Joint Statement on World Health Organization (WHO) Global Status Report on Cancer 2026

Geneva, 23 July 2026 — Based on the evidence in WHO’s recent Global Status Report on Cancer 2026, the International Council of Nurses (ICN), International Society of Nurses in Cancer Care (ISNCC) and International Children's Palliative Care Network (ICPCN) urge leaders to invest in and protect the nursing and health workforce to urgently strengthen health systems and improve cancer outcomes across the full continuum of care.

ICN, ISNCC, ICPCN welcome the report’s clear message that the future of cancer care will not be secured through medicines and technology alone, but through the health workforces that are the backbone of care. We affirm that meeting the world’s most urgent cancer challenges depends on investing in nurses and multidisciplinary teams; addressing workforce shortages and burnout; and moving away from medicalized models towards people-centred, equitable health care across prevention, treatment, survivorship, rehabilitation and palliative services.

The scale of the challenge demands urgent action

The WHO report sets out the growing global cancer burden with stark urgency. Without urgent intervention, annual cancer diagnoses will almost double by 2050, rising to 35 million. One in five people will develop cancer in their lifetime, and around 92% of the world’s population will be affected by cancer either personally, through family members, or as caregivers.

Yet the world is off track on the health system and health workforce investments needed to meet these challenges. According to the report, only 12 countries are currently on course to meet the Sustainable Development Goal target of reducing premature cancer mortality by one third.

The report also exposes profound inequalities in cancer outcomes between and within countries. Five-year breast cancer survival is reported at 87% in high-income countries compared with 42% in many low-income countries. For childhood cancers, survival rates in high-income settings are also almost double those in many low-income settings. These

unacceptable disparities reflect unequal access to prevention, early detection, diagnostics, treatment, pain relief, rehabilitation, palliative care and skilled health professionals including nurses.

ICN, ISNCC, ICPCN warn that rising cancer burdens, global failures to meet cancer targets, and stark inequalities in survival all point to the same conclusion: governments must act now to build stronger, better staffed and more equitable health systems and bring quality care to all.

Beyond medicalized models: People-centred cancer control is a health workforce issue

The report reinforces that cancer control requires health system transformation away from disease-focused services and towards integrated, people-centred approaches that respond to the realities of patients, families and caregivers at every stage and “value care as highly as cure”.

ICN, ISNCC, ICPCN support the report’s recognition that “plans without people are not plans”: the response to cancer cannot succeed without the people who deliver it. Effective cancer prevention, treatment and care depend on skilled, supported multidisciplinary teams that include nurses at every level.

The report’s findings on cancer health workforce shortages, burnout, low retention and attrition echo what ICN and ISNCC have long warned: without sustained and immediate workforce investment, quality, safety, continuity and timely access to cancer care are at risk.

No cancer plans without nurses

ICN has long advocated for transforming health systems towards integrated, people- centred care, which requires investing in nursing education, retention and empowerment and enabling nurses to work to their full scope of practice.

ICN President José Luis Cobos Serrano said:

“The report’s title, The Future We Choose Together, is exactly right. We cannot continue to accept avoidable deaths, unequal treatment outcomes, and unacceptable working conditions for health professionals. It is time to choose a future in which cancer care is equitable, person-centred and accessible and the nursing and health workforce is fully supported and empowered.

Nurses are the largest part of the health workforce, the most trusted health professionals, and often the first, most frequent and most continuous point of contact for people affected by cancer. Across the cancer journey, they provide prevention education, vaccination, screening, early detection, treatment support, psychosocial care, rehabilitation, coordination and palliative care.

Leaders must make the choice to structurally enable nurses through funded nursing workforce plans, safe staffing, decent working conditions, and continued education and leadership roles. That is how nurses can transform health systems to deliver care that reaches people earlier, supports positive treatment outcomes, reduces suffering, and protects dignity at every stage.”

