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Charpentier P, Cavalieri M, Desmoulins I, Coutant C. [Live birth rates after breast cancer among women who desired a child]. Bull Cancer 2024; 111:463-472. [PMID: 38580527 DOI: 10.1016/j.bulcan.2024.02.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2023] [Revised: 01/15/2024] [Accepted: 02/01/2024] [Indexed: 04/07/2024]
Abstract
INTRODUCTION In France, the breast cancer is the most common cancer among women under the age of 40. From 38 to 70% of women have not fulfilled their parental plans at the time of diagnosis. The gonadotoxicity of the treatments and the follicular physiological decline linked to age can become an obstacle to this project. METHODS Among the patients, 386 were treated for breast cancer at the Centre Georges-François-Leclerc in Dijon between January 2011 and December 2018 were identified. 192 patients aged under 39 met the inclusion criteria. We excluded metastatic cancers, cancer in situ and pregnant patients at diagnosis. A total of 124 patients agreed to participate in the study. The included patients filled out a self-questionnaire. Data were collected from the patient's electronic medical. The primary endpoint of this study was the live birth rate. RESULT Among women who desired a child after breast cancer, the overall rate of live births was 36.2 % (21/58). Most achieved pregnancies were spontaneous (90.5 %). No factor was significantly associated with the absence of obtaining birth. Fertility was preserved by oocyte cryopreservation in 13.8 % of patients (17/124). The median time to conception in patients who received chemotherapy was 8 months [1.0-60.0] vs 2 months [1.0-7.0] in women who did not receive chemotherapy. DISCUSSION The non-negligible proportion of live births following spontaneous pregnancy after breast cancer allows us to be reassuring for patients. However, the emergence of new chemotherapy protocols whose consequences on long-term gonadotoxicity are still not well known requires further studies and prompts the promotion of fertility preservation as a precautionary measure.
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Affiliation(s)
- Pauline Charpentier
- Service de gynécologie-obstétrique et médecine de la reproduction, CHU François-Mitterrand, Cote d'Or, Dijon, France.
| | - Mathilde Cavalieri
- Service de gynécologie-obstétrique et médecine de la reproduction, CHU François-Mitterrand, Cote d'Or, Dijon, France
| | - Isabelle Desmoulins
- Centre Francois-Leclerc, 1, rue du Professeur-Marion, Cote d'Or, 21000 France
| | - Charles Coutant
- Centre Francois-Leclerc, 1, rue du Professeur-Marion, Cote d'Or, 21000 France
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2
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Duraes M, Rathat G, Bringer-Deutsch S, Ranisavljevic N, Brouillet S, Defez-Fougeron C, Duflos C. Fertility preservation in patients of childbearing age treated for breast cancer: A nationwide cohort study. Breast 2022; 64:121-126. [PMID: 35661841 PMCID: PMC9163100 DOI: 10.1016/j.breast.2022.05.006] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2022] [Revised: 05/12/2022] [Accepted: 05/27/2022] [Indexed: 11/19/2022] Open
Abstract
Background Approximately 7% of breast cancers are diagnosed in women under 40. Question of subsequent fertility has become fundamental. We aimed to evaluate the rate of fertility preservation (FP) by oocyte retrieval (OR) after ovarian stimulation in patients of childbearing age, managed for breast cancer with adjuvant chemotherapy in France, reuse rate of frozen gametes and live births rate (LBR) after treatment. Methods We included 15,774 women between 18 and 40 years old, managed by surgery and adjuvant chemotherapy for breast cancer, between January 2011 and December 2020 from a French health registry. Patients with OR after breast surgery and before chemotherapy were considered as FP group; those with no OR as no FP group. To compare LBR with French population independently of age, we calculated Standardized Incidence Rates (SIR) of live births using indirect standardization method. Results FP rate increased gradually since 2011, reaching 17% in 2019. A decrease in use was observed in 2020 (13,9%). Among patients with at least 2 years of follow-up, gamete reuse rate was 5,6%. Births after cancer were mostly from spontaneous pregnancies. Among patients with at least 3 years of follow-up, LBR was 19,6% in FP group, 3,9% in second group. SIR of live births was of 1,05 (95% CI = 0.91–1.19) and 0.33 (95% CI = 0.30–0.36) in FP and no FP group respectively. Conclusion Oncofertility activity increased until 2019 in France, reaching 17%. Gamete reuse rate was low. Births resulted mainly from spontaneous pregnancies. SIR of live births was lower in no FP group. Fertility preservation rate increased gradually since 2011, reaching 17% in 2019. Among patients with at least 2 years of follow-up, gamete reuse rate was 5,6%. Births after breast cancer were mostly from spontaneous pregnancies. Life births rate was 19,6% in fertility preservation group, 3,9% in second group.
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Affiliation(s)
- Martha Duraes
- Department of Gynecological and Breast Surgery, Montpellier University Hospital, Montpellier, France.
| | - Gauthier Rathat
- Department of Gynecological and Breast Surgery, Montpellier University Hospital, Montpellier, France
| | - Sophie Bringer-Deutsch
- Department of Obstetrics, Gynecology and Reproductive Medicine, Montpellier University Hospital, Montpellier, France
| | - Noémie Ranisavljevic
- Department of Obstetrics, Gynecology and Reproductive Medicine, Montpellier University Hospital, Montpellier, France
| | - Sophie Brouillet
- Department of Reproductive Biology, Montpellier University Hospital, Montpellier, France
| | | | - Claire Duflos
- Clinical Research and Epidemiology Unit, Montpellier University Hospital, Montpellier, France
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3
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Linnane S, Quinn A, Riordan A, Dowling M. Women's fertility decision-making with a diagnosis of breast cancer: A qualitative evidence synthesis. Int J Nurs Pract 2022; 28:e13036. [PMID: 35088478 DOI: 10.1111/ijn.13036] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2020] [Revised: 04/18/2021] [Accepted: 12/19/2021] [Indexed: 11/30/2022]
Abstract
AIM To synthesize qualitative evidence of premenopausal women's experiences of fertility decision-making with a diagnosis of breast cancer. BACKGROUND Breast cancer is increasingly more common in premenopausal women who may have not yet considered starting a family or have completed their families. DESIGN Qualitative evidence synthesis guided by Thomas and Harden's three-stage approach to thematic analysis. DATA SOURCES Twelve electronic databases were searched: CINAHL, Embase, Pubmed, Proquest, PsychINFO, Lenus, Scopus, Web of Science, Rian.ie, Medline, EThOS e-theses online and DART Europe. No year limit was set. REVIEW METHODS The 'Enhancing transparency in reporting the synthesis of qualitative research guidelines' (ENTREQ) statement was followed. RESULTS Fifteen qualitative studies were included in the synthesis. Seven review findings under four major themes were identified: (1) first comes survival, (2) making decisions 'under the gun', (3) health-care professionals should not make assumptions and (4) we want accurate, detailed information and we want it early. High confidence in six of the review findings was agreed. CONCLUSION Most women experienced rushed fertility preservation decision-making at a time when they also faced cancer treatment decisions. Women want detailed, clear information on fertility preservation early after their diagnosis.
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Affiliation(s)
- Sharon Linnane
- Public Health Nurse, Mervue Health Centre, Galway, Ireland
| | - Aoife Quinn
- Clinical Nurse Specialist (Oncology), Galway University Hospitals, Galway, Ireland
| | - Anne Riordan
- National Health Library and Knowledge Service, Merlin Park University Hospital, Galway, Ireland
| | - Maura Dowling
- School of Nursing and Midwifery, National University of Ireland, Galway, Ireland
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4
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Rodgers RJ, Abbott JA, Walters KA, Ledger WL. Translational Physiology of Anti-Müllerian Hormone: Clinical Applications in Female Fertility Preservation and Cancer Treatment. Front Endocrinol (Lausanne) 2021; 12:689532. [PMID: 34557157 PMCID: PMC8454407 DOI: 10.3389/fendo.2021.689532] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/01/2021] [Accepted: 08/09/2021] [Indexed: 12/21/2022] Open
Abstract
Background Whilst the ability of AMH to induce the regression of the Müllerian ducts in the male fetus is well appreciated, AMH has additional biological actions in relation to steroid biosynthesis and ovarian follicle dynamics. An understanding of the physiology of AMH illuminates the potential therapeutic utility of AMH to protect the ovarian reserve during chemotherapy and in the treatment of female malignancies. The translation of the biological actions of AMH into clinical applications is an emerging focus of research, with promising preliminary results. Objective and Rationale Studies indicate AMH restrains primordial follicle development, thus administration of AMH during chemotherapy may protect the ovarian reserve by preventing the mass activation of primordial follicles. As AMH induces regression of tissues expressing the AMH receptor (AMHRII), administration of AMH may inhibit growth of malignancies expressing AMHR II. This review evaluates the biological actions of AMH in females and appraises human clinical applications. Search Methods A comprehensive search of the Medline and EMBASE databases seeking articles related to the physiological functions and therapeutic applications of AMH was conducted in July 2021. The search was limited to studies published in English. Outcomes AMH regulates primordial follicle recruitment and moderates sex steroid production through the inhibition of transcription of enzymes in the steroid biosynthetic pathway, primarily aromatase and 17α-hydroxylase/17,20-lyase. Preliminary data indicates that administration of AMH to mice during chemotherapy conveys a degree of protection to the ovarian reserve. Administration of AMH at the time of ovarian tissue grafting has the potential to restrain uncontrolled primordial follicle growth during revascularization. Numerous studies demonstrate AMH induced regression of AMHR II expressing malignancies. As this action occurs via a different mechanism to traditional chemotherapeutic agents, AMH has the capacity to inhibit proliferation of chemo-resistant ovarian cancer cells and cancer stem cells. Wider Implications To date, AMH has not been administered to humans. Data identified in this review suggests administration of AMH would be safe and well tolerated. Administration of AMH during chemotherapy may provide a synchronistic benefit to women with an AMHR II expressing malignancy, protecting the ovarian reserve whilst the cancer is treated by dual mechanisms.
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Affiliation(s)
- Rachael Jean Rodgers
- School of Women’s and Children’s Health, University of New South Wales, Sydney, NSW, Australia
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Garg R, Rebić N, De Vera MA. Information Needs About Cancer Treatment, Fertility, and Pregnancy: Qualitative Descriptive Study of Reddit Threads. JMIR Cancer 2020; 6:e17771. [PMID: 33263547 PMCID: PMC7744261 DOI: 10.2196/17771] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2020] [Revised: 06/11/2020] [Accepted: 08/22/2020] [Indexed: 01/23/2023] Open
Abstract
BACKGROUND A reproductive health implication of the increasing incidence of cancer among women is the impact of cancer treatment on fertility. OBJECTIVE As patients are increasingly using the internet, particularly online forums, to seek and share experiences, our objective was to understand information needs about cancer treatment, fertility, and pregnancy of women with cancer as well as their caregivers. METHODS We searched threads (original posts and responses) on four subreddit sites of Reddit ("r/Cancer," "r/TryingForABaby," "r/BabyBumps," and "r/Infertility") over a 5-year period between February 4th, 2014 and February 4th, 2019. Threads with original posts involving a lived experience or question regarding cancer treatment and female fertility and/or pregnancy or parenting/having children from the perspective of either patient or caregiver were included in our analysis. We analyzed threads using thematic analysis. RESULTS From 963 Reddit threads identified, 69 were analyzed, including 56 with original posts by women with cancer and 13 with original posts by caregivers. From threads made by patients, we identified themes on becoming a part of an online community, impacts of cancer treatment and fertility concerns on self and social relationships, making family planning decisions, and experiences with medical team. We also identified a theme on the impact of cancer treatment and fertility concerns on caregivers. CONCLUSIONS Reddit provided a rich pool of data for analyzing the information needs of women facing cancer. Our findings demonstrate the far-reaching impacts of cancer treatment and fertility on physical, mental, and psychosocial health for both patients and their caregivers.
