Paulina Wojtyła-Buciora, Jarosław Drobnik, Piotr Pobrotyn, Dorota Waśko-Czopnik, Tomasz Sowi
Cancers.2025; 17(23): 3725. CrossRef

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6 Crossref

Palliative medicine

A National Study of Life-Sustaining Treatments in South Korea: What Factors Affect Decision-Making?: So-Youn Park, Bomyee Lee, Jeong Yeon Seon, In-Hwan Oh; Cancer Res Treat. 2021;53(2):593-600. Published online November 21, 2020; DOI: https://doi.org/10.4143/crt.2020.803

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Purpose
This cross-sectional study investigated the status of life-sustaining treatment (LST) practices and identified characteristics and factors influencing decision-making practices.
Materials and Methods
The National Agency for Management of Life-sustaining Treatment retains records provided by doctors regarding patients subject to LST implementation. A total of 71,327 patients receiving LST were identified. We analyzed all nationally reported data between February 2018 and October 2019. Indicators such as the proportion of deaths, records for decision to terminate LST, implementation of LST records, and registration of Advance Statements on LST were analyzed.
Results
A total of 67,252 (94.3%) end-of life decisions were implemented in South Korea. The proportion of deaths preceded by a LST plan, non-self-determination LST decision, and any advance statements was 33.5% (23,891/71,327), 66.5% (47,436/71,327), and 1.2% (890/71,327), respectively. The logistic regression model revealed that self-determination to terminate LST was more frequent for men than for women and higher for those aged 30-69. Disability (odds ratio [OR], 0.59; 95% confidence interval [CI], 0.56 to 0.61), living in non-metropolitan areas (OR, 0.84; 95% CI, 0.81 to 0.86), and disease comorbidity was independently associated with a low level of self-determination.
Conclusion
After the implementation of the new LST Act, about a third of patients in end-of-life process made decisions regarding their medical LST. However, family members still play a major role in LST decisions where the patient’s intention cannot be verified. Decisions related to LST are predominantly made when death is imminent. Thus, it is necessary to increase awareness of end-of-life LST decision-making among medical staff and the public.

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Junho Seong, Hye-in Chung, Jin-Heon Jeong, Jung Hwa Seo, Dae-Hyun Kim, Yong-Hwan Cho, Jae Hyung Choi, Jae-Kwan Cha
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Songwu Luo, Dongje Cho, Jaehyun Cho
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Hyo Jin Lee, Kwonhyung Hyung, Heemoon Park, Hyun Woo Lee, Jung-Kyu Lee, Eun Young Heo, Deog Kyeom Kim, Tae Yun Park
Journal of Palliative Medicine.2026;[Epub] CrossRef
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Yoon Jung Jang, Yun Jung Yang, Hoi Jung Koo, Hye Won Yoon, Seongbeom Uhm, Sun Young Kim, Jeong Eun Kim, Jin Won Huh, Tae Won Kim, Seyoung Seo
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Risky Lifestyle Behaviors among Gastric Cancer Survivors Compared with Matched Non-cancer Controls: Results from Baseline Result of Community Based Cohort Study: Minkyung Kim, Kui Son Choi, Mina Suh, Jae Kwan Jun, Kumban Walter Chuck, Boyoung Park; Cancer Res Treat. 2018;50(3):738-747. Published online July 24, 2017; DOI: https://doi.org/10.4143/crt.2017.129

Abstract PDF PubReader ePub

Purpose
This study investigated the prevalence of smoking, drinking, and physical inactivity and the associated factors of these behaviors in gastric cancer survivors.
Materials and Methods
The baseline data from the nationwide cohort study was used. Four hundred thirty-seven gastric cancer survivors who survived ≥ 2 years from diagnosis and reported completion of treatment were matched with 4,370 controls according to age, sex, education, and household income.
Results
The prevalence rates of current smoking and drinking among gastric cancer survivors were 8.7% and 38.3%, which were significantly lower than those among matched controls (p ≤ 0.001), but the prevalence rates of physical inactivity were not significantly different (55.8% vs. 59.9%, p=0.248). In gastric cancer survivors, ≥ 5 years since cancer diagnosis and current drinking contributed to more current smoking; otherwise, age increment and femalewere associatedwith lower current smoking. Thosewith household income ≥ $2,000 and current smokers were more likely to drink and female showed less drinking. Female, currently employed state, and self-rated health status were associated with more physical inactivity.
Conclusion
Although gastric cancer survivors showed better health behaviors than controls, suggesting that the diagnosis of cancer may motivate individuals towards healthy behaviors, their current prevalence rates of smoking and drinking were still high, and more than 50% of them were physically inactive. Tailored interventions to improve their health behaviors considering associated factors for the gastric cancer survivors are necessary.

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