51
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Martins A, Taylor RM, Lobel B, McCann B, Soanes L, Whelan JS, Fern LA. Sex, Body Image, and Relationships: A BRIGHTLIGHT Workshop on Information and Support Needs of Adolescents and Young Adults. J Adolesc Young Adult Oncol 2018; 7:572-578. [DOI: 10.1089/jayao.2018.0025] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
- Ana Martins
- University College London Hospitals NHS Foundation Trust, London, United Kingdom
| | - Rachel M. Taylor
- University College London Hospitals NHS Foundation Trust, London, United Kingdom
| | - Brian Lobel
- Division of Theatre, University of Chichester, Chichester, United Kingdom
| | - Beth McCann
- University College London Hospitals NHS Foundation Trust, London, United Kingdom
| | - Louise Soanes
- University College London Hospitals NHS Foundation Trust, London, United Kingdom
| | - Jeremy S. Whelan
- University College London Hospitals NHS Foundation Trust, London, United Kingdom
| | - Lorna A. Fern
- University College London Hospitals NHS Foundation Trust, London, United Kingdom
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Frederick NN, Campbell K, Kenney LB, Moss K, Speckhart A, Bober SL. Barriers and facilitators to sexual and reproductive health communication between pediatric oncology clinicians and adolescent and young adult patients: The clinician perspective. Pediatr Blood Cancer 2018; 65:e27087. [PMID: 29697189 DOI: 10.1002/pbc.27087] [Citation(s) in RCA: 56] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/22/2018] [Revised: 03/15/2018] [Accepted: 03/16/2018] [Indexed: 11/12/2022]
Abstract
BACKGROUND Sexual and reproductive health (SRH) is identified by adolescent and young adult (AYA) patients with cancer as an important but often neglected aspect of their comprehensive cancer care. The purpose of this study was to investigate the attitudes and perceptions of pediatric oncology clinicians towards discussing SRH with AYAs, and to understand perceived barriers to effective communication in current practice. PROCEDURE Pediatric oncology clinicians (physicians, certified nurse practitioners, and physician assistants) participated in semi-structured qualitative interviews investigating attitudes about SRH communication with AYAs and barriers to such conversations. Twenty-two clinicians participated from seven institutions in the Northeastern United States. Interviews were audio-recorded, transcribed, and coded using a thematic analysis approach. RESULTS Interviews with pediatric oncology clinicians revealed the following five primary themes: the role for pediatric oncology clinicians to discuss SRH, the focus of current SRH conversations on fertility, the meaning of "sexual health" as safe sex and contraception only, clinician-reported barriers to SRH conversations, and the need for education and support. Communication barriers included lack of knowledge/experience, lack of resources/referrals, low priority, parents/family, patient discomfort, clinician discomfort, time, and lack of rapport. Clinicians identified resource and support needs, including formal education and SRH education materials for patients and families. CONCLUSIONS Although the study participants identified a role for pediatric oncology clinicians in SRH care for AYA patients with cancer, multiple barriers interfere with such discussions taking place on a regular basis. Future efforts must focus on resource development and provider education and training in SRH to optimize the care provided to this unique patient population.
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Affiliation(s)
- Natasha N Frederick
- Center for Cancer and Blood Disorders, Connecticut Children's Medical Center, Hartford, Connecticut
| | - Kevin Campbell
- Department of Pediatrics, Boston Children's Hospital, Boston, Massachusetts
| | - Lisa B Kenney
- Perini Family Survivors' Center, Dana-Farber Cancer Institute, Boston, Massachusetts.,Dana-Farber/Boston Children's Cancer and Blood Disorders Center, Boston, Massachusetts
| | - Kerry Moss
- Center for Cancer and Blood Disorders, Connecticut Children's Medical Center, Hartford, Connecticut
| | | | - Sharon L Bober
- Perini Family Survivors' Center, Dana-Farber Cancer Institute, Boston, Massachusetts
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53
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Sodergren SC, Husson O, Rohde GE, Tomaszewska IM, Vivat B, Yarom N, Griffiths H, Darlington AS. A Life Put on Pause: An Exploration of the Health-Related Quality of Life Issues Relevant to Adolescents and Young Adults with Cancer. J Adolesc Young Adult Oncol 2018; 7:453-464. [DOI: 10.1089/jayao.2017.0110] [Citation(s) in RCA: 39] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Affiliation(s)
| | - Olga Husson
- Department of Medical Psychology, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Gudrun E. Rohde
