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Almont T, Sougué PO, Houpert R, Beaubrun-Renard M, Montabord C, Joachim C, Véronique-Baudin J, Bouhnik AD, Bendiane MK, Mancini J, Huyghe É. Communication and sexual function and frequency in breast cancer patients 2 years after diagnosis: results from the VICAN 2 study. J Sex Med 2024; 21:333-341. [PMID: 38410031 DOI: 10.1093/jsxmed/qdae007] [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: 12/29/2022] [Revised: 12/18/2023] [Accepted: 12/30/2023] [Indexed: 02/28/2024]
Abstract
BACKGROUND Breast cancer treatments may have impacts on several aspects of sexual health, including psychological, psychosexual, physiological, physical, and relational. AIM In this study we sought to assess sexual function and sexual frequency in breast cancer patients 2 years after diagnosis. METHODS We selected all breast cancer participants from the the French national VIe après le CANcer 2 (VICAN 2) longitudinal study. Data sources included patient and medical questionnaires, along with medico-administrative databases. OUTCOMES Outcomes assessed were the dimensions of sexual function and frequency from the Relationship and Sexuality Scale and communication about sexuality with healthcare providers. RESULTS Out of 1350 participating women, 60.2% experienced a decrease in sexual desire, 61.4% reported a lower frequency of intercourse, and 49.5% faced decreased ability to orgasm. In contrast, 64.8% had engaged in sexual intercourse in the previous 2 weeks, 89.5% were "Somewhat" to "Very much" satisfied with the frequency of intimate touching and kisses with their partner, and 81.6% expressed satisfaction with their intercourse frequency. However, a mere 15% of women discussed sexuality with the healthcare providers. Independent factors associated with increased communication about sexuality included age younger than 50 years (OR = 1.90 95% CI [1.28-2.82], P = .001), being in a partner relationship (OR = 2.53 95% CI [1.28-2.82], P = .003), monthly income above 1,500 euros (OR = 1.73 95% CI [1.15-2.60], P = .009), and absence of diabetes (OR = 6.11 95% CI [1.39-26.93], P = .017). CLINICAL TRANSLATION The study findings underscore the need for continuing education in oncosexology and dedicated sexual health interventions that should involve a holistic approach that takes into consideration age, treatments, relationship status, and whether the patient has diabetes. STRENGTHS AND LIMITATIONS Strengths of the study are the sample size, the national representativeness, and data reliability. However, the cross-sectional design could introduce potential recall, recency, or social desirability biases. Also, social determinants influencing sexual health, such as ethnicity or geographic locations, have not been considered in the analyses. CONCLUSIONS This study revealed that sexual disorders persist 2 years after a breast cancer diagnosis, with a noticeable communication gap regarding sexuality between patients and medical teams. These findings underscore the necessity for tailored sexual health interventions, particularly designed for women who are single, older aged, and diabetes patients.
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Affiliation(s)
- Thierry Almont
- RESEARCH on Cancer Unit UF3596, Oncology Department, Martinique University Hospital (CHU Martinique), 97261 Fort-de-France, Martinique
- General Cancer Registry of Martinique UF1441, Oncology Departmxent, Martinique University Hospital (CHU Martinique), 97261 Fort-de-France, Martinique
- Oncosexology Unit, Oncology Department, Martinique University Hospital (CHU Martinique), 97261 Fort-de-France, Martinique
- Laboratoire Développement Embryonnaire, Fertilité et Environnement (DEFE) UMR 1203, INSERM, Université de Montpellier, CHRU 34295 Montpellier, Université Toulouse 3 Paul Sabatier, CHU 31300, Toulouse, Occitanie, France. https://www.defe.fr
| | - Prisca Ouowéné Sougué
- RESEARCH on Cancer Unit UF3596, Oncology Department, Martinique University Hospital (CHU Martinique), 97261 Fort-de-France, Martinique
| | - Rémi Houpert
- RESEARCH on Cancer Unit UF3596, Oncology Department, Martinique University Hospital (CHU Martinique), 97261 Fort-de-France, Martinique
- General Cancer Registry of Martinique UF1441, Oncology Departmxent, Martinique University Hospital (CHU Martinique), 97261 Fort-de-France, Martinique
| | - Murielle Beaubrun-Renard
- Oncosexology Unit, Oncology Department, Martinique University Hospital (CHU Martinique), 97261 Fort-de-France, Martinique
| | - Christelle Montabord
- RESEARCH on Cancer Unit UF3596, Oncology Department, Martinique University Hospital (CHU Martinique), 97261 Fort-de-France, Martinique
| | - Clarisse Joachim
- RESEARCH on Cancer Unit UF3596, Oncology Department, Martinique University Hospital (CHU Martinique), 97261 Fort-de-France, Martinique
- General Cancer Registry of Martinique UF1441, Oncology Departmxent, Martinique University Hospital (CHU Martinique), 97261 Fort-de-France, Martinique
- Oncosexology Unit, Oncology Department, Martinique University Hospital (CHU Martinique), 97261 Fort-de-France, Martinique
| | - Jacqueline Véronique-Baudin
- RESEARCH on Cancer Unit UF3596, Oncology Department, Martinique University Hospital (CHU Martinique), 97261 Fort-de-France, Martinique
- General Cancer Registry of Martinique UF1441, Oncology Departmxent, Martinique University Hospital (CHU Martinique), 97261 Fort-de-France, Martinique
- Oncosexology Unit, Oncology Department, Martinique University Hospital (CHU Martinique), 97261 Fort-de-France, Martinique
- Laboratoire Développement Embryonnaire, Fertilité et Environnement (DEFE) UMR 1203, INSERM, Université de Montpellier, CHRU 34295 Montpellier, Université Toulouse 3 Paul Sabatier, CHU 31300, Toulouse, Occitanie, France. https://www.defe.fr
| | - Anne-Déborah Bouhnik
- Sciences Economiques & Sociales de la Santé & Traitement de l'Information Médicale (SESSTIM), Aix Marseille Univ, INSERM, IRD, ISSPAM, 13385, Marseille, France
| | - Marc-Karim Bendiane