Specialist cancer nursing is essential to quality, safety and equity

The WHO report recognizes the increasing complexity of cancer care, including rapid advances in diagnostics, systemic therapies, radiotherapy, digital tools and supportive care. This makes specialist cancer expertise especially critical.

ISNCC President Lena Sharp commented:

“Specialist cancer nurses play a vital role in translating advances in cancer treatment into safe, effective, compassionate care.

The experiences described in the report must guide action. People with cancer are not only facing a diagnosis; many are facing fear, financial hardship, psychological distress, fragmented services and uncertainty about the future. Cancer nurses are often the professionals who stay alongside patients and families throughout this journey, explaining treatment, managing symptoms, and helping people to navigate complex systems and health decisions.

Governments and health systems must invest in cancer nursing education, continuing professional development, advanced practice roles, nurse-led services and nursing leadership in cancer policy. Every cancer service should have functioning multidisciplinary team structures that include nursing expertise, because high-quality cancer care depends on the full team.”

Palliative care is core cancer care, including for children

The WHO report’s emphasis on the full cancer care pathway reinforces that palliative care is an essential component of quality cancer care, including pain and symptom control, emotional and spiritual support, communication, family support, rehabilitation and quality of life. Palliative care is also embedded in ICN’s Definition of nursing, reflecting nurses’ and health professionals’ responsibility to relieve suffering, promote comfort and support people and families throughout illness.

ICPCN Chief Executive Julia Downing said:

“The stories and lived experiences reflected in the report remind us that cancer is not just a disease of older age. It also affects children and has impacts on their whole family. Parents, siblings and caregivers often carry enormous emotional, practical and financial burdens. Children’s palliative care provides vital support to children and families from diagnosis, throughout treatment, into survivorship, or through end-of-life care and bereavement when cure is not possible.

‘Every national cancer control plan must include children’s palliative care, access to pain relief, trained nurses within multidisciplinary teams, and family-centred models of care. The ICPCN’s Close the Gap Campaign is calling for palliative care to be available for children everywhere. Equity in cancer care means ensuring that every child, everywhere in the world, can receive both the best possible treatment and the best possible care.”

ICN, ISNCC and ICPCN call on governments, health systems, international agencies and partners to act on the WHO report by making immediate and sustained investments in nursing and multidisciplinary cancer workforces across the full continuum of care.

The future we choose together must be one in which care is valued as highly as cure; where nurses and other health professionals are valued, enabled, protected from burnout and empowered to lead; and where children and adults have access to safe, effective care, including palliative care, no matter where they live or what they can afford.

The International Council of Nurses (ICN) is a federation of more than 140 national nurses associations representing the 30 million nurses worldwide. Operated by nurses and leading nursing internationally, ICN works to ensure quality care for all and sound health policies globally.

The International Society of Nurses in Cancer Care (ISNCC) is an international membership organization of oncology nurse leaders dedicated to improving the health and well-being of people at risk for or living with cancer, promoting the nurse's role in improving cancer care, and developing nursing leadership in cancer care delivery.

The International Children’s Palliative Care Network (ICPCN) is the only global organization working to improve access to palliative care for the more than 21 million children worldwide who need it. ICPCN is recognized as the world leader in children’s palliative care (CPC) and has a globally renowned expert leadership, a wealth of educational resources and a network of members in over 140 countries.

In this issue of ISNCC Academic Express, we highlight reflections from a nursing education research team at The Nethersole School of Nursing, The Chinese University of Hong Kong, Hong Kong SAR, on conducting the revised eHealth Literacy Scale (eHEALS-R) survey among more than 1,000 nursing students using English and Chinese versions. The project explored students’ readiness to evaluate online health information, use interactive digital tools, and apply digital resources in clinical decision-making.

This work is particularly relevant to oncology nursing practice, as patients and families increasingly rely on digital sources for information about cancer prevention, screening, treatment, symptom management, and survivorship. The survey provides valuable insights into how nursing education can strengthen students’ ability to identify misinformation, assess the credibility of online resources, and communicate complex information with clarity and compassion. Developing these competencies will help future nurses deliver patient-centred, evidence-based cancer care in a rapidly evolving digital health environment.

