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Kállay É, Müller-Fabian A, Dégi CL. Fear of cancer progression and the quality of sexual life of female cancer patients in Romania. Front Public Health 2024; 12:1417681. [PMID: 38919914 PMCID: PMC11196963 DOI: 10.3389/fpubh.2024.1417681] [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: 04/15/2024] [Accepted: 05/28/2024] [Indexed: 06/27/2024] Open
Abstract
Introduction As cancer survival rates increase, it has become crucial to pay attention to the long-term quality of life of survivors, including sexual functioning. The quality of sexual life and fear of cancer progression are often unmet needs, significantly impacting cancer patients' overall quality of life. In this study, we investigate these factors in Romanian female cancer patients and highlight their relationship with mental health and demographic variables. Methods This study included 242 Romanian female cancer patients who completed questionnaires assessing sexual functioning (EORTC QLQ-SHQ22), fear of cancer progression (FoP-Q), depression (PHQ-9), and anxiety (GAD-7). We examined these relationships using descriptive, exploratory, and regression analyses. Results Around 50% of patients reported impairments in sexual satisfaction and pain during sex. Lower sexual satisfaction increased sexual dysfunction, and heightened fear of cancer progression (FCP) were associated with depression, anxiety, younger age, lower education, rural residence, and unmarried status. Discussion This study reveals a complex interplay between sexual health, fear of cancer progression, and psychological well-being among female cancer survivors in Romania. Addressing sexual concerns, providing psychoeducation, promoting coping with the fear of progression, and utilizing interdisciplinary interventions are essential to improving these patients' overall quality of life. These findings underscore the need for integrated care approaches that consider both physical and psychological dimensions of cancer survivorship.
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Affiliation(s)
- Éva Kállay
- Babeș-Bolyai University, Psychology and Educational Sciences, Cluj-Napoca, Romania
| | | | - Csaba László Dégi
- Babeș-Bolyai University, Sociology and Social Work, Cluj-Napoca, Romania
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Jackson Levin N, Tan CY, Stelmak D, Iannarino NT, Zhang A, Ellman E, Herrel LA, Walling EB, Moravek MB, Chugh R, Haymart MR, Zebrack B. Banking on Fertility Preservation: Financial Concern for Adolescent and Young Adult Cancer Patients Considering Oncofertility Services. J Adolesc Young Adult Oncol 2023; 12:710-717. [PMID: 36603107 PMCID: PMC10611956 DOI: 10.1089/jayao.2022.0055] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023] Open
Abstract
Purpose: Financial concern is a major issue for adolescent and young adult (AYA) cancer patients. Furthermore, unaddressed oncofertility challenges (e.g., infertility) are linked to psychological distress and decreased overall quality of life. Little is known about how financial concern in terms of oncofertility (i.e., concern regarding affording fertility preservation [FP] services) impacts AYAs' decision making and experiences. Methods: AYA cancer patients (n = 27) aged 12-25 years whose cancer treatment conferred risk of infertility were recruited through electronic health record query. Participants completed semi-structured interviews, which were recorded, transcribed, and deductively coded for themes related to information needs, knowledge of treatment effects on fertility, and reproductive concerns after cancer. Emergent, inductive themes related to financial concern were identified. The Institutional Review Board at the University of Michigan approved this study (HUM#00157267). Results: Financial concern was a dominant theme across the qualitative data. Emergent themes included (1) varied access to health insurance, (2) presence of parental/guardian support, (3) reliance upon financial aid, (4) negotiating infertility risk, and (5) lack of preparation for long-term costs. AYAs relied heavily upon parents for out-of-pocket and insurance coverage support. Some participants sought financial aid when guided by providers. Several participants indicated that no financial support existed for their circumstance. Conclusions: Financial consequences in terms of oncofertility are a major issue affecting AYA cancer patients. The incidence and gravity of financial concern surrounding affording oncofertility services merits attention in future research (measuring financial resources of AYAs' parental/support networks), clinical practice (strategically addressing short- and long-term costs; tailored psychosocial support), and health care policy (promoting legislation to mandate pre- and post-treatment FP coverage).
