Background: As a nurse, when caring for children with cancer, you need to offer the best care for the child and in the meantime focus on family centered care in order to meet the thoughts and wishes the family carries. Caring for children with cancer might contain many obstacles and difficulties. Communication, education and to understand one's role as a nurse is important when caring for these children. Aim: To identify nursing experience when caring for children with cancer. Method: A literature overview has been done and ten studies were gathered through the databases PubMed and Cinahl. The analysis of these studies created four categories with associated subcategories. Results: It came through those nurses faced difficulties in pediatric care in different situations. These situations created categories which were: Ethical issues, Education, Cooperation with the family and Nurses emotions and support. Conclusion: Factors found in this study were nurses' experience of lacking the necessary preparation, the need of emotional support and the importance of working close to the families. It is found that nurses felt unprepared for their work and dealing with tough situations. The relationship between the nurse and the patient's family is important to provide high quality care. Nurses expressed the need for support from colleagues and family members in order to grow as a nurse and as a person.

Rhabdomyosarcoma (RMS) is a type of soft tissue sarcoma that mainly occurs in children. RMS can be divided into two subtypes embryonal (ERMS) and alveolar (ARMS). The ARMS subtype can be especially aggressive when a balanced chromosomal translocation is present. This translocation results in the expression of a PAX3/7-FOXO1 fusion protein, an oncogenic transcription factor. PAX3-FOXO1 positive RMS has an especially bad prognosis and survival rate. In the cell painting assay relevant organelles are stained and morphological features are extracted on a cellular level. Based on these features, morphological profiles of each cell type and a similarity score can be calculated. The morphological profiles of ERMS cell lines RD and RD18 as well as the ARMS cell lines RH30 and CW9019 were obtained. RD and RD18 are most similar to each other followed by RH30. CW9019 has a very different profile from the other cell lines. Since ERMS is associated with a better survival rate a drug that reprograms the phenotype from ARMS to a more ERMS-like phenotype might sensitize the cells to the standard treatment of RMS. ARMS patients might then benefit from a combination therapy of such a drug and the standard treatment. To find such a drug a drug screen was conducted. Drugs were selected for the screen that either target fusion-protein stability or overexpressed targets of the fusion protein. Phenotypic reference compounds were included to get a first idea of the mechanisms and involved organelles of the screened drugs. In total, 30 compounds and 9 phenotypic reference compounds were screened for changing morphological profiles of RMS cell lines with the cell painting assay. 15 compounds were identified that change the phenotype of the ARMS cell line RH30. In addition, 7 of these compounds shift the phenotype of RH30 towards an ERMS-like phenotype. If that morphological resemblance of RH30 cells to ERMS cells translates into a change of a more ERMS-like behavior and sensitizes the cells for the standard treatment of RMS remains to be investigated. The reprogramming hits showed high similarity with phenotypic reference compounds that increase nucleus size which might suggest changed behavior of the fusion protein. Especially, Bosutinib, Midostaurin and Alisertib are promising new compounds for ARMS treatment. They shifted the ARMS phenotype towards an ERMS-like phenotype in the drug screen. This shift is likely a result of the interaction with PLK1 or Aurora-kinase A that are shown to have an influence on fusion-protein stability.