- Faculty of Health and Sport Sciences, University of Agder, Kristiansand, Norway
- Department of Clinical Research, Sorlandet Hospital, Kristiansand, Norway
- Marie Curie Palliative Care Research Department and Division of Psychiatry, University College London, London, United Kingdom
| | - Iwona M. Tomaszewska
- Department of Medical Education, Jagiellonian University Medical College, Krakow, Poland
| | - Bella Vivat
- Marie Curie Palliative Care Research Department and Division of Psychiatry, University College London, London, United Kingdom
| | - Noam Yarom
- Oral Medicine Unit, Sheba Medical Center, Tel-Hashomer, Israel
- The Maurice and Gabriela Goldschleger School of Dental Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Helen Griffiths
- Department of Psychological Medicine, Oxford University Hospital, Oxford, United Kingdom
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54
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Jibb L, Croal L, Wang J, Yuan C, Foster J, Cheung V, Gladstone B, Stinson J. Children’s Experiences of Cancer Care: A Systematic Review and Thematic Synthesis of Qualitative Studies. Oncol Nurs Forum 2018; 45:527-544. [DOI: 10.1188/18.onf.527-544] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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55
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Lehmann V, Keim MC, Ferrante AC, Olshefski RS, Gerhardt CA. Psychosexual development and satisfaction with timing of developmental milestones among adult survivors of childhood cancer. Psychooncology 2018; 27:1944-1949. [DOI: 10.1002/pon.4746] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2018] [Revised: 04/16/2018] [Accepted: 04/17/2018] [Indexed: 01/06/2023]
Affiliation(s)
- Vicky Lehmann
- Center for Biobehavioral Health; The Research Institute at Nationwide Children's Hospital; Columbus OH USA
- Department of Psychology; St. Jude Children's Research Hospital; Memphis TN USA
| | | | - Amanda C. Ferrante
- Center for Biobehavioral Health; The Research Institute at Nationwide Children's Hospital; Columbus OH USA
| | - Randal S. Olshefski
- Division of Pediatric Hematology/Oncology; Nationwide Children's Hospital; Columbus OH USA
| | - Cynthia A. Gerhardt
- Center for Biobehavioral Health; The Research Institute at Nationwide Children's Hospital; Columbus OH USA
- Department of Pediatrics; The Ohio State University; Columbus OH USA
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56
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Jibb LA, Stevens BJ, Nathan PC, Seto E, Cafazzo JA, Johnston DL, Hum V, Stinson JN. Perceptions of Adolescents With Cancer Related to a Pain Management App and Its Evaluation: Qualitative Study Nested Within a Multicenter Pilot Feasibility Study. JMIR Mhealth Uhealth 2018; 6:e80. [PMID: 29625951 PMCID: PMC5910537 DOI: 10.2196/mhealth.9319] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2017] [Revised: 01/08/2018] [Accepted: 01/26/2018] [Indexed: 01/06/2023] Open
Abstract
BACKGROUND Pain in adolescents with cancer is common and negatively impacts health-related quality of life. The Pain Squad+ smartphone app, capable of providing adolescents with real-time pain management support, was developed to enhance pain management using a phased approach (ie, systematic review, consensus conference and vetting, iterative usability testing cycles). A 28-day Pain Squad+ pilot was conducted with 40 adolescents with cancer to evaluate the feasibility of implementing the app in a future clinical trial and to obtain estimates of treatment effect. OBJECTIVE The objective of our nested qualitative study was to elucidate the perceptions of adolescents with cancer to determine the acceptability and perceived helpfulness of Pain Squad+, suggestions for app improvement, and satisfaction with the pilot study protocol. METHODS Post pilot study participation, telephone-based, semistructured, and audio-recorded exit interviews were conducted with 20 adolescents with cancer (12-18 years). All interviews were transcribed and independently coded by 2 study team members. Content analysis was conducted to identify data categories and overarching themes. RESULTS Five major themes comprising multiple categories and codes emerged. These themes focused on the acceptability of the intervention, acceptability of the study, the perceived active ingredients of the intervention, the suitability of the intervention to adolescents' lives, and recommendations for intervention improvement. CONCLUSIONS Overall, Pain Squad+ and the pilot study protocol were acceptable to adolescents with cancer. Suggestions for intervention and study improvements will be incorporated into the design of a future randomized clinical trial (RCT) aimed at assessing the effectiveness of Pain Squad+ on adolescents with cancer health outcomes.