Conducting the revised eHealth Literacy Scale (eHEALS‑R) survey among nursing students in Hong Kong was a meaningful experience that deepened our understanding of digital health literacy in nursing education. More than 400 students completed the English version and over 600 completed the Chinese version, generating a substantial bilingual dataset that reflected the multicultural context of Hong Kong’s nursing education. Beyond its methodological value, the survey prompted reflection on how well future nurses are prepared to support patients in an increasingly digital healthcare environment.

The original eHealth Literacy Scale was developed when digital health resources were less complex and less embedded in everyday practice. Today, nursing students must navigate online platforms, mobile applications, social media, and artificial intelligence tools. The original scale no longer fully captures the competencies required in contemporary healthcare. In response, a team of experts and educators produced the revised eHEALS‑R, which assesses students’ ability to evaluate online information, use interactive digital tools, and apply digital resources in clinical decision‑making. Using this updated scale allowed us to examine students’ digital readiness in a way that is more relevant to current nursing practice.

The relevance of eHealth literacy becomes particularly clear in cancer care. Patients and families often search online for information about prevention, screening, treatment, symptom management, and survivorship. However, the quality of online cancer information varies widely, and misinformation may create confusion, anxiety, or inappropriate health decisions. Nurses, as frontline educators and advocates, need to help patients identify reliable resources and interpret complex information. In this sense, the eHEALS‑R survey did more than measure students’ digital skills; it offered insight into their future capacity to provide accurate, patient‑centred cancer education.

From an educational perspective, the survey reinforced the need to integrate eHealth literacy more explicitly into nursing curricula, particularly in oncology and palliative care modules. For example, when learning about cancer screening or chemotherapy‑related symptom management, students should not only understand clinical guidelines but also critically appraise online patient education materials. The findings may help identify areas where students require further support, such as judging credibility, recognizing misinformation, and translating digital information into clear and compassionate patient education.

This project strengthened our appreciation of the close connection between research, education, and clinical practice. Managing a large bilingual survey required organization, ethical sensitivity, and attention to student engagement. More importantly, it encouraged us to reflect on how research findings can inform curriculum development and ultimately influence patient outcomes. By assessing and strengthening nursing students’ eHealth literacy, we are also enhancing their ability to provide reliable cancer information, reduce the impact of misinformation, and empower patients to make informed health decisions.

In conclusion, the eHEALS‑R survey was more than an academic exercise. It provided valuable insight into nursing students’ preparedness to function as digital health educators, especially in cancer care. The experience reinforced the importance of embedding eHealth literacy into nursing education as a foundation for effective communication, patient empowerment, and evidence‑based practice. Equipping future nurses with these skills is essential for delivering compassionate, reliable, and digitally informed cancer care in an era shaped by rapidly evolving health information.

In this issue of ISNCC Academic Express, we highlight research led by Prof. Kailei Yan from the College of Nursing, University of Central Florida, USA. The study examines anxiety trajectories among cancer patients receiving active treatment and identifies factors associated with persistent anxiety.

This research underscores that anxiety during cancer treatment is not one-size-fits-all. By assessing emotional distress over time and supporting patients’ coping self-efficacy, oncology nurses can identify high-risk patients earlier, address anxiety alongside physical symptoms, and promote patient-centred, evidence-based cancer care.

Why we chose this research topic?

Anxiety remains a common and clinical important concern in cancer care. It is especially relevant during active treatment, when many patients experience clinically significant anxiety that may persist, worsen co-existing symptoms, reduce quality of life, and contribute to poorer adjustment and health outcomes. For many patients, it is part of the treatment experience itself. However, anxiety does not look the same for everyone. For cancer nurses, this means anxiety care cannot be “one-size-fits-all.”

What we discovered?