Fluorescerande protein kan användas som reportrar i genetiska kretsar för att identifiera framgångsrikt modifierade celler. Med hjälp av syntetisk biologi kan genetiska kretsar, som är en sammansättning gener som kodar för protein, skapas. Genetiska kretsar möjliggör modifiering av celler och har haft stor framgång, vid immunterapi av cancer. Chimeric antigen receptor (CAR) T-celler är en genetisk krets där T-celler modifieras till att eliminera tumörceller baserat på en utvald ytmarkör. Med hjälp av fluorescerande proteiner kan olika komponenter i genetiska kretsar märkas in och därmed tydligt följas vid modifieringen av celler, ofta används Blue fluorescent protein (BFP) eller Green fluorescent protein (GFP). För att utveckla mer komplexa genetiska kretsar med flera komponenter krävs fler fluorescerande proteiner som kan kombineras med BFP och GFP, såsom sådana i det röda spektrumet. I denna studie undersöktes rödfluorescerade proteinerna E2Crimson, TagRFP657, mNeptune2.5, mKelly2, mKate2, mCardinal och Katushka2S. Med hjälp av klonade vektorer för respektive protein kan lentivirus produceras för att transducera Jurkat celler. Flödescytometri användes för att identifiera proteinernas fluorescensintensitet i det röda spektrumet, samt deras läckage i BFP och GFP spektrat. Proteinerna med högst fluorescensintensitet i det röda spektrumet samt minst läckage i BFP och GFP spektrat var E2Crimson samt mCardinal. E2Crimson har enligt tidigare studie låg toxicitet och god ljusstyrka samt hade i denna studie högst fluorescensintensitet i det röda spektrumet. E2Crimson anses därför vara optimal att kombinera med BFP och GFP i genetiska kretsar med flera komponenter. / Fluorescent protein can be used as reporters in genetic circuits to identify successfully modified cells. Using synthetic biology, genetic circuits, which are an assembly of genes that code for protein, can be created. Genetic circuits enable the modification of cells and have had great success in immunotherapy of cancer. Chimeric antigen receptor (CAR) T cells are a genetic circuit which modifies T cells to eliminate tumor cells based on a selected surface marker. With the help of the fluorescent protein, various components of genetic circuits can be marked and thus followed during the modification of cells, Blue fluorescent protein (BFP) or Green fluorescent protein (GFP) are often used as reporters. When developing complex genetic circuits with multiple components more fluorescent proteins that can combine with BFP and GFP are required, such as those in the red spectrum. In this study, the far-red fluorescent proteins E2Crimson, TagRFP657, mNeptune2.5, mKelly2, mKate2, mCardinal and Katushka2S were included. Using cloned vectors for each protein, lentiviruses can be produced to transduce Jurkat cells. Flow cytometry was used to identify the proteins fluorescence intensity in the red spectrum, as well as their leakage in the BFP and GFP spectra. The proteins with the highest fluorescence intensity in the red spectrum and the least leakage in the BFP and GFP spectra were E2Crimson and mCardinal. E2Crimson has according to other studies low toxicity and good brightness and in this study E2Crimson showed the highest fluorescence intensity in the red spectrum. E2Crimson is therefore considered optimal to combine with BFP and GFP in multicomponent genetic circuits.

Background: Prostate cancer is the most prevalent form of cancer affecting men.In case of biochemical recurrence, positron emission tomography (PET) targeting prostate-specific membrane antigen (PSMA) on prostate tumor cells is primarily used, in combination with computed tomography (CT), for detection and localization of recurrence. Research for optimizing a PSMA-ligand with high affinity for tumor cells and minimal excretion to the urinary bladder is constantly ongoing, in order to allow better evaluation of the prostate and nearby regions. One such ligand is 18F-PSMA-1007, which was expected to be excreted in the urinary bladder at a rate of 5-10%. However, after switching from diagnostic to low-dose CT, the elimination of 18F-PSMA-1007 in the bladder was higher than expected. Purpose: To evaluate whether hydration during the accumulation period could affect the activity concentration in the bladder. Materials and Methods: The study involved analyzing PET-CT scans obtained from two prostate cancer patient groups who underwent 18F-PSMA-1007-PET with low-dose CT. The groups consisted of 20 participants each, with one group hydrating during the tracer’s accumulation time, while scans from the comparison group were obtained from a time point where patients did not receive instructions about water intake. The amount of radioactivity was measured by placing a standardized 3.00 cm Volume of Interest (VOI) on the bladder, which was then adjusted based on the individual size and shape of the patients' bladder. From the VOI, a standardized uptake value (SUV) was determined, which can be represented as either SUVmean or SUVmax. These values represent the average tracer concentration within a VOI and the highest concentration of the tracer in the urinary bladder, respectively. Results: SUV in the urinary bladder was lower for the hydrated group, where the SUVmean was 1,55 vs 4,5 (p=0,011) for the non-hydrated group. Similar values were obtained for SUVmax, 2,3 vs 6,65 (p< 0,003). Conclusion: This retrospective study suggests that water intake during the accumulation period leads to significantly lower activity concentration in the bladder among these patients, which benefits the detection of recurrences in adjacent areas.

