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Ranniger RL, Lamaita RM, D’Abreu BF, Tolentino MR, Cândido EB, Andrade WP, Nogueira-Rodrigues A, Silva-Filho AL. Fertility preservation in female cancer patients in Brazil: perceptions and attitudes of infertility specialists. REVISTA BRASILEIRA DE GINECOLOGIA E OBSTETRÍCIA 2024; 46:e-rbgo25. [PMID: 38765513 PMCID: PMC11075391 DOI: 10.61622/rbgo/2024rbgo25] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2023] [Accepted: 10/12/2023] [Indexed: 05/22/2024] Open
Abstract
Objective Fertility preservation is a priority in oncology for female cancer patients. However, there is a lack of communication between infertility specialists and oncologists. This study aimed to evaluate infertility specialists' perceptions and experiences regarding fertility preservation. Methods Conduct an online survey to profile infertility specialists. Participants were infertility affiliated with the Brazilian Federation of Gynecology and Obstetrics Associations (FEBRASGO). The specialists received an online survey, which response rate were 30.9%, most of whom were in southern and southeastern. The survey consisted on 14 questions about the infertility specialists' location, techniques in clinical practice, treatment successful rate, patients idea, etc. Results The average experience in human reproduction were 15.5 ± 10.2 years (mean ± standard deviation, range 1-40). Among reproductive-aged female cancer patients recommended for fertility preservation, 60.3 ± 28.8% (range 10-100%) underwent preservation procedures. Main barriers were cost (41%), oncologists' knowledge or acceptance (35%) and accessibility (9%). Most infertility specialists (58%) considered 40 years the limit for fertility preservation. Leukemia, lymphoma, breast and ovarian cancers were prioritized for fertility preservation, while lung, thyroid, gastric, and brain cancers were less relevant. Conclusion This is the first Brazilian study about infertility specialists' perceptions on oncology patients access to fertility preservation. These patients primarily receive treatment in the public health system, while infertility specialists mainly work in the private healthcare. This healthcare mode is currently fragmented, but integrating these experts is enhancing patient access to fertility preservation. Studies on this topic are still warranted.
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Affiliation(s)
- Renata Lack Ranniger
- Universidade Estadual Paulista "Júlio de Mesquita Filho"Faculdade de Medicina de BotucatuDepartment of GynecologyBotucatuSPBrazilDepartment of Gynecology, Obstetrics and Mastology, Faculdade de Medicina de Botucatu, Universidade Estadual Paulista "Júlio de Mesquita Filho", Botucatu, SP, Brazil.
| | - Rívia Mara Lamaita
- Universidade Federal de Minas GeraisDepartment of Gynecology and ObstetricsBelo HorizonteMGBrazilDepartment of Gynecology and Obstetrics, Universidade Federal de Minas Gerais, Belo Horizonte, MG, Brazil.
- Mater DeiDepartment of Assisted ReproductionBelo HorizonteMGBrazilDepartment of Assisted Reproduction, Mater Dei, Belo Horizonte, MG, Brazil.
| | - Bárbara Flecha D’Abreu
- Universidade Federal de Minas GeraisDepartment of Gynecology and ObstetricsBelo HorizonteMGBrazilDepartment of Gynecology and Obstetrics, Universidade Federal de Minas Gerais, Belo Horizonte, MG, Brazil.
| | - Mariana Rodrigues Tolentino
- Mater DeiDepartment of Assisted ReproductionBelo HorizonteMGBrazilDepartment of Assisted Reproduction, Mater Dei, Belo Horizonte, MG, Brazil.
| | - Eduardo Batista Cândido
- Universidade Federal de Minas GeraisDepartment of Gynecology and ObstetricsBelo HorizonteMGBrazilDepartment of Gynecology and Obstetrics, Universidade Federal de Minas Gerais, Belo Horizonte, MG, Brazil.
| | - Warne Pedro Andrade
- Universidade Estadual Paulista "Júlio de Mesquita Filho"Faculdade de Medicina de BotucatuDepartment of GynecologyBotucatuSPBrazilDepartment of Gynecology, Obstetrics and Mastology, Faculdade de Medicina de Botucatu, Universidade Estadual Paulista "Júlio de Mesquita Filho", Botucatu, SP, Brazil.
| | - Angélica Nogueira-Rodrigues
- Universidade Federal de Minas GeraisDepartment of Internal MedicineBelo HorizonteMGBrazilDepartment of Internal Medicine, Universidade Federal de Minas Gerais, Belo Horizonte, MG, Brazil.
| | - Agnaldo Lopes Silva-Filho
- Universidade Estadual Paulista "Júlio de Mesquita Filho"Faculdade de Medicina de BotucatuDepartment of GynecologyBotucatuSPBrazilDepartment of Gynecology, Obstetrics and Mastology, Faculdade de Medicina de Botucatu, Universidade Estadual Paulista "Júlio de Mesquita Filho", Botucatu, SP, Brazil.
- Universidade Federal de Minas GeraisDepartment of Gynecology and ObstetricsBelo HorizonteMGBrazilDepartment of Gynecology and Obstetrics, Universidade Federal de Minas Gerais, Belo Horizonte, MG, Brazil.
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Yokoshima T, Sugisaki K. Cancer Awareness, Cause Recognition, and Sources of Information Among Japanese Students: A Repeated Cross-Sectional Nationwide Survey. Cancer Control 2024; 31:10732748241272477. [PMID: 39138604 PMCID: PMC11325464 DOI: 10.1177/10732748241272477] [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] [Indexed: 08/15/2024] Open
Abstract
OBJECTIVES Cancer education has been promoted under the Basic Plan for Cancer Education in Japan. We conducted a repeated cross-sectional survey of Japanese students to determine changes in attitudes regarding cancer over time. METHODS A nationwide survey of fifth-grade elementary students was conducted in February 2013. A repeated cross-sectional survey was conducted following previous studies with second-year high school students in February 2019, as second-year high school students in 2019 corresponded to the generation of fifth-grade students in 2013. The self-administered, multiple-choice questionnaire inquired about the awareness of cancer and its causes and sources of cancer information. Statistical analyses were performed by calculating the percentage of selections and 95% confidence intervals for each question. RESULTS The differences between values in 2019 and 2013 were examined. Responses were received from 94 schools (44.1%) in 2013 and 114 schools (52.8%) in 2019. After excluding incomplete responses, valid responses from 2213 and 3822 respondents, respectively, were analyzed. Desirable changes over time were observed in awareness. Increasing age was associated with a rise in misperceptions and a decline in desirable rather than undesirable perceptions of the causes of cancer. The Internet was a common source of information among high school students, followed by health education at school. CONCLUSION Cancer education in schools should aim to counteract misconceptions and promote positive, evidence-based information. Improving perceptions of cancer screening could increase intentions of undergoing screening. Additionally, presenting cancer information using social networking sites could help promote cancer prevention among junior high and high school students.