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Affiliation(s)
- Ria Garg
- Faculty of Pharmaceutical Sciences, University of British Columbia, Vancouver, BC, Canada.,Collaboration for Outcomes Research and Evaluation, University of British Columbia, Vancouver, BC, Canada
| | - Nevena Rebić
- Faculty of Pharmaceutical Sciences, University of British Columbia, Vancouver, BC, Canada.,Collaboration for Outcomes Research and Evaluation, University of British Columbia, Vancouver, BC, Canada.,Arthritis Research Canada, Richmond, BC, Canada
| | - Mary A De Vera
- Faculty of Pharmaceutical Sciences, University of British Columbia, Vancouver, BC, Canada.,Collaboration for Outcomes Research and Evaluation, University of British Columbia, Vancouver, BC, Canada.,Arthritis Research Canada, Richmond, BC, Canada
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Harries J, Constant D, Cairncross L, Moodley J. Contraceptive needs and fertility intentions of women with breast cancer in Cape Town, South Africa: a qualitative study. BMC WOMENS HEALTH 2020; 20:224. [PMID: 33023554 PMCID: PMC7539427 DOI: 10.1186/s12905-020-01094-3] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 07/03/2020] [Accepted: 09/30/2020] [Indexed: 12/24/2022]
Abstract
Background No known studies have been undertaken in South Africa exploring the contraceptive and fertility needs and preferences of women of reproductive age (18–49) diagnosed with breast cancer. This study set out to understand the contraceptive needs and fertility intentions of women with breast cancer in Cape Town, South Africa. Methods Qualitative in-depth interviews were conducted with 24 women diagnosed with breast cancer and 4 health care providers at a tertiary hospital in Cape Town, South Africa. We explored contraceptive use prior to diagnosis; the impact of breast cancer on future fertility intentions and contraceptive use; understanding of suitable contraceptive methods during and after treatment and women’s fertility related counseling needs during their continuum of care. Data were analysed using a thematic analysis approach. Results Since being diagnosed with breast cancer, of those women using a contraceptive method, the non-hormonal intrauterine device (IUD) was the most commonly used method. However, women reported receiving limited information from health care providers about contraceptive use and future fertility planning post treatment when fertility desires might change. Many women reported limited information received from healthcare providers about the impact of cancer treatment on their future fertility. Most women did not receive information around fertility preservation options, and few were familiar with the concept. Providers focus was more on preventing pregnancy during treatment and ensuring a patient was on a non-hormonal contraceptive method. Providers supported a more holistic, multidisciplinary approach to breast cancer patient’s contraceptive and future fertility needs. Conclusions Limited contraceptive and future fertility counseling were reported by women despite many women being provided with the IUD. There is a need for improved information and counseling regarding the impact of treatment on contraceptive and fertility options. It is important that cancer care providers provide timely information regarding fertility options and communicate with patients about their fertility concerns prior to treatment and throughout the course of survivorship. The development of evidence-based information tools to enhance patient-provider communication and counseling could address knowledge gaps.
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Affiliation(s)
- Jane Harries
- Women's Health Research Unit, School of Public Health and Family Medicine, University of Cape Town, Cape Town, South Africa.
| | - Deborah Constant
- Women's Health Research Unit, School of Public Health and Family Medicine, University of Cape Town, Cape Town, South Africa
| | - Lydia Cairncross
- Department of Surgery, University of Cape Town, Cape Town, South Africa
| | - Jennifer Moodley
- Women's Health Research Unit, School of Public Health and Family Medicine, University of Cape Town, Cape Town, South Africa.,Cancer Research Initiative, Faculty of Health Sciences, University of Cape Town, Anzio Road, Observatory, Cape Town, 7925, South Africa.,SAMRC Gynaecology Cancer Research Centre, Faculty of Health Sciences, University of Cape Town, Anzio Road. Observatory, Cape Town, 7925, South Africa
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7
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Abstract
Safety of pregnancy occurring after breast cancer treatment has been studied largely, but it is still debatable. These studies have generally showed that overall and disease-free survival in breast cancer survivors with subsequent pregnancy is not less than those without future pregnancy . Also, breast cancer survivors treated with chemotherapy , radiation therapy, or both had no increased risk of congenital anomalies, single gene disorders, or chromosomal syndromes in their offspring. However, it appears that the incidence of preterm labor, low birth weight, and fetal anomalies is higher in these cases.These issues as well as safe time interval from breast cancer treatment to pregnancy , safe contraceptive method after breast cancer, counseling about pregnancy in survivors, and how to follow up the patient for breast cancer recurrence during pregnancy are discussed in this chapter.
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8
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Lu H, Xie J, Gerido LH, Cheng Y, Chen Y, Sun L. Information Needs of Breast Cancer Patients: Theory-Generating Meta-Synthesis. J Med Internet Res 2020; 22:e17907. [PMID: 32720899 PMCID: PMC7420822 DOI: 10.2196/17907] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2020] [Revised: 05/07/2020] [Accepted: 06/03/2020] [Indexed: 01/01/2023] Open
Abstract
BACKGROUND Breast cancer has become one of the most frequently diagnosed carcinomas and the leading cause of cancer deaths. The substantial growth in the number of breast cancer patients has put great pressure on health services. Meanwhile, the information patients need has increased and become more complicated. Therefore, a comprehensive and in-depth understanding of their information needs is urgently needed to improve the quality of health care. However, previous studies related to the information needs of breast cancer patients have focused on different perspectives and have only contributed to individual results. A systematic review and synthesis of breast cancer patients' information needs is critical. OBJECTIVE This paper aims to systematically identify, evaluate, and synthesize existing primary qualitative research on the information needs of breast cancer patients. METHODS Web of Science, EBSCO, Scopus, ProQuest, PubMed, PsycINFO, The Cochrane Library, the Cumulative Index to Nursing and Allied Health Literature were searched on February 12 and July 9, 2019, to collect relevant studies. A Google Scholar search, interpersonal network recommendations, and reference chaining were also conducted. Eligible studies included qualitative or mixed-methods studies focusing on the information needs (across the cancer continuum) of breast cancer patients or their social networks. Subsequently, a Critical Appraisals Skills Programme checklist was used to assess the quality of included research. The results, findings, and discussions were extracted. Data analysis was guided by the theory-generating meta-synthesis and grounded theory approach. RESULTS Three themes, 19 categories, and 55 concepts emerged: (1) incentives (physical abnormality, inquiry from others, subjective norm, and problems during appointments); (2) types of information needs (prevention, etiology, diagnosis, clinical manifestation, treatment, prognosis, impact and resumption of normal life, scientific research, and social assistance); (3) moderating variables (attitudes, health literacy, demographic characteristics, disease status, as well as political and cultural environment). The studies revealed that the information needs of breast cancer patients were triggered by different incentives. Subsequently, the patients sought a variety of information among different stages of the cancer journey. Five types of variables were also found to moderate the formation of information needs. CONCLUSIONS This study contributes to a thorough model of information needs among breast cancer patients and provides practical suggestions for health and information professionals.
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Affiliation(s)
- Hongru Lu
- School of Information Management, Nanjing University, Nanjing, China
| | - Juan Xie
- School of Information Management, Nanjing University, Nanjing, China
| | | | - Ying Cheng
- School of Information Management, Nanjing University, Nanjing, China
| | - Ya Chen
- School of Information Management, Nanjing University, Nanjing, China
| | - Lizhu Sun
- Department of Oncology, The Affiliated Shuyang Hospital of Xuzhou Medical University, Shuyang, China
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Sella T, Partridge AH. Fertility Counseling and Preservation in Breast Cancer. CURRENT BREAST CANCER REPORTS 2020. [DOI: 10.1007/s12609-019-00348-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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10
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Villarreal-Garza C, Mesa-Chavez F, Lopez-Martinez EA, Fonseca A, Pineda C, Rivera F, Garcia-Garcia M, de la Rosa-Pacheco S, Mohar A, Ellsworth-Beaumont C, Platas A. Gaps in Knowledge and Understanding of Patients With Metastatic Breast Cancer in Mexico. Cancer Control 2020; 27:1073274820920637. [PMID: 32397745 PMCID: PMC7223866 DOI: 10.1177/1073274820920637] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2019] [Revised: 02/25/2020] [Accepted: 03/31/2020] [Indexed: 11/17/2022] Open
Abstract
There is paucity of data regarding the knowledge and understanding of patients with metastatic breast cancer (MBC) about their disease stage and treatment goals. This study assessed these patients' awareness of MBC incurability, topics reviewed with their oncologist, perceptions of having enough knowledge to participate in treatment decision-making, most helpful information source, and satisfaction with the information they received. For this purpose, 185 patients with MBC who attended follow-up medical appointments at a Mexican referral cancer center completed a survey designed by the Metastatic Breast Cancer Alliance. Clinical data were obtained from medical records. Descriptive statistics were applied, and associations between qualitative and quantitative variables were assessed with χ2 and Mann-Whitney U tests, respectively. Half (52%) of the patients were aware that their disease was incurable, while 31% were not sure, and 17% thought it was curable. Forty percent found it difficult to talk about treatments because they did not understand the options that were available to them. The medical staff was the most helpful information source for 74% of participants, and 64% scored their satisfaction with information ≥9 of 10. A significant association was found between higher satisfaction and knowing that MBC is incurable, as well as being older than 40 years. These results illustrate the significant lack of understanding patients with MBC have regarding their cancer, even when reporting high satisfaction with the provided information, and identify a critical need for improved patient education to enhance their comprehension and promote their participation in decision-making processes, treatment adherence, and, ultimately, outcomes.
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Affiliation(s)
- Cynthia Villarreal-Garza
- Departamento de Tumores Mamarios e Investigacion, Instituto Nacional de Cancerologia, Mexico City, Mexico
- Centro de Cancer de Mama, Hospital Zambrano Hellion, Tecnologico de Monterrey, Monterrey, Nuevo Leon, Mexico
- Joven & Fuerte, Programa para la Atencion e Investigacion para Pacientes Jovenes con Cancer de Mama en Mexico, Mexico City, Mexico
| | - Fernanda Mesa-Chavez
- Centro de Cancer de Mama, Hospital Zambrano Hellion, Tecnologico de Monterrey, Monterrey, Nuevo Leon, Mexico
- Joven & Fuerte, Programa para la Atencion e Investigacion para Pacientes Jovenes con Cancer de Mama en Mexico, Mexico City, Mexico
| | - Edna Anakarenn Lopez-Martinez
- Centro de Cancer de Mama, Hospital Zambrano Hellion, Tecnologico de Monterrey, Monterrey, Nuevo Leon, Mexico
- Joven & Fuerte, Programa para la Atencion e Investigacion para Pacientes Jovenes con Cancer de Mama en Mexico, Mexico City, Mexico
| | - Alan Fonseca
- Departamento de Tumores Mamarios e Investigacion, Instituto Nacional de Cancerologia, Mexico City, Mexico
- Joven & Fuerte, Programa para la Atencion e Investigacion para Pacientes Jovenes con Cancer de Mama en Mexico, Mexico City, Mexico
| | - Claudia Pineda
- Departamento de Tumores Mamarios e Investigacion, Instituto Nacional de Cancerologia, Mexico City, Mexico
- Joven & Fuerte, Programa para la Atencion e Investigacion para Pacientes Jovenes con Cancer de Mama en Mexico, Mexico City, Mexico
| | - Fernanda Rivera
- Departamento de Tumores Mamarios e Investigacion, Instituto Nacional de Cancerologia, Mexico City, Mexico
| | - Marisol Garcia-Garcia
- Centro de Cancer de Mama, Hospital Zambrano Hellion, Tecnologico de Monterrey, Monterrey, Nuevo Leon, Mexico
- Joven & Fuerte, Programa para la Atencion e Investigacion para Pacientes Jovenes con Cancer de Mama en Mexico, Mexico City, Mexico
| | | | - Alejandro Mohar
- Departamento de Tumores Mamarios e Investigacion, Instituto Nacional de Cancerologia, Mexico City, Mexico
- Joven & Fuerte, Programa para la Atencion e Investigacion para Pacientes Jovenes con Cancer de Mama en Mexico, Mexico City, Mexico
| | | | - Alejandra Platas
- Departamento de Tumores Mamarios e Investigacion, Instituto Nacional de Cancerologia, Mexico City, Mexico
- Joven & Fuerte, Programa para la Atencion e Investigacion para Pacientes Jovenes con Cancer de Mama en Mexico, Mexico City, Mexico
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11
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Speller B, Micic S, Daly C, Pi L, Little T, Baxter NN. Oncofertility Decision Support Resources for Women of Reproductive Age: Systematic Review. JMIR Cancer 2019; 5:e12593. [PMID: 31199289 PMCID: PMC6592478 DOI: 10.2196/12593] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2018] [Revised: 04/30/2019] [Accepted: 05/01/2019] [Indexed: 01/15/2023] Open
Abstract
BACKGROUND Cancer treatments have the potential to cause infertility among women of reproductive age. Many cancer patients do not receive sufficient oncofertility information or referrals to reproductive specialists prior to starting cancer treatment. While health care providers cite lack of awareness on the available oncofertility resources, the majority of cancer patients use the internet as a resource to find additional information to supplement discussions with their providers. OBJECTIVE Our aim was to identify and characterize Web-based oncofertility decision aids and health education materials accessible for women of reproductive age with a diagnosis of any cancer. METHODS We searched five databases and the gray literature for the years 1994-2018. The developer and content information for identified resources was extracted. Each resource underwent a quality assessment. RESULTS We identified 31 open access resources including 4 decision aids and 27 health educational materials. The most common fertility preservation options listed in the resources included embryo (31/31, 100%), egg (31, 100%), and ovarian tissue freezing (30, 97%). Notably, approximately one-third (11, 35%) contained references and 5 (16%) had a reading level of grade 8 or below. Resources were of varying quality; two decision aids from Australia and the Netherlands, two booklets from Australia and the United Kingdom, and three websites from Canada and the United States rated as the highest quality. CONCLUSIONS This comprehensive review characterizes numerous resources available to support patients and providers with oncofertility information, counseling, and decision making. More focus is required to improve the awareness and the access of existing resources among patients and providers. Providers can address patient information needs by leveraging or adapting existing resources to support clinical discussions and their specific patient population.