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Affiliation(s)
- Lindsay A Jibb
- School of Nursing, Faculty of Health Sciences, University of Ottawa, Ottawa, ON, Canada.,Evidence-to-Practice Program, Children's Hospital of Eastern Ontario Research Institute, Ottawa, ON, Canada
| | - Bonnie J Stevens
- Child Health Evaluative Sciences Program, Hospital for Sick Children, Toronto, ON, Canada.,Lawrence S Bloomberg Faculty of Nursing, University of Toronto, Toronto, ON, Canada
| | - Paul C Nathan
- Child Health Evaluative Sciences Program, Hospital for Sick Children, Toronto, ON, Canada.,Division of Hematology/Oncology, Hospital for Sick Children, Toronto, ON, Canada.,Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, ON, Canada
| | - Emily Seto
- Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, ON, Canada.,eHealth Innovation, University Health Network, Toronto, ON, Canada
| | - Joseph A Cafazzo
- Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, ON, Canada.,eHealth Innovation, University Health Network, Toronto, ON, Canada
| | - Donna L Johnston
- Evidence-to-Practice Program, Children's Hospital of Eastern Ontario Research Institute, Ottawa, ON, Canada.,Division of Hematology/Oncology, Children's Hospital of Eastern Ontario, Ottawa, ON, Canada.,Faculty of Medicine, University of Ottawa, Ottawa, ON, Canada
| | - Vanessa Hum
- Think Research Corporation, Toronto, ON, Canada
| | - Jennifer N Stinson
- Child Health Evaluative Sciences Program, Hospital for Sick Children, Toronto, ON, Canada.,Lawrence S Bloomberg Faculty of Nursing, University of Toronto, Toronto, ON, Canada.,Department of Anesthesia and Pain Medicine, Hospital for Sick Children, Toronto, ON, Canada
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57
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Ismail Y, Hendry J. Support needs of adolescents' post-cancer treatment: A systematic review. Radiography (Lond) 2018; 24:175-183. [PMID: 29605116 DOI: 10.1016/j.radi.2017.12.004] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2017] [Revised: 11/30/2017] [Accepted: 12/05/2017] [Indexed: 11/16/2022]
Abstract
INTRODUCTION The study aimed to investigate the support needs for adolescents' post-cancer treatment. MATERIALS AND METHODS A systematic literature review was conducted, articles were obtained from the following databases, Science Direct, PubMed and SCOPUS. Additional studies were identified from the reference lists of articles included in the review. RESULTS 119 articles were identified as potentially relevant, of these, a total of 16 articles were nominated to be included in the review for analysis. CONCLUSION The role of relationships and key workers were important to enabling survivors to self-manage. Studies have commended the role of friendships during the cancer treatment process but also as a means to coping with issues relating to survivorship. Using a coping mechanism thought to be beneficial by the survivor often improves their overall wellbeing. The eagerness to continue a normal successful life post-cancer treatment seems to be over-shadowed by the fear of not being able to conceive offspring. This, in turn, can impact the psychological wellbeing of survivors, thus signifying the need to develop ways in supporting these individuals. With research into quality of life (QoL) and survivorship issues continuing to progress and reach new heights, there is still much to be done.
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Affiliation(s)
- Y Ismail
- Kingston University, St. George's, University of London, United Kingdom.
| | - J Hendry
- Kingston University, St. George's, University of London, United Kingdom.
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58
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Tuinman MA, Lehmann V, Hagedoorn M. Do single people want to date a cancer survivor? A vignette study. PLoS One 2018; 13:e0194277. [PMID: 29566002 PMCID: PMC5863988 DOI: 10.1371/journal.pone.0194277] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2016] [Accepted: 02/21/2018] [Indexed: 01/11/2023] Open
Abstract
Objective Qualitative studies indicated that cancer survivors may be worried about finding a partner in the future, but whether this concern is warranted is unknown. We examined single people´s interest in dating a cancer survivor, how they perceive survivors’ traits, and their preferences about the timing of disclosing a cancer history. Methods In three experimental vignette studies, dating website members (n = 324) and college students (n = 138 and n = 131) were randomly assigned to a vignette of a person with or without a history of cancer (experiment 1 & 2), or a cancer survivor beyond or during active follow-up (experiment 3). Respondents rated their interest in dating this fictive person, this person’s traits, and indicated their preferences about the timing of disclosure. ANOVAs with main and interaction effects of condition, gender, and relationship history were conducted, partial eta squared and Cohen’s d were used to estimate the magnitude of effects. Correlations were used to investigate relationships between interest in a date and assessment of traits. Results Cancer survivors’ traits were assessed more positively, but interest to date them did not differ from healthy vignettes for both men and women. However, widowed respondents were much less interested in a date with a cancer survivor, and women showed less interest in a cancer survivor during active follow-up relative to survivors beyond follow-up. Most respondents wanted to hear about the cancer diagnosis after a few dates, hardly anyone wanted to hear about this before the first date (2% - 5%). Conclusion and implications for cancer survivors Cancer survivors do not have to expect any more problems in finding a date than people without a cancer history, and can wait a few dates before disclosing. Survivors dating widowed people and survivors in active follow-up could expect more hesitant reactions and should disclose earlier.