Introduktion: Bröstcancer är den vanligaste cancerformen att drabba kvinnor och statistik visar att 1 av 14 kvinnor kommer drabbas av bröstcancer under sin livstid. Behandlingen för bröstcancer kan bidra till olika biverkningar som bland annat påverkar kvinnors sexuella hälsa. Syfte: Beskriva erfarenheter av sexuell hälsa hos kvinnor med bröstcancer. Metod: En beskrivande litteraturstudie baserat på resultatet från 10 vetenskapliga artiklar. Huvudresultat: Majoriteten av studiedeltagarna beskrev en förändring av den sexuella hälsan. Fåtalet upplevde ingen skillnad alls efter diagnos och behandling. Kvinnorna beskrev erfarenheter av minskad sexuell lust och smärtor som ledde till minskad sexuell aktivitet. De beskrev rädslor kopplat till sex och bröstcancer. Vissa upplevde en förändrad självkänsla på grund av kroppsliga förändringar. Kvinnorna beskrev erfarenheter av att ha sex trots att ingen lust fanns på grund av en vilja att göra sin partner tillfredsställd eller av religiösa skäl. Fåtalet kvinnor beskrev erfarenheter av en förbättrad sexuell hälsa i form av mer sexuell lust eller en starkare intim relation med sin partner efter diagnos och behandling. Slutsats: Kvinnorna har erfarenheter av en förändrad sexuell hälsa i samband med bröstcancer och behandling. Resultatet tyder på att det finns en brist på information och att vissa av kvinnorna saknar stöd från sjukvården gällande deras sexuella förändringar i samband med bröstcancer och behandling. Sjukvården bör därför erbjuda dessa kvinnor mer stöd och information om problem som kan uppstå för att främja kvinnornas sexuella hälsa. / Introduction: Breast cancer is the most common cancer to affect women and statistics show that 1 in 14 women will be affected by breast cancer in their lifetime. Treatment for breast cancer can contribute to a variety of side effects, including those affecting women's sexual health. The aim: To describe the sexual health experiences of women with breast cancer. Methods: A descriptive literature review based on the results of 10 scientific articles. Main results: The majority of study participants described a change in their sexual health. A few experienced no difference at all after diagnosis and treatment. The women described experiences of decreased sexual desire and pain leading to decreased sexual activity. They described fears related to sex and breast cancer. Some experienced a change in self-esteem due to physical changes. Women described experiences of having sex when there was no desire because of a desire to please their partner or for religious reasons. Few women described experiences of improved sexual health in terms of more sexual desire or a stronger intimate relationship with their partner after diagnosis and treatment. Conclusion: Women have experiences of a change in sexual health associated with breast cancer and treatment. The results suggest that there is a lack of information and that some of the women lack support from the health care system regarding their sexual changes related to breast cancer and treatment. Health care should therefore offer these women more support and information about problems that may arise in order to promote their sexual health.