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Affiliation(s)
- Nina Jackson Levin
- Department of Anthropology, School of Social Work, University of Michigan, Ann Arbor, Michigan, USA
| | - Chiu Yi Tan
- Department of Psychiatry, University of Michigan, Ann Arbor, Michigan, USA
| | - Daria Stelmak
- School of Medicine, University of Michigan, Ann Arbor, Michigan, USA
| | - Nicholas T. Iannarino
- Department of Language, Culture, and the Arts at University of Michigan-Dearborn, Dearborn, Michigan, USA
| | - Anao Zhang
- School of Social Work, University of Michigan, Ann Arbor, Michigan, USA
| | - Erin Ellman
- Rogel Cancer Center, University of Michigan, Ann Arbor, Michigan, USA
| | - Lindsey A. Herrel
- Department of Urology, University of Michigan, Ann Arbor, Michigan, USA
| | - Emily B. Walling
- Department of Pediatric Hematology/Oncology, University of Michigan, Ann Arbor, Michigan, USA
| | - Molly B. Moravek
- Department of Urology, University of Michigan, Ann Arbor, Michigan, USA
- Department of Obstetrics & Gynecology, University of Michigan, Ann Arbor, Michigan, USA
| | - Rashmi Chugh
- Department of Internal Medicine, Endocrinology & Diabetes Clinic, University of Michigan, Ann Arbor, Michigan, USA
| | - Megan R. Haymart
- Department of Metabolism, Endocrinology & Diabetes Clinic, University of Michigan, Ann Arbor, Michigan, USA
| | - Brad Zebrack
- School of Social Work, University of Michigan, Ann Arbor, Michigan, USA
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Croghan SM, Cullen IM, Raheem O. Functional outcomes and health-related quality of life following penile cancer surgery: a comprehensive review. Sex Med Rev 2023; 11:441-459. [PMID: 37204120 DOI: 10.1093/sxmrev/qead021] [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: 02/28/2023] [Revised: 04/18/2023] [Accepted: 04/21/2023] [Indexed: 05/20/2023]
Abstract
INTRODUCTION Organ-sparing surgery (OSS) in penile cancer management aspires to maintain organ form and function and preserve health-related quality of life (HRQoL), yet there is a lack of integrated evidence exploring these outcomes. OBJECTIVES The aim sought to review HRQoL, functional, aesthetic, and psychological outcomes following OSS or radical penectomy for penile cancer. METHODS A systematic review of MEDLINE and Cochrane databases included studies reporting on function (sexual, urinary or sensory), genital appearance or HRQoL/psychological well-being following surgical treatment of primary penile cancer. English-language reports (2000-2022), incorporating patient-reported or objective clinical outcome measures, were eligible. Studies of nonsurgical treatment strategies and those in the context of metastatic disease were excluded. Data were compiled and analyzed. RESULTS Twenty-six studies were included. Sexual function was the most studied outcome (754 pooled respondents; 19 studies), most frequently with the original 15-item and abridged 5-item International Index of Erectile Function. Preservation of erectile function following OSS is generally described, with some reduction in overall sexual satisfaction cited. Heterogeneous assessment of voiding function with little preoperative evaluation render interstudy comparison difficult. Most patients appear able to void from a standing position following OSS, with spraying the most common symptom. Maintenance of some sensory function is described with both split-thickness skin grafting and urethral glanduloplasty following radical glansectomy. Limited studies suggest reasonable patient satisfaction with genital cosmesis post-OSS. A negative impact on HRQoL is described in most studies following penile cancer surgery, variably correlated with aggressiveness of penile surgery and addition of lymphadenectomy. Anxiety, depression, and reduced self-esteem have been reported in penile cancer survivors. Relationship well-being varies, with some survivors reporting this to be unchanged. CONCLUSION OSS can preserve elements of sexual, urinary, and sensory function, supporting advantages over radical penectomy for eligible patients. However, a comprehensive understanding remains limited due to small, heterogeneous patient cohorts, challenges in obtaining premorbid data, and variability in outcome measures. Standardization of patient-reported outcomes following OSS is desirable.
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Affiliation(s)
- Stefanie M Croghan
- Department of Surgery, Royal College of Surgeons, Dublin D02 YN77, Ireland
- Department of Urology, Blackrock Clinic, Dublin A94 E4X7, Ireland
| | - Ivor M Cullen
- Department of Urology, Blackrock Clinic, Dublin A94 E4X7, Ireland
- Department of Urology, Beaumont Hospital, Dublin D09V2N0, Ireland
| | - Omer Raheem
- Department of Surgery, Section of Urology, University of Chicago Medicine, Chicago, IL 60637, United States
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Shahsavar Y, Choudhury A. Examining influential factors in newly diagnosed cancer patients and survivors: Emphasizing distress, self-care ability, peer support, health perception, daily life activity, and the role of time since diagnosis. PLoS One 2023; 18:e0291064. [PMID: 37656716 PMCID: PMC10473484 DOI: 10.1371/journal.pone.0291064] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2023] [Accepted: 08/18/2023] [Indexed: 09/03/2023] Open
Abstract
This study investigates the complex interrelationships between peer support, mental distress, self-care abilities, health perceptions, and daily life activities among cancer patients and survivors while considering the evolving nature of these experiences over time. A cross-sectional survey design is employed, utilizing de-identified data from the National Cancer Institute's 2022 nationally representative dataset, which comprises responses from 1234 participants, including 134 newly diagnosed patients undergoing cancer treatment. Partial least squares structural equation modeling is employed for data analysis. The results reveal that peer support significantly reduces mental distress and positively influences the perception of self-care abilities and health perceptions among cancer patients and survivors. Additionally, the study finds that mental distress negatively affects daily life activities and self-care abilities. This means that when cancer patients and survivors experience high levels of mental distress, they may struggle with everyday tasks and find it challenging to care for themselves effectively. The research also shows that mental distress tends to decrease as time passes since diagnosis and health perceptions improve, highlighting the resilience of cancer patients and survivors over time. Furthermore, the study uncovers significant moderating effects of age, education, and income on the relationships between daily life activity difficulties, perception of self-care ability, and perception of health. In conclusion, this research provides a comprehensive understanding of the intricate associations between the variables of interest among cancer patients and survivors. The findings underscore the importance of peer support and targeted interventions for promoting well-being, resilience, and quality of life in this population, offering valuable insights for healthcare providers, researchers, and policymakers. Identifying moderating effects further emphasizes the need to consider individual differences when designing and implementing support systems and interventions tailored to the unique needs of cancer patients and survivors.