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Affiliation(s)
- Marrit Annika Tuinman
- Department of Health Psychology, University of Groningen, University Medical Center Groningen, Groningen, the Netherlands
- * E-mail:
| | - Vicky Lehmann
- Department of Health Psychology, University of Groningen, University Medical Center Groningen, Groningen, the Netherlands
| | - Mariët Hagedoorn
- Department of Health Psychology, University of Groningen, University Medical Center Groningen, Groningen, the Netherlands
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59
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Ussher JM, Perz J. Threat of biographical disruption: the gendered construction and experience of infertility following cancer for women and men. BMC Cancer 2018; 18:250. [PMID: 29506492 PMCID: PMC5836444 DOI: 10.1186/s12885-018-4172-5] [Citation(s) in RCA: 37] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2017] [Accepted: 02/26/2018] [Indexed: 12/24/2022] Open
Abstract
BACKGROUND Infertility is a major concern for people with cancer and their partners. There have been calls for further research on the gendered nature of psychosocial, emotional and identity concomitants of fertility post-cancer across women and men. METHOD The gendered construction and experience of infertility following cancer was examined through a survey of 693 women and 185 men, and in-depth one-to-one interviews with a subsample of survey respondents, 61 women and 17 men, purposively selected across cancer types and age groups. Thematic decomposition was used to examine the open ended survey responses and interviews. The chi square test for independence was used to test for group differences between women and men on closed survey items. RESULTS In the thematic decomposition, infertility was identified as providing a 'Threat of Biographical Disruption' which impacted on life course and identity, for both women and men. Subthemes identified were: 'Parenthood as central to adulthood'; 'Infertility as a threat to gender identity'; ' Unknown fertility status and delayed parenthood'; 'Feelings of loss and grief'; 'Absence of understanding and support'; 'Benefit finding and renegotiation of identity'. In the closed survey items, the majority of women and men agreed that they had always 'wanted to be a parent' and that 'parenthood was a more important life goal than a satisfying career'. 'It is hard to feel like a true adult until you have a child' and impact upon 'my feelings about myself as a man or a woman' was reported by both women and men, with significantly more women reporting 'I feel empty because of fertility issues'. Many participants agreed they 'could visualise a happy life without a child' and there is 'freedom without children'. Significantly more men than women reported that they had not discussed fertility with a health care professional. CONCLUSION The fear of infertility following cancer, or knowledge of compromised fertility, can have negative effects on identity and psychological wellbeing for both women and men, serving to create biographical disruption. Support from family, partners and health care professionals can facilitate renegotiation of identity and coping.
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Affiliation(s)
- Jane M. Ussher
- Translational Health Research Institute, School of Medicine, Western Sydney University, Locked Bag 1797, Penrith South, 2751 Australia
| | - Janette Perz
- Translational Health Research Institute, School of Medicine, Western Sydney University, Locked Bag 1797, Penrith South, 2751 Australia
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60
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Algarroba GN, Sanfilippo JS, Valli-Pulaski H. Female fertility preservation in the pediatric and adolescent cancer patient population. Best Pract Res Clin Obstet Gynaecol 2017; 48:147-157. [PMID: 29221705 DOI: 10.1016/j.bpobgyn.2017.10.009] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2017] [Accepted: 10/15/2017] [Indexed: 01/26/2023]
Abstract
The 5-year survival rate for childhood cancer is over 80%, thereby increasing the number of young women facing infertility in the future because of the gonadotoxic effects of chemotherapy and radiation. The gonadotoxic effects of childhood cancer treatment vary by the radiation regimen and the chemotherapeutic drugs utilized. Although the American Society of Clinical Oncology guidelines recommend fertility preservation for all patients, there are several barriers and ethical considerations to fertility preservation in the pediatric and adolescent female population. Additionally, the fertility preservation methods for pre- and postpubertal females differ, with only experimental methods available for prepubertal females. We will review the risk of chemotherapy and radiation on female fertility, the approach to fertility preservation in the pediatric and adolescent female population, methods of fertility preservation for both pre- and postpubertal females, barriers to fertility preservation, cost, and psychological and ethical considerations.
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Affiliation(s)
- Gabriela N Algarroba
- University of Pittsburgh School of Medicine, 3550 Terrace St., Pittsburgh, PA 15213, USA.
| | - Joseph S Sanfilippo
- Department of Obstetrics, Gynecology & Reproductive Sciences, University of Pittsburgh School of Medicine, 300 Halket St., Suite 5150, Pittsburgh, PA 15213, USA.
| | - Hanna Valli-Pulaski
- Department of Obstetrics, Gynecology & Reproductive Sciences, University of Pittsburgh School of Medicine, 204 Craft Ave, Pittsburgh, PA 15213, USA.
