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.

Background: Radiation therapy used for head and neck cancer patients cause many side effects in the oral cavity and above all affects the salivary glands. Complaint of dry mouth (xerostomia) and hyposalivation are common as well as swallowing difficulty (dysphagia) even after the cancer is remitted.  Aim: The aim of the study is to examine the correlation between hyposalivation and xerostomia in patients undergoing radiotherapy.   Methods: Six patients undergoing radiotherapy for head and neck cancer at Norrlands University Hospital participated in the study. A questionnaire regarding xerostomia was answered and a collection of stimulated as well as unstimulated saliva was taken.  Results: Regarding the stimulated salivary flowrate, one out six patients was below the limit of hyposalivation. Three out of six patients were below the limit of hyposalivation with reference to the unstimulated salivary output. The questionnaire regarding xerostomia showed that all patients experienced dry mouth symptoms to varying degrees. The questions concerning the dryness of the tongue and the amount of saliva in the mouth had the highest rating.  Conclusion: Regarding the patients that participated in this study, a correlation is shown between xerostomia and unstimulated salivary output. However, due to the lack of participants in the study, no firm conclusion can be drawn.

Bakgrund: Bröstcancer är idag den vanligaste cancerformen som drabbar kvinnor i världen. För unga kvinnor under 45 årsåldern riskerar endast 4-6% att drabbas av bröstcancer vilket utgör diagnosen till en ovanlig sjukdom. På grund av bröstcancerns svåra patologi och dess unika prognostik krävs särskild uppmärksamhet hos unga kvinnor då cancern påverkar flera aspekter på livet som fertilitet, familjeliv och karriär.  Syfte: Syftet med litteraturöversikten var att beskriva den unga kvinnans upplevelser av att leva med bröstcancer.  Metod: Studien är en kvalitativ litteraturstudie innefattande av tolv artiklar där en kvalitativ innehållsanalys tillämpats vid analysering av data.  Resultat: Olika upplevelser som identifierades i de inkluderade artiklarna kunde sammankopplas under följande huvudkategorier: 1) Den unga kvinnans sexuella hälsa, 2) Ångest och livskris, 3) Den sociala aspekten.  Slutsatser: Olika upplevelser identifierades hos unga kvinnor under deras bröstcancerdiagnos. För att öka sjuksköterskors förståelse för unga bröstcancerpatienter och möjliggöra implementationen av förbättrad vård bör sjuksköterskestudenter och nuvarande sjuksköterskor utbildas om omvårdnad vid unga bröstcancerpatienter. / Background: Breast cancer is today the most common form of cancer that affects women in the world. For young women under the age of 45, only 4-6% are at risk of suffering from breast cancer, which constitutes the diagnosis of an unusual disease. Due to the difficult pathology of breast cancer and its unique prognosis, special attention is required in young women as the cancer affects several aspects of life such as fertility, family life and career. Aim: The purpose of the literature review was to describe the young woman's experiences of living with breast cancer. Method: The study is a qualitative literature study comprising twelve articles where a qualitative content analysis is applied when analyzing the data. Results: Different experiences identified in the included articles could then be linked under the following main categories: 1) The young woman's sexual health, 2) Anxiety and lifecrisis, 3) The social aspect. Conclusion: Different experiences were identified in young women during their breast cancer diagnosis. In order to increase nurses' understanding of young breast cancer patients and enable the implementation of improved care, nursing students and current nurses should be educated about nursing care for young breast cancer patients.

A high expression of stromal PDGFRβ is known to be a poor prognosis marker in several solid tumor types. However, the role of stromal PDGFRβ for non-small cell lung cancer (NSCLC) patients remains unclear. Therefore, we investigated the activation status of PDGFRβ with proximity ligation assay (PLA) by studying the interaction between the receptor and GRB2, one of PDGFRβs downstream signaling molecules. The main aim is in this study is to investigate the activation status of stromal PDGFRβ in NSCLC tissues and look into its clinical relevance for lung cancer patients. Our data revealed that PDGFRβ activation status did not affect overall survival, and was not associated to smoking, sex, age or stage of cancer. PDGFRβ activation status was higher in the histological subgroup of squamous cell carcinoma-patients compared to the adenocarcinoma subgroup. The PDGFRβ activation status showed a clear correlation to the general expression level of PDGFRβ investigated by immunohistochemistry (IHC). The correlation also showed that a high activation status required a high general expression, indicating a specific pipeline.