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Affiliation(s)
- Yeganeh Shahsavar
- Industrial and Management Systems Engineering, Benjamin M. Statler College of Engineering and Mineral Resources, West Virginia University, Morgantown, West Virginia, United States of America
| | - Avishek Choudhury
- Industrial and Management Systems Engineering, Benjamin M. Statler College of Engineering and Mineral Resources, West Virginia University, Morgantown, West Virginia, United States of America
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Oveisi N, Khan Z, Brotto LA. A qualitative study of sexual health and function of females with pelvic cancer. Sex Med 2023; 11:qfac002. [PMID: 36910701 PMCID: PMC9978583 DOI: 10.1093/sexmed/qfac002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2021] [Revised: 04/06/2022] [Accepted: 09/22/2022] [Indexed: 03/06/2023] Open
Abstract
Background Pelvic cancers are among the most common cancers, impacting millions of individuals worldwide annually. However, little is known about the impact of more rare pelvic cancers on the sexual health of females. Aim In this study we explored sexual health experiences of female pelvic cancer survivors (FPCS) and their healthcare providers (HCP) in order to identify the most salient impacts of pelvic cancer on sexual function. Methods In this qualitative study, semi-structured online interviews were conducted with 15 female patients with vulvar, vaginal, uterine, ovarian, endometrial, cervical, bladder, and/or colorectal cancers. Additionally, semi-structured online interviews were conducted with HCPs who treat pelvic cancers (n = 9). For data analysis, qualitative framework analysis was used. Outcomes We used the collected data and analysis of findings to establish recommendations including ways to improve sexual health and function in female survivors of pelvic cancer. Results Most FPCS experienced negative impacts on their sexual health and function through increased pain and dryness, bleeding due to atrophy, decreased libido, and psychosocial issues such as body dysmorphia. Females with the rarer vulvar and vaginal cancers faced additional challenges to their sexual health such as shortening of vaginal canals, high levels of neuropathy, lack of sexual activity with their partners, and suicidal ideation. FPCS had unmet sexual health needs, which can be attributed to lack of appropriate training by HCPs and lack of resources and availability of services. Although HCPs recognized the importance of providing sexual healthcare, they lacked confidence in their ability to facilitate a conversation on sexual health with their patients, and often avoided this topic. Clinical implications The sexual health outcomes of FPCS can be improved by providing targeted training for HCPs, developing standard resources for sexual health, and integrating tiers of support, including group interventions and counseling. Strengths and limitations The main strength of this study is that data were collected from HCPs as well as FPCS, thus providing a more in-depth overall picture of the current strengths and weaknesses of the resources for sexual health support available for this patient population. A limitation of this study is that the experiences of transgender men were not captured. Conclusions Sexual difficulties are very common in all FPCS, particularly survivors of vulvar and vaginal cancers. Improvement of sexual health outcomes is needed in this patient population, which can be achieved by providing more training for HCPs, developing robust resources for FPCS and their sexual health, and providing more opportunities for tiered support.
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Affiliation(s)
- Niki Oveisi
- Faculty of Pharmaceutical Sciences, University of British Columbia, 2405 Wesbrook Mall, Vancouver, BC V6T 1Z3, Canada
| | - Zeba Khan
- Faculty of Medicine, University of British Columbia, 2329 West Mall, Vancouver, British Columbia, V6T 1Z4, Canada
| | - Lori A Brotto
- Department of Obstetrics and Gynaecology, University of British Columbia, 2775 Laurel Street, 6th Floor, Vancouver, British Columbia, V5Z 1M9, Canada
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Limoncin E, Ciocca G, Castellini G, Sansone A, Cavalieri F, Cavallo F, Cocchiaro T, Ricca V, di Lorenzo G, Rossi A, Fisher AD, Rochira V, Corona G, Jannini EA. Hypersexuality as a tip of the iceberg of a primary psychopathology: a joined position statement of the Italian Society of Andrology and Sexual Medicine (SIAMS) and of the Italian Society of Psychopathology (SOPSI). J Endocrinol Invest 2022; 45:1787-1799. [PMID: 35527295 DOI: 10.1007/s40618-022-01798-3] [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] [Received: 01/28/2022] [Accepted: 03/28/2022] [Indexed: 10/18/2022]
Abstract
In the last years, hypersexual behavior has been broadly scientifically studied. The interest in this topic, belonging to psycho-sexology and sexual medicine, has been due to its still unclear aetiology, nature, and its manifestation in relationship with several organic and psychopathological conditions. So, the specialist (the psychologist, psychiatrist, endocrinologist, neurologist) may encounter some difficulties in diagnosing and managing this symptom. The first main objective of this position statement, which has been developed in collaboration between the Italian Society of Andrology and Sexual Medicine (SIAMS) and the Italian Society of Psychopathology (SOPSI) is to give to the reader evidence about the necessity to consider hypersexuality as a symptom related to another underlying condition. Following this consideration, the second main objective is to give specific statements, for the biopsychosocial assessment and the diagnosis of hypersexual behavior, developed on the basis of the most recent literature evidence. To develop a psycho-pharmacological treatment tailored on patients' needs, our suggestion is to assess the presence of specific comorbid psychopathological and organic conditions, and the impact of pharmacological treatments on the presence of an excess of sexual behavior. Finally, a suggestion of a standardized psychometric evaluation of hypersexuality will be given.