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Affiliation(s)
- Tsuyoshi Yokoshima
- Department of Health and Welfare, Graduate School of Niigata University of Health and Welfare, Niigata, Japan
| | - Koshu Sugisaki
- Department of Health and Sports, Niigata University of Health and Welfare, Niigata, Japan
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3
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Yamauchi K, Nakashima M, Nakao M. Time-Related Characteristics of Medical and Psychosocial Decisions in Japanese Women with Breast Cancer: Results of a Web-Based Open-Ended Response. Asian Pac J Cancer Prev 2023; 24:3381-3387. [PMID: 37898841 PMCID: PMC10770686 DOI: 10.31557/apjcp.2023.24.10.3381] [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: 01/25/2023] [Accepted: 10/07/2023] [Indexed: 10/30/2023] Open
Abstract
BACKGROUND This study aimed to articulate chronological characteristics of decisions made by Japanese women with breast cancer (BC) since their diagnosis. METHODS Open-ended questions were asked using an Internet-based cross-sectional survey method. Qualitative content analysis was performed on 1,158 free descriptive responses obtained from 549 participants, which were categorized according to the content of decisions. Furthermore, 994 text data from 433 respondents to the quantitative questions were categorized according to the decisions' timing and examined in relation to medical and sociodemographic factors. RESULTS Whereas more than 60% of medical decisions, except chemotherapy, were made before initial treatment, approximately more than one-third of sociopsychological decisions were made only after the initial treatment. In decisions regarding medical care, only surgical decisions showed an association between timing and the participants' decision-making style. Meanwhile, in decisions regarding sociopsychological matters, socioeconomic status at the time of diagnosis, such as marital and employment status, along with the perceived importance of what was to be determined, were associated with the timing of decision-making related to employment, attitudes toward life with BC, family matters and financial affairs. CONCLUSION Women make various decisions depending on the amount of time since the diagnosis of BC. Generally, medical decisions are made prior to initial treatment, while these temporal characteristics are not observed for decisions relating to sociopsychological matters. Furthermore, socioeconomic status influences the timing of decision-making regarding sociopsychological matters. This finding can illustrate the manner in which to go through life with BC, and thus, help women who are unexpectedly diagnosed with BC to be more prepared.
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Affiliation(s)
- Keiko Yamauchi
- Department of Public Health, School of Medicine, Kurume University, Fukuoka, Japan.
| | - Mitsuyo Nakashima
- Department of Nursing, School of Medicine, Fukuoka University, Fukuoka, Japan.
| | - Motoyuki Nakao
- Department of Public Health, School of Medicine, Kurume University, Fukuoka, Japan.
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4
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Kayiira A, Neda John J, Zaake D, Xiong S, Kambugu Balagadde J, Gomez-Lobo V, Wabinga H, Ghebre R. Understanding Fertility Attitudes and Outcomes Among Survivors of Adolescent and Young Adult Cancers in a Low-Resource Setting: A Registry-Based Computer-Assisted Telephone Interview Survey. J Adolesc Young Adult Oncol 2023; 12:520-528. [PMID: 36579945 PMCID: PMC10457622 DOI: 10.1089/jayao.2022.0114] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022] Open
Abstract
Purpose: To establish the extent of self-reported reproductive failure associated with cancer treatment, and attitudes toward fertility among adolescent and young adult (AYA) cancer survivors in Uganda. Methods: A registry-based computer-assisted telephone interview survey was conducted in Uganda. The survey population were survivors of childhood, adolescent and early adulthood cancers diagnosed between 2007 and 2018. The survey explored fertility outcomes, experiences of oncofertility and fertility attitudes of AYA cancer survivors. Results: Thirty-four (female = 14 and male = 20) interviews were completed. Survivors were 18-35 years of age. The median age at cancer diagnosis was 23.5 for females and 17.5 for males. Kaposi's sarcoma contributed to 44% of primary cancer diagnoses. All the survivors had received chemotherapy alone or in combination with other modalities and 79% of survivors had not received satisfactory information about future fertility before cancer treatment. Twenty one percent of males and 46% females met the criteria for infertility and 60% of these had met this criterion after their cancer diagnosis. Eighty two percent wanted to raise a biologically related child. Forty seven percent would be dissatisfied with their lives if they were unable to have a child or additional children. Conclusion: AYA cancer survivors in this low-resource setting reported reproductive failure, despite a strong fertility desire. Information and counseling provided on therapy-related problems before cancer treatment was insufficient and reinforces the need to build capacity for oncofertility resources within the region.
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Affiliation(s)
- Anthony Kayiira
- Department of Obstetrics and Gynecology, Uganda Martyrs University School of Medicine, Kampala, Uganda
- Department of Reproductive Endocrinology and Infertility, Mulago Specialized Women's and Neonatal Hospital, Kampala, Uganda
| | | | - Daniel Zaake
- Department of Obstetrics and Gynecology, Uganda Martyrs University School of Medicine, Kampala, Uganda
| | - Serena Xiong
- Division of Epidemiology and Community Health, University of Minnesota School of Public Health, Minneapolis. Minnesota, USA
| | | | - Veronica Gomez-Lobo
- Department of Pediatric and Adolescent Gynecology, Eunice Kennedy Shriver National Institute of Child Health and Human Development, Bethesda, Maryland, USA
| | - Henry Wabinga
- Kampala Cancer Registry, Makerere University College of Health Sciences, Kampala, Uganda
| | - Rahel Ghebre
- Department of Obstetrics, Gynecology, and Women's Health, University of Minnesota, Minneapolis, Minnesota, USA
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Allison KR, Patterson P, Ussher JM, McDonald FEJ, Perz J. Evaluating Maybe Later Baby, a Fertility Information Resource for Adolescents and Young Adults Diagnosed with Cancer: A Randomized, Controlled Pilot Study. J Adolesc Young Adult Oncol 2023; 12:101-109. [PMID: 35333618 DOI: 10.1089/jayao.2021.0206] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Purpose: Fertility is a major concern for adolescents and young adults (AYAs, 15-30 years) diagnosed with cancer, yet they often report a lack of information and understanding about fertility impacts and preservation options. This study aimed to evaluate the acceptability and preliminary efficacy of Maybe Later Baby (MLB), an oncofertility information resource for AYAs diagnosed with cancer. Methods: In a randomized controlled trial, 13 participants received MLB alone and 10 received an augmented intervention involving an additional consultation with a health care professional (HCP). Pre- and postintervention surveys and interviews explored participants' well-being, fertility knowledge, health literacy, and experiences using the resource. Results: Participants indicated that the resource was accessible and understandable and provided valuable information without increasing distress. When averaged across conditions, functional health literacy (p = 0.006) and oncofertility knowledge (p = 0.002) increased, although there were no significant changes in fertility-related emotions (p > 0.05), and quality of life decreased (p = 0.014). While qualitative accounts suggested that HCP consultations were useful and validated participants' experiences and concerns, participants receiving the augmented intervention became more nervous/fearful about fertility treatment (p = 0.005). There were no other differences in outcomes between conditions. Conclusions: Young people diagnosed with cancer want and value information about oncofertility and resources such as MLB are acceptable and useful means of providing this information. This could be supplemented by clinical discussion to ensure that tailored situation-specific information is provided and understood and patient distress is appropriately managed. Clinical Trial Registration number: 12615000624583.