Our study confirmed that cancer patients on active treatments showed different anxiety trajectories over time. Some patients had consistently low anxiety, some had moderate and relatively stable anxiety, and many experienced high anxiety throughout treatment. Younger patients were more likely to be in the high-anxiety group. Patients with stronger cancer coping self-efficacy were more likely to have lower anxiety over time.

We also found that anxiety was closely connected with the broader symptom experience. Patients in the high-anxiety group more likely to report including depression, nausea, and difficulty concentrating. High anxiety group had higher number of symptoms, more symptom communication barrier. Importantly, high anxiety was also linked with poorer quality of life, more emergency department visits, more hospitalizations, and greater use of hospital resources.

Implication for cancer care

Anxiety can change over time, thus, nurses should assess emotional distress not only at diagnosis but throughout the treatment journey. Regular screening can help identify patients who are at risk for persistent or worsening anxiety and connect them with support earlier.

Our findings also suggest that cancer nurses should pay close attention to patients who may be more vulnerable, including younger adults and those with lower confidence in their ability to cope with cancer-related challenges. Nursing care can help strengthen coping self-efficacy through education, symptom-management guidance, emotional support, and practical strategies for managing uncertainty during treatment.

Because anxiety is closely tied to physical symptoms, it should be addressed as part of whole-person symptom management. Nurses can help patients manage symptom clusters by assessing anxiety alongside pain, fatigue, nausea, sleep disturbance, depression, and cognitive concerns. They can also reduce communication barriers by encouraging patients to report symptoms early and by creating timely opportunities to discuss emotional distress.

Overall, anxiety management should be viewed as an essential component of high-quality cancer care. By identifying high-risk patients early, supporting coping skills, improving symptom communication, and coordinating timely referrals, nurses can help improve patients’ quality of life and may also reduce avoidable emergency department visits, hospitalizations, and healthcare resource use.

Source：

 Yan, K., Kim, E., Small, B., Wang, H. L., Elliott, A., & Loerzel, V. (2026). Anxiety trajectories in cancer patients during active treatments: Clusters, influencing factors, and impact on quality of life and health service utilization. Journal of affective disorders, 408, 121900. Advance online publication. https://doi.org/10.1016/j.jad.2026.121900. 

In this issue of the ISNCC Academic Express column, we highlight research led by Jianfei Xie and colleagues from China, published in the Journal of Nursing Management. The study applies machine learning to predict nursing interruption during medication administration, a key patient safety challenge in cancer care.

By identifying major workplace and personal risk factors and developing practical prediction tools, the research supports proactive risk management and safer medication practices. This study provides valuable insights for oncology nursing practice and contributes to improving the quality and safety of patient-centred cancer care.

Why We Chose This Research Topic?

Oncology nurses handle high-alert medications under immense cognitive load. As the final safeguard before patient contact, nurses intercept up to 86% of potential errors. However, 99% report being interrupted during medication tasks, with each interruption increasing error risk by 13%. 

Despite these high stakes, current clinical management relies heavily on retrospective reporting. To bridge this gap, we developed a machine learning prediction model to shift from reactive monitoring to proactive risk stratification, empowering nurses and safeguarding cancer care.

What We Discovered?

Surveying 4,758 clinical nurses across 12 Chinese tertiary hospitals, we found that 52.1% experienced at least one NIMA event during their latest shift. Using machine learning algorithms, we identified 18 key predictors of NIMA. The Logistic Regression model performed best, achieving an AUC of 0.748.

Interestingly, the most significant predictors were interpersonal demands, specifically, the needs of doctors, patients, and patients' families. Furthermore, nurses' personal factors, such as high resignation intention and lower general self-efficacy, significantly increased interruption risks. To bridge the gap between complex algorithms and clinical utility, we translated our findings into an 18-variable nomogram and a simplified 5-variable interactive web-based calculator for rapid bedside assessment.

Implications for Cancer Care

Our findings offer highly actionable insights for oncology nursing:

1.Proactive Risk Management: Using our 5-variable web calculator, managers can conduct rapid bedside assessments to identify nurses at high risk of NIMA. This enables a crucial shift from reactive incident reporting to proactive risk management, allowing for targeted supervision and optimized staffing before errors occur.