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61
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Sodergren SC, Husson O, Robinson J, Rohde GE, Tomaszewska IM, Vivat B, Dyar R, Darlington AS. Systematic review of the health-related quality of life issues facing adolescents and young adults with cancer. Qual Life Res 2017; 26:1659-1672. [PMID: 28251543 PMCID: PMC5486886 DOI: 10.1007/s11136-017-1520-x] [Citation(s) in RCA: 80] [Impact Index Per Article: 11.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/02/2017] [Indexed: 02/03/2023]
Abstract
PURPOSE For adolescents and young adults (AYAs), the impact of a cancer diagnosis and subsequent treatment is likely to be distinct from other age groups given the unique and complex psychosocial challenges of this developmental phase. In this review of the literature, we report the health-related quality of life (HRQoL) issues experienced by AYAs diagnosed with cancer and undergoing treatment. METHODS MEDLINE, EMBASE, CINAHL, PsychINFO and the Cochrane Library Databases were searched for publications reporting HRQoL of AYAs. Issues generated from interviews with AYAs or from responses to patient reported outcome measures (PROMs) were extracted. RESULTS 166 papers were reviewed in full and comprised 72 papers covering 69 primary studies, 49 measurement development or evaluation papers and 45 reviews. Of the 69 studies reviewed, 11 (16%) used interviews to elicit AYAs' descriptions of HRQoL issues. The majority of the PROMs used in the studies represent adaptations of paediatric or adult measures. HRQoL issues were organised into the following categories: physical, cognitive, restricted activities, relationships with others, fertility, emotions, body image and spirituality/outlook on life. CONCLUSION The HRQoL issues presented within this review are likely to be informative to health care professionals and AYAs. The extensive list of issues suggests that the impact of a cancer diagnosis and treatment during adolescence and young adulthood is widespread and reflects the complexities of this developmental phase.
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Affiliation(s)
| | - Olga Husson
- Department of Medical Psychology, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Jessica Robinson
- Faculty of Health Sciences, University of Southampton, Southampton, UK
| | - Gudrun E Rohde
- Faculty of Health and Sport Sciences, University of Agder, Kristiansand, Norway
- Department of Clinical Research, Sorlandet Hospital, Kristiansand, Norway
| | - Iwona M Tomaszewska
- Department of Medical Education, Jagiellonian University Medical College, Kraków, Poland
| | - Bella Vivat
- Marie Curie Palliative Care Research Department and Division of Psychiatry, University College London, London, UK
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62
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Moules NJ, Estefan A, Laing CM, Schulte F, Guilcher GMT, Field JC, Strother D. "A Tribe Apart": Sexuality and Cancer in Adolescence. J Pediatr Oncol Nurs 2017; 34:295-308. [PMID: 28615000 DOI: 10.1177/1043454217697669] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
This qualitative study employed hermeneutic phenomenology and narrative inquiry to examine the topic of sexuality and adolescents with cancer from the perspectives of survivors who had experienced cancer as adolescents. This investigation examined the potentially sensitive, disquieting, and often taboo issue of sexuality in the interest of optimizing wellness in young people, and, ultimately, in the health of adults. Understanding the adolescent body as a sensitive, sexual, and developing self can enrich our understanding of adolescent cancer and promote best health care and practices, examining ways that we might mitigate the long-term effects of arrested or delayed development of sexual identity. In this article, we discuss phase 1 of the study, which used hermeneutics as the method of inquiry. Findings included a general experience of adolescents having a sense of "losing themselves" while at the same time finding themselves in a new light. Other findings include the connection between sexuality, self, and identity; the unique "tribe" of adolescents with cancer; the necessity for sexuality to take a backseat to cancer; the changing mirror images from self and others; sexuality and fertility; and, ultimately, that sexuality is a relational experience.