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Affiliation(s)
- Kimberley R Allison
- Research and Youth Cancer Services, Canteen Australia, Sydney, Australia.,Translational Health Research Institute, School of Medicine, Western Sydney University, Sydney, Australia
| | - Pandora Patterson
- Research and Youth Cancer Services, Canteen Australia, Sydney, Australia.,Faculty of Medicine and Health, The University of Sydney, Sydney, Australia
| | - Jane M Ussher
- Translational Health Research Institute, School of Medicine, Western Sydney University, Sydney, Australia
| | - Fiona E J McDonald
- Research and Youth Cancer Services, Canteen Australia, Sydney, Australia.,Faculty of Medicine and Health, The University of Sydney, Sydney, Australia
| | - Janette Perz
- Translational Health Research Institute, School of Medicine, Western Sydney University, Sydney, Australia
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Fertility preservation in uro-oncology. Curr Opin Support Palliat Care 2022; 16:230-233. [PMID: 36349382 DOI: 10.1097/spc.0000000000000621] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
PURPOSE OF REVIEW The purpose of this review is to highlight the demand for fertility preservation among cancer survivors and to draw attention to areas where healthcare workers need to improve. As technology advances, maximizing cryopreservation rates will be paramount to increase the ability individuals to conceive after cancer treatment. RECENT FINDINGS Guidelines recommending discussion of fertility for those diagnosed with cancer have been shown to increase patient satisfaction and overall quality of life. Our review demonstrated that increasing counseling rates remains an ongoing challenge and should remain an area of improvement for all healthcare professionals working in the oncology field. Formal programs to improve patient and provider education and access to fertility preservation increase uptake of fertility preservation. For men, many options exist to cryopreserve sperm; a slight delay to achieve fertility preservation has not been shown to lead to worse outcomes. Cryopreservation strategies differ based on puberty status and remain an active area of clinical research. SUMMARY Improving fertility outcomes for cancer survivors is possible with appropriate counseling techniques at the time of cancer diagnosis. Clinicians should challenge current barriers for patient access to fertility preservation surrounding cancer treatments.
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Tajima K, Ishikawa T, Noda A, Matsuzaki F, Morishita K, Inoue R, Iwama N, Nishigori H, Sugawara J, Saito M, Obara T, Mano N. Development and validation of claims-based algorithms to identify pregnancy based on data from a university hospital in Japan. Curr Med Res Opin 2022; 38:1651-1654. [PMID: 35833671 DOI: 10.1080/03007995.2022.2101817] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
OBJECTIVE When using administrative data, validation is essential since these data are not collected for research purposes and misclassification can occur. Thus, this study aimed to develop algorithms identifying pregnancy and to evaluate the validity of administrative claims data in Japan. METHODS All females who visited the Tohoku University Hospital Department of Obstetrics in 2018 were included. The diagnosis, medical procedure, medication, and medical service addition fee data were utilized to identify pregnancy, with the electronic medical records set as the gold standard. Combination algorithms were developed using predefined pregnancy-related claims data with a positive predictive value (PPV) ≥80%. Sensitivity (SE), specificity (SP), PPV, and negative predictive value (NPV) with their corresponding 95% confidence intervals (CIs) were calculated for these combination algorithms. RESULTS This study included 1757 females with a mean age of 32.8 (standard deviation: 5.9) years. In general, the individual claims data were able to identify pregnancy with a PPV ≥80%; however, the number of pregnancies identified using a single claims data was limited. Based on the combination algorithm with all of the categories, including diagnosis, medical procedure, medication, and medical service addition, the calculated SE, SP, PPV, and NPV were 73.4% (95% CI: 71.2%-75.4%), 96.9% (95% CI: 89.3%-99.6%), 99.8%,(95% CI: 99.4%-100.0%), and 12.3% (95% CI: 9.6%-15.4%), respectively. CONCLUSIONS The combination algorithm to identify pregnancy demonstrated a high PPV and moderate SE. The algorithm validated in this study is expected to accelerate future studies that aim to identify pregnancies and evaluate pregnancy outcome.
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Affiliation(s)
- Kentaro Tajima
- Laboratory of Clinical Pharmacy, Tohoku University Graduate School of Pharmaceutical Sciences, Sendai, Japan
| | - Tomofumi Ishikawa
- Laboratory of Clinical Pharmacy, Tohoku University Graduate School of Pharmaceutical Sciences, Sendai, Japan
| | - Aoi Noda
- Division of Preventive Medicine and Epidemiology, Tohoku University Tohoku Medical Megabank Organization, Sendai, Japan
- Department of Pharmaceutical Sciences, Tohoku University Hospital, Sendai, Japan
- Department of Molecular Epidemiology, Environment and Genome Research Center, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Fumiko Matsuzaki
- Division of Preventive Medicine and Epidemiology, Tohoku University Tohoku Medical Megabank Organization, Sendai, Japan
| | - Kei Morishita
- Department of Pharmaceutical Sciences, Tohoku University Hospital, Sendai, Japan
- Department of Molecular Epidemiology, Environment and Genome Research Center, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Ryusuke Inoue
- Department of Medical Informatics, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Noriyuki Iwama
- Division of Preventive Medicine and Epidemiology, Tohoku University Tohoku Medical Megabank Organization, Sendai, Japan
- Department of Obstetrics and Gynecology, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Hidekazu Nishigori
- Fukushima Medical Center for Children and Women, Fukushima Medical University, Fukushima, Japan
| | - Junichi Sugawara
- Division of Community Medical Supports, Tohoku Medical Megabank Organization, Tohoku University, Sendai, Japan
- Department of Feto-Maternal Medical Science, Environment and Genome Research Center, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Masatoshi Saito
- Department of Obstetrics and Gynecology, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Taku Obara
- Division of Preventive Medicine and Epidemiology, Tohoku University Tohoku Medical Megabank Organization, Sendai, Japan
- Department of Pharmaceutical Sciences, Tohoku University Hospital, Sendai, Japan
- Department of Molecular Epidemiology, Environment and Genome Research Center, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Nariyasu Mano
- Laboratory of Clinical Pharmacy, Tohoku University Graduate School of Pharmaceutical Sciences, Sendai, Japan
- Department of Pharmaceutical Sciences, Tohoku University Hospital, Sendai, Japan
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Tomioka A, Obama K, Okada H, Yamauchi E, Iwase K, Maru M. Nurse’s perceptions of support for sexual and reproductive issues in adolescents and young adults with cancer. PLoS One 2022; 17:e0265830. [PMID: 35675269 PMCID: PMC9176807 DOI: 10.1371/journal.pone.0265830] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2021] [Accepted: 03/08/2022] [Indexed: 11/30/2022] Open
Abstract
Adolescent and young adult (AYA) with cancer are at risk for developing sexual and reproductive problems; therefore, they have special needs. AYA with cancer treated in both pediatric and adult wards are a minority in Japan; thus, accumulating experience for supporting this unique patient population is difficult for nurses. Hence, this study aimed to clarify nurses’ perceptions on support for sexual and reproductive issues among AYA with cancer. A questionnaire survey was administered to nurses at designated cancer hospitals across Japan who had been working for at least 1 year in a department involved in the treatment or follow-up of patients aged 15–39 years. Nurses were asked regarding their perceptions on support for sexual and reproductive issues faced by AYA with cancer. A total of 865 nurses responded to this survey; nurses affiliated with adult departments, those with more experience in cancer nursing, those affiliated with cancer-related academic and professional societies, and certified nurse specialists or certified nurses significantly recognized insufficient support for sexual and reproductive issues. However, nurses were hesitant and found it difficult to intervene in such issues. Nurses recognized the importance of providing support for sexual and reproductive issues but faced difficulties in addressing them. They need to discuss these issues and improve the care provided to AYA with cancer.