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Affiliation(s)
- E Limoncin
- Endocrinology and Medical Sexology (ENDOSEX), Department of Systems Medicine, University Tor Vergata, E Tower South. Floor 4, Room E413, Via Montpellier 1, 00133, Rome, Italy
- Department of Dynamic, Clinical Psychology and Health, University Sapienza, Rome, Italy
| | - G Ciocca
- Department of Dynamic, Clinical Psychology and Health, University Sapienza, Rome, Italy
| | - G Castellini
- Psychiatric Unit, Department of Neuroscience, Psychology, Drug Research and Child Health, University of Florence, Florence, Italy
| | - A Sansone
- Endocrinology and Medical Sexology (ENDOSEX), Department of Systems Medicine, University Tor Vergata, E Tower South. Floor 4, Room E413, Via Montpellier 1, 00133, Rome, Italy
| | - F Cavalieri
- Department of Medicine, Unit of Andrology and Reproduction Medicine, University of Padova, Padua, Italy
| | - F Cavallo
- Spinal Unit, San Raffaele Institute of Sulmona, Sulmona, Italy
| | - T Cocchiaro
- Department of Gender, Parenting, Child and Adolescent Medicine, Unit of Reproductive Pathophysiology and Andrology, "Sandro Pertini" Hospital, Rome, Italy
| | - V Ricca
- Psychiatric Unit, Department of Neuroscience, Psychology, Drug Research and Child Health, University of Florence, Florence, Italy
| | - G di Lorenzo
- Laboratory of Psychophysiology and Cognitive Neuroscience, Chair of Psychiatry, Department of Systems Medicine, University of Rome Tor Vergata, Rome, Italy
- Psychiatry and Clinical Psychology Unit, Section of Psychiatry, Fondazione Policlinico Tor Vergata, Rome, Italy
| | - A Rossi
- Department of Biotechnological and Applied Clinical Sciences, University of L'Aquila, L'Aquila, Italy
| | - A D Fisher
- Sexual Medicine and Andrology Unit, Department of Experimental, Clinical and Biomedical Sciences, University of Florence, Florence, Italy
| | - V Rochira
- Unit of Endocrinology, Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, Modena, Italy
- Unit of Endocrinology, Department of Medical Specialties, Azienda Ospedaliero-Universitaria of Modena, Modena, Italy
| | - G Corona
- Endocrinology Unit, Medical Department, Maggiore-Bellaria Hospital, Bologna, Italy
| | - E A Jannini
- Endocrinology and Medical Sexology (ENDOSEX), Department of Systems Medicine, University Tor Vergata, E Tower South. Floor 4, Room E413, Via Montpellier 1, 00133, Rome, Italy.
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Shrem NS, Wood L, Hamilton RJ, Kuhathaas K, Czaykowski P, Roberts M, Matthew A, Izard JP, Chung P, Nappi L, Jones J, Soulières D, Aprikian A, Power N, Canil C. Testicular cancer survivorship: Long-term toxicity and management. Can Urol Assoc J 2022; 16:257-272. [PMID: 35905486 PMCID: PMC9343164 DOI: 10.5489/cuaj.8009] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2023]
Affiliation(s)
- Noa Shani Shrem
- Division of Medical Oncology, Department of Medicine, The Ottawa Hospital, University of Ottawa, Ottawa, ON, Canada
| | - Lori Wood
- Division of Medical Oncology, Queen Elizabeth II Health Sciences Centre, Dalhousie University, Halifax, NS, Canada
| | - Robert J. Hamilton
- Division of Urology, Department of Surgical Oncology, Princess Margaret Cancer Center, University Health Network, University of Toronto, Toronto, ON, Canada
| | - Kopika Kuhathaas
- Division of Urology, Department of Surgical Oncology, Princess Margaret Cancer Center, University Health Network, University of Toronto, Toronto, ON, Canada
| | - Piotr Czaykowski
- Department of Medical Oncology and Hematology, CancerCare Manitoba, University of Manitoba, Winnipeg, MB, Canada
| | - Matthew Roberts
- Division of Urology, Department of Surgery, University of Ottawa, Ottawa, ON, Canada
| | - Andrew Matthew
- Department of Surgical Oncology, Princess Margaret Cancer Centre, Department of Psychiatry, University of Toronto, Toronto, ON, Canada
| | - Jason P. Izard
- Departments of Urology and Oncology, Queen’s University, Kingston, ON, Canada
| | - Peter Chung
- Department of Radiation Oncology, Radiation Medicine Program, Princess Margaret Hospital, University of Health Network, University of Toronto, Toronto, ON, Canada
| | - Lucia Nappi
- Division of Medical Oncology, British Columbia Cancer - Vancouver Cancer Centre, University of British Columbia, Vancouver, BC, Canada
| | - Jennifer Jones
- Department of Supportive Care, Princess Margaret Cancer Centre, Department of Psychiatry, University of Toronto, Toronto, ON, Canada
| | - Denis Soulières
- Division of Medical Oncology/Hematology, Le Centre Hospitalier de l’Université de Montréal, Montreal, QC, Canada
| | - Armen Aprikian
- Division of Urology, Department of Surgery, McGill University Health Centre, Montreal, QC, Canada
| | - Nicholas Power
- Division of Urology, Department of Surgery, Western University, London, ON, Canada
| | - Christina Canil
- Division of Medical Oncology, Department of Medicine, The Ottawa Hospital, University of Ottawa, Ottawa, ON, Canada
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Levin NJ, Zhang A, Kattari S, Moravek M, Zebrack B. "Queer Insights": Considerations and Challenges for Assessing Sex, Gender Identity, and Sexual Orientation in Oncofertility Research. ANNALS OF LGBTQ PUBLIC AND POPULATION HEALTH 2022; 3:111-128. [PMID: 38078047 PMCID: PMC10704859 DOI: 10.1891/lgbtq-2021-0015] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/30/2024]