2.Managing Interpersonal Demands: Since demands from doctors, patients, and families are primary drivers of NIMA, oncology wards must implement structural interventions. Establishing “no-interruption zones” during chemotherapy preparation and streamlining interdisciplinary communication can effectively shield nurses from non-urgent requests, ultimately protecting their cognitive focus.

3.Supporting Nurses’ Well-being: Oncology nursing carries a profound emotional burden. The strong link between turnover intention, self-efficacy, and NIMA proves that patient safety is deeply intertwined with psychological health. By providing targeted psychosocial support and addressing oncology-specific burnout, managers can foster professional confidence, reduce medication errors, and retain invaluable staff.

By leveraging data-driven tools, we can create safer work environments, protect our oncology nurses from cognitive overload, and ultimately ensure the highest standard of care for our patients.

Reference:

Dong, X., et al. Identifying Nurses at Risk of Nursing Interruptions During Medication Administration Using Machine Learning: A Multicenter Cross-Sectional Study. Journal of Nursing Management, 2026, 4433675.

Jianfei Xie (Corresponding Author)

To promote academic exchange and advance oncology nursing practice, the Academic Express column invites ISNCC members to share their latest research achievements with the global cancer nursing community. In recognition of World No Tobacco Day on May 31,  this issue highlights a recent multicentre randomized controlled trial led by William Ho Cheung Li from The Nethersole School of Nursing, The Chinese University of Hong Kong, which explores the use of mobile instant messaging to deliver brief motivational interviewing with individualized motivational support for smoking cessation among patients with noncommunicable diseases who had no intention to quit smoking. This study provides valuable insights into how digital, patient-centred interventions can support health behaviour change and strengthen the role of nurses in cancer prevention, chronic disease management, and equitable care.

Smoking remains one of the most significant yet preventable contributors to poor health outcomes among people living with noncommunicable diseases (NCDs), including cancer. A recent multicenter randomized controlled trial titled Instant messaging delivered brief motivational interviewing for noncommunicable disease patients with no intention to quit smoking provides timely and compelling evidence that patients who initially have no intention of quitting can still be engaged through innovative and patient centered digital interventions.

A defining strength of this trial is its focus on a population often overlooked in smoking cessation research and clinical practice. Smokers with NCD who report no intention to quit are frequently perceived as non-receptive and therefore excluded from conventional cessation programs. Yet this group represents a substantial proportion of patients encountered in oncology and chronic disease settings. In this trial, 728 adults with NCDs, including cancer, were randomized to receive either usual care or a novel intervention combining a single ten-minute face-to-face brief motivational interviewing (MI) session with individualized motivational support delivered via mobile instant messaging over six months. Participants in the intervention group were approximately three times more likely to achieve biochemically validated smoking abstinence at six and twelve months compared with those receiving usual care.

One particularly notable feature of the intervention is its pragmatic and respectful design. Rather than requiring participants to focus immediately on smoking, individuals were first encouraged to select another unhealthy behavior, such as diet, physical inactivity, or alcohol use, that they were more willing to address. This foot-in-the-door approach aligns closely with MI principles by respecting patient autonomy and readiness to change while reducing psychological resistance. Such flexibility is especially relevant in cancer care, where patients often face substantial physical, emotional, and cognitive burdens related to diagnosis and treatment.

The implications for cancer care are substantial. Tobacco use remains a major modifiable risk factor for cancer progression, treatment complications, disease recurrence, second primary cancer, and mortality. Continued smoking has been associated with reduced treatment effectiveness and poorer survival outcomes, whereas cessation after a cancer diagnosis may improve treatment response, reduce treatment-related adverse effects, and enhance quality of life. Despite this strong evidence base, many people living with cancer continue to smoke and frequently express ambivalence or no intention to quit. The intervention tested in this trial offers a feasible and compassionate way to engage this challenging group without provoking disengagement or resistance.