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Affiliation(s)
- Akiko Tomioka
- Faculty of Healthcare, Tokyo Healthcare University, Tokyo, Japan
- * E-mail:
| | - Kyoko Obama
- Institute for Cancer Control, National Cancer Center, Tokyo, Japan
| | - Hiromi Okada
- Faculty of Healthcare, Tokyo Healthcare University, Tokyo, Japan
| | - Eiko Yamauchi
- Faculty of Medicine, Ehime University, Matsuyama, Ehime, Japan
| | - Kimiko Iwase
- Faculty of Nursing & Rehabilitation, Konan Women’s University, Kobe, Hyogo, Japan
| | - Mitsue Maru
- College of Nursing Art & Science, University of Hyogo, Kobe, Japan
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Ishiki H, Hirayama T, Horiguchi S, Iida I, Kurimoto T, Asanabe M, Nakajima M, Sugisawa A, Mori A, Kojima Y, Udagawa R, Tsuchiya H, Oki M, Shimizu M, Yanai Y, Touma S, Nozawa K, Kojima R, Inamura N, Maehara A, Suzuki T, Satomi E. A Support System for Adolescent and Young Adult Patients with Cancer at a Comprehensive Cancer Center. JMA J 2022; 5:44-54. [PMID: 35224259 PMCID: PMC8827278 DOI: 10.31662/jmaj.2021-0106] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2021] [Accepted: 10/05/2021] [Indexed: 01/08/2023] Open
Abstract
Cancer patients in adolescents and young adults (AYA) generation aged 15-39 years have various psychosocial needs during their treatment course such as school enrollment, finding employment, marriage, and fertility. It is difficult for medical professionals to gain experience related to providing medical care and consultation support to these kinds of AYA generation cancer patients. There is a need to provide information and establish both support and medical care systems that are able to meet the diverse needs unique to this generation. This review will explain how to launch an AYA support team (AST). We have worked and established the AST since 2016, which is medical care teams that provide support according to the life stage of each individual patient and build a multidisciplinary AYA generation patient support system. The team-building process consisted of two main projects: building and enlarging multidisciplinary team and establishing screening process of psychosocial needs of AYA generation patients. Multidisciplinary healthcare professionals got involved in the AST with already-existing patient support functions in our center: the patient support center, which is an outpatient department and the palliative care team, which is an inpatient interdepartmental team. The AST systematically finds patients in need of assistance and offers them support as a multidisciplinary team. The AST also established a procedure that systematically gathers information about the needs of patients by using a screening tool. In addition, the AST provides the following specialized services: reproductive medicine, supporting cancer patients with children, employment support, and peer support. The AST has been established and sophisticatedly worked. It can flexibly provide various psychosocial support services. This review will explain how to launch an AST.
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Affiliation(s)
- Hiroto Ishiki
- Department of Palliative Medicine, National Cancer Center Hospital, Tokyo, Japan
| | - Takatoshi Hirayama
- Department of Psycho-Oncology, National Cancer Center Hospital, Tokyo, Japan
| | - Saki Horiguchi
- Department of Nursing, National Cancer Center Hospital, Tokyo, Japan
| | - Ikumi Iida
- Department of Nursing, National Cancer Center Hospital, Tokyo, Japan
| | - Tamae Kurimoto
- Department of Nursing, National Cancer Center Hospital, Tokyo, Japan
| | - Mihoko Asanabe
- Department of Nursing, National Cancer Center Hospital, Tokyo, Japan
| | - Miho Nakajima
- Department of Pediatric Oncology, National Cancer Center Hospital, Tokyo, Japan
| | - Akiko Sugisawa
- Department of Nursing, National Cancer Center Hospital, Tokyo, Japan
| | - Ayako Mori
- Department of Nursing, National Cancer Center Hospital, Tokyo, Japan
| | - Yuki Kojima
- Department of Medical Oncology, National Cancer Center Hospital, Tokyo, Japan
| | - Ryoko Udagawa
- Department of Pharmacy, National Cancer Center Hospital, Tokyo, Japan
| | - Hayato Tsuchiya
- Nutrition Management Office, National Cancer Center Hospital, Tokyo, Japan
| | - Mami Oki
- Department of Rehabilitation, National Cancer Center Hospital, Tokyo, Japan
| | - Mariko Shimizu
- Center for Physician Referral and Medical Social Service, National Cancer Center Hospital, Tokyo, Japan
| | - Yuko Yanai
- Department of Psycho-Oncology, National Cancer Center Hospital, Tokyo, Japan
| | - Shoko Touma
- Appearance Support Center, National Cancer Center Hospital, Tokyo, Japan
| | - Keiko Nozawa
- Appearance Support Center, National Cancer Center Hospital, Tokyo, Japan
| | - Rebekah Kojima
- Department of Palliative Medicine, National Cancer Center Hospital, Tokyo, Japan
| | - Naoko Inamura
- Department of Nursing, National Cancer Center Hospital, Tokyo, Japan
| | - Asami Maehara
- Department of Palliative Medicine, National Cancer Center Hospital, Tokyo, Japan.,Department of Nursing, National Cancer Center Hospital, Tokyo, Japan
| | - Tatsuya Suzuki
- Department of Hematology, National Cancer Center Hospital, Tokyo, Japan
| | - Eriko Satomi
- Department of Palliative Medicine, National Cancer Center Hospital, Tokyo, Japan.,Center for Physician Referral and Medical Social Service, National Cancer Center Hospital, Tokyo, Japan
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Uehara T, Monzen H, Tamura M, Inada M, Otsuka M, Doi H, Matsumoto K, Nishimura Y. Feasibility study of volumetric modulated arc therapy with Halcyon™ linac for total body irradiation. Radiat Oncol 2021; 16:236. [PMID: 34906180 PMCID: PMC8670260 DOI: 10.1186/s13014-021-01959-3] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2021] [Accepted: 11/29/2021] [Indexed: 01/11/2023] Open
Abstract
Background The use of total body irradiation (TBI) with linac-based volumetric modulated arc therapy (VMAT) has been steadily increasing. Helical tomotherapy has been applied in TBI and total marrow irradiation to reduce the dose to critical organs, especially the lungs. However, the methodology of TBI with Halcyon™ linac remains unclear. This study aimed to evaluate whether VMAT with Halcyon™ linac can be clinically used for TBI. Methods VMAT planning with Halcyon™ linac was conducted using a whole-body computed tomography data set. The planning target volume (PTV) included the body cropped 3 mm from the source. A dose of 12 Gy in six fractions was prescribed for 50% of the PTV. The organs at risk (OARs) included the lens, lungs, kidneys, and testes. Results The PTV D98%, D95%, D50%, and D2% were 8.9 (74.2%), 10.1 (84.2%), 12.6 (105%), and 14.2 Gy (118%), respectively. The homogeneity index was 0.42. For OARs, the Dmean of the lungs, kidneys, lens, and testes were 9.6, 8.5, 8.9, and 4.4 Gy, respectively. The V12Gy of the lungs and kidneys were 4.5% and 0%, respectively. The Dmax of the testes was 5.8 Gy. Contouring took 1–2 h. Dose calculation and optimization was performed for 3–4 h. Quality assurance (QA) took 2–3 h. The treatment duration was 23 min. Conclusions A planning study of TBI with Halcyon™ to set up VMAT-TBI, dosimetric evaluation, and pretreatment QA, was established. Supplementary Information The online version contains supplementary material available at 10.1186/s13014-021-01959-3.