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Affiliation(s)
- Brittany Speller
- Department of Surgery, St. Michael's Hospital, Toronto, ON, Canada.,Li Ka Shing Knowledge Institute, St. Michael's Hospital, Toronto, ON, Canada
| | - Selena Micic
- Department of Surgery, St. Michael's Hospital, Toronto, ON, Canada.,Li Ka Shing Knowledge Institute, St. Michael's Hospital, Toronto, ON, Canada
| | - Corinne Daly
- Department of Surgery, St. Michael's Hospital, Toronto, ON, Canada.,Li Ka Shing Knowledge Institute, St. Michael's Hospital, Toronto, ON, Canada
| | - Lebei Pi
- Department of Surgery, St. Michael's Hospital, Toronto, ON, Canada.,Li Ka Shing Knowledge Institute, St. Michael's Hospital, Toronto, ON, Canada
| | - Tari Little
- Department of Surgery, St. Michael's Hospital, Toronto, ON, Canada.,Li Ka Shing Knowledge Institute, St. Michael's Hospital, Toronto, ON, Canada
| | - Nancy N Baxter
- Department of Surgery, St. Michael's Hospital, Toronto, ON, Canada.,Li Ka Shing Knowledge Institute, St. Michael's Hospital, Toronto, ON, Canada.,Institute of Health Policy, Management, and Evaluation, Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada
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12
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EUropean REcommendations for female FERtility preservation (EU-REFER): A joint collaboration between oncologists and fertility specialists. Crit Rev Oncol Hematol 2019; 138:233-240. [DOI: 10.1016/j.critrevonc.2019.03.010] [Citation(s) in RCA: 36] [Impact Index Per Article: 7.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2018] [Revised: 10/25/2018] [Accepted: 03/20/2019] [Indexed: 11/17/2022] Open
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Abstract
Breast cancer is the most commonly diagnosed cancer in women. As long-term survival rates have improved, there has been a concurrent increase in quality of life considerations, of which fertility preservation is of utmost importance. A number of fertility preservation options are available to women diagnosed with breast cancer, including administration of a GnRH agonist during chemotherapy in an attempt to minimize ovarian damage, oocyte or embryo cryopreservation prior to the administration of chemotherapy, in vitro maturation of oocytes or ovarian tissue cryopreservation. The safety of pregnancy after a diagnosis of breast cancer has been confirmed in numerous studies.
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Affiliation(s)
- Rachael J Rodgers
- School of Women's and Children's Health University of New South Wales, Sydney, Australia -
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14
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Hawkins Bressler L, Mersereau JE, Anderson C, Rodriguez JL, Hodgson ME, Weinberg CR, Sandler DP, Nichols HB. Fertility-related experiences after breast cancer diagnosis in the Sister and Two Sister Studies. Cancer 2019; 125:2675-2683. [PMID: 31012960 DOI: 10.1002/cncr.32126] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2018] [Revised: 02/05/2019] [Accepted: 03/05/2019] [Indexed: 12/21/2022]
Abstract
BACKGROUND Commonly used chemotherapies can be toxic to the ovaries. To the authors' knowledge, the majority of studies evaluating receipt of fertility counseling for women in their reproductive years have been performed in specific settings, thereby limiting generalizability. METHODS A nationwide sample of US women diagnosed with breast cancer before age 45 years completed a survey assessing the prevalence of fertility counseling. Age-adjusted log-binomial regression was used to estimate prevalence ratios (PRs) and 95% CIs for fertility counseling. RESULTS Among 432 survivors diagnosed between 2004 and 2011, 288 (67%) had not discussed the effects of treatment on fertility with a health care provider before or during treatment. Fertility discussion was associated with younger age (PR, 3.49 [95% CI, 2.66-4.58] for aged <35 years vs ≥40 years) and lower parity (PR, 1.81 [95% CI, 1.29-2.53] for parity 1 vs 2). Approximately 20% of respondents reported that they were interested in future fertility (87 of 432 respondents) at the time of their diagnosis, but not all of these individuals (66 of 87 respondents) received counseling regarding the impact of treatment on their fertility, and few (8 of 87 respondents) used fertility preservation strategies. Among 68 women with a fertility interest who provided reasons for not taking steps to preserve fertility, reasons cited included concern for an adverse impact on cancer treatment (56%), lack of knowledge (26%), decision to not have a child (24%), and cost (18%). CONCLUSIONS Across multiple treatment settings, the majority of women of reproductive age who are diagnosed with breast cancer did not discuss fertility with a health care provider or use fertility preservation strategies. Discussing the potential impact of cancer treatment on future fertility is an important aspect of patient education.
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Affiliation(s)
- Leah Hawkins Bressler
- Division of Reproductive Epidemiology and Infertility, Department of Obstetrics and Gynecology, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina
| | - Jennifer E Mersereau
- Division of Reproductive Epidemiology and Infertility, Department of Obstetrics and Gynecology, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina
| | - Chelsea Anderson
- Department of Epidemiology, UNC Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina
| | - Juan L Rodriguez
- Division of Cancer Prevention and Control, Centers for Disease Control and Prevention, Atlanta, Georgia
| | | | - Clarice R Weinberg
- Biostatistics and Computational Biology Branch, National Institute of Environmental Health Services, Research Triangle Park, North Carolina
| | - Dale P Sandler
- Epidemiology Branch, National Institute of Environmental Health Services, Research Triangle Park, North Carolina
| | - Hazel B Nichols
- Department of Epidemiology, UNC Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina
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Villarreal‐Garza C, López‐Martínez EA, Martínez‐Cannon BA, Platas A, Castro‐Sánchez A, Miaja M, Mohar A, Monroy A, Águila C, Gálvez‐Hernández CL. Medical and information needs among young women with breast cancer in Mexico. Eur J Cancer Care (Engl) 2019; 28:e13040. [DOI: 10.1111/ecc.13040] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2018] [Revised: 12/13/2018] [Accepted: 03/25/2019] [Indexed: 11/29/2022]
Affiliation(s)
- Cynthia Villarreal‐Garza
- Research and Breast Tumors Department Instituto Nacional de Cancerología Mexico City Mexico
- Breast Cancer Center Hospital Zambrano Hellion, Tecnológico de Monterrey San Pedro Garza Garcia Mexico
| | - Edna A. López‐Martínez
- Breast Cancer Center Hospital Zambrano Hellion, Tecnológico de Monterrey San Pedro Garza Garcia Mexico
- Joven & Fuerte: Program for the Care and Research of Young Women with Breast Cancer in Mexico Mexico City Mexico
| | - Bertha A. Martínez‐Cannon
- Breast Cancer Center Hospital Zambrano Hellion, Tecnológico de Monterrey San Pedro Garza Garcia Mexico
- Joven & Fuerte: Program for the Care and Research of Young Women with Breast Cancer in Mexico Mexico City Mexico
| | - Alejandra Platas
- Research and Breast Tumors Department Instituto Nacional de Cancerología Mexico City Mexico
- Joven & Fuerte: Program for the Care and Research of Young Women with Breast Cancer in Mexico Mexico City Mexico
| | - Andrea Castro‐Sánchez
- Joven & Fuerte: Program for the Care and Research of Young Women with Breast Cancer in Mexico Mexico City Mexico
- Cátedras CONACYT Instituto Nacional de Cancerología Mexico City Mexico
| | - Melina Miaja
- Breast Cancer Center Hospital Zambrano Hellion, Tecnológico de Monterrey San Pedro Garza Garcia Mexico
- Joven & Fuerte: Program for the Care and Research of Young Women with Breast Cancer in Mexico Mexico City Mexico
| | - Alejandro Mohar
- Research and Breast Tumors Department Instituto Nacional de Cancerología Mexico City Mexico
- Joven & Fuerte: Program for the Care and Research of Young Women with Breast Cancer in Mexico Mexico City Mexico
| | - Alejandra Monroy
- Research and Breast Tumors Department Instituto Nacional de Cancerología Mexico City Mexico
| | | | - Carmen Lizette Gálvez‐Hernández
- Joven & Fuerte: Program for the Care and Research of Young Women with Breast Cancer in Mexico Mexico City Mexico
- Cátedras CONACYT Instituto Nacional de Cancerología Mexico City Mexico
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16
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Grossesse après cancer du sein : revue de la littérature. Presse Med 2019; 48:376-383. [DOI: 10.1016/j.lpm.2019.01.011] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/17/2016] [Revised: 02/14/2017] [Accepted: 01/31/2019] [Indexed: 11/18/2022] Open
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17
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Korkidakis A, Lajkosz K, Green M, Strobino D, Velez MP. Patterns of Referral for Fertility Preservation Among Female Adolescents and Young Adults with Breast Cancer: A Population-Based Study. J Adolesc Young Adult Oncol 2019; 8:197-204. [PMID: 30676852 PMCID: PMC6479234 DOI: 10.1089/jayao.2018.0102] [Citation(s) in RCA: 27] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
Abstract
Purpose: To assess the fertility preservation (FP) referral rates and patterns of newly diagnosed breast cancer in female adolescent and young adult (AYA) patients. Methods: Women aged 15–39 years with newly diagnosed breast cancer in Ontario from 2000 to 2017 were identified using the Ontario Cancer Registry. Exclusion criteria included prior sterilizing procedure, health insurance ineligibility, and prior infertility or cancer diagnosis. Women with a gynecology consult between cancer diagnosis and chemotherapy commencement with the billed infertility diagnostic code (ICD-9 628) were used as a surrogate for FP referral. The effect of age, parity, year of cancer diagnosis, staging, income, region, neighborhood marginalization, and rurality on referral status was investigated. Results: A total of 4452 patients aged 15–39 with newly diagnosed breast cancer met the inclusion criteria. Of these women, 178 (4.0%) were referred to a gynecologist with a billing code of infertility between cancer diagnosis and initiation of chemotherapy. Older patients, prior parity, and advanced disease were inversely correlated with referrals. Referral rates also varied regionally: patients treated in the south-east and south-west Local Health Integration Networks (LHINs) had the highest probability of referral, and patients covered by north LHINs had the lowest (central LHIN as reference). General surgeons accounted for 36.5% of all referrals, the highest percentage of all specialists. Referral rates significantly increased over time from 0.4% in 2000 to 10.7% in 2016. Conclusion: FP referral rates remain low and continue to be influenced by patient demographics and prognosis. These findings highlight the need for further interdisciplinary coordination in addressing the fertility concerns of AYA with newly diagnosed breast cancers.