Abstract
This article addresses issues related to clinical and research approaches to oncofertility for adolescent and young adult (AYA) sexual and gender minority (SGM) cancer patients. Limited attention has been dedicated to understanding the extent to which oncofertility services are appropriately and equitably delivered to AYAs with diverse orientations toward sexual orientation, gender identity, and future family. Unresolved challenges to conducting research with this vulnerable population perpetuate a lack of adequate knowledge about SGM AYA oncofertility needs. Therefore, the purpose of this paper is to inform considerations of sex, gender identity, and sexual orientation for investigations that include SGM AYAs. In order to improve the knowledge base and clinical services for this population, we discuss (1) challenges to sampling this population; (2) categorization and survey logic (e.g., skip patterns) in light of fluid sexual orientation and gender identities; and (3) clinical implications of accurately assessing sex and gender for oncofertility research and practice. We also recommend strategies for producing inclusive and accurate assessments of sexual and gender identity categories in both research and clinical encounters with SGM AYAs. Incorporating "queer insights" into empirical research - that is, positioning queer theory at the center of oncofertility study design - is suggested as a future direction for oncofertility research and practice.
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Affiliation(s)
- Nina Jackson Levin
- University of Michigan, School of Social Work and Department of Anthropology
| | - Anao Zhang
- University of Michigan, School of Social Work
| | - Shanna Kattari
- University of Michigan, School of Social Work and Department of Women’s and Gender Studies
| | - Molly Moravek
- University of Michigan, Department of Obstetrics and Gynecology and Department of Urology, Ann Arbor, MI, USA
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Importance of Addressing the Psychosocial Impact of Penile Cancer on Patients and Their Families. Semin Oncol Nurs 2022; 38:151286. [DOI: 10.1016/j.soncn.2022.151286] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
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10
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Heyne S, Esser P, Geue K, Friedrich M, Mehnert-Theuerkauf A. Frequency of Sexual Problems and Related Psychosocial Characteristics in Cancer Patients-Findings From an Epidemiological Multicenter Study in Germany. Front Psychol 2021; 12:679870. [PMID: 34367002 PMCID: PMC8339199 DOI: 10.3389/fpsyg.2021.679870] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2021] [Accepted: 06/28/2021] [Indexed: 12/21/2022] Open
Abstract
Background Multimodal cancer treatments are often associated with sexual problems. Identifying patients with sexual problems could help further elucidate serious issues with their sexuality and thus promote or maintain patients’ sexual health. We aimed to assess the occurrence of sexual problems in patients across different tumor locations and to explore associated sociodemographic, medical and psychosocial factors. Methods We included 3,677 cancer patients (mean age 58 years, age range 18–75 years, 51.4% women) from a large epidemiological multicenter study in Germany on average 13.5 months after cancer diagnosis. The occurrence and frequency of sexual problems were assessed via a binary item on the problem checklist of the Distress Thermometer (DT). Controlled associations of these problems with sociodemographic, medical and psychosocial factors including distress (DT), anxiety (GAD-7), depression (PHQ-9), quality of life (EORTC-QLQ-C30), and social support (SSUK-8) are analyzed using logistic regression analysis. Results We found that 31.8% of patients reported sexual problems, with a significant higher proportion in men (40.5%) compared to women (23.7%), OR 2.35, 95% CI [1.80–3.07] and a higher proportion in patients with a partner (35.6%) compared to those without a partner (3.5%), OR 2.83, 95% CI [2.17–3.70]. Tumor location was associated with occurrence of sexual problems: patients with cancer, affecting the male genital organs had the highest chance for sexual problems, OR 2.65, 95% CI [1.18–3.95]. There was no significant difference in the occurrence of sexual problems between age groups OR 0.99, 95% CI [2.13–3.53] and type of therapy (e.g., operation OR 0.91, 95% CI [0.72–1.15]). Sexual problems were further associated with elevated levels of anxiety, OR 1.05, 95% CI [1.02–1.10], less social support, OR 0.93, 95% CI [0.90–0.97] and lower quality of life in terms of impaired functioning (e.g., social function, OR 0.99, 95% CI [0.99–1.00]). Conclusions Sexual problems are commonly reported by patients. Male patients and those living with a partner are more likely to report sexual problems. Sexual problems are associated with different aspects of well-being. The findings imply the practical relevance to screen for sexual problems among patients and identified groups that should be particularly monitored.
