This multidisciplinary research compilation explores cancer from five distinct but interconnected perspectives: epidemiology, biomedical engineering, pharmacology, caregiver psychology, and phytotherapy to enhance cancer care, especially in resource-limited settings. An epidemiological study in Erbil, Kurdistan, analyzed 374 pediatric cancer cases, revealing leukemia and lymphomas as the most prevalent types, thereby informing regional healthcare planning. A finite element simulation study optimized microwave ablation for breast cancer treatment, showing that single-slot antennas at specific frequencies (2.45 and 4.47 GHz) generated the most effective necrotic zones. A clinical observational study in Hyderabad reported 325 drug-related problems (DRPs) in 107 cancer patients, with 81.5% being adverse drug reactions (ADRs), predominantly hematological, especially among elderly males and those on monotherapy. A qualitative study in Swat documented the emotional, economic, and social burdens on caregivers of esophageal cancer patients undergoing PEG tube feeding, highlighting unmet training and support needs. Lastly, phytochemical and in silico analysis of Murraya paniculata leaf extracts demonstrated strong antioxidant activity and promising estrogen receptor-binding potential, positioning it as a low-toxicity candidate for anticancer drug development. Together, these studies underscore the need for integrative, patient-centered approaches that combine modern science with traditional knowledge to address the complex challenges of cancer care in low-resource environments.

Cancer, Microwave ablation, Drug-related problems, Caregiver burden, Herbal anticancer agents, Breast cancer, Esophageal cancer.

Gastric cancer arises from abnormal cell growth in the stomach, often diagnosed late, reducing curability. Breast cancer, the most prevalent cancer in women, accounts for 23% of new cases and causes over 411,000 deaths annually. Microwave ablation, a heat-based cancer therapy, is limited by high-power demands and backward heating. Antenna type and frequency selection can improve treatment.[1-5]

Pregnancy complicates cancer management due to hormonal and immune changes affecting cancer risk and treatment decisions. Additionally, ozone depletion increases UV-B radiation exposure, raising cancer risk, especially for vulnerable groups like pregnant women, due to fetal sensitivity to ionizing radiation.[6-10]

Cancer patients are highly vulnerable to DRPs due to polypharmacy, complex chemotherapy regimens, and comorbidities. DRPs can lead to treatment failure, higher mortality, extended hospital stays, and reduced quality of life. Esophageal cancer, the eighth most common globally, often requires percutaneous endoscopic gastrostomy (PEG) tube feeding in advanced stages, placing additional burdens on undertrained caregivers. Murraya paniculata (MP), a medicinal plant from the Rutaceae family, has traditional uses in treating diarrhea and joint pain, and exhibits anti-inflammatory, anti-diabetic, and anticancer properties. Herbal medicines like MP offer promising low-toxicity alternatives for developing anticancer drugs and addressing treatment resistance and side effects.[11-15]

Herbal compounds have long served as promising sources for anticancer drug development due to their low toxicity and therapeutic potential. Recent research emphasizes medicinal plants to combat cancer drug resistance. Pediatric cancer types vary globally; in Sub-Saharan Africa, lymphomas and nephroblastomas predominate, while data from Sulaymaniyah, Kurdistan, highlight leukemia and brain tumors.[16-20]

However, research and coordinated data collection remain limited in regions like Erbil. Meanwhile, caregivers of cancer patients, especially those managing PEG tube feeding, face significant burdens without adequate training or support. Addressing caregiver needs through education, peer networks, and respite services is crucial for improving cancer care outcomes.[21-25]

Epidemiological study of pediatric cancer in Erbil
A cross-sectional, descriptive epidemiological study was conducted using secondary data obtained from the cancer registry of Erbil, Kurdistan Region of Iraq. The dataset spanned January 2015 to January 2019 and included complete medical records of 639 pediatric cancer patients from across Iraq, treated in Erbil. After excluding patients older than 10 years and those not residing within the Kurdistan Region, 374 eligible pediatric cases were analysed. Cancers were classified using the International Classification of Diseases for Oncology, Third Edition (ICD-O-3). Data analysis was performed using Microsoft Excel 2010. Ethical standards were maintained by anonymizing all patient records through ID codes, ensuring privacy and confidentiality. The study followed American Psychological Association (APA) guidelines for reporting and declared no conflicts of interest.

Microwave ablation simulation using finite element modelling
An experimental simulation study was conducted using COMSOL Multiphysics™ 4.4 to model microwave ablation in breast cancer tissue. The finite element method (FEM) was employed to simulate electromagnetic and thermal interactions based on Maxwell’s equations and Pennes’ bioheat transfer equation. Breast fat tissue was modelled as a uniform cylindrical volume (30 mm in diameter and 90 mm deep), with antennas inserted at a depth of 70 mm. Two antenna designs, single-slot and monopole, were analysed, both consisting of inner and outer conductors and a dielectric protected by a polytetrafluoroethylene (PTFE) catheter to enhance electromagnetic coupling.