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Affiliation(s)
- Ann Korkidakis
- 1 Division of Reproductive Endocrinology and Infertility, Department of Obstetrics and Gynecology, Queen's University, Kingston, Canada.,2 Division of Reproductive Endocrinology and Infertility, University of British Columbia, Vancouver, Canada
| | - Katherine Lajkosz
- 3 Institute for Clinical Evaluative Sciences, Queen's University, Kingston, Canada
| | - Michael Green
- 4 Department of Family Medicine, Centre for Health Services and Policy Research, Queen's University, Institute for Clinical Evaluative Sciences, Kingston, Canada
| | - Donna Strobino
- 5 Department of Population, Family, and Reproductive Health, Bloomberg School of Public Health, Baltimore, Maryland
| | - Maria P Velez
- 1 Division of Reproductive Endocrinology and Infertility, Department of Obstetrics and Gynecology, Queen's University, Kingston, Canada
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18
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The Fertility Management Experiences of Australian Women with a Non-communicable Chronic Disease: Findings from the Understanding Fertility Management in Contemporary Australia Survey. Matern Child Health J 2018; 22:830-840. [PMID: 29411252 DOI: 10.1007/s10995-018-2454-9] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
Introduction Despite the considerable and increasing proportion of women of reproductive age with a chronic non-communicable disease (NCD) and the potential adverse implications of many NCDs for childbearing, little is known about the fertility management experiences of women with an NCD, including their contraceptive use, pregnancy experiences and outcomes, and reproductive health care utilisation. The aim of this study was to investigate the fertility management experiences of women with an NCD and draw comparisons with women without an NCD. Method A sample of 18-50 year-old women (n = 1543) was randomly recruited from the Australian electoral roll in 2013. Of these women, 172 women reported a physical, chronic non-communicable disease: diabetes, arthritis, asthma, hypertension, heart disease, thyroid disorders, and cystic fibrosis. Respondents completed an anonymous, self-administered questionnaire. Factors associated with fertility management were identified in multivariable analyses. Results Women who reported having an NCD were significantly more likely than women who did not report an NCD to have ever been pregnant (75.9 vs. 67.5%, p = 0.034), have had an unintended pregnancy (33.47 vs. 25.5%, p = 0.026), and have had an abortion (20.3 vs. 14.2%, p = 0.044); they were less likely to consult a healthcare provider about fertility management (45.0 vs. 54.4%, p = 0.024). Similar proportions were using contraception (48.8 vs. 54.5%, p = 0.138). Conclusion The findings have implications for healthcare providers and women with an NCD and highlight the importance of addressing possible assumptions about the inability of women with an NCD to become pregnant, and ensuring women receive information about suitable methods of contraception and pre-pregnancy care.
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Daly C, Micic S, Facey M, Speller B, Yee S, Kennedy ED, Corter AL, Baxter NN. A review of factors affecting patient fertility preservation discussions & decision-making from the perspectives of patients and providers. Eur J Cancer Care (Engl) 2018; 28:e12945. [PMID: 30375696 DOI: 10.1111/ecc.12945] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2017] [Revised: 08/17/2018] [Accepted: 09/08/2018] [Indexed: 11/30/2022]
Abstract
Women undergoing cancer treatments and their healthcare providers encounter challenges in fertility preservation (FP) discussions and decision-making. A systematic review of qualitative research was conducted to gain in-depth understanding of factors influencing FP discussions and decision-making. Major bibliographic databases and grey literature in English from 1994 to 2016 were searched for qualitative research exploring patient/provider perspectives on barriers and facilitators to FP decision-making. Two researchers screened article titles, abstracts and full-texts. Verbatim data on research questions, study methodology, participants, findings and discussions of findings were extracted. Quality assessment and thematic analysis were conducted. The search yielded 74 studies dating from 2007 onwards; 29 met the inclusion criteria. Analysis revealed three types of barriers: (a) FP knowledge, skills and information deficits contributed to discomfort for providers and discontent for patients; (b) psychosocial factors and clinical issues influenced providers' practices around FP discussions and patients' decision-making; and (c) material, social and structural factors (e.g., lack of resources and accessibility) posed challenges to FP discussions. Potential facilitators to FP discussions and decision-making were also identified. A discussion of ways to improve physician's knowledge and facilitate women's decision-making and access to FP is presented, along with areas for policy development and further research.
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Affiliation(s)
- Corinne Daly
- Department of Surgery, Li Ka Shing Knowledge Institute, St. Michael's Hospital, Toronto, Ontario, Canada
| | - Selena Micic
- Department of Surgery, Li Ka Shing Knowledge Institute, St. Michael's Hospital, Toronto, Ontario, Canada
| | - Marcia Facey
- Leslie Dan Faculty of Pharmacy, University of Toronto, Toronto, Ontario, Canada
| | - Brittany Speller
- Department of Surgery, Li Ka Shing Knowledge Institute, St. Michael's Hospital, Toronto, Ontario, Canada
| | - Samantha Yee
- Factor-Inwentash Faculty of Social Work, University of Toronto, Toronto, Ontario, Canada
| | - Erin D Kennedy
- Department of Surgery, Mount Sinai Health System, Toronto, Ontario, Canada.,Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
| | - Arden L Corter
- Department of Surgery, Li Ka Shing Knowledge Institute, St. Michael's Hospital, Toronto, Ontario, Canada
| | - Nancy N Baxter
- Department of Surgery, Li Ka Shing Knowledge Institute, St. Michael's Hospital, Toronto, Ontario, Canada.,Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
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20
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Gálvez-Hernández CL, Ortega Mondragón A, Villarreal-Garza C, Ramos del Río B. Mujeres Jóvenes con Cáncer de Mama: Necesidades de Apoyo en Atención y Resiliencia. PSICOONCOLOGIA 2018. [DOI: 10.5209/psic.61436] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Antecedentes: las mujeres menores de 40 años con cáncer de mama (CaMa) presentan características bio-psico-sociales únicas que ameritan ser atendidas y estudiadas. Objetivo: evaluara) la percepción de necesidades de apoyo en la atención (NAT) insatisfechas y nivel de resiliencia,b) la diferencia de NAT entre pacientes en tratamiento y sobrevivientes y c) la relación entre NAT y resiliencia, y su asociación con variables clínicas y sociodemográficas, respectivamente. Método: se estudiaron transversalmente a 150 mujeres jóvenes con CaMa en tratamiento y sobrevivientes, con una encuesta de NAT y una de resiliencia mexicanas. Resultados: la mediana de edad de las participantes fue de 36 años. Las necesidades menos satisfechas fueron las de sistema de salud e información. El grupo de tratamiento presentó más NAT comparado con las sobrevivientes (p=0,005). Se encontró que cuanto más NAT insatisfechas (globales, psicológicas, cuidado y apoyo, e información), menores valores en los dominios de resiliencia (p<0,005) en ambos grupos y por separado. Conclusiones: las condiciones externas (infraestructura, servicios de salud proporcionados y apoyo en seguridad social), habilidades propias (auto-confianza, estructura y organización) y/o recursos de apoyo externo (social y familiar) pudieron contribuir a que las pacientes percibieran pocas NAT insatisfechas. Los resultados resaltan la relevancia clínica de implementar intervenciones basadas en resiliencia.
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21
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Shliakhtsitsava K, Suresh D, Hadnott T, Su HI. Best Practices in Counseling Young Female Cancer Survivors on Reproductive Health. Semin Reprod Med 2017; 35:378-389. [PMID: 29036745 DOI: 10.1055/s-0037-1603770] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/14/2023]
Abstract
AbstractIn the United States, there are more than 400,000 girls and young women of reproductive-age with a history of cancer. Cancer treatments including surgery, chemotherapy, targeted therapy, and radiation can adversely impact their reproductive health. This review discusses infertility, contraception, and adverse pregnancy and child health outcomes in reproductive-aged cancer survivors, to increase awareness of these health risks for survivors and their health care providers. Infertility rates are modestly higher, while rates of using contraception and using highly effective contraceptive methods are lower in cancer survivors than in women without a history of cancer. During pregnancy, preterm births are also more common in survivors, resulting in more low-birth-weight offspring. Children of cancer survivors do not have more childhood cancers, birth defects, or chromosomal abnormalities than the general population, with the exception of families with hereditary cancer. Reproductive risks in survivors depend on cancer treatment exposures. For example, women with prior abdominal or pelvic radiation have additional risks of spontaneous abortions, small-for-gestational-age offspring and stillbirths, while those with prior chest radiation or anthracycline exposures have higher risks of cardiomyopathy. To help survivors achieve their reproductive goals safely, family planning and preconception counseling are central to survivorship care.
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Affiliation(s)
- Ksenya Shliakhtsitsava
- Department of Pediatric Hematology and Oncology, University of California, San Diego, La Jolla, California
| | - Deepika Suresh
- Moores Cancer Center, University of California, San Diego, La Jolla, California
| | - Tracy Hadnott
- Department of Reproductive Medicine, University of California, San Diego, La Jolla, California
| | - H Irene Su
- Moores Cancer Center, University of California, San Diego, La Jolla, California.,Department of Reproductive Medicine, University of California, San Diego, La Jolla, California
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22
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Jones G, Hughes J, Mahmoodi N, Smith E, Skull J, Ledger W. What factors hinder the decision-making process for women with cancer and contemplating fertility preservation treatment? Hum Reprod Update 2017; 23:433-457. [DOI: 10.1093/humupd/dmx009] [Citation(s) in RCA: 72] [Impact Index Per Article: 10.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2016] [Accepted: 03/27/2017] [Indexed: 02/07/2023] Open
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23
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Lawson AK, McGuire JM, Noncent E, Olivieri JF, Smith KN, Marsh EE. Disparities in Counseling Female Cancer Patients for Fertility Preservation. J Womens Health (Larchmt) 2017; 26:886-891. [PMID: 28498013 DOI: 10.1089/jwh.2016.5997] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
BACKGROUND Female cancer patients who are exposed to gonadotoxic chemotherapy are at risk of future infertility. Research suggests that disparities in fertility preservation counseling (FPC) may exist. Previous research is limited by recall bias; therefore, this study examined objective electronic medical chart data regarding FPC at an academic medical center. MATERIALS AND METHODS This study included reproductive-aged women (18-45 years old) with a diagnosis of breast, gynecological, or hematological cancer and who were exposed to a gonadotoxic chemotherapeutic agent from 2009 to 2013. Chi-square and logistic regression analyses were utilized to analyze disparities in FPC. RESULTS Two hundred fifty-nine women met the study criteria. One hundred eighty-one women were diagnosed with breast cancer, 52 with hematological cancer, and 26 with gynecological cancer. 160/259 (62%) women had documented counseling for fertility preservation (FP), 60 (23%) women were not counseled as counseling was determined to be "not applicable," 16 (6%) women were not counseled and no explanation was given for the lack of counseling, and counseling was not documented in 23 (9%) charts. Age, marital status, and racial/ethnic background were related to counseling status. Patients with gynecological or hematological cancer were more likely to be counseled than other patients. Logistic regression results demonstrated that FPC was largely driven by cancer diagnosis. CONCLUSIONS Although cancer diagnosis was the greatest predictor of FPC, disparities were evident in the counseling of female cancer patients for FP treatment. Equality in counseling female patients for FP treatment is imperative to reduce the risk of emotional harm and future infertility.