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Affiliation(s)
| | | | | | - Fiona Schulte
- 1 University of Calgary, Calgary, Alberta, Canada.,2 Alberta Children's Hospital, Calgary, Alberta, Canada
| | - Gregory M T Guilcher
- 1 University of Calgary, Calgary, Alberta, Canada.,2 Alberta Children's Hospital, Calgary, Alberta, Canada
| | | | - Douglas Strother
- 1 University of Calgary, Calgary, Alberta, Canada.,2 Alberta Children's Hospital, Calgary, Alberta, Canada
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63
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Rosenberg AR, Bona K, Ketterl T, Wharton CM, Wolfe J, Baker KS. Intimacy, Substance Use, and Communication Needs During Cancer Therapy: A Report From the "Resilience in Adolescents and Young Adults" Study. J Adolesc Health 2017; 60:93-99. [PMID: 27769762 PMCID: PMC5228591 DOI: 10.1016/j.jadohealth.2016.08.017] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/21/2016] [Revised: 08/05/2016] [Accepted: 08/11/2016] [Indexed: 11/17/2022]
Abstract
PURPOSE The prevalence of intimacy and substance use among adolescents and young adults during cancer therapy has not been well described. METHODS The "Resilience in Adolescents and Young Adults with Cancer" study was a prospective, multicenter, mixed-methods cohort study. English-speaking patients 14-25 years old with newly diagnosed cancer were invited to complete a comprehensive survey at the time of enrollment (T1) and 3-6 months later (T2). Intimate relationships and health behaviors were assessed with questions adapted from the Guidelines for Adolescent Preventative Services assessment. Descriptive statistics characterized the prevalence of sexual and substance-related behaviors at each time point. RESULTS Of 42 eligible and enrolled participants, 35 (83%) and 25 (59%) completed T1 and T2 surveys, respectively. Their mean age was 17.6 years (standard deviation 2.3), 57% were male, and the most common diagnoses were sarcoma and acute leukemia. Over a third of participants reported dating at each time point; 26% were sexually active at T1, and 32% at T2. Of those endorsing sexual activity, fewer than half reported consistent birth control or condom use and 4 reported their first sexual intercourse during our observation. In addition, 46% (T1) and 44% (T2) reported alcohol use and 23% (T1) and 26% (T2) reported illicit drug use. Despite these activities, fewer than 10% endorsed a worry or need to discuss these behaviors with oncology providers. CONCLUSIONS Intimacy and substance use among adolescents and young adults are common during cancer therapy. Clinical and research implications include the identification of optimal communication and patient-centered supports.
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Affiliation(s)
- Abby R. Rosenberg
- Cancer and Blood Disorders Center, Seattle Children’s Hospital, Seattle, Washington,Clinical Research Division, Fred Hutchinson Cancer Research Center, Seattle, Washington,Treuman Katz Center for Pediatric Bioethics, Seattle Children’s Research Institute, Seattle, Washington,Department of Pediatrics, University of Washington School of Medicine, Seattle, Washington,Address correspondence to: Abby R. Rosenberg, M.D., M.S., Cancer and Blood Disorders Center, Seattle Children’s Hospital, 4800 Sand Point Way NE, M/S MB.8.501, Seattle, WA 98145. (A.R. Rosenberg)
| | - Kira Bona
- Department of Medicine, Boston Children’s Hospital, Boston, Massachusetts,Department of Pediatric Oncology, Dana-Farber Cancer Institute, Boston, Massachusetts,Department of Pediatric Hematology/Oncology, Harvard Medical School, Boston, Massachusetts
| | - Tyler Ketterl
- Cancer and Blood Disorders Center, Seattle Children’s Hospital, Seattle, Washington,Clinical Research Division, Fred Hutchinson Cancer Research Center, Seattle, Washington,Department of Pediatrics, University of Washington School of Medicine, Seattle, Washington
| | - Claire M. Wharton
- Cancer and Blood Disorders Center, Seattle Children’s Hospital, Seattle, Washington,Clinical Research Division, Fred Hutchinson Cancer Research Center, Seattle, Washington
| | - Joanne Wolfe
- Department of Medicine, Boston Children’s Hospital, Boston, Massachusetts,Department of Pediatric Hematology/Oncology, Harvard Medical School, Boston, Massachusetts,Department of Psychosocial Oncology and Palliative Care, Dana-Farber Cancer Institute, Boston, Massachusetts
| | - K. Scott Baker