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Affiliation(s)
- Takuya Uehara
- Department of Radiation Oncology, Faculty of Medicine, Kindai University, Osaka, Japan
| | - Hajime Monzen
- Department of Medical Physics, Graduate School of Medical Science, Kindai University, 377-2 Ohno-Higashi, Osaka-Sayama, Osaka, 589-8511, Japan.
| | - Mikoto Tamura
- Department of Medical Physics, Graduate School of Medical Science, Kindai University, 377-2 Ohno-Higashi, Osaka-Sayama, Osaka, 589-8511, Japan
| | - Masahiro Inada
- Department of Radiation Oncology, Faculty of Medicine, Kindai University, Osaka, Japan
| | - Masakazu Otsuka
- Department of Medical Physics, Graduate School of Medical Science, Kindai University, 377-2 Ohno-Higashi, Osaka-Sayama, Osaka, 589-8511, Japan
| | - Hiroshi Doi
- Department of Radiation Oncology, Faculty of Medicine, Kindai University, Osaka, Japan
| | - Kenji Matsumoto
- Department of Medical Physics, Graduate School of Medical Science, Kindai University, 377-2 Ohno-Higashi, Osaka-Sayama, Osaka, 589-8511, Japan
| | - Yasumasa Nishimura
- Department of Radiation Oncology, Faculty of Medicine, Kindai University, Osaka, Japan
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11
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Cheng HY, Chau HC, Cheung CKC, Yang LS, Lee SLK, Leung AWK, Li CK, Lam TTN, Yeung NCY, Cheung YT. Perceptions of Infertility Risk Among Chinese Parents of Children with Cancer: A Qualitative Study. J Adolesc Young Adult Oncol 2021; 11:394-401. [PMID: 34613849 DOI: 10.1089/jayao.2021.0106] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Objective: Anticancer treatment may be associated with damage to the reproductive organs and risk of infertility in children with cancer. The collectivist cultural norms of Asian societies may lead Chinese parents to have unique concerns regarding infertility. This qualitative study explored the perceptions of infertility risk and parenthood among parents of childhood cancer survivors in Hong Kong. Methods: Thirteen parents were recruited via a snowball sampling approach from a nongovernmental organization in Hong Kong, representing nine survivors of childhood cancer (leukemia n = 5, solid tumors n = 4). The in-depth semistructured interviews were audiotaped and transcribed verbatim. A thematic analysis was performed using ATLAS.ti 8. Results: Parents mostly perceived their children's fertility status as a distant concern (n = 11, 85%) but emphasized the need for timely information from clinicians when their children reach young adulthood (n = 8, 62%). They reported receiving inconsistent fertility information from different oncology practitioners (n = 9, 69%). A few parents acknowledged that under the influence of the Chinese culture, their children, especially sons, have an important duty to continue the family lineage. However, even if the cancer treatment were associated with infertility risk, almost all parents (n = 12, 92%) stated that it would still not affect their willingness to let their child undergo treatment because survival and cure were still their highest priority. Conclusion: Our findings suggest the need to proactively provide fertility information to parents both during active treatment and when survivors reach reproductive age. Future studies should evaluate the benefits of developing culturally relevant decision-making aids to address parents' informational needs regarding fertility issues.
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Affiliation(s)
- Ho Yu Cheng
- The Nethersole School of Nursing, Faculty of Medicine, The Chinese University of Hong Kong, New Territories, Hong Kong SAR, China
| | - Ho Cheung Chau
- School of Pharmacy, Faculty of Medicine, The Chinese University of Hong Kong, New Territories, Hong Kong SAR, China
| | - Cedric Ka Chun Cheung
- School of Pharmacy, Faculty of Medicine, The Chinese University of Hong Kong, New Territories, Hong Kong SAR, China
| | - Lok Sum Yang
- School of Pharmacy, Faculty of Medicine, The Chinese University of Hong Kong, New Territories, Hong Kong SAR, China
| | - Samantha Lai-Ka Lee
- Department of Paediatrics & Adolescent Medicine, Hong Kong Children's Hospital, Hong Kong, Hong Kong SAR, China
| | - Alex Wing Kwan Leung
- Department of Paediatrics & Adolescent Medicine, Hong Kong Children's Hospital, Hong Kong, Hong Kong SAR, China.,Department of Paediatrics, Faculty of Medicine, The Chinese University of Hong Kong, New Territories, Hong Kong SAR, China.,Hong Kong Hub of Paediatric Excellence, The Chinese University of Hong Kong, New Territories, Hong Kong SAR, China
| | - Chi Kong Li
- Department of Paediatrics & Adolescent Medicine, Hong Kong Children's Hospital, Hong Kong, Hong Kong SAR, China.,Department of Paediatrics, Faculty of Medicine, The Chinese University of Hong Kong, New Territories, Hong Kong SAR, China.,Hong Kong Hub of Paediatric Excellence, The Chinese University of Hong Kong, New Territories, Hong Kong SAR, China
| | - Teddy Tai Ning Lam
- School of Pharmacy, Faculty of Medicine, The Chinese University of Hong Kong, New Territories, Hong Kong SAR, China.,Little Life Warriors Society Hong Kong, Kowloon, Hong Kong SAR, China
| | - Nelson Chun Yiu Yeung
- JC School of Public Health and Primary Care, Faculty of Medicine, The Chinese University of Hong Kong, New Territories, Hong Kong SAR, China
| | - Yin Ting Cheung
- School of Pharmacy, Faculty of Medicine, The Chinese University of Hong Kong, New Territories, Hong Kong SAR, China
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12
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Yoshida K, Matsui Y. The Impact of Cancer on Romantic Relationships and Marriage Postdiagnosis Among Young Adult Cancer Survivors in Japan: A Qualitative Study. J Adolesc Young Adult Oncol 2021; 11:146-155. [PMID: 34143655 DOI: 10.1089/jayao.2020.0199] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Purpose: This study explored the impact of cancer on romantic relationships and marriage postdiagnosis among adolescents and young adults (AYAs) who had been diagnosed with cancer in Japan. Methods: Semistructured interviews were conducted with 24 AYA cancer survivors, regardless of cancer type, who were unmarried and aged 15-39 at the time of cancer diagnosis. For theme and category generation, the authors coded the interview transcripts independently through inductive thematic analysis. Results: The analysis yielded 11 themes. The most common impact on romantic partnership was "fertility and parenthood concerns" (45.8%), followed by "disclosure of cancer history" (37.5%), and finally by "recurrence, metastasis, and poor health" (25.0%). Conclusions: Although the impacts of cancer that were identified in this study were mostly consistent with earlier findings, certain impacts seem to stem from traditional family perceptions in East Asia. Because men are traditionally seen as the family successors, unlike women, they are primarily concerned about fertility and parenthood. This causes a parental influence on romantic and marital choices. The fact that there exists a parental influence in partner selection from the parents of both men and women indicates that cultural factors in East Asia/Japan influence romantic and/or marriage postdiagnosis.