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Affiliation(s)
- Svenja Heyne
- Department of Medical Psychology and Medical Sociology, University Medical Center Leipzig, Leipzig, Germany
| | - Peter Esser
- Department of Medical Psychology and Medical Sociology, University Medical Center Leipzig, Leipzig, Germany
| | - Kristina Geue
- Department of Medical Psychology and Medical Sociology, University Medical Center Leipzig, Leipzig, Germany
| | - Michael Friedrich
- Department of Medical Psychology and Medical Sociology, University Medical Center Leipzig, Leipzig, Germany
| | - Anja Mehnert-Theuerkauf
- Department of Medical Psychology and Medical Sociology, University Medical Center Leipzig, Leipzig, Germany
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Krouwel EM, Albers LF, Nicolai MPJ, Putter H, Osanto S, Pelger RCM, Elzevier HW. Discussing Sexual Health in the Medical Oncologist's Practice: Exploring Current Practice and Challenges. JOURNAL OF CANCER EDUCATION : THE OFFICIAL JOURNAL OF THE AMERICAN ASSOCIATION FOR CANCER EDUCATION 2020; 35:1072-1088. [PMID: 31209770 PMCID: PMC7679345 DOI: 10.1007/s13187-019-01559-6] [Citation(s) in RCA: 37] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/09/2023]
Abstract
Sexuality is a significant quality-of-life concern for many cancer patients. Patients may be disadvantaged if they are not informed and not offered sexual health care. We sought to reveal oncologists' current practice and opinions concerning sexual counselling. The aim of this study was to explore the knowledge, attitude and practice patterns of Dutch medical oncologists regarding treatment-related sexual dysfunction. Questionnaires were sent to 433 members of the Dutch Society of Medical Oncology. The majority (81.5%) of the 120 responding medical oncologists (response rate 30.6%) stated they discussed sexual function with fewer than half of their patients. At the same time, 75.8% of the participating oncologists agreed that addressing sexual function is their responsibility. Sexual function was discussed more often with younger patients and patients with a curative treatment intent. Barriers for avoiding discussing sexual function were lack of time (56.1%), training (49.5%) and advanced age of the patient (50.4%). More than half (64.6%) stated they had little knowledge about the subject and the majority (72.9%) wanted to acquire additional training in sexual function counselling. Medical oncologists accept that sexual function counselling falls within their profession, yet they admit to not counselling patients routinely concerning sexual function. Only in a minority of cases do medical oncologists inform their patients about sexual side effects of treatment. Whether they counsel patients is related to how they view patient's prognosis, patient's age, and self-reported knowledge. Findings indicate there is a role for developing education and practical training.
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Affiliation(s)
- E M Krouwel
- Department of Urology, J3P, Leiden University Medical Centre, PO Box 9600, 2300 WB, Leiden, The Netherlands
- Department of Medical Decision Making, Leiden University Medical Centre, PO Box 9600, 2300 WB, Leiden, The Netherlands
| | - L F Albers
- Department of Urology, J3P, Leiden University Medical Centre, PO Box 9600, 2300 WB, Leiden, The Netherlands.
- Department of Medical Decision Making, Leiden University Medical Centre, PO Box 9600, 2300 WB, Leiden, The Netherlands.
| | - M P J Nicolai
- Department of Urology, J3P, Leiden University Medical Centre, PO Box 9600, 2300 WB, Leiden, The Netherlands
- Department of Medical Decision Making, Leiden University Medical Centre, PO Box 9600, 2300 WB, Leiden, The Netherlands
| | - H Putter
- Department of Medical Statistics, Leiden University Medical Centre, PO Box 9600, 2300 WB, Leiden, The Netherlands
| | - S Osanto
- Department of Oncology, Leiden University Medical Centre, PO Box 9600, 2300 WB, Leiden, The Netherlands
| | - R C M Pelger
- Department of Urology, J3P, Leiden University Medical Centre, PO Box 9600, 2300 WB, Leiden, The Netherlands
- Department of Medical Decision Making, Leiden University Medical Centre, PO Box 9600, 2300 WB, Leiden, The Netherlands
| | - H W Elzevier
- Department of Urology, J3P, Leiden University Medical Centre, PO Box 9600, 2300 WB, Leiden, The Netherlands
- Department of Medical Decision Making, Leiden University Medical Centre, PO Box 9600, 2300 WB, Leiden, The Netherlands
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Arthur EK, Worly B, Carpenter KM, Postl C, Rosko AE, Krok-Schoen JL, Quick AM, Jenkins LC. Let's get it on: Addressing sex and intimacy in older cancer survivors. J Geriatr Oncol 2020; 12:312-315. [PMID: 32912736 DOI: 10.1016/j.jgo.2020.08.003] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2020] [Revised: 07/29/2020] [Accepted: 08/03/2020] [Indexed: 11/16/2022]
Affiliation(s)
- Elizabeth K Arthur
- The Ohio State University Comprehensive Cancer Center - Arthur G. James Cancer Hospital and Richard, J. Solove Research Institute, 460 W 10(th) Ave., Columbus, OH 43210, USA; The Ohio State University College of Nursing, 1585 Neil Ave., Columbus, OH 43210, USA.
| | - Brett Worly
- The Ohio State University College of Medicine, 395 W. 12(th) Avenue, Columbus, OH 43210, USA; The Ohio State University Wexner Medical Center, 410 W 10(th) Ave., Columbus, OH 43210, USA.
| | - Kristen M Carpenter
- The Ohio State University Comprehensive Cancer Center - Arthur G. James Cancer Hospital and Richard, J. Solove Research Institute, 460 W 10(th) Ave., Columbus, OH 43210, USA; The Ohio State University Wexner Medical Center, 410 W 10(th) Ave., Columbus, OH 43210, USA.