- Cancer and Blood Disorders Center, Seattle Children’s Hospital, Seattle, Washington,Clinical Research Division, Fred Hutchinson Cancer Research Center, Seattle, Washington,Department of Pediatrics, University of Washington School of Medicine, Seattle, Washington
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Robertson EG, Sansom-Daly UM, Wakefield CE, Ellis SJ, McGill BC, Doolan EL, Cohn RJ. Sexual and Romantic Relationships: Experiences of Adolescent and Young Adult Cancer Survivors. J Adolesc Young Adult Oncol 2016; 5:286-91. [DOI: 10.1089/jayao.2015.0061] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
- Eden G. Robertson
- Discipline of Paediatrics, School of Women's and Children's Health, UNSW Medicine, University of New South Wales, Kensington, Australia
- Behavioural Sciences Unit proudly supported by the Kids with Cancer Foundation, Kids Cancer Centre, Sydney Children's Hospital, Randwick, Australia
| | - Ursula M. Sansom-Daly
- Discipline of Paediatrics, School of Women's and Children's Health, UNSW Medicine, University of New South Wales, Kensington, Australia
- Behavioural Sciences Unit proudly supported by the Kids with Cancer Foundation, Kids Cancer Centre, Sydney Children's Hospital, Randwick, Australia
- Sydney Youth Cancer Service, Prince of Wales/Sydney Children's Hospital, Randwick, Australia
| | - Claire E. Wakefield
- Discipline of Paediatrics, School of Women's and Children's Health, UNSW Medicine, University of New South Wales, Kensington, Australia
- Behavioural Sciences Unit proudly supported by the Kids with Cancer Foundation, Kids Cancer Centre, Sydney Children's Hospital, Randwick, Australia
| | - Sarah J. Ellis
- Discipline of Paediatrics, School of Women's and Children's Health, UNSW Medicine, University of New South Wales, Kensington, Australia
- Behavioural Sciences Unit proudly supported by the Kids with Cancer Foundation, Kids Cancer Centre, Sydney Children's Hospital, Randwick, Australia
| | - Brittany C. McGill
- Discipline of Paediatrics, School of Women's and Children's Health, UNSW Medicine, University of New South Wales, Kensington, Australia
- Behavioural Sciences Unit proudly supported by the Kids with Cancer Foundation, Kids Cancer Centre, Sydney Children's Hospital, Randwick, Australia
| | - Emma L. Doolan
- Discipline of Paediatrics, School of Women's and Children's Health, UNSW Medicine, University of New South Wales, Kensington, Australia
- Behavioural Sciences Unit proudly supported by the Kids with Cancer Foundation, Kids Cancer Centre, Sydney Children's Hospital, Randwick, Australia
| | - Richard J. Cohn
- Discipline of Paediatrics, School of Women's and Children's Health, UNSW Medicine, University of New South Wales, Kensington, Australia
- Behavioural Sciences Unit proudly supported by the Kids with Cancer Foundation, Kids Cancer Centre, Sydney Children's Hospital, Randwick, Australia
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Walker E, Martins A, Aldiss S, Gibson F, Taylor RM. Psychosocial Interventions for Adolescents and Young Adults Diagnosed with Cancer During Adolescence: A Critical Review. J Adolesc Young Adult Oncol 2016; 5:310-321. [PMID: 27486837 DOI: 10.1089/jayao.2016.0025] [Citation(s) in RCA: 34] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/18/2023] Open
Abstract
Adolescents and young adults (AYA) face individual and social challenges different to other age groups that shape their experience of cancer and the associated psychological distress. This critical review examined the availability of AYA-specific psychosocial interventions to assess the impact they have and identify elements that make them successful. Five literature databases were searched for psychosocial intervention studies involving AYAs with cancer, on and off treatment, aged 10-30 years, published between 1980 and 2016. Eleven out of 42 identified studies were included in the final review after quality assessment. All but two interventions showed positive results on at least one measure of psychosocial well-being. A distinctive difference between the supportive needs of those on and off treatment was noted, and differences in intervention design and delivery formats were identified between the two subgroups. Analysis of specific intervention characteristics that achieved the successful outcomes was more challenging due to the large variation in outcome measures used. This review demonstrates that psychosocial intervention research for AYA with cancer is increasing and the results show a potential benefit of intervention participation. Further work is needed to validate whether the benefits achieved by intervention participation remain over time.