Bakgrund: Bröstcancer är en av de vanligaste cancerformer som kvinnor insjuknar i och som leder till flest dödsfall. Behandligen mot bröstcancer består vanligtsvis av cytostaktikabehandling, kirurgi, hormonbehandling och strålbhenadling. Behandlingarna medför många oönskade och påfrestande biverkningar. Vilket påverkar kvinnans välmående och livskvalitet i efterförloppet. Både de fysiska och psykosociala problemen. Sjuksköterskan ska med empati stötta och utöva en god personcentrerad vård för att hjälpa kvinnorna att finna en sturktur i vardagen, syftet att främja hälsa och förebygga ohälsa.  Syfte: Syftet med studien var att belysa kvinnors upplevelser av det vardagliga livet efter att ha överlevt bröstcancer.  Metod: En litteraturstuide baserad på fyra patografier. Datamaerialet analyserades utifrån Lundman och Hällgren Graneheims kvaliatavita innehållsanalys.  Resultatet: Resultatet presenteras i tre kategorier och sex underkategorier. De tre huvudkategorierna var upplevad begränsningar i vardagslivet, känslan av förändrad kroppsbild och betydelsen av stödet. De sex underkatoegorierna var mental trötthet begränsar vardagen, känslan av oro för återfall påverkar vardagen, att kroppen förändras leder till negativia känslor, ökad livskvalitet tack vare bröstrekonstruktion, upplevt stöd från hälso- och sjukvården och upplevt stöd från omgivningen har betydelse.  Slutsats: Vardagslivet i efterförloppet har påverkats för alla kvinnor. Kvinnorna lever med mentaltrötthet. Detta påverlade deras vardag så pass att de inte orkade göra samma saker som innan. Kvinnorna hade en rädsla för att få återfall. Kvinnornas självkänsla påverkades av att de hade varit tvugna att genomgå mastektomi. Kvinnorna kände att de var i behov av stöd ifrån sjukvården i efterförloppet och berättade att stödet från anhöriga var en stor del i deras nya vardag.

Neuroblastoma constitutes roughly 8% of all childhood cancers where 95% of all neuroblastoma cases occur before the age of 10. The survival rate of infants and young children is very poor, which alone contributes to research novel biomarkers for classification methods, improved diagnosis and better anti-tumor therapies. The aim of this meta-analysis was to identify dysregulated miRNAs in neuroblastoma that has the potential to be used as antioncogenic biomarkers for diagnostic interventions. Additionally, explore miRNA interconnectedness on a systemic level and conversely extend the support of using miRNAs as biomarkers. A comprehensive literature search was performed within NIH-PubMed, NCBI-PMC and in the reference list of already reviewed publications, which yielded 9 eligible publications. Quality of evidence was assessed according to the guidelines adapted from MIAME, MINSEQE and MIQE. miRNet 2.0 was used to find the most significantly enriched annotations linked to neuroblastoma. A total of 251 samples (Cancer: 141; Control: 110) was reported by the 9 studies. These involved 66 dysregulated miRNAs (Up-regulated: 43; Down-regulated: 23) which was used for enrichment analysis. Four miRNAs (miR-17-5p, -92a-3p -421, -125b) were significantly linked to neuroblastoma, and associated secondary diseases; medulloblastoma (-92a-3p, -125b), bladder cancer (-17-5p, -125b), acute myeloid leukemia (-92a-3p, -125b) and cardiac hypertrophy (- 125b). miR-125b showed exceptional interconnectivity with these diseases and a multidimensional potential in neural tumorigenesis. This study showed that dysregulation and biological processes of these miRNAs were concurrent with the original studies, endorsing that these miRNAs have potential as diagnostic indicators or classifiers of such diseases. / Popular scientific summary Neuroblastoma (NB) is one of the most common types of pediatric neurological cancers in children and constitutes roughly 8% of all childhood cancer types, in which 95% of all NB cases occur before the age of 10. Even with frequent advancements in medical diagnosis and anti-tumor therapies, the current treatment options for patients with NB offers a survival rate that is very poor. This alone is a reason to pursue developing novel classification methods, improve diagnosis and research better anti-tumor therapies. Micro Ribonucleic Acids (miRNAs) are small non-coding single stranded biomolecules that have gotten a lot of attention in recent years due to their ability to regulate genes involved in various biological cancer processes, such as; tumor growth and development. miRNAs regulate these processes by altering the function of messenger RNAs (mRNAs), which are single-stranded biomolecules that resembles a piece of genetic code from the DNA of an organism cell. When these mRNAs become dysregulated, their cancer-promoting genes are disrupted which prevent them from working