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Affiliation(s)
- Angela K Lawson
- 1 Division of Reproductive Endocrinology, Department of Obstetrics and Gynecology, Feinberg School of Medicine, Northwestern University , Chicago, Illinois
| | - Jamie M McGuire
- 1 Division of Reproductive Endocrinology, Department of Obstetrics and Gynecology, Feinberg School of Medicine, Northwestern University , Chicago, Illinois
| | - Edernst Noncent
- 1 Division of Reproductive Endocrinology, Department of Obstetrics and Gynecology, Feinberg School of Medicine, Northwestern University , Chicago, Illinois
| | - John F Olivieri
- 1 Division of Reproductive Endocrinology, Department of Obstetrics and Gynecology, Feinberg School of Medicine, Northwestern University , Chicago, Illinois
| | - Kristin N Smith
- 1 Division of Reproductive Endocrinology, Department of Obstetrics and Gynecology, Feinberg School of Medicine, Northwestern University , Chicago, Illinois
| | - Erica E Marsh
- 2 Department of Obstetrics and Gynecology, University of Michigan , Ann Arbor, Michigan
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Britton L. Unintended Pregnancy: A Systematic Review of Contraception Use and Counseling in Women With Cancer. Clin J Oncol Nurs 2017; 21:189-196. [PMID: 28315546 PMCID: PMC5878924 DOI: 10.1188/17.cjon.189-196] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
BACKGROUND Women with past or current cancer diagnoses can benefit from planning pregnancies to optimize maternal health and birth outcomes.
. OBJECTIVES The purpose of this systematic review is to identify unmet needs for family planning services among women with cancer by describing the prevalence of contraception counseling, contraception use, unintended pregnancy, and abortion.
. METHODS Using the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines, 16 studies were included.
. FINDINGS Women with cancer experience unintended pregnancy and abortion throughout their care. Not all women reported receiving contraception counseling, and many reported inconsistencies between contraception counseling desired and received. A prominent theme was uncertainty about fertility status. Use of highly effective contraceptive methods was low to moderate in eight patient populations.
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25
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Kobayashi T, Shin T, Nishio K, Shimomura Y, Iwahata T, Suzuki K, Miyata A, Kobori Y, Arai G, Okada H. A questionnaire survey on attitude toward sperm cryopreservation among hematologists in Japan. Int J Hematol 2016; 105:349-352. [PMID: 27844197 DOI: 10.1007/s12185-016-2134-8] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2016] [Revised: 10/31/2016] [Accepted: 11/02/2016] [Indexed: 11/26/2022]
Abstract
Advances in multimodal treatment have led to dramatic improvement in cancer treatment outcomes. It is now necessary to consider cancer patients' holistic quality of life. Fertility preservation is the top concern for cancer survivors of reproductive age. Sperm cryopreservation before treatment is recommended for postpubescent men, but many patients lose fertility without having been informed about options for fertility preservation. To determine how sperm cryopreservation is perceived and practiced in Japan, we surveyed hematologists who often treat young males. A questionnaire about sperm cryopreservation was sent to 45 major hematology institutions. A total of 22 institutions responded before the deadline. All institutions but one responded that they felt sperm cryopreservation is necessary. Only 15 institutions responded that they inform patients about sperm cryopreservation, and 12 institutions responded that they perform sperm cryopreservation before chemotherapy. A total of 213 young males started their first course of chemotherapy during the survey period, of whom 61 (28.6%) had their sperm cryopreserved. Although almost all hematologists stated that sperm cryopreservation is necessary for fertility preservation, not all institutions informed patients about it. Our findings indicate that, to promote fertility preservation in Japan, it will be necessary to systematize sperm cryopreservation and build inter-hospital networks.
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Affiliation(s)
- Tomohiro Kobayashi
- Department of Urology, Dokkyo Medical University Koshigaya Hospital, 2-1-50 Minamikoshigaya, Koshigaya, Saitama, 343-8555, Japan.
| | - Takeshi Shin
- Department of Urology, Dokkyo Medical University Koshigaya Hospital, 2-1-50 Minamikoshigaya, Koshigaya, Saitama, 343-8555, Japan
- Center for Reproductive Medicine, Dokkyo Medical University Koshigaya Hospital, 2-1-50 Minamikoshigaya, Koshigaya, Saitama, 343-8555, Japan
| | - Kojiro Nishio
- Department of Urology, Dokkyo Medical University Koshigaya Hospital, 2-1-50 Minamikoshigaya, Koshigaya, Saitama, 343-8555, Japan
| | - Yukihito Shimomura
- Department of Urology, Dokkyo Medical University Koshigaya Hospital, 2-1-50 Minamikoshigaya, Koshigaya, Saitama, 343-8555, Japan
| | - Toshiyuki Iwahata
- Department of Urology, Dokkyo Medical University Koshigaya Hospital, 2-1-50 Minamikoshigaya, Koshigaya, Saitama, 343-8555, Japan
| | - Keisuke Suzuki
- Department of Urology, Dokkyo Medical University Koshigaya Hospital, 2-1-50 Minamikoshigaya, Koshigaya, Saitama, 343-8555, Japan
- Center for Reproductive Medicine, Dokkyo Medical University Koshigaya Hospital, 2-1-50 Minamikoshigaya, Koshigaya, Saitama, 343-8555, Japan
| | - Akane Miyata
- Center for Reproductive Medicine, Dokkyo Medical University Koshigaya Hospital, 2-1-50 Minamikoshigaya, Koshigaya, Saitama, 343-8555, Japan
| | - Yoshitomo Kobori
- Department of Urology, Dokkyo Medical University Koshigaya Hospital, 2-1-50 Minamikoshigaya, Koshigaya, Saitama, 343-8555, Japan
| | - Gaku Arai
- Department of Urology, Dokkyo Medical University Koshigaya Hospital, 2-1-50 Minamikoshigaya, Koshigaya, Saitama, 343-8555, Japan
| | - Hiroshi Okada
- Department of Urology, Dokkyo Medical University Koshigaya Hospital, 2-1-50 Minamikoshigaya, Koshigaya, Saitama, 343-8555, Japan
- Center for Reproductive Medicine, Dokkyo Medical University Koshigaya Hospital, 2-1-50 Minamikoshigaya, Koshigaya, Saitama, 343-8555, Japan
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The need for supportive care among head and neck cancer patients: psychometric assessment of the Dutch version of the Supportive Care Needs Survey Short-Form (SCNS-SF34) and the newly developed head and neck cancer module (SCNS-HNC). Support Care Cancer 2016; 24:4639-49. [PMID: 27318479 PMCID: PMC5031728 DOI: 10.1007/s00520-016-3307-y] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2016] [Accepted: 06/06/2016] [Indexed: 12/04/2022]
Abstract
Purpose The purpose of this study is to assess the psychometric properties of the Dutch version of the 34-item Short-Form Supportive Care Needs Survey (SCNS-SF34) and the newly developed module for head and neck cancer (HNC) patients (SCNS-HNC). Methods HNC patients were included from two cross-sectional studies. Content validity of the SCNS-HNC was analysed by examining redundancy and completeness of items. Factor structure was assessed using confirmatory and exploratory factor analyses. Cronbach’s alpha, Spearman’s correlation, Mann–Whitney U test, Kruskall–Wallis and intraclass correlation coefficients (ICC) were used to assess internal consistency, construct validity and test–retest reliability. Results Content validity of the SCNS-HNC was good, although some HNC topics were missing. For the SCNS-SF34, a four-factor structure was found, namely physical and daily living, psychological, sexuality and health system and information and patient support (alpha = .79 to .95). For the SCNS-HNC, a two-factor structure was found, namely HNC-specific functioning and lifestyle (alpha = .89 and .60). Respectively, 96 and 89 % of the hypothesised correlations between the SCNS-SF34 or SCNS-HNC and other patient-reported outcome measures were found; 57 and 67 % also showed the hypothesised magnitude of correlation. The SCNS-SF34 domains discriminated between treatment procedure (physical and daily living p = .02 and psychological p = .01) and time since treatment (health system, information and patient support p = .02). Test–retest reliability of SCNS-SF34 domains and HNC-specific functioning domain was above .70 (ICC = .74 to .83), and ICC = .67 for the lifestyle domain. Floor effects ranged from 21.1 to 70.9 %. Conclusions The SCNS-SF34 and SCNS-HNC are valid and reliable instruments to evaluate the need for supportive care among (Dutch) HNC patients. Electronic supplementary material The online version of this article (doi:10.1007/s00520-016-3307-y) contains supplementary material, which is available to authorized users.
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Ellis SJ, Wakefield CE, McLoone JK, Robertson EG, Cohn RJ. Fertility concerns among child and adolescent cancer survivors and their parents: A qualitative analysis. J Psychosoc Oncol 2016; 34:347-62. [DOI: 10.1080/07347332.2016.1196806] [Citation(s) in RCA: 39] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
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Karunaratne K, Premaratne S, Hapuachchige C, Ihalagama H. Counselling pregnant women with cancer. Best Pract Res Clin Obstet Gynaecol 2016; 33:117-23. [DOI: 10.1016/j.bpobgyn.2015.10.001] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2015] [Accepted: 10/08/2015] [Indexed: 10/22/2022]
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Angarita AM, Johnson CA, Fader AN, Christianson MS. Fertility Preservation: A Key Survivorship Issue for Young Women with Cancer. Front Oncol 2016; 6:102. [PMID: 27200291 PMCID: PMC4843761 DOI: 10.3389/fonc.2016.00102] [Citation(s) in RCA: 34] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2015] [Accepted: 04/11/2016] [Indexed: 12/14/2022] Open
Abstract
Fertility preservation in the young cancer survivor is recognized as a key survivorship issue by the American Society of Clinical Oncology and the American Society of Reproductive Medicine. Thus, health-care providers should inform women about the effects of cancer therapy on fertility and should discuss the different fertility preservation options available. It is also recommended to refer women expeditiously to a fertility specialist in order to improve counseling. Women’s age, diagnosis, presence of male partner, time available, and preferences regarding use of donor sperm influence the selection of the appropriate fertility preservation option. Embryo and oocyte cryopreservation are the standard techniques used while ovarian tissue cryopreservation is new, yet promising. Despite the importance of fertility preservation for cancer survivors’ quality of life, there are still communication and financial barriers faced by women who wish to pursue fertility preservation.
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Affiliation(s)
- Ana Milena Angarita
- Department of Gynecology and Obstetrics, The Kelly Gynecologic Oncology Service, Johns Hopkins University School of Medicine , Baltimore, MD , USA
| | - Cynae A Johnson
- Department of Gynecology and Obstetrics, The Kelly Gynecologic Oncology Service, Johns Hopkins Hospital , Baltimore, MD , USA
| | - Amanda Nickles Fader
- Department of Gynecology and Obstetrics, The Kelly Gynecologic Oncology Service, Johns Hopkins University School of Medicine , Baltimore, MD , USA
| | - Mindy S Christianson
- Division of Reproductive Endocrinology, Department of Gynecology and Obstetrics, Johns Hopkins University School of Medicine , Baltimore, MD , USA
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Wang Y, Chen L, Ruan JY, Cheung WY. Discussions about reproductive and sexual health among young adult survivors of cancer. Cancer Med 2016; 5:1037-46. [PMID: 26899556 PMCID: PMC4924361 DOI: 10.1002/cam4.666] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2015] [Revised: 12/23/2015] [Accepted: 01/18/2016] [Indexed: 12/17/2022] Open
Abstract
Fertility preservation and sexual health are increasingly important as more young cancer patients survive their disease. Our aims were to describe the frequency with which reproductive and sexual health discussions occur, and to identify clinical factors associated with these discussions. Medical records of patients aged 20–39 diagnosed with solid tumors from 2008–2010 who survived ≥2 years were retrospectively reviewed. Multivariate logistic models were used to explore the relationship between clinical factors and occurrence of discussions. We analyzed 427 survivors: median age was 35 years, 29% were men, 88% had baseline [Eastern Cooperative Oncology Group (ECOG)] ECOG 0, and 79% were in a relationship. Only 58% and 7% of patients received discussions about reproductive and sexual health, respectively, at their initial oncology consultation, most of which were led by medical oncologists. There was a significant association between reproductive and sexual health conversations, in that those who engaged in dialog about one topic were more likely to participate in discussions about the other (P = 0.01). Patients with gynecologic malignancies (P < 0.0001) were more inclined to engage in sexual health discussions. Only a minority (19%) of patients took specific action toward fertility preservation, but the receipt of reproductive health discussions was a strong and independent driver for pursuing fertility preservation (P < 0.0001). The impact of cancer and its treatment on fertility and sexual health was inadequately addressed at the time of diagnosis among young cancer survivors. This warrants specific attention since having reproductive health discussions was strongly predictive of patients pursuing fertility preservation strategies.