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Affiliation(s)
- Emma Walker
- 1 Bradford Teaching Hospitals NHS Foundation Trust , Bradford, United Kingdom
| | - Ana Martins
- 2 Cancer Division, University College London Hospitals NHS Foundation Trust , London, United Kingdom
| | - Susie Aldiss
- 3 School of Health Sciences, University of Surrey , Guildford, United Kingdom
| | - Faith Gibson
- 3 School of Health Sciences, University of Surrey , Guildford, United Kingdom .,4 Centre for Outcomes and Experiences Research in Children's Health, Illness and Disability (ORCHID), Great Ormond Street Hospital for Children NHS Foundation Trust , London, United Kingdom
| | - Rachel M Taylor
- 2 Cancer Division, University College London Hospitals NHS Foundation Trust , London, United Kingdom .,5 School of Health and Social Care, London South Bank University , London, United Kingdom
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Ritenour CWM, Seidel KD, Leisenring W, Mertens AC, Wasilewski-Masker K, Shnorhavorian M, Sklar CA, Whitton JA, Stovall M, Constine LS, Armstrong GT, Robison LL, Meacham LR. Erectile Dysfunction in Male Survivors of Childhood Cancer-A Report From the Childhood Cancer Survivor Study. J Sex Med 2016; 13:945-54. [PMID: 27117527 DOI: 10.1016/j.jsxm.2016.03.367] [Citation(s) in RCA: 36] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2015] [Revised: 03/06/2016] [Accepted: 03/08/2016] [Indexed: 11/30/2022]
Abstract
INTRODUCTION With survival rates higher than 80%, the number of survivors from pediatric cancer continues to increase. Late effects resulting from cancer and cancer therapy are being characterized, but little information exists on sexual health for men who have survived childhood cancer. AIM To assess erectile dysfunction (ED) in men who survived childhood and adolescent cancers and to identify potential risk factors for ED. METHODS In total, 1,622 men and 271 eligible brothers in the Childhood Cancer Survivor Study cohort completed the Male Health Questionnaire, which provided information on sexual practices and sexual function. Combined with demographic, cancer, and treatment information from medical record abstraction, results of the Male Health Questionnaire were analyzed using multivariable modeling. The International Index of Erectile Function was used to identify ED in subjects. MAIN OUTCOME MEASURE International Index of Erectile Function. RESULTS Survivors (mean age = 37.4 years, SD = 7.3 years) reported significantly lower sexual activity in the year before the survey than the brothers (mean age = 38.8 years, SD = 8.5 years) without cancer. ED was reported by 12.3% (95% CI = 10.4-14.3) of survivors and 4.2% (95% CI = 2.0-7.9) of brothers. Survivors showed significantly higher relative risk (RR) for ED (RR = 2.63, 95% CI = 1.40-4.97). In addition to older age, survivors who were exposed to higher-dose (≥10 Gy) testicular radiation (RR = 3.55, 95% CI = 1.53-8.24), had surgery on the spinal cord or nerves (RR = 2.87, 95% CI = 1.36-6.05), prostate surgery (RR = 6.56, 95% CI = 3.84-11.20), or pelvic surgery (RR = 2.28, 95% CI = 1.04-4.98) were at higher risk for ED. CONCLUSION Men who have survived childhood cancer have a greater than 2.6-fold increased risk for ED and certain cancer-specific treatments are associated with increased risk. Attention to sexual health, with its physical and emotional implications, and opportunities for early detection and intervention in these individuals could be important.
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Affiliation(s)
- Chad W M Ritenour
- Department of Urology, Emory University School of Medicine, Atlanta, GA, USA.
| | - Kristy D Seidel
- Cancer Prevention Program, Fred Hutchinson Cancer Research Center, Seattle, WA, USA
| | - Wendy Leisenring
- Cancer Prevention Program, Fred Hutchinson Cancer Research Center, Seattle, WA, USA; Clinical Statistics Program, Fred Hutchinson Cancer Research Center, Seattle, WA, USA
| | - Ann C Mertens
- The Aflac Cancer and Blood Disorders Center at Children's Healthcare of Atlanta, Atlanta, GA, USA; Department of Pediatrics, Emory University School of Medicine, Atlanta, GA, USA
| | - Karen Wasilewski-Masker
- The Aflac Cancer and Blood Disorders Center at Children's Healthcare of Atlanta, Atlanta, GA, USA; Department of Pediatrics, Emory University School of Medicine, Atlanta, GA, USA
| | - Margarett Shnorhavorian
- Division of Pediatric Urology, Seattle Children's Hospital, University of Washington, Seattle, WA, USA
| | - Charles A Sklar
- Department of Pediatrics, Memorial Sloan-Kettering Cancer Center, New York, NY, USA
| | - John A Whitton
- Cancer Prevention Program, Fred Hutchinson Cancer Research Center, Seattle, WA, USA
| | - Marilyn Stovall
- Department of Radiation Physics, University of Texas M.D. Anderson Cancer Center, Houston, TX, USA
| | - Louis S Constine
- Departments of Radiation Oncology and Pediatrics, University of Rochester, Rochester, NY, USA
| | - Gregory T Armstrong
- Department of Epidemiology and Cancer Control, St. Jude Children's Research Hospital, Memphis, TN, USA
| | - Leslie L Robison
- Department of Epidemiology and Cancer Control, St. Jude Children's Research Hospital, Memphis, TN, USA
| | - Lillian R Meacham
- The Aflac Cancer and Blood Disorders Center at Children's Healthcare of Atlanta, Atlanta, GA, USA; Department of Pediatrics, Emory University School of Medicine, Atlanta, GA, USA
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