Radiofrequency and heat transfer modules simulated energy absorption and subsequent necrotic zone formation. Specific Absorption Rate (SAR), temperature distribution, and heating patterns were evaluated across multiple frequencies (0.03-9.22 GHz). ImageJ software was used to measure dimensions of the ablation zones (length, diameter, and aspect ratio), enabling assessment of antenna performance in creating controlled tissue necrosis.

Clinical study on drug-related problems in cancer patients
A single-center, six-month observational study was conducted at Continental Hospitals in Hyderabad, India, involving 107 cancer patients aged above 2 years. Inclusion criteria comprised patients receiving chemotherapy, immunotherapy, hormonal therapy, or targeted treatments, while neonates and infants were excluded. Data were gathered from electronic medical records, medication charts, nurse notes, and clinical case sheets, and reviewed by study coordinators to ensure accuracy.

A structured data collection form was designed to capture relevant clinical parameters, treatment regimens, and adverse drug events. Analysis was performed using Microsoft Excel to identify DRPs, with a particular focus on ADRs, drug interactions, and dosing errors. The study emphasized stratification based on age and gender, allowing for the identification of high-risk subgroups.

Qualitative study of caregivers of esophageal cancer patients
A phenomenological qualitative study explored the lived experiences of 12 purposively selected primary caregivers of esophageal cancer patients undergoing percutaneous PEG tube feeding at Saidu Teaching Hospital, Swat. Participants were selected based on having at least one month of caregiving experience and provided informed consent.

Data were collected via in-depth, semi-structured interviews conducted in private settings to promote openness. Interviews were audio-recorded, transcribed verbatim, and supported by field notes and non-verbal observations. Reflexivity was maintained through a journal, and peer debriefing sessions were used to ensure credibility. Data were analyzed using Braun and Clarke’s six-step thematic analysis with the help of NVivo software. Themes were validated through member checking and methodological triangulation, which included interviews, observation, and document review. This approach allowed for a comprehensive understanding of the emotional, social, and practical challenges faced by caregivers.

Phytochemical and in silico evaluation of Murraya paniculata
Pharmacognostic and computational studies were conducted on Murraya paniculata leaf extracts to investigate their antioxidant and potential anticancer properties. Dried MP leaves were extracted using Soxhlet extraction with 98% methanol, then filtered and concentrated under vacuum. The extract was stored at 4°C for subsequent analysis.

Preliminary phytochemical screening identified bioactive constituents such as flavonoids, alkaloids, saponins, tannins, and phenols. Antioxidant activity was assessed via a nitric oxide (NO) scavenging assay using Griess reagent, measuring absorbance at 550 nm. The percentage inhibition of NO production was calculated and compared to a standard (ascorbic acid).

For chemical profiling, liquid chromatography-mass spectrometry (LC-MS) was used. Molecular docking studies were conducted using AutoDock Vina and Desmond (Schrodinger) software, targeting the human estrogen receptor alpha (PDB ID: 3ERT). Ligand preparation involved various MP phytochemicals known for bioactivity, including coumarins and alkylated flavonoids. Binding affinities and interaction energies were evaluated to identify potential anticancer candidates.

Absorption, distribution, metabolism, excretion, and toxicity (ADMET) predictions were performed using Swiss ADME to assess drug-likeness, blood-brain barrier permeability, and intestinal absorption. Finally, molecular dynamics simulations (250 ps) were conducted using the optimized potentials for liquid simulations version 3 (OPLS3) force field and simple point charge (SPC) water model to assess the stability of ligand-receptor complexes under physiological conditions.

Epidemiological profile of pediatric cancers: Insights from 374 cases in Erbil
Darya YM et al., study provides a detailed epidemiological analysis of 374 pediatric cancer cases, offering key insights into the distribution, frequency, and demographic characteristics of childhood cancers in the studied population. The central finding is that a small group of cancer types accounts for most cases, indicating that targeted strategies could potentially address a significant portion of the pediatric cancer burden.

The analysis revealed that over 75% of all cases fell into five major cancer categories. The most common topographic site was the hematopoietic and reticuloendothelial systems, which include leukemias and lymphomas, accounting for nearly a third (32.9%) of all diagnoses. This was followed by cancers of the urinary tract (12.8%), lymph nodes (8.3%), brain (7.5%), and bones, joints, and cartilage (6.4%). These findings not only reflect global pediatric cancer trends but also offer critical data for regional planning and prioritization of healthcare resources.