properly, leading to tumor regression or termination. The effect of this biological event is then objectively measured by using the miRNA as an indicator, also known as a biomarker. miRNA biomarkers have massive potential to improve various medical applications, such as; faster and more accurate diagnosis, detailed disease-classification and more precise drug trial predictions. However, a lot of individual studies have been published about the same miRNAs, which report a variation of conclusions. This makes it more difficult to determine the true nature of miRNAs. This issue can be addressed with systematic reviews and meta-analyses, which could yield additional support and give a broader picture of how miRNAs regulate different biological processes in NB. A meta-analysis is a scientific statistical process that combines the results of many research publications associated with the same scientific question and presents the best collective estimate of truth with increased precision than what could be achieved from individual studies alone. Thus, meta-analysis is an important tool in research which makes sure that the most trustworthy effect estimate can be achieved among many similar answers. The aim of this meta-analysis was to identify dysregulated miRNAs in NB that has the potential to be used as anti-cancer promoting biomarkers for diagnostic interventions. Additionally, explore how different miRNAs are connected to NB and conversely extend the support of using miRNAs as biomarkers. The end goal of this meta-analysis is to provide more reliable evidence for further research that can improve the life expectancy of NB patients in the future. In this study, 4 miRNAs (miR-17-5p, -92a-3p -421 and -125b) were identified to be significantly linked to NB, and associated secondary diseases; medulloblastoma (-92a-3p & -125b), bladder cancer (-17-5p & -125b), acute myeloid leukemia (-92a-3p & -125b) and cardiac hypertrophy (- 125b). Specifically, miR-125b showed exceptional interconnectivity for these diseases and potential to indirectly down-regulate n-Myc in NB, a gene that promote cancer cell proliferation. miR-125b was also found to be a significant sole regulator and effector of the CDX2 gene responsible for cancer cell differentiation in acute myeloid leukemia, a relationship that has been supported by other publications. This meta-analysis showed that the reported dysregulation and biological processes of these miRNAs were concurrent with the original studies, endorsing that these miRNAs have potential as diagnostic indicators or classifiers of such diseases while warranting that the gene regulatory function of miRNAs are becoming more intricate than previously thought.

High-grade serous ovarian cancer (HGSOC) is the most aggressive subtype of ovarian cancer, and its heterogeneity poses a challenge for the discovery of reliable diagnostic biomarkers, therapeutic targets, and predicting treatment response, particularly to immunotherapy. The current standard diagnostic and treatment options are inadequate, resulting in late diagnosis and poor prognosis. To improve our understanding of the immunophenotype of tumours, potentially enhancing diagnostic and treatment capabilities, the aim of the present study was to develop a stringent workflow for studying the immune microenvironment of HGSOC tumours. We utilized publicly available single-cell RNA sequencing data and literature to identify genes enriched in certain cell types of HGSOC tumours, followed by validation using immunofluorescent-based multiplex protein profiling. A 9-plex immunofluorescence workflow was developed using the Opal™ system, and quantitative image analysis was performed to evaluate the expression of PD-L1, CD8A, FoxP3, CD163, KRT7, PDGFRB, and CD79A in large tissue sections of ovarian cancer. Each of these markers are specific to different cell types, and by staining the multiplex marker panel together with new markers with little or no literature linked to HGSOC we can gain novel insights on the immune microenvironment of HGSOC. In this project, for a proof of concept, we focused on two proteins; GZMK and SLAMF7. The optimized multiplex panel developed as part of this project will be used to identify cell-type-specific markers that may play a crucial role in the immune microenvironment of HGSOC, which could lead to better immunophenotype stratification of patients and a more optimal immunotherapy response. Moreover, the panel could also be used to study markers of less well-known immune cell types, further improving our understanding of HGSOC. Overall, this project has the potential to significantly contribute to the development of reliable diagnostic biomarkers and therapeutic targets for HGSOC, ultimately improving patient outcomes.

