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van der Hoef C, Bawuah Dsane L, Schuur N, Louwers YV, Mens JW, Hikary-Bhal N, van Doorn HC. Hormone replacement therapy in women with iatrogenic premature ovarian insufficiency after radiotherapy for cervical cancer: A retrospective cohort and survey study. Maturitas 2024; 185:108004. [PMID: 38663162 DOI: 10.1016/j.maturitas.2024.108004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2023] [Revised: 04/08/2024] [Accepted: 04/16/2024] [Indexed: 06/03/2024]
Abstract
OBJECTIVES This study assessed the uptake of hormone replacement therapy (HRT) in cervical cancer patients with iatrogenic menopause. Survival in relation to HRT use was assessed via a retrospective chart study, and the severity of menopausal symptoms, motivations and barriers to starting HRT were examined via questionnaires. STUDY DESIGN In total, 293 women under the age of 51 and treated with radiotherapy for cervical cancer between 2010 and 2020 were identified. Medical records were searched for information on HRT use. If still living, women were sent digital questionnaires addressing menopausal symptoms, quality of life (QoL) and potential barriers and motivations concerning HRT use. Univariable data were analysed using Mann-Whitney U, chi-square, and Fisher's exact test, while logistical regression was used to analyse relationships between certain variables and use of HRT and survival. RESULTS Overall HRT uptake was 78.1 %, which was related to age and Charlson Comorbidity Index, but independent of the duration of radiotherapy or FIGO stage. Overall survival was higher for HRT users (χ2(1) = 4.3, p = 0.038). Questionnaires were sent to 193 patients and 100 completed it (response rate 51.8 %). Main reasons for HRT use were relief of hot flushes and improvement in QoL. For women below age 51, QoL was indeed higher for current HRT users than for non-HRT users (EQ-index 0.8 vs. 0.7, p = 0.008). CONCLUSIONS HRT prescription rate was inversely correlated with age. Survival was not negatively affected by HRT use. It is important to stress the benefits of HRT and address women's fears regarding its use.
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Affiliation(s)
- Charlotte van der Hoef
- Department of Gynaecologic Oncology, ErasmusMC Cancer Institute, University Medical Center Rotterdam, the Netherlands
| | - Lawrencia Bawuah Dsane
- Department of Gynaecologic Oncology, ErasmusMC Cancer Institute, University Medical Center Rotterdam, the Netherlands.
| | - Nicoline Schuur
- Department of Gynaecologic Oncology, ErasmusMC Cancer Institute, University Medical Center Rotterdam, the Netherlands.
| | - Yvonne V Louwers
- Division of Reproductive Medicine, Department of Obstetrics and Gynaecology, ErasmusMC, University Medical Center Rotterdam, the Netherlands.
| | - Jan Willem Mens
- Department of Radiation Oncology, ErasmusMC Cancer Institute, University Medical Center Rotterdam, the Netherlands.
| | | | - Helena C van Doorn
- Department of Gynaecologic Oncology, ErasmusMC Cancer Institute, University Medical Center Rotterdam, the Netherlands.
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Liu XQ, Wang L, Gu X, Shan X, Xie J, Gao WY, Gu YH, Zhang Y, Gu DM. The Experience of Cervical Cancer Patients Undergoing Hysterectomy: A Qualitative Study. J Transcult Nurs 2024:10436596241246976. [PMID: 38634631 DOI: 10.1177/10436596241246976] [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: 04/19/2024] Open
Abstract
INTRODUCTION Due to different social and cultural backgrounds, cervical cancer patients' experience of the treatment process and quality of life after treatment will be different. This study sought to gain in-depth understanding of the experiences of Chinese cervical cancer patients as regards their quality of life and physical symptoms. METHODOLOGY Semi-structured interviews were used to collect data. We recruited 15 women with cervical cancer in eastern China for in-depth interviews. All data were entered into the NVivo 12 software program for analysis. RESULTS Four themes emerged from the data: (a) uncertainty; (b) physical suffering; (c) psychological pressure; and (d) challenges of marriage and family. DISCUSSION Cervical cancer patients showed concerns about the disease itself and the physical discomfort it causes, as well as changes in social relations. Health professionals need to talk about these issues and develop strategies to address them accordingly.