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Affiliation(s)
- Kanako Yoshida
- Graduate School of Comprehensive Human Sciences, University of Tsukuba, Tokyo, Japan
| | - Yutaka Matsui
- Graduate School of Comprehensive Human Sciences, University of Tsukuba, Tokyo, Japan
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13
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Yang LS, Ma CT, Chan CH, Luk MS, Woo HK, Lee VWY, Leung AWK, Lee SLK, Yeung NCY, Li CK, Cheung YT. Awareness of diagnosis, treatment and risk of late effects in Chinese survivors of childhood cancer in Hong Kong. Health Expect 2021; 24:1473-1486. [PMID: 34101943 PMCID: PMC8369092 DOI: 10.1111/hex.13288] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2021] [Revised: 04/22/2021] [Accepted: 05/12/2021] [Indexed: 02/02/2023] Open
Abstract
BACKGROUND For survivors of childhood cancer, awareness of personal health risks is a critical component of long-term health management. OBJECTIVE To evaluate the awareness of the diagnosis, treatment and risk of late effects among survivors of childhood cancer in Hong Kong. METHODS Between June 2019 and March 2020, this cross-sectional study recruited 155 adult survivors (mean age = 26.9, standard deviation [SD] = 6.4 years) and 45 parents of paediatric survivors (mean age = 11.1, SD = 3.6 years) from a long-term follow-up clinic. At >10 years post-treatment (mean = 13.4, SD = 7.6 years), they completed a structured questionnaire to report their cancer-specific knowledge. Multiple linear regression analysis was conducted to identify clinical, socioeconomic and behavioural factors associated with poor awareness. RESULTS The majority of participants accurately recalled their diagnoses (73.5%) and major treatment modalities (chemotherapy 92.4%, radiation 82.9% and surgery 88.2%). However, less than half (45%) of the participants recognized more than 25% of the total late effects for which they were at risk. The highest levels of awareness were reported for endocrine problems (49%), neurocognitive impairment (44%) and secondary cancers (43%), and the lowest for peripheral neuropathy (21%) and vision problems (23%). Compared with survivors of haematological malignancies, those of central nervous system (CNS) tumours (standardized estimate [B] = -9.33, 95% confidence interval [95% CI]: -13.41 to -5.26) and non-CNS solid tumours (B = -8.47, 95% CI: -12.39 to -4.94) had less knowledge about their diagnosis. Retaining medical records (P < .0001) and better medical information-seeking habits (P = .048) were associated with better awareness. CONCLUSIONS Survivors of childhood cancer in Hong Kong have deficient awareness of their personal health risks. They may benefit from the provision of a survivorship care plan and personalized education regarding treatment-related late effects. PATIENT CONTRIBUTION Patients contributed in designing the study tools. Results were presented at a non-governmental organization.
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Affiliation(s)
- Lok Sum Yang
- School of Pharmacy, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, Hong Kong
| | - Chung Tin Ma
- School of Pharmacy, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, Hong Kong
| | - Chun Him Chan
- School of Pharmacy, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, Hong Kong
| | - Mei Shum Luk
- School of Pharmacy, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, Hong Kong
| | - Hoi Kei Woo
- School of Pharmacy, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, Hong Kong
| | - Vivian Wai-Yan Lee
- Centre for Learning Enhancement and Research, The Chinese University of Hong Kong, Hong Kong, Hong Kong
| | - Alex Wing Kwan Leung
- Department of Paediatrics & Adolescent Medicine, Hong Kong Children's Hospital, Hong Kong, Hong Kong.,Department of Paediatrics, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, Hong Kong
| | - Samantha Lai-Ka Lee
- Department of Paediatrics & Adolescent Medicine, Hong Kong Children's Hospital, Hong Kong, Hong Kong
| | - Nelson Chun-Yiu Yeung
- The Jockey Club School of Public Health and Primary Care, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, Hong Kong
| | - Chi-Kong Li
- Department of Paediatrics & Adolescent Medicine, Hong Kong Children's Hospital, Hong Kong, Hong Kong.,Department of Paediatrics, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, Hong Kong.,Hong Kong Hub of Paediatric Excellence, The Chinese University of Hong Kong, Hong Kong, Hong Kong
| | - Yin Ting Cheung
- School of Pharmacy, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, Hong Kong
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14
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Tajima K, Tsuchiya M, Ishikawa T, Obara T, Mano N. Real-world anticancer medications for reproductive-age women with breast cancer by using a claims database in Japan. Future Oncol 2021; 17:1907-1921. [PMID: 33625252 DOI: 10.2217/fon-2020-1053] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023] Open
Abstract
Aim: To describe real-world breast cancer medications among reproductive-age women. Patients & methods: Using data from a Japanese claims database, anticancer prescriptions were classified into seven categories of amenorrhea risk based on fertility preservation guidelines. Results: We identified 2999 women with records of breast cancer and anticancer prescription from 2005 to 2018. The proportions of prescriptions were as follows: high, 4.1-12.9%; intermediate: 6.0-16.3%; low: 0.4-2.3%; very low/no: 0.3-12.2%; unknown: 33.9-45.5%; unlisted combination: 12.2-23.4%; and unlisted drug: 12.5-26.7%. The common drugs in the unknown category were trastuzumab (n = 1527), docetaxel (n = 1014), and paclitaxel (n = 995). For medications unlisted in the guidelines, various drugs and drug combinations were observed. Conclusion: Numerous anticancer drugs are currently being prescribed with insufficient evidence regarding amenorrhea risk.
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Affiliation(s)
- Kentaro Tajima
- Laboratory of Clinical Pharmacy, Tohoku University Graduate School of Pharmaceutical Sciences, 1-1 Seiryo-machi, Aoba-ku, Sendai, Miyagi, 980-8574, Japan
| | - Masami Tsuchiya
- Laboratory of Clinical Pharmacy, Tohoku University Graduate School of Pharmaceutical Sciences, 1-1 Seiryo-machi, Aoba-ku, Sendai, Miyagi, 980-8574, Japan.,Department of Pharmacy, Miyagi Cancer Center, 47-1 Nodayama, Medeshimashiote, Natori, Miyagi, 9811293, Japan
| | - Tomofumi Ishikawa
- Laboratory of Clinical Pharmacy, Tohoku University Graduate School of Pharmaceutical Sciences, 1-1 Seiryo-machi, Aoba-ku, Sendai, Miyagi, 980-8574, Japan
| | - Taku Obara
- Department of Pharmaceutical Sciences, Tohoku University Hospital, 1-1, Seiryo-machi, Aoba-ku, Sendai, Miyagi, 9808574, Japan.,Division of Preventive Medicine & Epidemiology, Tohoku Medical Megabank Organization, Tohoku University, 2-1, Seiryo-machi, Aoba-ku, Sendai, Miyagi, 9808573, Japan.,Department of Molecular Epidemiology, Environment & Genome Research Center, Tohoku University Graduate School of Medicine, 2-1, Seiryo-machi, Aoba-ku, Sendai, Miyagi, 9808573, Japan
| | - Nariyasu Mano
- Laboratory of Clinical Pharmacy, Tohoku University Graduate School of Pharmaceutical Sciences, 1-1 Seiryo-machi, Aoba-ku, Sendai, Miyagi, 980-8574, Japan.,Department of Pharmaceutical Sciences, Tohoku University Hospital, 1-1, Seiryo-machi, Aoba-ku, Sendai, Miyagi, 9808574, Japan
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15
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Łuczak J, Bagłaj M, Ciaputa R, Szymerowski A, Nowak M. Does open ovarian biopsy in prepubertal age affect ovarian reserve in a rat model? J Pediatr Surg 2021; 56:360-367. [PMID: 32653162 DOI: 10.1016/j.jpedsurg.2020.05.046] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/07/2020] [Revised: 05/29/2020] [Accepted: 05/30/2020] [Indexed: 11/24/2022]
Abstract
BACKGROUND Partial resection of the ovary carries a possible risk of fertility reduction. We studied the influence of open ovarian biopsy on ovarian reserve, including anti-Müllerian hormone and follicle-stimulating hormone serum level evaluation, in a prepubertal rat model. METHODS Interventions - the initial surgery was unilateral ovarian biopsy (38 rats, group B1, B2) or unilateral ovarian biopsy and ovarian resection of the contralateral gonad (38 rats, group BR1, BR2). The second operation was bilateral ovarian resection and total resection of the remaining ovary. All rats had hormone serum levels evaluated. The control group had only a blood test taken and bilateral ovarian resection done at the second intervention (30 rats, group C1, C2). The collected tissue was examined estimating follicle count and anti-Müllerian hormone immunoexpression. RESULTS Anti-Müllerian hormone levels were significantly lower at the second intervention in the group BR2 but significantly higher in the group C2. Follicle-stimulating hormone levels were significantly higher in all but one group (BR2). CONCLUSIONS Biopsy itself might not reduce ovarian reserve if done properly but we should know its possible negative effects in the case of a single remaining ovary.