Pancreatic cancer is a form of severe neoplasm with a swift disease progression and a high rate of mortality. It is the 12th leading cause of death globally for all cancer-related mortalities. Diagnosis is often late in the disease progression due to the late manifestation of symptoms which limits curative treatment options, resulting in primary palliative treatments. Patients experience a broad variety of symptoms that affect their physical and mental health causing a tremendous symptom burden. Therefore, the aim of this study was to describe the patient’s experience of living with pancreatic cancer. A literature review of qualitative and quantitative research articles was conducted to answer the purpose of this study. Data was collected through Cinahl, PsycINFO and PubMed and generated eleven articles which were analyzed, nine qualitative and two quantitative. The results were presented in two categories living in uncertainty which presented the patients emotions associated with getting the diagnosis together with unmeet informational needs and living with an unwell body which presented the physical bodily changes. This study concluded that pancreatic cancer has a significant impact on both the patients’ physical and mental health. Furthermore, there was a correlation between physical and psychological symptoms that all affected the patients' state of well-being. Moreover, patients experienced a lack of sufficient information concerning the disease. Therefore, it is of utmost importance that the patient is seen as a whole entity by the healthcare personnel to meet the individual care needs that arise from the illness.

Bakgrund: Årligen diagnostiseras cirka 400 000 barn i världen med cancer, medvarierande överlevnadschanser beroende på var barnet bor. En cancerdiagnos medför ofta en stor livsomställning för alla inblandade och mötet med barncancer kan upplevas som svårt. Genom att undersöka barnens perspektiv och erfarenheter av cancer kan förståelsen och bemötandet till dessa barn förbättras. Syfte: Syftet var att beskriva barns erfarenheter av att leva med cancer. Metod: Litteraturstudien har en deskriptiv design och artiklarna i resultatet söktes fram via databasen PubMed. Totalt valdes 13 artiklar ut som svarade på syftet. Huvudresultat: Resultaten visade att barn med cancer genomgick många utmaningar som berörde dem fysiskt, psykiskt och socialt. Fysiska utmaningar innefattade främst smärta, rörelsebegränsningar, trötthet samt illamående och kräkningar. Psykiska utmaningar lyfte barnens olika känslor. Vanligast var rädsla, sorg och orättvisa. Sociala utmaningar inkluderade förändrade relationer samt upplevd isolering. Barnen hanterade utmaningarna genom olika strategier, innefattande positiv inställning och stöd från närstående samt vårdpersonal. De upplevde att cancern bidragit till personlig utveckling och givit nya livsperspektiv. Slutsats: Barns erfarenheter av att leva med cancer framställer åtskilliga utmaningar som de behövde hantera under sjukdomen. Känslorna speglades av cancerns olika faser och gjorde att barnen konstant pendlade mellan hopp och förtvivlan. Denna litteraturstudie kan ha en betydande roll för sjuksköterskor inför mötet med barn som lever med cancer. En ökad förståelse för barns cancererfarenheter kan underlätta bemötandet av barnens individuella behov, samt bidra till att främja barnens vårdupplevelser. / Background: About 400 000 children worldwide are annually diagnosed with cancer, with varying chances of survival depending on where the child lives. A cancer diagnosis often entails a major life change for everyone involved and the encounter with childhood cancer can be experienced as difficult. By examining the children's perspective and experiences of cancer, the comprehension and personal treatment of these children can be improved. Aim: The aim was to describe children's experiences of living with cancer. Method: The literature study has a descriptive design and the articles in the result were found through the database PubMed. A total of 13 articles were selected that responded to the aim. Main results: The results showed that children with cancer went through many challenges that affected them physically, psychologically and socially. Physical challenges mainly included pain, movement restrictions, fatigue as well as nausea and vomiting. Psychological challenges emphasized the children's different emotions. Most common were fear, sadness and injustice. Social challenges included changed relationships and perceived isolation. The children handled the challenges through various strategies, including positive attitude and support from relatives and health care professionals. They felt that the cancer contributed to personal development and gave new life perspectives. Conclusion: Children's experiences of living with cancer present several challenges that they needed to deal with during the illness. The feelings were reflected by the different phases of cancer, which caused the children to constantly oscillate between hope and despair. This literature study could have a significant role for nurses before facing children living with cancer. An increased understanding of children's cancer experiences can facilitate children's individual needs, as well as contribute to promoting children's health care experiences.