From an oncology nursing perspective, the intervention model is practical and scalable. It requires minimal time, limited resources, and can be delivered effectively by trained nurses within routine clinical workflows. The use of mobile instant messaging enables timely, real-time, personalized communication that extends professional support beyond clinical settings. For patients undergoing cancer treatment, who may experience fatigue, frequent appointments, and psychosocial stress, this flexible mode of care is particularly valuable.

In conclusion, this trial highlights the pivotal role of oncology nurses in delivering digitally enabled brief MI and demonstrates how nurse-led innovation can advance person-centered and equitable cancer care worldwide.

Source：

Ho, L. L. K., Chan, D. N. S., Chung, J. O. K., Choi, K. C., Xia, W., & Li, W. H. C. (2026). Instant messaging-delivered brief motivational interviewing for noncommunicable disease patients with no intention to quit smoking. NPJ digital medicine, 10.1038/s41746-026-02578-6. Advance online publication. https://doi.org/10.1038/s41746-026-02578-6

Prof. William Ho Cheung Li

During China’s 32nd National Cancer Prevention and Control Awareness Week, initiated by the China Anti-Cancer Association, the Oncology Nursing Committee of the Chinese Nursing Association, an ISNCC member, actively mobilized its network of oncology nursing institutions to conduct cancer prevention and health education activities in hospitals and communities across the country.

The initiative aimed to raise public awareness of cancer prevention and control, strengthen community understanding of cancer care, and promote the dissemination of evidence-based health knowledge. Activities included outreach by oncology nursing experts to grassroots communities, health education lectures, free medical consultations, nursing consultations, public education sessions, and the distribution of cancer prevention and health education materials.

The campaign was carried out across 27 provinces, municipalities, and autonomous regions in China. In total, 511 activities were organized, involving 10,079 healthcare professionals and reaching approximately 1.57 million people, including cancer patients, family members, and members of the general public.

Through these efforts, oncology nurses played an important role in promoting cancer prevention awareness, encouraging healthy lifestyle practices, and supporting cancer prevention and control initiatives at both hospital and community levels. This initiative also reflects the shared commitment of ISNCC members to advancing cancer nursing, promoting public health education, and contributing to cancer prevention and control efforts worldwide.

To foster global knowledge sharing and support evidence-informed oncology nursing practice, Academic Express features recent research contributed by ISNCC members and colleagues worldwide. This issue presents a qualitative study by Dr. David Asakitogum and co-authors, exploring women’s experiences with traditional medicine in the treatment of cervical cancer in Accra, Ghana. By highlighting how cultural beliefs, access barriers, cost, and trust shape care-seeking decisions, this study offers valuable insights for oncology nurses striving to provide safe, respectful, and culturally responsive cancer care.

Why We Chose This Topic

TM including herbal medicine, complementary and alternative medicine, is deeply embedded in many African communities. However, TM use is often under‑reported in clinical settings, creating safety risks and care gaps. As oncology researchers, we chose this topic to amplify women’s voices and to better understand how TM, access barriers, and cost influence cancer‑related health decisions. Understanding these experiences is essential for delivering compassionate, culturally responsive, and safe cancer care.

What We Discovered

Interview findings revealed that women commonly used herbal medicines, prayer, and intravaginal insertion of substances to manage signs and symptoms of cervical cancer. Many initiated TM before receiving a definitive diagnosis, relying on symptom‑based advice from herbalists, friends, or faith leaders. Herbal preparations were often self‑prepared and administered orally, by bathing, or through vaginal douching.  While some women reported symptom improvement, others experienced worsening conditions that delayed hospital treatment. Cost, accessibility, trust, and faith strongly influenced TM use.