Bakgrund: Under 2020 fick 7570 kvinnor i Sverige diagnosen bröstcancer. Under sjukdomsförloppet kommer behandling sättas in för att bota cancern och förebygga att den ska sprida sig och komma tillbaka i framtiden. De vanligaste behandlingarna vid bröstcancer är mastektomi, strålbehandling samt cytostatika. Det är viktigt att sjuksköterskan har rätt resurser, förutsättningar samt kunskap för att kunna möta kvinnan i sin sjukdom och förstå hur hennes sexualitet, självbild och identitet förändras under behandlingstiden vid bröstcancer. Syfte: Syftet var att beskriva hur kvinnans sexualitet, självbild och identitet förändras under behandlingstiden vid en bröstcancerdiagnos. Metod: Studien genomfördes med en kvalitativ design med induktiv ansats. Litteraturstudien utgick från tre patografier och analysen genomfördes i enlighet med Graneheim och Lundmans (2017) kvalitativa innehållsanalys. Resultat: Resultatet i denna studie baserades på två huvudkategorier/ teman och fyra underkategorier/ teman. De olika kategorierna/ teman beskriver hur tre kvinnor med en bröstcancerdiagnos upplever att deras självbild förändras under behandlingsperioden. Huvudkategorierna/ teman i studien är att inte känna igen sig själv, kroppsliga förändringar samt emotionella reaktioner. Under behandlingen förändras kvinnans självbild och identitet. Saker så som självständighet, kroppsuppfattning samt känsla av sexualitet omvärderas i relation till hur kvinnans liv var innan dess att hon fick bröstcancerdiagnosen  Slutsats: Slutsatsen som kan dras efter att ha studerat resultatet är att kvinnors självbild förändras under behandling av bröstcancer. I resultatet framkom det att flera aspekter av självbilden förändras. Bland dessa fanns förändrad identitet samt upplevelsen av kvinnans sexualitet. Resultatet i denna studie är riktat till den grundutbildade sjuksköterskan men kan med fördel också intressera övrig sjukvårdspersonal och bröstcancerdrabbade kvinnor.

Umeå University Hospital has acquired a new treatment planning system, RayStation, for radiotherapy. It has a different set of dose calculation algorithms that require new planning strategies for stereotactic lung cancer treatments. This \paper{} has two parts and the first investigates the Monte Carlo algorithm, recalculating doses for 21 historical treatments, and finds that it is slow but fast enough to be used and that it reports dose coverage that is usually lower than that of simpler algorithms, particularly for small tumours in low density lungs. The second part investigates the performance of four alternative planning methods: a straight forward PTV/ITV based method, a method using density override of the PTV, an ITV based semi-robust method and a fully robust method treating both setup margins and breathing motion robustly. The new methods are tested on 12 historical cases and are compared, using robust evaluation, to each other and the original plans. The first three are found to all be viable alternatives, while the fully robust method, while impressive, is found not to be a practical alternative at this time. / Norrlands Universitetssjukhus har skaffat ett nytt dosplaneringssystem, RayStation, till radioterapin. Det har en annan uppsättning dosberäkningsalgoritmer som kräver en ny planeringsstrategi för stereotaktisk lungcancerbehandling. Den här rapporten innehåller två delar och den första undersöker Monte Carlo-algoritmen genom att räkna om doserna för 21 tidigare behandlingar. Den visar sig vara långsam men snabb nog för att vara användbar och den rapporterar lägre dostäckning än enklare algoritmer, särskilt för små tumörer i lungor med låg densitet. Den andra delen undersöker fyra alternativa planeringsmetoder: en baserad på PTV och ITV utan krusiduller, en dito med s.k. override av PTVs densitet, en ITV-baserad med robust hantering av setup-marginaler och en helt robust metod med robust hantering av både marginaler och andningsrörelser. De nya metoderna testas på 12 tidigare behandlingar och jämförs, medelst robust utvärdering, med varandra och originalplanerna. De tre första visar sig alla vara goda alternativ medan den helt robusta, som visserligen är imponerande, inte är praktiskt användbar än.