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Affiliation(s)
- Ying Wang
- British Columbia Cancer Agency, Vancouver, Canada
| | - Leo Chen
- British Columbia Cancer Agency, Vancouver, Canada
| | - Jenny Y Ruan
- British Columbia Cancer Agency, Vancouver, Canada
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Lawson AK, Klock SC, Pavone ME, Hirshfeld-Cytron J, Smith KN, Kazer RR. Psychological Counseling of Female Fertility Preservation Patients. J Psychosoc Oncol 2015; 33:333-53. [PMID: 25996581 DOI: 10.1080/07347332.2015.1045677] [Citation(s) in RCA: 34] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
Young cancer patients are increasingly interested in preserving their fertility prior to undergoing gonadotoxic therapies. Although the medical safety and treatment protocols for fertility preservation have been well documented, limited research has addressed the emotional issues that arise in fertility preservation patients. We briefly review the literature on the psychosocial issues in adult female fertility preservation treatment and describe our experiences within this patient population. Our findings suggest that several important issues to be addressed during the psychological counseling of adult female fertility preservation patients include: (1) preexisting psychological distress in patients undergoing treatment, (2) choice of fertility preservation strategy in the face of an uncertain relationship future, (3) decision making regarding use of third-party reproduction (e.g., sperm/egg donation, gestational surrogacy), (4) treatment expectations regarding pregnancy and miscarriage, (5) ethical issues related to treatment including the creation, cryopreservation, and disposition of embryos/oocytes, and (6) decision regret from patients who declined fertility preservation.
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Affiliation(s)
- Angela K Lawson
- a Department of Obstetrics and Gynecology, Northwestern University , Chicago , IL , USA
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Richter D, Geue K, Sender A, Paasch U, Brähler E, Stöbel-Richter Y, Ernst J. Medical consultations about fertility preservation with haematological patients of childbearing age: A qualitative study. Eur J Oncol Nurs 2015; 21:146-52. [PMID: 26481504 DOI: 10.1016/j.ejon.2015.09.005] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2014] [Revised: 08/03/2015] [Accepted: 09/22/2015] [Indexed: 10/22/2022]
Abstract
PURPOSE Oncological treatments can cause serious long-term consequences, including effects on patients' fertility. Communication about possible fertility impairment is essential for cancer patients who want to have children. When oncologists initiate this discussion in a timely manner, patients can be referred to fertility specialists and avail themselves of fertility preservation methods. The oncologist plays a key role in this context. METHODS 30 cancer patients of childbearing age (21-43 years) took part in semi-structured interviews between March 2011 and April 2012 about fertility and their desire to have children. Interview transcripts were thematically analyzed. RESULTS Physician-patient consultations broached the issue as a central theme in almost all patients. A few consultations were patient initiated, and the majority took place before the beginning of treatment. Almost half of the patients were satisfied with their consultations and were referred to a fertility specialist. The ideal setting for these conversations is in the presence of the patient's partner, in a private space, before the beginning of treatment. CONCLUSIONS All patients should be informed about the possibility of their fertility being impaired due to treatments, even if they have not explicitly expressed wanting children. The oncologist is the first and most important contact for the patient and, hence, should bring up the issue of family planning and fertility. An interdisciplinary communication and collaboration between oncologists and fertility specialists can improve patient care.
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Affiliation(s)
- Diana Richter
- University Medical Center Leipzig, Department of Medical Psychology and Medical Sociology, Philipp-Rosenthal-Straße 55, 04103 Leipzig, Germany.
| | - Kristina Geue
- University Medical Center Leipzig, Department of Medical Psychology and Medical Sociology, Philipp-Rosenthal-Straße 55, 04103 Leipzig, Germany
| | - Annekathrin Sender
- University Medical Center Leipzig, Department of Medical Psychology and Medical Sociology, Philipp-Rosenthal-Straße 55, 04103 Leipzig, Germany
| | - Uwe Paasch
- University Medical Center Leipzig, Clinic and Policlinic of Dermatology, Venereology and Allergology, Philipp-Rosenthal-Straße 23, 04103 Leipzig, Germany
| | - Elmar Brähler
- University Medical Center Leipzig, Department of Medical Psychology and Medical Sociology, Philipp-Rosenthal-Straße 55, 04103 Leipzig, Germany; Clinic and Policlinic of Psychosomatic Medicine and Psychotherapy, University Medical Center Mainz, Untere Zahlbacher Straße 8, 55131 Mainz, Germany
| | - Yve Stöbel-Richter
- University of Applied Sciences Zittau/Görlitz, Faculty of Managerial and Cultural Studies, Chair of Health Sciences, Furtstraße 3, House G IV, 02826 Görlitz, Germany
| | - Jochen Ernst
- University Medical Center Leipzig, Department of Medical Psychology and Medical Sociology, Philipp-Rosenthal-Straße 55, 04103 Leipzig, Germany
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Ben Charif A, Bouhnik AD, Rey D, Provansal M, Courbiere B, Spire B, Mancini J. Satisfaction with fertility- and sexuality-related information in young women with breast cancer--ELIPPSE40 cohort. BMC Cancer 2015; 15:572. [PMID: 26239242 PMCID: PMC4523948 DOI: 10.1186/s12885-015-1542-0] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2014] [Accepted: 07/13/2015] [Indexed: 11/25/2022] Open
Abstract
Background Young breast cancer survivors are often dissatisfied with the information provided on fertility and sexuality. Our aim was to discuss possible contributing factors and to propose strategies to increase patient satisfaction with such information. Methods Using the French National Health Insurance System database, we constituted the ELIPPSE40 regional cohort of 623 women, aged 18–40, diagnosed with breast cancer between 2005 and 2011. As of January 2014, 319 women had taken part in the 10-, 16-, 28 and 48-month telephone interviews. Satisfaction with the information provided about the potential impact of cancer and its treatment on fertility and sexuality was assessed at 48 months after diagnosis on 5-point Likert scales. Results Four years after diagnosis, only 53.0 and 42.6 % of women were satisfied with fertility- and sexuality-related information, respectively, without any significant change over the 2009–2014 period (P = 0.585 and P = 0.676 respectively). The two issues were moderately correlated (ρ = 0.60; P <0.001). General satisfaction with medical follow-up was the only common correlate. Irrespective of sociodemographic and medical characteristics, satisfaction with fertility-related information was greater among women with a family history of breast/ovarian cancer who had the opportunity to ask questions at the time of cancer disclosure. Satisfaction with sexuality-related information increased with the spontaneous provision of information by physicians at cancer disclosure. Conclusions Promoting both patients’ question asking behavior and more systematic information could improve communication between caregivers and young breast cancer survivors and address distinct unmet needs regarding fertility- and sexuality- related information. Electronic supplementary material The online version of this article (doi:10.1186/s12885-015-1542-0) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Ali Ben Charif
- UMR912 "Economics and Social Sciences Applied to Health & Analysis of Medical Information" (SESSTIM), 13006,, Marseille, France. .,UMR_S912, IRD, Aix Marseille Université, Marseille, France. .,ORS PACA, Southeastern Health Regional Observatory, Marseille, France.
| | - Anne-Déborah Bouhnik
- UMR912 "Economics and Social Sciences Applied to Health & Analysis of Medical Information" (SESSTIM), 13006,, Marseille, France. .,UMR_S912, IRD, Aix Marseille Université, Marseille, France.
| | - Dominique Rey
- UMR912 "Economics and Social Sciences Applied to Health & Analysis of Medical Information" (SESSTIM), 13006,, Marseille, France. .,UMR_S912, IRD, Aix Marseille Université, Marseille, France. .,ORS PACA, Southeastern Health Regional Observatory, Marseille, France.
| | - Magali Provansal
- UMR912 "Economics and Social Sciences Applied to Health & Analysis of Medical Information" (SESSTIM), 13006,, Marseille, France. .,Institut Paoli-Calmettes, Marseille, France.
| | - Blandine Courbiere
- IMBE UMR7263, Aix Marseille Université, CNRS, IRD, Avignon Université, Marseille, France. .,Department of Obstetrics, Gynecology and Reproductive Medicine, APHM, La Conception Hospital, Marseille, France.
| | - Bruno Spire
- UMR912 "Economics and Social Sciences Applied to Health & Analysis of Medical Information" (SESSTIM), 13006,, Marseille, France. .,UMR_S912, IRD, Aix Marseille Université, Marseille, France. .,ORS PACA, Southeastern Health Regional Observatory, Marseille, France.
| | - Julien Mancini
- UMR912 "Economics and Social Sciences Applied to Health & Analysis of Medical Information" (SESSTIM), 13006,, Marseille, France. .,UMR_S912, IRD, Aix Marseille Université, Marseille, France. .,BiosTIC, La Timone Hospital, APHM, Marseille, France. .,UMR912, SESSTIM, "Cancers, Biomedicine & Society" group, Institut Paoli-Calmettes, 232 Bd Ste Marguerite, 13273, Marseille, France.
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An investigative study into psychological and fertility sequelae of gestational trophoblastic disease: the impact on patients' perceived fertility, anxiety and depression. PLoS One 2015; 10:e0128354. [PMID: 26030770 PMCID: PMC4452269 DOI: 10.1371/journal.pone.0128354] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2015] [Accepted: 04/24/2015] [Indexed: 11/19/2022] Open
Abstract
OBJECTIVES Gestational Trophoblastic Disease (GTD) comprises a group of disorders that derive from the placenta. Even if full recovery is generally expected, women diagnosed with GTD have to confront: the loss of a pregnancy, a potentially life-threatening diagnosis and delays in future pregnancies. The aim of the study is to evaluate the psychological impact of GTD, focusing on perceived fertility, depression and anxiety. METHODS 37 patients treated for GTD at San Raffaele Hospital, Milan, took part in the study. The STAI-Y (State-Trait Anxiety Inventory), the BDI-SF (Beck Depression Scale-Short Form) and the FPI (Fertility Problem Inventory) were used. Patients were grouped on the basis of presence of children (with or without), age (< or ≥35) and type of diagnosis (Hydatidiform Mole, HM, or Gestational Trophoblastic Neoplasia, GTN). Differences in the values between variables were assessed by a t-type test statistic. Three-way ANOVAs were also carried out considering the same block factors. RESULTS The study highlights that women suffering from GTN had higher depression scores compared to women suffering from HM. A significant correlation was found between anxiety (state and trait) and depression. Younger women presented higher Global Stress scores on the FPI, especially tied to Need for Parenthood and Relationship Concern subscales. Need for Parenthood mean scores significantly varied between women with and without children too. CONCLUSIONS We can conclude that fertility perception seems to be negatively affected by GTD diagnosis, particularly in younger women and in those without children. Patients should be followed by a multidisciplinary team so as to be supported in the disease's psychological aspects too.
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Chirol A, Debled M, Fournier M, Papaxanthos A, Hoppe S, Brouste V, Conri V, Bonnefoi H, Von Théobald P, Mathoulin S, Hocké C, Tunon de Lara C. [Oncofertility and breast cancer: Where have we come from, where are we going?]. Bull Cancer 2015; 102:489-96. [PMID: 25991386 DOI: 10.1016/j.bulcan.2015.04.004] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2015] [Revised: 04/04/2015] [Accepted: 04/09/2015] [Indexed: 11/26/2022]
Abstract
BACKGROUND Focusing on the current context of national and international recommendations, techniques development to evaluate and preserve fertility and patients' claims, this study aims to make a survey about the management of patients' breast cancer regarding oncofertility. METHODS Retrospective and analytic study of medical practices at Bergonié Institute of health professionals (medical oncologists, surgical oncologists, nurses) dedicated to the care of non-disseminated breast cancer patients younger than 37, needing medical treatment. RESULTS The number of participants was 230. The most interested practitioners in fertility theme are those of multidisciplinary consultation and surgeons (P<0.001), with an increasing interest during last years (P<0.05). The information about hypofertilizing risks of treatments are delivered most of the time by oncologists (57.7%). The motherhood project is expressed by 11 patients (4.9%) before treatment, only 4 of them receive information on the risks and 49 patients (21.7%) during follow-up. Only 24 patients (48% of the 49) are encouraged for motherhood. CONCLUSION To satisfy patients' requests, several improvements have to be made regarding the patients' information, the health professionals' awareness and care coordination.