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Affiliation(s)
- Xiao-Qin Liu
- Nursing Department of Affiliated Hospital of Nantong University, China
| | - Lan Wang
- College of Health and Social Care, Shanghai Urban Construction Vocational College, China
| | - Xuan Gu
- School of Nursing and Rehabilitation, Nantong University, China
| | - Xiao Shan
- School of Nursing and Rehabilitation, Nantong University, China
| | - Juan Xie
- Nursing Department of Affiliated Hospital of Nantong University, China
| | - Wen-Ying Gao
- School of Nursing and Rehabilitation, Nantong University, China
| | - Yu-Hui Gu
- Nursing Department of Affiliated Hospital of Nantong University, China
| | - Yan Zhang
- Nursing Department of Affiliated Hospital of Nantong University, China
| | - Dong-Mei Gu
- Nursing Department of Affiliated Hospital of Nantong University, China
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Tie H, Shi L, Wang L, Hao X, Fang H, Li L. Symptom clusters and characteristics of cervical cancer patients receiving concurrent chemoradiotherapy: A cross-sectional study. Heliyon 2023; 9:e22407. [PMID: 38107307 PMCID: PMC10724552 DOI: 10.1016/j.heliyon.2023.e22407] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2023] [Revised: 11/08/2023] [Accepted: 11/10/2023] [Indexed: 12/19/2023] Open
Abstract
Background Cervical cancer patients have a high symptom burden during concurrent chemoradiotherapy (CCRT) and urgently need precise symptom management strategies. Nonetheless, the symptom profile and influencing factors are unclear. Methods A total of 234 patients with cervical cancer who underwent CCRT in a tertiary care hospital clinical oncology center in Guangxi Zhuang Autonomous Region from March 2022 to March 2023 were included in the study. The general information questionnaire, M.D. Anderson symptom inventory, Fatigue Scale-14, Pittsburgh Sleep Quality Index, and grip strength test were used for the investigation. Symptom clusters were extracted by exploratory factor analysis, and latent profile analysis was performed using Mplus 8.0 software. Multinomial logistic regression was used to explore the factors influencing the potential categories of symptom clusters. Results Exploratory factor analysis extracted four symptom clusters: a fatigue-related symptom cluster, a gastrointestinal-related symptom cluster, a mood-related symptom cluster, and a physical-related symptom cluster, of which the fatigue-related symptom cluster was more severe and was divided into three potential categories: low fatigue-good muscle fitness type (25.63%), general fatigue-moderate muscle fitness type (68.37%) and high fatigue-low muscle fitness type (6%). Multinomial logistic regression analysis showed that hemoglobin levels, tumor stage, absence of complications, and unemployment were factors influencing the fatigue-related symptom cluster in patients undergoing CCRT for cervical cancer. Conclusions Cervical cancer patients experience multiple symptom clusters during CCRT. Different characteristics appeared in different clusters. Among them, fatigue-related symptom clusters were more severe and heterogeneous. In clinical practice, we should pay attention to and use high symptom feature predictors, focusing on the core symptoms that play a dominant role, achieving early identification and management, and reducing patients' symptom burden.
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Affiliation(s)
- Hao Tie
- Oncology Center Radiotherapy Ward 1, Guangxi Academy of Medical Sciences, The People’s Hospital of Guangxi Zhuang Autonomous Region, Nanning, China
- School of Nursing, Guangxi University of Chinese Medicine, Nanning, China
| | - Limei Shi
- Oncology Center Radiotherapy Ward 2, Guangxi Academy of Medical Sciences, The People’s Hospital of Guangxi Zhuang Autonomous Region, Nanning, China
| | - Li Wang
- School of Nursing and Health, Zhengzhou University, Zhengzhou, China
| | - Xinyu Hao
- School of Nursing, Guangxi University of Chinese Medicine, Nanning, China
| | - Hongyan Fang
- Oncology Center Radiotherapy Ward 1, Guangxi Academy of Medical Sciences, The People’s Hospital of Guangxi Zhuang Autonomous Region, Nanning, China
| | - Lirong Li
- Oncology Center Radiotherapy Ward 1, Guangxi Academy of Medical Sciences, The People’s Hospital of Guangxi Zhuang Autonomous Region, Nanning, China
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Stuopelytė R, Žukienė G, Breivienė R, Rudaitis V, Bartkevičienė D. Quality of Life in Cervical Cancer Survivors Treated with Concurrent Chemoradiotherapy. MEDICINA (KAUNAS, LITHUANIA) 2023; 59:medicina59040777. [PMID: 37109735 PMCID: PMC10141383 DOI: 10.3390/medicina59040777] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/23/2023] [Revised: 03/31/2023] [Accepted: 04/15/2023] [Indexed: 04/29/2023]
Abstract
Background and Objectives: Cervical cancer is the fourth most common cancer in women globally. As survival rates gradually increase, it becomes necessary to assess the quality of life (QoL) after treatment. It is known that different treatment modalities have different effects on QoL. Therefore, we aimed to evaluate the QoL of cervical cancer survivors (CCSs) treated with concurrent chemoradiotherapy (CCRT). Materials and Methods: A cross-sectional monocentric study, conducted in Vilnius university hospital Santaros klinikos between November 2018 and November 2022, included 20 women, who were interviewed once using the European Organization for Research and Treatment of Cancer (EORTC)-designed Quality-of-Life questionnaire cervical cancer module (QLQ-CX24). The sociodemographic and clinical data as well as the results of the questionnaire are presented in mean, standard deviation and percentages. The QoL scores were compared between different age and stage groups using the Mann-Whitney U test. Results: Twenty participants, aged from 27 to 55 years, with a mean age of 44 years (SD = 7.6) participated in the study. All the participants were CCSs with an International Federation of Gynecology and Obstetrics (FIGO) stage from IB to IIIB and all of them were treated with CCRT. The symptom experience was relatively low and revealed a good result (21.8, SD = 10.2). Mean scores on body image, sexual/vaginal functioning, menopausal symptoms and sexual worry scales indicated moderate functioning and a moderate level of some of the cervical cancer specific symptoms after CCRT. Sexual activity and sexual enjoyment of the CCSs were low (11.7 (SD = 16.3), 14.3 (SD = 17.8), respectively). Conclusions: Cervical cancer survivors report a relatively good quality of life regarding symptom experience; however, women following concurrent chemoradiotherapy tend not to be sexually active and rarely feel sexual enjoyment. In addition, this treatment modality negatively affects a woman's body image and self-perception as a woman.