The number of children and young adolescents diagnosed with cancer is increasing, leading to a need for new therapeutic strategies with diminished neurodegenerative side- effects. This report presents preliminary observations on glioma-initiating cells (GICs) in the way to develop a strategy that induces cell-cycle arrest or quiescence in neural stem cells (NSCs). To test how changes in membrane potential due to pharmacological treatments have effects on localization and levels of REV-ERBα protein, proneural (PN) and mesenchymal (MES) cells were treated with varying concentrations of REV-ERBα agonist SR9009 drug and T-type calcium channel blocker mibefradil. Treatments showed that both drugs do not relocalize REV-ERBα to the nucleus. However, SR9009 decreases the levels of REV-ERBα protein, whereas mibefradil does not have a similar effect.  Our preliminary data on mouse NSCs showed they engage with REV-ERBα protein while going into contact inhibition. Therefore, we investigated whether high confluency put PN and MES GICs into quiescence and the role of the main molecular clock protein REV-ERBα in this process. Cells were grown up to certain confluency, and following qPCR gene expression analysis revealed PN cells go into contact inhibition whereas MES cells continue proliferating even after they are grown to confluency. Moreover, REV-ERBα protein does not have any role in both outcomes.

Background: Neuroblastoma is the most common extracranial solid tumor in children. The survival rate in high-risk neuroblastoma is less than 50 % despite intensive multimodal therapy, and there is thus an immense need for new treatment options. In a previous preclinical study conducted at Uppsala University, treatment with sunitinib was found to inhibit tumor growth and angiogenesis in an orthotopic model of high-risk neuroblastoma.  Aim: The present study aimed to further explore the effect of sunitinib on tumor stroma, focusing on whether it was possible to detect and quantify tumor-associated neutrophils (TANs) in tumor sections from the above-mentioned study using immunohistochemistry (IHC). Methods: Tissue sections from formalin-fixated paraffin-embedded tumors were stained with anti-Ly-6G/Ly-6C, anti-ITGAM, or hematoxylin-eosin, and the number of granulocytes was quantified manually using a light microscope. An independent samples two-tailed t-test was used for statistical analysis. Results: The average number of granulocytes increased by 40 % in animals treated with sunitinib compared to control animals (p = 0.003) in hematoxylin-eosin stained tumor sections of orthotopic neuroblastomas. The results from the staining with anti-Ly-6G/Ly-6C or anti-ITGAM, on the other hand, were impossible to quantify due to the high background staining despite the concentration of antibody used. Conclusion: In conclusion, this report indicates that the density of TANs in an orthotopic murine neuroblastoma model is increased by treatment with sunitinib. However, to confirm this result, the study should be repeated once a reliable IHC method for the detection of TANs has been developed.

Background: Every year, hundreds of children are diagnosed with cancer. This affects the whole child's family, which means that the nurse during the child's cancer care must be there to support the whole family. The parent needs to feel involved in the child's care and have a trusting relationship with the nurse. As a parent, you have to go through a great deal of suffering, which requires the nurse to adapt her support to the needs of the parent and the child. Aim: The purpose of this study was to shed light on how a parent with a child with cancer experiences the nurse's support during and after cancer care. Method: A literature-based study was conducted. Ten qualitative articles were selected and analyzed, based on Friberg's analysis step model. This participates in three categories and a total of eight subcategories. Results: The results showed that the nurse's support was an important factor in an attempt to reduce the parent's suffering. This support could be divided into three categories: Cooperation between nurse and parent, parent's need for support and accessibility and communication. Conclusion: Pediatric cancer affects the whole child's family, and the parent is in great need of support to deal with their suffering and at the same time support their child. During their child’scancer care, the parent goes through many feelings of no longer recognizing their own child, as well as being helpless in their parenting role. By the nurse working in an empathetic and inclusive way where there is an opportunity to build meaningful and strengthening relationships between the parent and the nurse and that the parent's needs are also met, the parent's suffering can be reduced with the help of the nurse's support.