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Affiliation(s)
- Aurélie Chirol
- Institut de lutte contre le cancer, institut Bergonié, service de chirurgie, Bordeaux, France; Université de Bordeaux, Bordeaux, France; Université de la Réunion, France
| | - Marc Debled
- Institut de lutte contre le cancer, institut Bergonié, service d'oncologie médicale, Bordeaux, France
| | - Marion Fournier
- Institut de lutte contre le cancer, institut Bergonié, service de chirurgie, Bordeaux, France
| | - Aline Papaxanthos
- CHU Pellegrin, service de biologie de la reproduction, Bordeaux, France
| | - Stéphanie Hoppe
- Institut de lutte contre le cancer, institut Bergonié, service de biostatistiques, Bordeaux, France
| | - Véronique Brouste
- Institut de lutte contre le cancer, institut Bergonié, service de biostatistiques, Bordeaux, France
| | - Vanessa Conri
- CHU Pellegrin, service de gynécologie et reproduction, Bordeaux, France
| | - Hervé Bonnefoi
- Institut de lutte contre le cancer, institut Bergonié, service d'oncologie médicale, Bordeaux, France; Université de Bordeaux, Bordeaux, France
| | - Peter Von Théobald
- CHU Felix-Guyon, service de gynécologie, 97400 Saint-Denis, Réunion; Université de la Réunion, France
| | - Simone Mathoulin
- Institut de lutte contre le cancer, institut Bergonié, service de biostatistiques, Bordeaux, France; Université de Bordeaux, Bordeaux, France
| | - Claude Hocké
- CHU Pellegrin, service de gynécologie et reproduction, Bordeaux, France; Université de Bordeaux, Bordeaux, France
| | - Christine Tunon de Lara
- Institut de lutte contre le cancer, institut Bergonié, service de chirurgie, Bordeaux, France.
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Margulies AL, Selleret L, Zilberman S, Nagarra IT, Chopier J, Gligorov J, Berveiller P, Ballester M, Darai E, Chabbert-Buffet N. [Pregnancy after cancer: for whom and when?]. Bull Cancer 2015; 102:463-9. [PMID: 25917345 DOI: 10.1016/j.bulcan.2015.03.012] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2014] [Accepted: 03/04/2015] [Indexed: 11/18/2022]
Abstract
Planning a pregnancy for patients with a history of cancer, including breast cancer, is a clinical situation that becomes more and more common. Several specific items are to be discussed: decrease of fertility after cancer treatment, fertility preservation options, impact of pregnancy on cancer recurrence risk and appropriate interval between cancer and pregnancy. Programming pregnancy after cancer is doable in a multidisciplinary setting, and begins at cancer diagnosis to anticipate the various specific pitfalls. Favor adequate oncologic care remains the leading rule.
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Affiliation(s)
- Anne Laure Margulies
- AP-HP, hôpital Bichat, département de gynécologie obstétrique médecine de la reproduction, 75018 Paris, France
| | - Lise Selleret
- AP-HP, université Pierre-et-Marie-Curie Paris 6, hôpital Tenon, département de gynécologie obstétrique médecine de la reproduction, 75020 Paris, France; Réseau INCA cancers associés à La grossesse (CALG), 75020 Paris, France
| | - Sonia Zilberman
- AP-HP, université Pierre-et-Marie-Curie Paris 6, hôpital Tenon, département de gynécologie obstétrique médecine de la reproduction, 75020 Paris, France; Réseau INCA cancers associés à La grossesse (CALG), 75020 Paris, France
| | | | | | - Joseph Gligorov
- Hôpital Tenon, service d'oncologie médicale, 75020 Paris, France
| | - Paul Berveiller
- Réseau INCA cancers associés à La grossesse (CALG), 75020 Paris, France; AP-HP, hôpital Trousseau, département de gynécologie obstétrique, 75012 Paris, France
| | - Marcos Ballester
- AP-HP, université Pierre-et-Marie-Curie Paris 6, hôpital Tenon, département de gynécologie obstétrique médecine de la reproduction, 75020 Paris, France; Réseau INCA cancers associés à La grossesse (CALG), 75020 Paris, France; Université Pierre-et-Marie-Curie Paris 6, UMRS-938, 75005 Paris, France
| | - Emile Darai
- AP-HP, université Pierre-et-Marie-Curie Paris 6, hôpital Tenon, département de gynécologie obstétrique médecine de la reproduction, 75020 Paris, France; Réseau INCA cancers associés à La grossesse (CALG), 75020 Paris, France; Université Pierre-et-Marie-Curie Paris 6, UMRS-938, 75005 Paris, France
| | - Nathalie Chabbert-Buffet
- AP-HP, université Pierre-et-Marie-Curie Paris 6, hôpital Tenon, département de gynécologie obstétrique médecine de la reproduction, 75020 Paris, France; Réseau INCA cancers associés à La grossesse (CALG), 75020 Paris, France; Université Pierre-et-Marie-Curie Paris 6, UMRS-938, 75005 Paris, France.
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Armuand GM, Wettergren L, Rodriguez-Wallberg KA, Lampic C. Women more vulnerable than men when facing risk for treatment-induced infertility: a qualitative study of young adults newly diagnosed with cancer. Acta Oncol 2015; 54:243-52. [PMID: 25140859 DOI: 10.3109/0284186x.2014.948573] [Citation(s) in RCA: 54] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
BACKGROUND Being diagnosed with cancer constitutes not only an immediate threat to health, but cancer treatments may also have a negative impact on fertility. Retrospective studies show that many survivors regret not having received fertility-related information and being offered fertility preservation at time of diagnosis. This qualitative study investigates newly diagnosed cancer patients' experiences of fertility-related communication and how they reason about the risk of future infertility. MATERIAL AND METHODS Informants were recruited at three cancer wards at a university hospital. Eleven women and 10 men newly diagnosed with cancer participated in individual semi-structured interviews focusing on three domains: experiences of fertility-related communication, decision-making concerning fertility preservation, and thoughts and feelings about the risk of possible infertility. Data was analyzed through qualitative content analysis. RESULTS The analysis resulted in three sub-themes, 'Getting to know', 'Reacting to the risk' and 'Handling uncertainty', and one main theme 'Women more vulnerable when facing risk for infertility', indicating that women reported more negative experiences related to patient-provider communication regarding fertility-related aspects of cancer treatment, as well as negative emotional reactions to the risk of infertility and challenges related to handling uncertainty regarding future fertility. The informants described distress when receiving treatment with possible impact on fertility and used different strategies to handle the risk for infertility, such as relying on fertility preservation or thinking of alternative ways to achieve parenthood. The negative experiences reported by the female informants may be related to the fact that none of the women, but almost all men, had received information about and used fertility preservation. CONCLUSIONS Women newly diagnosed with cancer seem to be especially vulnerable when facing risk for treatment-induced infertility. Lack of shared decision-making concerning future fertility may cause distress and it is therefore necessary to improve the fertility-related communication targeted to female cancer patients.
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Affiliation(s)
- Gabriela M Armuand
- Karolinska Institutet, Department of Neurobiology, Care Sciences and Society , Huddinge , Sweden
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Gorman JR, Su HI, Roberts SC, Dominick SA, Malcarne VL. Experiencing reproductive concerns as a female cancer survivor is associated with depression. Cancer 2014; 121:935-42. [PMID: 25377593 DOI: 10.1002/cncr.29133] [Citation(s) in RCA: 107] [Impact Index Per Article: 10.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2014] [Revised: 09/25/2014] [Accepted: 10/01/2014] [Indexed: 12/16/2022]
Abstract
BACKGROUND Young adult female cancer survivors have unmet reproductive concerns and informational needs that are associated with poorer quality of life. The purpose of this study was to examine the association between current reproductive concerns and moderate to severe depression among young survivors. METHODS This cross-sectional study included 200 female cancer survivors between the ages of 18 and 35 years who completed a Web-based survey measuring reproductive history, parenthood desires, reproductive concerns after cancer, and quality-of-life indicators. RESULTS The mean age of the participants was 28 years (standard deviation, 4.4 years), and almost two-thirds were diagnosed within 5 years of survey completion. A multivariate logistic regression analysis controlling for education, duration of survivorship, and social support revealed an association between experiencing reproductive concerns and moderate to severe depression (odds ratio for each 5-unit increase in the Reproductive Concerns After Cancer [RCAC] score, 1.30; 95% confidence interval, 1.06-1.60). Among those with moderate to severe depression, 23% had high RCAC scores, whereas 6% of those with minimal to mild depression did (P < .001). CONCLUSIONS A higher level of reproductive concerns was associated with greater odds of experiencing moderate to severe depression. Almost a quarter of survivors in this sample reported moderate to severe depression, and addressing reproductive concerns represents one potential area of intervention for improving the psychosocial health of young survivors.
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Affiliation(s)
- Jessica R Gorman
- Moores Cancer Center, University of California San Diego, La Jolla, California
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Razzano A, Revelli A, Delle Piane L, Salvagno F, Casano S, Randaccio S, Benedetto C. Fertility preservation program before ovarotoxic oncostatic treatments: role of the psychological support in managing emotional aspects. Gynecol Endocrinol 2014; 30:822-4. [PMID: 25054374 DOI: 10.3109/09513590.2014.944153] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/26/2022] Open
Abstract
Fertility preservation programs (FPPs) based on oocyte or ovarian tissue cryostorage may be offered to women facing oncostatic treatments at risk of precocious ovarian insufficiency. The way in which FPPs are presented to patients affects their decision to join them. We studied herein 48 young women to whom a FPP was proposed, aiming at clarifying the emotional aspects involved. A psychologist attended the consultations in which the FPP was offered to patients; at the end of the talk, a questionnaire was administered and a semi-structured interview was carried out. Finally, the STAI test was administered to measure trait (TAI) and state (SAI) anxiety, both immediately after consultation, and later on, when patients returned home. We observed that the possibility to join a FPP implied important emotional aspects, and that the presence of a psychologist was helpful to integrate technical information and emotions as well as to reduce trait and state anxiety levels. Our study suggests that the presence of a psychologist during the meeting in which a FPP is offered improves communication between doctors and patients, and helps these women to get a full awareness before choosing to join the FPP.
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Affiliation(s)
- Alessandra Razzano
- Psychology Unit, Department of Gynecology and Obstetrics, S. Anna Hospital, University of Torino , Torino , Italy and
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A national study of the provision of oncofertility services to female patients in Canada. JOURNAL OF OBSTETRICS AND GYNAECOLOGY CANADA 2014; 34:849-858. [PMID: 22971454 DOI: 10.1016/s1701-2163(16)35384-1] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
OBJECTIVE This study aimed to gain a better understanding of the fertility preservation services provided by Canadian fertility clinics to women with cancer. METHODS We invited a total of 76 fertility clinics across Canada to complete a mailed questionnaire related to the availability, accessibility, affordability, and utilization of fertility preservation services for oncology patients. RESULTS The total response rate was 59.2%: 72.4% for IVF clinics and 51.1% for fertility centres without on-site IVF. Not all the responding IVF centres accepted oncology referrals for women. Six clinics without on-site IVF accepted cancer patients for consultation. The medical consultation fees are covered by public health insurance in all provinces. The majority of respondents expedited the referrals to schedule an initial medical appointment within three days. Despite that, the referral volume reported by respondents was markedly low for all except two facilities. With over 4000 young women of reproductive age given a diagnosis of cancer each year in Canada, the findings suggest that cancer patients are severely under-served by fertility clinics. CONCLUSION There is a need to develop a stronger partnership between the fields of oncology and reproductive medicine to further improve access of patients with cancer to fertility preservation services. Development of evidence-based practice guidelines covering medical, clinical, psychosocial, ethical, and legal aspects geared to the Canadian health care system would help to avoid ambiguity relating to the roles and responsibilities in the provision of fertility preservation services. Such processes would ensure optimization of services so that all young cancer patients would receive the best care in protecting their fertility.