| | - Claire Postl
- The Ohio State University Wexner Medical Center, 410 W 10(th) Ave., Columbus, OH 43210, USA.
| | - Ashley E Rosko
- The Ohio State University Comprehensive Cancer Center - Arthur G. James Cancer Hospital and Richard, J. Solove Research Institute, 460 W 10(th) Ave., Columbus, OH 43210, USA; The Ohio State University College of Medicine, 395 W. 12(th) Avenue, Columbus, OH 43210, USA.
| | - Jessica L Krok-Schoen
- The Ohio State University Comprehensive Cancer Center - Arthur G. James Cancer Hospital and Richard, J. Solove Research Institute, 460 W 10(th) Ave., Columbus, OH 43210, USA; School of Health and Rehabilitation Sciences, College of Medicine, The Ohio State University, 453 W. 10(th) Ave., Columbus, OH 43210, USA.
| | - Allison M Quick
- The Ohio State University Comprehensive Cancer Center - Arthur G. James Cancer Hospital and Richard, J. Solove Research Institute, 460 W 10(th) Ave., Columbus, OH 43210, USA; The Ohio State University College of Medicine, 395 W. 12(th) Avenue, Columbus, OH 43210, USA.
| | - Lawrence C Jenkins
- The Ohio State University Comprehensive Cancer Center - Arthur G. James Cancer Hospital and Richard, J. Solove Research Institute, 460 W 10(th) Ave., Columbus, OH 43210, USA; The Ohio State University College of Medicine, 395 W. 12(th) Avenue, Columbus, OH 43210, USA.
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Bolat MS, Kocamanoglu F, Ozbek ML, Buyukalpelli R, Asci R. Can High Visceral Adiposity Index Be a Risk Factor for Sexual Dysfunction in Sexually Active Men? J Sex Med 2020; 17:1926-1933. [PMID: 32712095 DOI: 10.1016/j.jsxm.2020.06.014] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2020] [Revised: 05/29/2020] [Accepted: 06/17/2020] [Indexed: 02/08/2023]
Abstract
BACKGROUND To our knowledge, there is no study in the literature that has investigated a cutoff value of the visceral adiposity index (VAI) for erectile dysfunction (ED) in men. AIM To show a possible relationship between ED and VAI levels representing adipose tissue dysfunction and to identify a cutoff value of the VAI for ED. METHODS This prospective cross-sectional study included 276 participants in 5 groups: non-ED, mild ED, mild-moderate ED, moderate ED, and severe ED. The VAI was calculated. Fasting glucose, triglyceride, high-density lipoprotein, testosterone (T), prolactin, and estradiol were measured. Erectile function, sexual satisfaction, orgasm, desire, and general satisfaction scores were recorded using the International Index of Erectile Dysfunction 1-15 questionnaire. The participants were divided into BMI1 (<25.0), BMI2 (25-29.9), and BMI3 (>30.0) categories based on body mass index (BMI) and WC1 (<94 cm), WC2 (94-102 cm), and WC3 (>102 cm) categories based on waist circumference (WC). OUTCOMES The VAI was investigated as an independent risk factor for ED, compared with BMI and WC. RESULTS The median VAI progressively increased, but a marked increase was recorded in groups 4 and 5 (P = .001). A significant increase in ED was observed for a VAI score higher than 4.33 (P = .001). Each integer increase of the VAI was associated with a 1.3-fold increased risk of ED. The odds ratio of ED for the VAI = 4.33 was 4.4 (P < .001). The WC and BMI significantly increased as the degree of ED increased (P = .001), but statistical analysis showed a significant decrease only in moderate and severe ED groups (P < .05). Starting from non-ED patients, serum triglyceride increased and high-density lipoprotein decreased progressively in all ED groups (P = .001). T/E2 slightly reduced as the severity of ED increased (P > .05). T decreased in ED groups (P = .022). Regardless of the ED level, other sexual subdomains decreased in ED patients (P = .001). The ED rates in 3 increasing BMI and WC categories were similar (P > .05). For VAI = 4.33, BMI ≥ 30.0 kg/m2, and WC > 102 cm, sensitivity and specificity were 61.2% and 73.8%, 31.6% and 90.5%, and 54.3% and 69.0%, respectively. CLINICAL IMPLICATIONS The VAI should be considered as a reliable independent risk factor for ED as a predictor of visceral adipose dysfunction. STRENGTHS & LIMITATIONS The main strength is that this is the first study to investigate the association between the VAI and sexual dysfunction in men. The low number of participants is the limiting factor. CONCLUSION The findings suggest that the VAI can be used as a reliable independent risk factor marker for ED as a predictor of visceral adipose dysfunction. Bolat MS, Kocamanoglu F, Ozbek ML, et al. Can High Visceral Adiposity Index Be a Risk Factor for Sexual Dysfunction in Sexually Active Men? J Sex Med 2020;17:1926-1933.