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Affiliation(s)
- Raminta Stuopelytė
- Faculty of Medicine, Vilnius University, M.K. Ciurlionio Str. 21, LT-03101 Vilnius, Lithuania
| | - Guoda Žukienė
- Clinic of Obstetrics and Gynaecology, Faculty of Medicine, Institute of Clinical Medicine, Vilnius University, Santariskiu Str. 2, LT-03101 Vilnius, Lithuania
| | - Rūta Breivienė
- Clinic of Obstetrics and Gynaecology, Faculty of Medicine, Institute of Clinical Medicine, Vilnius University, Santariskiu Str. 2, LT-03101 Vilnius, Lithuania
| | - Vilius Rudaitis
- Clinic of Obstetrics and Gynaecology, Faculty of Medicine, Institute of Clinical Medicine, Vilnius University, Santariskiu Str. 2, LT-03101 Vilnius, Lithuania
| | - Daiva Bartkevičienė
- Clinic of Obstetrics and Gynaecology, Faculty of Medicine, Institute of Clinical Medicine, Vilnius University, Santariskiu Str. 2, LT-03101 Vilnius, Lithuania
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Suzuki Y, Huang Y, Ferris J, Kulkarni A, Hershman D, Wright JD. Prescription of hormone replacement therapy among cervical cancer patients with treatment-induced premature menopause. Int J Gynecol Cancer 2023; 33:26-34. [PMID: 36543392 DOI: 10.1136/ijgc-2022-003861] [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: 12/24/2022] Open
Abstract
OBJECTIVE To examine the utilization of hormone replacement therapy (HRT) among newly diagnosed cervical cancer patients who experienced premature menopause due to primary treatment. METHODS The MarketScan Databases were used to identify newly diagnosed cervical cancer patients <50 years of age with premature menopause after hysterectomy with bilateral salpingo-oophorectomy (primary surgery) or primary external beam pelvic radiation (primary radiotherapy). We examined the cumulative utilization of HRT until 24 months after the loss of ovarian function. Fine-Gray subdistribution hazard models were developed to examine the factors associated with cumulative HRT use. The duration of HRT use was analyzed by Kaplan-Meier curves. RESULTS A total of 1826 patients, including 352 (19.3%) who underwent primary surgery and 1474 (80.7%) who received primary radiotherapy, were identified. Overall, 39.0% of patients received HRT within 24 months of primary treatment. HRT was used in 49.4% of those who underwent primary surgery and in 36.6% of those who received primary radiotherapy (p<0.0001). The median duration of HRT use was 60 days among the entire cohort and was significantly shorter for the primary radiotherapy group than the primary surgery group (35 vs 90 days, p<0.0001). Primary radiotherapy, older age, residency in the Northeastern USA, and Black race were associated with a lower likelihood of HRT use. CONCLUSIONS HRT was prescribed to less than half of patients with newly diagnosed cervical cancer under the age of 50 who experienced premature menopause due to primary treatment. Among those who used HRT the duration of use was short.
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Affiliation(s)
- Yukio Suzuki
- Obstetrics and Gynecology, Columbia University, New York, New York, USA
| | - Yongmei Huang
- Obstetrics and Gynecology, Columbia University, New York, New York, USA
| | - Jennifer Ferris
- Obstetrics and Gynecology, Columbia University, New York, New York, USA
| | - Amita Kulkarni
- Obstetrics and Gynecology, Columbia University, New York, New York, USA
| | - Dawn Hershman
- Obstetrics and Gynecology, Columbia University, New York, New York, USA
| | - Jason D Wright
- Obstetrics and Gynecology, Columbia University, New York, New York, USA
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