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Hu Y, Fu X, Jiang X, Jiang M, Zheng X, Lu H, Xu M. The experience of fertility concerns in patients with testicular cancer: a qualitative study. Support Care Cancer 2024; 32:529. [PMID: 39028382 DOI: 10.1007/s00520-024-08720-y] [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: 02/28/2024] [Accepted: 07/04/2024] [Indexed: 07/20/2024]
Abstract
BACKGROUND Testicular cancer usually occurs in young adult men between the ages of 20 and 40 years, which largely coincides with the age of men's reproductive intentions. However, a serious side effect of testicular cancer therapy could reduce the fertility of patients. PURPOSE To explore the experience of fertility concerns in patients with testicular cancer. METHODS A phenomenological research was conducted on 12 patients with testicular cancer. Data collection was from May 2023 to August 2023, and Colaizzi analysis method was used to analyze the data. RESULTS Four themes were found: (1) multiple worries and negative emotions, (2) fertility decision-making faces many challenges, (3) self-coping strategies for facing fertility concerns, (4) unmet supportive care needs. CONCLUSION Medical staff should pay attention to the fertility needs of patients with testicular cancer and provide relevant interventions and support to reduce their fertility concerns.
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Affiliation(s)
- Ya Hu
- Department of Urology, Sun Yat-Sen University Cancer Center, 651 Dongfeng Road East, Guangzhou, 510060, P.R. China
- State Key Laboratory of Oncology in Southern China, Guangzhou, 510060, P.R. China
- Guangdong Provincial Clinical Research Center for Cancer, Guangzhou, 510060, P.R. China
| | - Xue Fu
- Department of Urology, Sun Yat-Sen University Cancer Center, 651 Dongfeng Road East, Guangzhou, 510060, P.R. China
- State Key Laboratory of Oncology in Southern China, Guangzhou, 510060, P.R. China
- Guangdong Provincial Clinical Research Center for Cancer, Guangzhou, 510060, P.R. China
| | - Xiaoya Jiang
- International Medical Center, Zhujiang Hospital, Southern Medical University, Guangzhou, 510282, P.R. China
| | - Mengxiao Jiang
- Department of Urology, Sun Yat-Sen University Cancer Center, 651 Dongfeng Road East, Guangzhou, 510060, P.R. China
- State Key Laboratory of Oncology in Southern China, Guangzhou, 510060, P.R. China
- Guangdong Provincial Clinical Research Center for Cancer, Guangzhou, 510060, P.R. China
| | - Xia Zheng
- Department of Urology, Sun Yat-Sen University Cancer Center, 651 Dongfeng Road East, Guangzhou, 510060, P.R. China.
- State Key Laboratory of Oncology in Southern China, Guangzhou, 510060, P.R. China.
- Guangdong Provincial Clinical Research Center for Cancer, Guangzhou, 510060, P.R. China.
| | - Huiming Lu
- Department of Urology, Sun Yat-Sen University Cancer Center, 651 Dongfeng Road East, Guangzhou, 510060, P.R. China.
- State Key Laboratory of Oncology in Southern China, Guangzhou, 510060, P.R. China.
- Guangdong Provincial Clinical Research Center for Cancer, Guangzhou, 510060, P.R. China.
| | - Man Xu
- Department of Urology, Sun Yat-Sen University Cancer Center, 651 Dongfeng Road East, Guangzhou, 510060, P.R. China.
- State Key Laboratory of Oncology in Southern China, Guangzhou, 510060, P.R. China.
- Guangdong Provincial Clinical Research Center for Cancer, Guangzhou, 510060, P.R. China.
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Chen L, Shen J, Jiang H, Lin H, He J, Fan S, Yang L, Yu D, Qiu R, Lin E. Incidence and influencing factors of fertility concerns in breast cancer in young women: a systematic review and meta-analysis. Front Oncol 2023; 13:1273529. [PMID: 38173831 PMCID: PMC10763242 DOI: 10.3389/fonc.2023.1273529] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2023] [Accepted: 12/04/2023] [Indexed: 01/05/2024] Open
Abstract
Objective This systematic review and meta-analysis aimed to evaluate the prevalence and influencing factors of fertility concerns in breast cancer in young women. Methods A literature search on PubMed, Embase, Web of Science, and Cochrane Library databases was conducted up to February 2023 and was analyzed (Revman 5.4 software) in this study. The papers were chosen based on inclusion standards, and two researchers independently extracted the data. The included studies' quality was evaluated using criteria set out by the Agency for Healthcare Research and Quality. To identify significant variations among the risk factors, odds ratios (ORs) and the corresponding 95% confidence intervals (CIs) were utilized. Results A total of 7 studies that included 1579 breast cancer in young women were enrolled in the study. The results showed that for breast cancer in young women, the incidence of fertility concerns 53%(95%CI [0.45,0.58]). The results showed that education (2.65, 95% CI 1.65-5.63), full-time work (0.12, 95% CI 1.03-1.93), fertility intentions (7.84, 95% CI 1.50-37.4), depression level (1.25, 95% CI 1.03-1.5), and endocrine therapy (1.32, 95% CI 1.08-1.62) were risk factors for fertility concerns in young women with BC. Having a partner (0.41, 95% CI 0.33-0.5), ≥1 child (0.3, 95% CI 0.22-0.4) were identified as protective factors against fertility concerns in young women with BC. Conclusions The incidence of fertility concerns in breast cancer in young women is at a moderately high level. We should pay more attention to the risk factors of fertility concerns to help breast cancer in young women cope with their fertility concerns and promote their psychological well-being.