The study also categorized specific neoplasms within rarer groups. Among 50 cases of complex mixed and stromal neoplasms, the most frequent were mesoblastic nephromas and nephroblastomas, both associated with kidney tumors in infants and young children. Of the 41 neuroepitheliomatous neoplasms, neuroblastomas and retinoblastomas, which are common in very young children, were the most prominent, further supporting age-specific screening and diagnostic efforts.

Additionally, most patients (79%) were from Erbil, suggesting a possible geographic concentration of cases, which may reflect either environmental factors, healthcare access, or population density.

Another significant observation was the increase in cancer diagnoses between 2015 and 2017, which may be attributed to improved diagnostic capacity, increased awareness, or a genuine rise in incidence. This trend signals the need for continuous surveillance and enhancement of early detection strategies to manage pediatric cancers more effectively.[26]

Optimization of microwave ablation: Influence of antenna type, frequency, and geometry on heating efficiency and necrotic zone formation
Amiegbereta EE et al., study demonstrates that the type, frequency, and geometry of microwave antennas play a critical role in determining the effectiveness of microwave ablation procedures. Through 26 simulations conducted across a frequency range of 0.03–9.22 GHz, the research assessed how different antenna configurations perform under standardized conditions (10 W for 300 seconds).

Single-slot antennas emerged as the most efficient, showing superior power dissipation and well-defined heating patterns, particularly at the frequencies of 2.45 GHz and 4.47 GHz. These antennas produced larger and more uniform ablation (necrotic) zones, which are desirable for targeting and destroying tumor tissues effectively.

Monopole antennas, tested in different lengths (8 mm, 10 mm, and 13.5 mm), showed that their heating efficiency was both frequency- and geometry-dependent. Among these, the 8 mm monopole antenna at 6.02 GHz achieved the most favorable results, indicating that precise tuning of both physical dimensions and frequency is essential for optimal outcomes.

A key finding was that the shape and size of the necrotic zone, as well as the aspect ratio, varied significantly based on the antenna design and operational parameters. Additionally, the study highlighted that high reflection coefficients-a measure of energy not absorbed by tissue led to inefficient energy transfer and raised the risk of unintended tissue damage.[27]

High incidence of drug-related problems in cancer patients: Impact of age, gender, and monotherapy on adverse drug reactions
Pradeep KRK et al., study sheds light on the high burden of DRPs among cancer patients, revealing that ADRs are the predominant issue, especially in older adults and male patients. Among the 107 cancer patients evaluated (mean age: 54 years), the age group most affected was 66–75 years, indicating that the elderly are particularly vulnerable to medication-related complications in oncology care.

A total of 325 DRPs were identified during the study period. Of these, a striking 265 (approximately 81.5%) were ADRs, followed by drug interactions and dosing errors. Among the ADRs, hematological reactions such as anemia, neutropenia, or thrombocytopenia were the most common, which is a critical finding given the already compromised health status of cancer patients. Additionally, Grade I ADRs, which are mild but potentially indicative of more serious problems if not addressed, were the most frequently observed, accounting for 54.3% of the ADRs.

One of the key findings was the significantly higher incidence of DRPs in male patients compared to females (p < 0.05). This sex-specific trend may be influenced by differences in drug metabolism, treatment adherence, or disease profiles, and it underlines the need for tailored pharmacological monitoring.

Interestingly, while monotherapy is often assumed to be a safer and simpler approach, the study found that it was linked to the highest incidence of DRPs, suggesting that even single-drug regimens can carry substantial risks in this patient population. This challenges traditional assumptions and suggests that monotherapy should not automatically be considered low risk in cancer treatment.[28]

Caregiving in esophageal cancer: Emotional, practical, and socioeconomic burdens among informal caregivers
Nisar K et al., study provides valuable insight into the multifaceted challenges faced by caregivers of esophageal cancer patients, focusing on a small but detailed sample of 12 individuals. The central finding is that caregiving imposes a profound emotional, practical, and socioeconomic burden, especially on women, who comprised 75% of the participants. Most caregivers were middle-aged and had low educational attainment, with 41.7% having only primary education. These demographic factors likely contributed to the difficulty in navigating complex caregiving tasks and accessing supportive resources.

Spouses (41.7%) and children (33.3%) emerged as the primary caregivers, reinforcing that caregiving responsibilities often fall on immediate family members. Many caregivers were either unemployed (66.7%) or had left their jobs (25%) to provide care, indicating the significant economic impact and career disruption associated with long-term caregiving. This highlights a pressing need for financial and employment support for informal caregivers.

In terms of duration, caregiving typically extended over 4 to more than 6 months, pointing to the sustained and intensive nature of support required for esophageal cancer patients, particularly those undergoing major treatments like feeding tube placements.[29]

Phytochemical and therapeutic potential of MP: Antioxidant activity and Estrogen receptor interaction
The study by Sri Ramya T et al. provides a comprehensive investigation into the phytochemical composition and pharmacological potential of methanol extracts from MP, a plant traditionally known for its medicinal properties. The core finding is that the extracts are rich in bioactive compounds with strong antioxidant, antimicrobial, and wound-healing potential, positioning MP as a promising candidate for therapeutic applications.