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Affiliation(s)
- Justyna Łuczak
- Pediatric Surgery and Urology Department, Wroclaw Medical University, 52 M. Sklodowskiej - Curie ST, 50-369 Wroclaw, Poland.
| | - Maciej Bagłaj
- Pediatric Surgery and Urology Department, Wroclaw Medical University, Wroclaw, Poland
| | - Rafał Ciaputa
- Department of Pathology, Division of Pathomorphology and Veterinary Forensics, Faculty of Veterinary Medicine, Wroclaw University of Environmental and Life Sciences, Wroclaw, Poland
| | - Adam Szymerowski
- Department of Pathology, Division of Pathomorphology and Veterinary Forensics, Faculty of Veterinary Medicine, Wroclaw University of Environmental and Life Sciences, Wroclaw, Poland
| | - Marcin Nowak
- Department of Pathology, Division of Pathomorphology and Veterinary Forensics, Faculty of Veterinary Medicine, Wroclaw University of Environmental and Life Sciences, Wroclaw, Poland
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16
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Nakayama H, Toh Y, Fujishita M, Nakagama H. Present status of support for adolescent and young adult cancer patients in member hospitals of Japanese Association of Clinical Cancer Centers. Jpn J Clin Oncol 2020; 50:1282-1289. [PMID: 32761084 DOI: 10.1093/jjco/hyaa141] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2020] [Revised: 07/10/2020] [Accepted: 07/13/2020] [Indexed: 11/12/2022] Open
Abstract
BACKGROUND the proportion of adolescent and young adult cancer patients is relatively small, but they require age-specific support. We conducted a survey on the present status of support for adolescent and young adult cancer patients in the Japanese Association of Clinical Cancer Centers. METHODS in December 2018, the primary questionnaires were sent to 32 hospitals of Japanese Association of Clinical Cancer Centers regarding support for adolescent and young adult cancer patients. Secondary questionnaires were sent to doctors, nurses and medical social workers in 24 hospitals for the implementation rates of information provision and consultation on 17 unmet needs identified in the study by the Ministry of Health, Labour and Welfare, Japan. RESULTS there were marked differences in support for adolescent and young adult cancer patients among hospitals. Only one hospital facilitated an adolescent and young adult department and ward. Thirteen hospitals cooperated with the paediatric cancer designated hospitals. A learning support for high school-aged patients was provided in 15 hospitals. Adolescent and young adult support teams were active in seven hospitals and staff training sessions were held in eight hospitals. Many hospitals had referrals for fertility preservation. The rates of information provision and consultation for more than 70% of adolescent and young adult patients showed statistically significant differences among the medical professions in most of the 17 items. CONCLUSIONS support systems and activities for adolescent and young adult cancer patients vary extremely across hospitals. Information provision and consultation for unmet needs are still insufficient. Therefore, sharing information and experiences is required to enhance the support for adolescent and young adult cancer patients.
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Affiliation(s)
- Hideki Nakayama
- The Japanese Association of Clinical Cancer Centers, Japan.,Department of Pediatrics, National Hospital Organization Kyushu Cancer Center, Fukuoka, Japan
| | - Yasushi Toh
- The Japanese Association of Clinical Cancer Centers, Japan.,National Hospital Organization Kyushu Cancer Center, Fukuoka, Japan
| | - Manami Fujishita
- The Japanese Association of Clinical Cancer Centers, Japan.,The Center for Cancer Control and Information Services, National Cancer Center Hospital, Tokyo, Japan
| | - Hitoshi Nakagama
- The Japanese Association of Clinical Cancer Centers, Japan.,National Cancer Center, Tokyo, Japan
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17
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Patel P, Kohn TP, Cohen J, Shiff B, Kohn J, Ramasamy R. Evaluation of Reported Fertility Preservation Counseling Before Chemotherapy Using the Quality Oncology Practice Initiative Survey. JAMA Netw Open 2020; 3:e2010806. [PMID: 32678451 PMCID: PMC7368166 DOI: 10.1001/jamanetworkopen.2020.10806] [Citation(s) in RCA: 37] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Abstract
IMPORTANCE The opportunity to discuss fertility preservation is essential for patients of reproductive age with newly diagnosed cancer before the initiation of treatment. OBJECTIVE To identify factors associated with fertility preservation counseling among patients of reproductive age before initiating chemotherapy. DESIGN, SETTING, AND PARTICIPANTS This cross-sectional study used data obtained from the American Society of Clinical Oncology (ASCO) Quality Oncology Practice Initiative, an oncologist-led quality assessment program that surveys approximately 400 oncology practices biannually, from January, 2015, to June, 2019. MAIN OUTCOMES AND MEASURES The primary outcome was whether reproductive risks were discussed before initiation of chemotherapy. Multivariate logistic regression was performed to identify factors associated with fertility preservation counseling, controlling for age, sex, race/ethnicity, cancer type, year of study, region, clinic type (academic vs private), annual clinic volume, and rates of insurance coverage. RESULTS Among the 6976 patients of reproductive age (3571 men [51%]; mean (SD) age, 42.5 [7.1] years), with reproductive age ranging from 18 to 40 years for 3405 women and from 18 to 50 years for 3571 men, clinics reported that 3036 of 6976 patients (44%) received counseling regarding the risk of infertility associated with chemotherapy. Women were more likely to be informed (1912 of 3405 [56%]) compared with men (1126 of 3571 [32%]) (P < .001). Factors associated with reduced likelihood of fertility risk discussion included male sex (odds ratio [OR], 0.73; 95% CI, 0.60-0.90), increasing age (OR, 0.93; 95% CI, 0.92-0.94), private practice setting (OR, 0.70; 95% CI, 0.53-0.93), and lack of multidisciplinary team planning (OR, 0.54; 95% CI, 0.41-0.70). Factors associated with increased likelihood of fertility risk discussion included having breast cancer (OR, 1.39; 95% CI, 1.12-1.73) and lymphatic or hematopoietic cancers (OR, 1.79; 95% CI, 1.33-2.40), participating in each subsequent study year (OR, 1.16; 95% CI, 1.08-1.24), receiving care in an academic clinic (OR, 1.45; 95% CI, 1.05-2.01), and being a practice offering clinical trial enrollment (OR, 1.60; 95% CI, 1.13-2.29). States with legislatively mandated coverage of fertility preservation had significantly higher rates of fertility risk discussion compared with states without legislation (48.6% vs 39.6%, P < .001). CONCLUSIONS AND RELEVANCE The findings suggest that clinicians are more likely to counsel younger patients and female patients about reproductive risks before initiation of chemotherapy. State laws mandating fertility preservation coverage may be associated with improved frequency of fertility counseling before chemotherapy. Further awareness and implementation of ASCO guidelines appear to be needed to improve rates of fertility risk discussion and referrals to fertility specialists before chemotherapy.