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Patel A, Roston A, Uy A, Radeke E, Roston A, Keith L, Zaren HA. Reproductive health and endocrine disruption in women with breast cancer: a pilot study. Support Care Cancer 2014; 23:411-8. [PMID: 25120011 DOI: 10.1007/s00520-014-2381-2] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2013] [Accepted: 07/31/2014] [Indexed: 11/24/2022]
Abstract
PURPOSE The purpose of this study was to assess whether incorporation of an original reproductive health assessment and algorithm into breast cancer care helps providers appropriately manage patient reproductive health goals and to follow laboratory markers for fertility and correlate these with menstruation. METHODS This prospective observational pilot study was set in an urban, public hospital. Newly diagnosed premenopausal breast cancer patients between 18 and 49 years old were recruited for this study prior to chemotherapy initiation. As the intervention, these patients received a reproductive health assessment and care per the study algorithm at 3-month intervals for 24 months. Blood samples were also collected at the same time intervals. The main outcome measures were to assess if the reproductive health management was consistent with patient goals and to track any follicle-stimulating hormone (FSH) and thyroid-stimulating hormone (TSH) level changes throughout treatment and post-treatment period. RESULTS Two patients were pregnant at study initiation. They received obstetric consultations, opted to continue pregnancies, and postpone treatment; both delivered at term without complications. One woman desired future childbearing and received fertility preservation counseling. All women received family planning consultations and received/continued effective contraceptive methods. Seventy-three percent used long-term contraception, 18 % remained abstinent, and 9 % used condoms. During chemotherapy, FSH rose to menopausal levels in 82 % of patients and TSH rose significantly in 9 %. While 82 % of women experienced amenorrhea, 44 % of these women resumed menstruation after chemotherapy. CONCLUSIONS The assessment and algorithm were useful in managing patients' reproductive health needs. Chemotherapy-induced endocrine disruption impacted reproductive health.
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Affiliation(s)
- Ashlesha Patel
- Division of Family Planning, Department of Obstetrics and Gynecology, John H. Stroger, Jr. Hospital of Cook County, 1900 W. Polk St., Room #435, Chicago, IL, 60612, USA,
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Woodson AH, Muse KI, Lin H, Jackson M, Mattair DN, Schover L, Woodard T, McKenzie L, Theriault RL, Hortobágyi GN, Arun B, Peterson SK, Profato J, Litton JK. Breast cancer, BRCA mutations, and attitudes regarding pregnancy and preimplantation genetic diagnosis. Oncologist 2014; 19:797-804. [PMID: 24951607 DOI: 10.1634/theoncologist.2014-0057] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023] Open
Abstract
BACKGROUND Women with premenopausal breast cancer may face treatment-related infertility and have a higher likelihood of a BRCA mutation, which may affect their attitudes toward future childbearing. METHODS Premenopausal women were invited to participate in a questionnaire study administered before and after BRCA genetic testing. We used the Impact of Event Scale (IES) to evaluate the pre- and post-testing impact of cancer or carrying a BRCA mutation on attitudes toward future childbearing. The likelihood of pursuing prenatal diagnosis (PND) or preimplantation genetic diagnosis (PGD) was also assessed in this setting. Univariate analyses determined factors contributing to attitudes toward future childbearing and likelihood of PND or PGD. RESULTS One hundred forty-eight pretesting and 114 post-testing questionnaires were completed. Women with a personal history of breast cancer had less change in IES than those with no history of breast cancer (p = .003). The 18 BRCA-positive women had a greater change in IES than the BRCA-negative women (p = .005). After testing, 31% and 24% of women would use PND and PGD, respectively. BRCA results did not significantly affect attitudes toward PND/PGD. CONCLUSION BRCA results and history of breast cancer affect the psychological impact on future childbearing. Intentions to undergo PND or PGD do not appear to change after disclosure of BRCA results. Additional counseling for patients who have undergone BRCA testing may be warranted to educate patients about available fertility preservation options.
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Affiliation(s)
- Ashley H Woodson
- Department of Breast Medical Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA
| | - Kimberly I Muse
- Department of Breast Medical Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA
| | - Heather Lin
- Department of Breast Medical Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA
| | - Michelle Jackson
- Department of Breast Medical Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA
| | - Danielle N Mattair
- Department of Breast Medical Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA
| | - Leslie Schover
- Department of Breast Medical Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA
| | - Terri Woodard
- Department of Breast Medical Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA
| | - Laurie McKenzie
- Department of Breast Medical Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA
| | - Richard L Theriault
- Department of Breast Medical Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA
| | - Gabriel N Hortobágyi
- Department of Breast Medical Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA
| | - Banu Arun
- Department of Breast Medical Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA
| | - Susan K Peterson
- Department of Breast Medical Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA
| | - Jessica Profato
- Department of Breast Medical Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA
| | - Jennifer K Litton
- Department of Breast Medical Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA
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The stressors and vulnerabilities of young single childless women with breast cancer: A qualitative study. Eur J Oncol Nurs 2014; 18:17-22. [DOI: 10.1016/j.ejon.2013.10.003] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2013] [Revised: 09/28/2013] [Accepted: 10/10/2013] [Indexed: 11/20/2022]
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Cruickshank S, Hume A. The experience of providing support about menopausal symptoms to women with breast cancer. Eur J Oncol Nurs 2014; 18:110-7. [DOI: 10.1016/j.ejon.2013.08.001] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2012] [Revised: 07/29/2013] [Accepted: 08/04/2013] [Indexed: 11/16/2022]
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Reidy M, Denieffe S. Breast cancer in younger women from diverse cultural backgrounds. ACTA ACUST UNITED AC 2014; 23:S19-22, S24-6. [DOI: 10.12968/bjon.2014.23.sup2.s19] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Affiliation(s)
- Mary Reidy
- Department of Nursing, School of Health Sciences, Waterford Institute of Technology, Waterford City, Ireland
| | - Suzanne Denieffe
- Department of Nursing, School of Health Sciences, Waterford Institute of Technology, Waterford City, Ireland
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Kirkman M, Winship I, Stern C, Neil S, Mann G, Fisher J. Women's reflections on fertility and motherhood after breast cancer and its treatment. Eur J Cancer Care (Engl) 2014; 23:502-13. [DOI: 10.1111/ecc.12163] [Citation(s) in RCA: 35] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/17/2013] [Indexed: 11/29/2022]
Affiliation(s)
- M. Kirkman
- Jean Hailes Research Unit; School of Public Health and Preventive Medicine; Monash University; Melbourne Australia
| | - I. Winship
- School of Medicine; The University of Melbourne; Melbourne Australia
| | - C. Stern
- Melbourne IVF; East Melbourne Australia
| | - S. Neil
- Melbourne Breast Unit; East Melbourne Australia
| | - G.B. Mann
- Royal Melbourne and Royal Women's Hospitals; Parkville Australia
| | - J.R.W. Fisher
- Jean Hailes Research Unit; School of Public Health and Preventive Medicine; Monash University; Melbourne Australia
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Perz J, Ussher J, Gilbert E. Loss, uncertainty, or acceptance: subjective experience of changes to fertility after breast cancer. Eur J Cancer Care (Engl) 2013; 23:514-22. [DOI: 10.1111/ecc.12165] [Citation(s) in RCA: 39] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/17/2013] [Indexed: 11/29/2022]
Affiliation(s)
- J. Perz
- Centre for Health Research; School of Medicine; University of Western Sydney; Sydney NSW Australia
| | - J. Ussher
- Centre for Health Research; School of Medicine; University of Western Sydney; Sydney NSW Australia
| | - E. Gilbert
- Centre for Health Research; School of Social Sciences and Psychology; University of Western Sydney; Sydney NSW Australia
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Ronn R, Holzer HEG. Oncofertility in Canada: an overview of Canadian practice and suggested action plan. ACTA ACUST UNITED AC 2013; 20:e465-74. [PMID: 24155643 DOI: 10.3747/co.20.1361] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND Cancer can be a devastating diagnosis. In particular, malignancy and its indicated treatments have profoundly negative effects on the fertility of young cancer patients. Oncofertility has emerged as a new interdisciplinary field to address the issue of gonadotoxicity associated with cancer therapies and to facilitate fertility preservation. In Canada, these fertility issues are often inadequately addressed despite the availability of resources. The goal of this four-part series is to facilitate systemic improvements in fertility preservation for adolescent and young adult Canadians with a new diagnosis of cancer. METHODS Here, we describe the services currently available in Canada and the challenges associated with their utilization. Finally, we outline strategies to help maximize and facilitate fertility preservation in the young cancer patient. RESULTS Despite an existing infrastructure to the oncofertility system in Canada, the ability of that system's components to function together and to coordinate patient care is a challenge. Areas of weakness include poor access and referral to fertility services, a lack of readily available education for patients and health care providers, and inconsistent interdisciplinary coordination in patient care. CONCLUSIONS The implementation of a framework for multidisciplinary resource allocation, education, patient referral, and established lines of communication may facilitate a functional oncofertility system in Canada.
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Affiliation(s)
- R Ronn
- Department of Obstetrics and Gynecology, Queen's University, Kingston, ON
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Küçük M, Yavaşoğlu I, Bolaman AZ, Kadıköylü G. Knowledge, attitudes, and practices of hematologists regarding fertility preservation in Turkey. Turk J Haematol 2013; 30:269-74. [PMID: 24385806 PMCID: PMC3878530 DOI: 10.4274/tjh.2012.0015] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2012] [Accepted: 08/22/2012] [Indexed: 12/15/2022] Open
Abstract
Objective: Fertility preservation stands before us as an issue of quality of life for cancer patients and their partners and families. Therefore, the object of the present study was to determine the extent of the knowledge that hematologists have about fertility preservation and to understand their attitudes and practices regarding this matter.
Materials and Methods: A total of 25 hematologists participated in a survey. The questionnaire included questions on sociodemographic characteristics and awareness concerning the subject of fertility preservation, as well as questions designed to determine the extent of the knowledge that hematologists had on the subject and to understand their attitudes and practices in this context. Results: Of the participants in the study, all expressed their awareness of the adverse effects that the various treatments they were prescribing could have on fertility; 2 (8%) revealed that they had never heard of the concept of fertility preservation. Of the participants, 19 (76%) indicated that they did not have adequate knowledge about fertility preservation, but 22 (88%) fortunately expressed a need for acquiring more knowledge about the subject. Of the respondents, 23 (92%) said that they did not have any brochures or published resources on this subject and stated their belief that if hematologists did have such documents, they would have more opportunity to discuss the various fertility preservation options with patients. All of the participants in the survey supported the idea of the Turkish Society of Hematology publishing a guidebook on this subject and organizing a session on fertility preservation in their regular congress. Conclusion: Meeting the needs of hematologists for training and knowledge in the subject of fertility preservation and ensuring the development of appropriate attitudes and practices in this area is an important issue. The Turkish Society of Hematology may play a significant key role. Conflict of interest:None declared.
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Affiliation(s)
- Mert Küçük
- Adnan Menderes University, Faculty of Medicine, Department of Obstetrics and Gynecology, Aydın, Turkey
| | - Irfan Yavaşoğlu
- Adnan Menderes University, Faculty of Medicine, Department of Internal Medicine, Division of Hematology, Aydın, Turkey
| | - Ali Zahit Bolaman
- Adnan Menderes University, Faculty of Medicine, Department of Internal Medicine, Division of Hematology, Aydın, Turkey
| | - Gürhan Kadıköylü
- Adnan Menderes University, Faculty of Medicine, Department of Internal Medicine, Division of Hematology, Aydın, Turkey
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Senkus E, Gomez H, Dirix L, Jerusalem G, Murray E, Van Tienhoven G, Westenberg AH, Bottomley A, Rapion J, Bogaerts J, Di Leo A, Nešković-Konstantinović Z. Attitudes of young patients with breast cancer toward fertility loss related to adjuvant systemic therapies. EORTC study 10002 BIG 3-98. Psychooncology 2013; 23:173-82. [DOI: 10.1002/pon.3384] [Citation(s) in RCA: 44] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2013] [Revised: 07/22/2013] [Accepted: 07/28/2013] [Indexed: 11/08/2022]
Affiliation(s)
| | - Henry Gomez
- Instituto Nacional de Enfermedades Neoplásicas; Lima Peru
| | | | | | - Elizabeth Murray
- Groote Schuur Hospital, University of Cape Town; Cape Town South Africa
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