Phytochemical screening revealed the presence of important secondary metabolites, including alkaloids, flavonoids, phenols, tannins, and saponins, all of which are known for their diverse biological activities. These compounds are often responsible for the therapeutic effects observed in herbal medicines.

A key highlight of the study is the extract’s strong NO scavenging activity, with a 50.88% inhibition rate at a concentration of 200 μg/ml. This activity was comparable to that of ascorbic acid, a well-established antioxidant. Since nitric oxide plays a significant role in oxidative stress and inflammation, the extract’s scavenging effect supports its antioxidant and anti-inflammatory potential.

The study further employed LC-MS to identify specific phytochemicals within the extract. One of the standout compounds, 5,7-dimethoxy-8-(2-oxo-3-methylbutyl) coumarin, exhibited the strongest binding interaction with the human estrogen receptor (ERT) in molecular docking simulations. This suggests potential hormone-related therapeutic applications, such as in hormone-responsive cancers or estrogen-related disorders.[30]

Table 1: Integrated cancer care framework from a multidisciplinary perspective

This multidisciplinary research highlights the complexity of cancer diagnosis, treatment, and care, particularly in vulnerable populations such as pediatric patients, pregnant women, and caregivers. The epidemiological study from Erbil highlights the predominance of hematopoietic and reticuloendothelial cancers in children, consistent with global patterns, and emphasizes the role of improved diagnostics in rising case detection. These findings underline the necessity for region-specific surveillance systems and resource allocation to manage pediatric cancer efficiently.

While the microwave ablation simulations demonstrate how engineering advances can optimize treatment delivery with minimal infrastructure. The single-slot devices at specific frequencies demonstrated superior tissue necrosis and minimized backward heating, suggesting they may improve treatment efficacy and safety in breast cancer cases.

The qualitative study on esophageal cancer caregiving paints a vivid picture of the emotional and financial strain borne by family caregivers, predominantly women with limited education and employment. These insights call for policy-level support such as caregiver training, economic relief, and psychosocial services to mitigate the caregiving burden.

Finally, the phytochemical analysis of MP illustrates the untapped potential of herbal compounds in addressing cancer treatment gaps with accessible, low-toxicity options. Altogether, these studies represent a holistic approach, one that links diagnostics, therapeutics, caregiver engagement, and drug discovery to enhance cancer care equity in developing regions.

From qualitative interviews to molecular simulations, these studies underscore the need for interdisciplinary collaboration melding engineering, pharmacology, medicine, and social science. Darya YM’s pediatric cancer study underscores the regional disease burden and the need for targeted healthcare planning. Amiegbereta EE’s simulation of microwave antennas demonstrates the role of biomedical engineering in enhancing treatment precision. Pradeep KRK et al.’s findings on drug-related problems stress the importance of vigilant pharmacological oversight in cancer therapy. Nisar K’s qualitative exploration reveals the often-unseen psychological and socioeconomic toll on caregivers, emphasizing the need for systemic support. Finally, Sri Ramya T et al., show the therapeutic potential of Murraya paniculata, suggesting opportunities for integrating traditional medicine into modern pharmacology.

Collectively, these studies illustrate that addressing cancer comprehensively requires a multidisciplinary, patient-centered, and context-specific approach. Future research must bridge laboratory advances with clinical and social realities, ensuring that innovations translate into improved outcomes and holistic care for both patients and their support systems.

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Corresponding Author:
Samatha Ampeti  PhD
Department of Pharmacology
Kakatiya University, University College of Pharmaceutical Sciences, Warangal, TS, India
Email: ampetisamatha9@gmail.com

Co-Authors:
Shubham Ravindra Sali, Mansi Srivastava, Raziya Begum Sheikh, Patel Nirali Kirankumar
Independent Researcher,
Department of Content, medtigo India Pvt Ltd, Pune, India

All authors contributed to the conceptualization, investigation, and data curation by acquiring and critically reviewing the selected articles. They were collectively involved in the writing, original draft preparation, and writing review & editing to refine the manuscript. Additionally, all authors participated in the supervision of the work, ensuring accuracy and completeness. The final manuscript was approved by all named authors for submission to the journal.

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https://doi.org/10.63096/medtigo3061234

Shubham RS, Samatha A, Mansi S, Raziya BS, Patel NK. Comprehensive Oncology Insights: Pediatric Trends, Therapeutic Advances, and Caregiver Challenges in Developing Settings. medtigo J Pharmacol. 2025;2(3):e3061234. doi:10.63096/medtigo3061234 Crossref