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Affiliation(s)
- Premal Patel
- Section of Urology, University of Manitoba, Winnipeg, Manitoba, Canada
| | - Taylor P. Kohn
- The James Buchanan Brady Urological Institute and Department of Urology, Johns Hopkins University School of Medicine, Baltimore, Maryland
| | - Jordan Cohen
- Department of Urology, University of Miami Miller School of Medicine, Miami, Florida
| | - Benjamin Shiff
- Department of Urology, University of Miami Miller School of Medicine, Miami, Florida
| | - Jaden Kohn
- Department of Gynecology and Obstetrics, Johns Hopkins University School of Medicine, Baltimore, Maryland
| | - Ranjith Ramasamy
- Department of Urology, University of Miami Miller School of Medicine, Miami, Florida
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18
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Takae S, Suzuki N. Current state and future possibilities of ovarian tissue transplantation. Reprod Med Biol 2019; 18:217-224. [PMID: 31312099 PMCID: PMC6613018 DOI: 10.1002/rmb2.12268] [Citation(s) in RCA: 21] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2018] [Revised: 02/25/2019] [Accepted: 03/08/2019] [Indexed: 12/19/2022] Open
Abstract
BACKGROUND As a result of recent developments in cancer treatment, cancer survivorship and survivors' quality of life have been emphasized. Although ovarian tissue cryopreservation (OTC) is an experimental technique, it would be the sole technique for fertility preservation treatment for girls with malignant disease. Indeed, OTC requires ovarian tissue transplantation (OTT) for conception. As for OTC, there is room to investigate OTT. The present review focused on the current state and progress of OTT. METHOD The literature regarding OTT, which is currently under development, was reviewed. MAIN FINDINGS To improve the outcome of OTT, both efficacy and safety are important. Good surgical technique and the optimal site are important surgical factors, with orthotopic transplantation increasing. Treatment of growth factors, gonadotropins, antioxidants, apoptosis suppression factors, and cell therapy may improve the efficacy of OTT by inducing neo-angiogenesis and preventing damage. Artificial ovaries, complete in vitro primordial follicle culture technique, and non-invasive ovarian imaging techniques, such as optical coherence tomography, to select the best ovarian tissue are future possibilities. CONCLUSION Improving neo-angiogenesis and preventing damage with optimization, as well as investigation of future techniques, may bring us to the next stage of a fertility preservation strategy.
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Affiliation(s)
- Seido Takae
- Department of Obstetrics and GynecologySt. Marianna University School of MedicineKawasaki CityJapan
| | - Nao Suzuki
- Department of Obstetrics and GynecologySt. Marianna University School of MedicineKawasaki CityJapan
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19
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Takae S, Lee JR, Mahajan N, Wiweko B, Sukcharoen N, Novero V, Anazodo AC, Gook D, Tzeng CR, Doo AK, Li W, Le CTM, Di W, Chian RC, Kim SH, Suzuki N. Fertility Preservation for Child and Adolescent Cancer Patients in Asian Countries. Front Endocrinol (Lausanne) 2019; 10:655. [PMID: 31681163 PMCID: PMC6804405 DOI: 10.3389/fendo.2019.00655] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/28/2019] [Accepted: 09/09/2019] [Indexed: 12/31/2022] Open
Abstract
Background: At present, fertility is one of the main concerns of young cancer patients. Following this trend, "fertility preservation (FP)" has been established and has become a new field of reproductive medicine. However, FP for child and adolescent (C-A) cancer patients is still developing, even in advanced countries. The aim of the present study was to assess the barriers to FP for C-A patients by investigating the current status of FP for C-A patients in Asian countries, which just have started FP activities. Method: A questionnaire survey of founding members of the Asian Society for Fertility Preservation (ASFP) was conducted in November 2018. Main findings: Of the 14 countries, 11 country representatives replied to this survey. FP for C-A patients is still developing in Asian countries, even in Australia, Japan, and Korea, which have organizations or academic societies specialized for FP. In all countries that replied to the present survey, the patients can receive embryo cryopreservation (EC), oocyte cryopreservation (OC), and sperm cryopreservation (SC) as FP. Compared with ovarian tissue cryopreservation (OTC), testicular tissue cryopreservation (TTC) is an uncommon FP treatment because of its still extremely experimental status (7 of 11 countries provide it). Most Asian countries can provide FP for C-A patients in terms of medical technology, but most have factors inhibiting to promote FP for C-A patients, due to lack of sufficient experience and an established system promoting FP for C-A patients. "Don't know how to provide FP treatment for C-A" is a major barrier. Also, low recognition in society and among medical staff is still a particularly major issue. There is also a problem with cooperative frameworks with pediatric departments. To achieve high-quality FP for C-A patients, a multidisciplinary approach is vital, but, according to the present study, few paramedical staff can participate in FP for C-A patients in Asia. Only Australia and Korea provide FP information by video and specific resources. Conclusion: The present study demonstrated the developing status of FP for C-A patients in Asian countries. More intensive consideration and discussion are needed to provide FP in Asian societies based on the local cultural and religious needs of patients.
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Affiliation(s)
- Seido Takae
- Department of Obstetrics and Gynecology, St. Marianna University School of Medicine, Kawasaki, Japan
- *Correspondence: Seido Takae
| | - Jung Ryeol Lee
- Department of Obstetrics and Gynecology, Seoul National University Bundang Hospital, Seoul, South Korea
| | | | - Budi Wiweko
- Division of Reproductive Endocrionolgy and Infertility, Department of Obstetrics and Gynecology, Faculty of Medicine, Universitas Indonesia, Depok, Indonesia
| | - Nares Sukcharoen
- Department of Obstetrics and Gynecology, Faculty of Medicine, Chulalongkorn University, Bankok, Thailand
| | - Virgilio Novero
- St. Luke's Medical Center, Quezon City, Philippines
- Section of Endocrinology and Infertility, Department of Obstetrics and Gynecology, University of Philippines Manila, Manila, Philippines
| | - Antoinette Catherine Anazodo
- Kids Cancer Centre and Sydney Youth Cancer Service, Sydney Children's Hospital, Randwick, NSW, Australia
- Nelune Comprehensive Cancer Centre, Prince of Wales Hospital, Randwick, NSW, Australia
- School of Women's and Children's Health, University of New South Wales, Kensington, NSW, Australia
| | - Debra Gook
- Melbourne IVF, Melbourne, VIC, Australia
| | - Chii-Ruey Tzeng
- Division of Infertility, Department of Obstetrics and Gynecology, Taipei Medical University Hospital, Taipei, Taiwan
| | | | - Wen Li
- Reproductive Medicine Center, Second Military Medical University, Changzheng Hospital, Shanghai, China
| | | | - Wen Di
- Department of Obstetrics and Gynecology, Ren Ji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
| | - Ri-Cheng Chian
- Center for Reproductive Medicine, Tenth People's Hospital of Tongji University, Shanghai, China
| | - Seok Hyun Kim
- Department of Obstetrics and Gynecology, Seoul National University College of Medicine, Seoul, South Korea
| | - Nao Suzuki
- Department of Obstetrics and Gynecology, St. Marianna University School of Medicine, Kawasaki, Japan
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