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Affiliation(s)
| | | | - Mustafa Latif Ozbek
- Department of Urology, OndokuzMayis University, Samsun, Turkey; Private Atasam Hospital, Samsun, Turkey
| | | | - Ramazan Asci
- Department of Urology, OndokuzMayis University, Samsun, Turkey
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McInnis MK, Pukall CF. Sex After Prostate Cancer in Gay and Bisexual Men: A Review of the Literature. Sex Med Rev 2020; 8:466-472. [DOI: 10.1016/j.sxmr.2020.01.004] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2019] [Revised: 01/26/2020] [Accepted: 01/27/2020] [Indexed: 12/24/2022]
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Can the provision of sexual healthcare for oncology patients be improved? A literature review of educational interventions for healthcare professionals. J Cancer Surviv 2020; 14:858-866. [PMID: 32488631 PMCID: PMC7572328 DOI: 10.1007/s11764-020-00898-4] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2020] [Accepted: 05/18/2020] [Indexed: 01/21/2023]
Abstract
Purpose Sexual health is an important quality-of-life concern for cancer patients and survivors, but a difficult discussion topic for patients and healthcare professionals. The most important barriers causing healthcare professionals to avoid the topic are lack of education and lack of knowledge. How effective education about sexual health is for oncology healthcare professionals is not clear. The aim of this review is to examine the effectiveness of interventions in improving the provision of sexual healthcare for cancer patients. Methods A systematic literature review was conducted according to PRISMA guidelines using the following data sources: PubMed, PsychInfo, Embase and Emcare. Quantitative research was included which contained pre-intervention and post-intervention outcomes. The assessment of the studies was conducted independently by two reviewers. A third reviewer was involved if there was no consensus. Results Seven studies were included. In total, 572 oncology healthcare professionals participated, including physicians, nurses and allied healthcare professionals. Interventions consisted of 6 face-to-face sessions and one online program. Primary objectives of the studies were the assessment of improvement in knowledge about sexual health, improvement of practice, frequency of discussing sexual health and comfort level and the decline of perceived barriers to discussing sexual health. Studies showed that interventions resulted in improved realization of the objectives. Conclusions Although improvement in the knowledge of healthcare professionals was achieved, it was not possible to give an overall recommendation for the development of interventions due to the limited number of studies and heterogeneity of the data. Implications for Cancer Survivors Sexual health is an important area of survivorship that is often neglected. Many oncology healthcare professionals lack training and knowledge to provide such care. More evidence-based practices are needed to improve sexual healthcare for cancer survivors. Electronic supplementary material The online version of this article (10.1007/s11764-020-00898-4) contains supplementary material, which is available to authorized users.
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Lu JY, Miller EJ, Welliver C. A Thematic Analysis of the Online Discussion Board, FrankTalk, Regarding Penile Implant. J Sex Med 2019; 17:325-330. [PMID: 31866124 DOI: 10.1016/j.jsxm.2019.11.258] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2019] [Revised: 10/23/2019] [Accepted: 11/04/2019] [Indexed: 11/19/2022]
Abstract
INTRODUCTION Medical websites and discussion boards are commonly used by patients to obtain information. The online forum FrankTalk.org provides a venue specifically for men to discuss sexual dysfunction and particularly inflatable penile prosthesis (IPP). By querying and better understanding the content of this forum related to implants, we can better understand patient concerns before and after IPP. AIM The aim of this study is to understand the main topics being discussed about IPPs online and to use these topics to understand patient concerns and patient needs and to improve care. METHODS Messages posted in a 6-month window from January 2018 to June 2018 under the topic "Implant" were identified on FrankTalk.org. Posts were broken down into preoperative and postoperative and then organized using a 3-stage analysis to determine central themes of each post: open coding, axial coding, and selective coding. MAIN OUTCOME MEASURE The primary outcome measure is the prevalence of each selective code. RESULTS Of all 587 posts, 304 were written preoperatively with the most common theme being "Size" (23.0%), followed by "seeking support" (18.4%). 283 posts were considered postoperative, of which the most common theme was "Concern about healing" (22.6 %) which questioned if they needed to see a physician, followed by size concerns (20.1%).When analyzed with the 3-stage coding system, there were a total of 41 axial codes which were organized into 6 selective codes: "Social Support" (27.8% of all posts), "Pre-Operative Worries" (23.58%),"Technical Issues" (11.1%), "Prosthesis Logistics" (14.37%), "Post-Operative Worries" (20.22%), "Forum and Misc" (2.93%) for topics outside the scope of penile prosthesis. CLINICAL IMPLICATIONS The percentage of men seeking medical opinion is concerning, and providers should consider using resources to better educate patients on normal postoperative findings. Implanters should continue to preoperatively counsel patients on size-related changes with surgery. STRENGTH & LIMITATIONS Strengths include the use of a common online website for men to discuss IPPs and a systematic coding system. Limitations include the applicability of these results to nonheterosexual men as these are likely oversampled in this population. The inherent bias of those willing to post on an online forum may have influenced results along with no oversight for factual accuracy. CONCLUSION Patients use online discussion boards like FrankTalk.org for social support, medical advice, and validation of their concerns. Providers should be aware of these online topic focuses to help open a discussion with patients about concerns they may feel are difficult to approach with providers. Lu JY, Miller EJ, Welliver C. A Thematic Analysis of the Online Discussion Board, FrankTalk, Regarding Penile Implant. J Sex Med 2020;17:325-330.
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Affiliation(s)
- Jennifer Y Lu
- Albany Medical Center, 50 New Scotland Ave, Albany 12208 NY, USA
| | - Eric J Miller
- Upstate University Hospital, 750 E Adams St, Syracuse 13210 NY, USA
| | - Charles Welliver
- Albany Medical Center, 50 New Scotland Ave, Albany 12208 NY, USA.
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