Call to Action for Oncology Nursing Practice  

Oncology nurses worldwide are uniquely positioned to lead safer, more culturally responsive cervical cancer care by openly addressing traditional medicine use in clinical practice. Nurses must routinely and respectfully assess patients’ use of herbal remedies, spiritual healing, and intravaginal practices, recognizing these as integral to women’s health beliefs rather than peripheral behaviors. By fostering non‑judgmental dialogue, providing targeted education to dispel harmful misconceptions, and partnering with community stakeholders such as traditional medicine practitioners and faith leaders, oncology nurses can reduce delays in diagnosis, prevent unsafe treatment practices, and advocate for patient safety. Embracing this expanded role is essential for advancing equity, improving outcomes, and strengthening global efforts toward cervical cancer prevention and control.

David Asakitogum, PhD, M.Phil., RN, Ataribuno Cervix Foundation, Ghana

Source：

Asakitogum, D. A., Ohene, L. A., & Aziato, L. (2026). Women’s experiences with traditional medicine for the treatment of cervical cancer: A qualitative study. BMC Complementary Medicine and Therapies.

The International Society of Nurses in Cancer Care (ISNCC) is proud to contribute to two recent Multidisciplinary Cancer Management Courses (MCMCs) with City Cancer Challenge (C/Can), the American Society of Clinical Oncology (ASCO) and the Access to Oncology Medicines (ATOM) Coalition — advancing our shared mission to improve equitable access to quality cancer care worldwide.

Phnom Penh, Cambodia | 19–21 November 2025
Represented by Prof Winnie So, ISNCC President, who delivered lectures, joined discussion forums, and met with medical and nursing teams to share expertise on strengthening cancer care through multidisciplinary approach and reinforcing the pivotal role of oncology nurses in multidisciplinary cancer management.

Ulaanbaatar, Mongolia | 19–21 March 2026
Represented by Dr Dorothy Chan, ISNCC Board of Director, who contributed as a global nursing expert, engaging in interdisciplinary dialogue and capacity-building activities with local healthcare teams.

Through these collaborations, ISNCC continues to champion the essential role of cancer nurses in multidisciplinary cancer management, fostering partnerships that bring us closer to global cancer control and health equity.

To promote academic exchange and advance oncology nursing practice, the Academic Express column invites ISNCC members to share their latest research achievements with the global cancer nursing community. In this issue, we highlight an important study on improving supportive care for cancer patients in the last days of life. This research, led by Xiaoting Hou and Yuhan Lu from China, explores the development and implementation of a hospital-based supportive care model designed to enhance the quality of end-of-life care for cancer patients.

Why We Chose This Research Topic

This research topic was chosen in response to the urgent clinical challenges in China, where 2.57 million cancer-related deaths occurred in 2022—accounting for 26.4% of the global total—and where terminally ill patients and their families endure significant physical, psychological, and socioeconomic burdens. Driven by national policies such as the Healthy China 2030 strategy, which prioritizes comprehensive, lifelong health services, nurses—as the most frequent caregivers for cancer patients—play a pivotal role in improving end-of-life outcomes. Although growing attention to palliative care in China, the quality of care in the final days of life remains inadequate, highlighting a critical gap: the absence of systematic, evidence-based implementation programs for end-of-life supportive care.

This study adopts a problem-oriented approach to initiate a hospital-based quality improvement program, and seeks to enhance the quality of care for cancer patients in their final stages, and then to improve the quality of death of cancer patients and family satisfaction. 

What We Discovered?

Between May 2023 and August 2024, the program was initiated and implemented in five hospitals located in Beijing, Nanjing, and Kunming involving 114 terminally ill cancer patients. The intervention featured 30 bundled supportive care strategies covering recognition of dying, end-of-life communication, patient-centered supportive care, family-centered supportive care, and bereavement support. By developing in-hospital practice standard and related materials, conducting stratified training, offering assistance for nurses and conducting quality supervision, these supportive care strategies have been integrated into clinical practice and implemented.