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Affiliation(s)
- Lijuan Chen
- Department of General Surgery, Zhongshan Hospital of Xiamen University, School of Medicine, Xiamen, China
| | - Jiali Shen
- School of Nursing, Fujian University of Traditional Chinese Medicine, Fuzhou, China
| | - Hongzhan Jiang
- School of Nursing, Fujian University of Traditional Chinese Medicine, Fuzhou, China
| | - Huihui Lin
- School of Nursing, Fujian University of Traditional Chinese Medicine, Fuzhou, China
| | - Jiaxi He
- School of Medicine, Xiamen University, Xiamen, China
| | - Siyue Fan
- School of Nursing, Fujian University of Traditional Chinese Medicine, Fuzhou, China
| | - Liping Yang
- School of Nursing, Fujian University of Traditional Chinese Medicine, Fuzhou, China
| | - Doudou Yu
- School of Nursing, Fujian University of Traditional Chinese Medicine, Fuzhou, China
| | - Rongliang Qiu
- The Third Clinical Medical College of Fujian Medical University, Fuzhou, China
| | - Ende Lin
- Department of General Surgery, Zhongshan Hospital of Xiamen University, School of Medicine, Xiamen, China
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Benedict C, Stal J, Davis A, Zeidman A, Pons D, Schapira L, Diefenbach M, Ford JS. Greater fertility distress and avoidance relate to poorer decision making about family building after cancer among adolescent and young adult female survivors. Psychooncology 2023; 32:1606-1615. [PMID: 37695291 PMCID: PMC10591918 DOI: 10.1002/pon.6212] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2023] [Revised: 07/28/2023] [Accepted: 08/26/2023] [Indexed: 09/12/2023]
Abstract
BACKGROUND Many adolescent and young adult female (AYA-F) cancer survivors face decisions about family building using reproductive medicine or adoption to achieve parenthood. This study evaluated associations among reproductive distress, avoidance, and family-building decision making and identified sociodemographic and clinical characteristics related to high distress and avoidance. METHODS A cross-sectional survey assessed AYA-F survivors' oncofertility experiences. Measures included an investigator-designed Unmet Information Needs scale, Reproductive Concerns After Cancer Scale, Impact of Events Scale-Avoidance subscale, Decision Self-Efficacy scale, and Decision Conflict Scale. Two linear regression models evaluated correlates of decision self-efficacy and decisional conflict about family building after cancer. Bivariate analyses evaluated correlates of avoidance using Pearson's correlation, t-test, and ANOVA. RESULTS AYA-Fs (N = 111) averaged 31-years-old (SD = 5.49) and 3 years post-treatment (range: 1-23 years); 90% were nulliparous. Most common diagnoses were leukemia (24%) and breast cancer (22%). Average decisional conflict was 52.12 (SD = 23.87, range: 0-100); 74% of the sample reported DCS scores within the clinically significant range. Higher levels of reproductive distress (B = -0.23, p = 0.04) and avoidance (B = -0.24, p = 0.02) related to lower decision self-efficacy. Younger age (B = -0.18, p = 0.03), greater unmet information needs (B = 0.33, p < 0.001), and higher levels of reproductive distress (B = 0.34, p = 0.001) related to worse decisional conflict. Predictors of distress and avoidance were identified. CONCLUSIONS After cancer treatment, high fertility distress and avoidant coping were associated with poorer quality decision making about family building after cancer. Fertility counseling post-treatment should support self-efficacy and constructive coping skills to counteract high distress, maladaptive coping, and facilitate values-based decision making.
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Affiliation(s)
- Catherine Benedict
- Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, Palo Alto, CA
- Stanford Cancer Institute, Stanford, CA
| | - Julia Stal
- Department off Population and Public Health Sciences, Keck School of Medicine of University of Southern California, Los Angeles, CA
| | - Ali Davis
- Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, Palo Alto, CA
- Department of Clinical Psychology, Palo Alto University, Palo Alto, CA
| | - Anna Zeidman
- Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, Palo Alto, CA
| | - Devon Pons
- University of San Francisco, San Francisco, CA
| | | | - Michael Diefenbach
- Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Manhasset, NY
| | - Jennifer S. Ford
- Hunter College and The Graduate Center, City University of New York (CUNY), New York, NY
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