This study examined the quality of death for patients using the Good Death Inventory (GDI) and family satisfaction using the Family Satisfaction with Advanced Cancer Care-2 (FAMCARE-2) scale. Despite some cultural challenges we encountered during implementation, encouraging research results were achieved. Nurse-rated Good Death Inventory scores reached 299.81±53.70, while family-rated scores were 310.76±49.55—substantially higher than historical controls. Family satisfaction measured by FAMCARE-2 was 80.52±8.75, exceeding previous Chinese studies.

Implications for Cancer Care

The implications are multifaceted. Practically, standardized pathways integrating evidence-based strategies into routine care from recognition of dying to bereavement support can systematically address patients' physical, psychological, social and spiritual needs of both patients and families, providing clear guidance for nurses. Educationally, stratified training with ongoing specialist support ensures homogeneous implementation. Policy-wise, implementation revealed culturally sensitive approaches must balance family protective instincts with patient autonomy.

This program demonstrates that structured, hospital-based supportive care can achieve satisfactory outcomes in improving the quality of death of cancer patients and the satisfaction of their family caregivers, offering a replicable model for advancing palliative care in China and similar contexts.

Source:

Hou X, Guo R, Yu W, Yuan L, Chen G, Ma X, Zhou Y, Zhang X, Liu L, Wang Y, Lu Y. Development and implementation of a supportive care model for cancer patients in  the last days of life: a hospital-based program. Asia Pac J Oncol Nurs. 2025;13:100828. doi:10.1016/j.apjon.2025.100828.    

We proudly continue our Academic Express section to advance oncology nursing through scholarly exchange.This edition features groundbreaking insights from Dr. Yingchun Zeng (National University of Singapore) on merging AI into cancer nursing. Her analysis reveals nursing’s "sweet spot" where AI enhances prediction, personalization, and patient experience while addressing critical implementation challenges.Discover how nurses can lead meaningful AI integration at the care frontier.

Artificial intelligence (AI), from being a “nice-to-have” technology to being a “need-to-have” technology that can augment nursing practice across the entire continuum of cancer care from early detection through survivorship and palliative care. However, the question is not whether we are going to use this technology; rather, how are we going to integrate this technology safely and meaningfully into nursing practice. 

Where AI is already making a difference
In screening and early detection, AI can enhance image interpretation and help expand access in settings where specialist capacity is limited. In treatment planning, AI can support precision (e.g., surgical support, radiation planning, toxicity prediction) and help identify patients at higher risk of complications—creating opportunities for earlier nursing interventions and tailored education.

The nursing “sweet spot”: prediction, personalization, and patient experience
Many high-impact nursing activities depend on timely recognition of risk and early supportive care. AI-enabled prediction models may help identify patients more likely to develop complications (e.g., lymphedema, venous thromboembolism, delirium), allowing nurses to intensify monitoring, education, and preventive strategies earlier. In survivorship and rehabilitation, AI can help tailor symptom management and supportive programs, while emerging approaches (e.g., analysis of large volumes of patient-generated text from forums) can broaden our understanding of patient concerns at scale—complementing, not replacing, human qualitative insights.

What stays hard: validation, bias, and trust
AI is not automatically safe because it is “data-driven.” Models require rigorous clinical validation, careful attention to privacy and consent, and ongoing monitoring for algorithmic bias and unintended harms. A particularly important concern is that some imaging AI systems may infer sensitive attributes (such as race) in ways that are not obvious to clinicians—raising equity risks that oncology nurses must help surface and mitigate.

What nurses must lead next
To ensure AI strengthens—rather than fragments—care, oncology nurses should co-design AI tools around nursing workflows, define implementation outcomes (workload, safety, equity, experience), and advocate for governance that is transparent and patient-centered. The goal is not “AI everywhere,” but AI where it improves outcomes, protects dignity, and supports nursing judgment.

Source:

Wang M, Abu-Odah H, Zeng Y. Merging artificial intelligence into cancer nursing care: Current applications, challenges, and opportunities. Asia Pac J Oncol Nurs. 2025 Dec 30;13:100849. doi: 10.1016/j.apjon.2025.100849. PMID: 41585538; PMCID: PMC12825068.

Dr Yingchun Zeng