- Sciences Economiques & Sociales de la Santé & Traitement de l'Information Médicale (SESSTIM), Aix Marseille Univ, INSERM, IRD, ISSPAM, 13385, Marseille, France
- Internal Medicine, Geriatrics and Therapeutic Unit, AP-HM, 270 Boulevard de Sainte Marguerite, 13009 Marseille, France
- ORS PACA, Observatoire Régional de la Santé, 27 Bd Jean Moulin, 13005 Marseille, Provence-Alpes-Côte d'Azur, France
| | - Julien Mancini
- Sciences Economiques & Sociales de la Santé & Traitement de l'Information Médicale (SESSTIM), Aix Marseille Univ, INSERM, IRD, ISSPAM, 13385, Marseille, France
- Public Health Department, Service Biostatistique et Technologies de l'Information et de la Communication (BIOSTIC), hôpital Timone, APHM, 13005 Marseille, France
| | - Éric Huyghe
- Laboratoire Développement Embryonnaire, Fertilité et Environnement (DEFE) UMR 1203, INSERM, Université de Montpellier, CHRU 34295 Montpellier, Université Toulouse 3 Paul Sabatier, CHU 31300, Toulouse, Occitanie, France. https://www.defe.fr
- Urology Department, Centre Hospitalier Universitaire de Toulouse, 1, avenue du Professeur Jean Poulhès - TSA 50032 - 31059 Toulouse, France
- Francophone Association for Supportive Care in Cancer (AFSOS), 33130 Bègles, France
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Jäkel K, Richter D, Leuteritz K, Sender A, Hinz A. Sexuality, fertility, family planning, family life, and partnership in young breast cancer patients: a longitudinal study. Front Psychol 2023; 14:1127359. [PMID: 37251020 PMCID: PMC10213958 DOI: 10.3389/fpsyg.2023.1127359] [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: 12/19/2022] [Accepted: 04/21/2023] [Indexed: 05/31/2023] Open
Abstract
Objectives Adolescent and young adult (AYA) breast cancer patients are often faced with sexuality-related problems. Since healthcare providers are often unfamiliar with problems specific to AYA cancer this topic is too little integrated into routine oncological care. The objective of this study was to analyze sexuality, fertility, family planning, family life, and partnership regarding satisfaction and supportive care needs in AYA breast cancer patients. Methods A total of 139 AYA breast cancer patients were examined twice, 1 year apart. The patients were asked to complete several questionnaires and to answer multiple questions about satisfaction with sexuality, fertility, family planning, family life, and corresponding supportive care needs in these domains. Results While the patients were largely satisfied with their family life and partnerships, they were less satisfied with their sexuality and family planning. Only small mean score changes were observed in these variables over the course of a year. Being a parent already and having the possibility of further completing family planning were strongly associated with higher satisfaction and lower supportive care needs in these domains. Satisfaction was generally negatively associated with supportive care needs. Older age was predictive of lower satisfaction with sexuality at follow-up. Conclusion AYA cancer patients deserve special consultations concerning the impact of cancer and treatment on their sexuality and fertility, and it is especially important that women who have yet to complete their family planning be actively offered information and support concerning sexuality and fertility protection before beginning treatment.
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Exploration of fertility and early menopause related information needs and development of online information for young breast cancer survivors. BMC Womens Health 2022; 22:329. [PMID: 35922784 PMCID: PMC9351061 DOI: 10.1186/s12905-022-01901-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2021] [Accepted: 07/24/2022] [Indexed: 11/10/2022] Open
Abstract
Abstract
Background
Approximately half of premenopausal women diagnosed with breast cancer desire to conceive after they finish treatment. Counseling about the risk of infertility prior to cancer treatment has been proven to improve quality of life after cancer treatment. As a result of this, guidelines focus on informing women on this topic prior to treatment. However, it is equally important to provide fertility related information after primary treatment has been completed, when the wish to conceive might become actual. Therefore, the aim of this study was to identify the fertility and early menopause related information needs of young breast cancer survivors and to design, develop and implement online information material with input of stakeholders.
Methods
A phenomenological qualitative study consisting of four phases was performed: identification of information needs through semi-structured interviews from a professional perspective (1) and a patient perspective (2). Exploration of stakeholders perspective regarding development and implementation of online information material (3) and development and implementation of the information material (4).
Results
Professionals indicated that there are no guidelines regarding the provision of fertility related information during cancer survivorship. Survivors reported unmet information needs. Women identified the following as most important information needs (a) fertility preservation options, (b) the risk of menopause or infertility, and (c) long term consequences of early menopause. A wide range of stakeholders involved in breast cancer care were interviewed. Based on their proposed design the information material was implemented on a nationwide website aiming at informing and supporting breast cancer patients.
Conclusions
Fertility and early menopause related information needs of young breast cancer survivors and their professionals were identified. Information material has been designed, developed and nationally implemented. This way, professionals in breast cancer care are provided with an information tool that helps them meet the information needs and preferences of their patients.
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Bae SY, Lee J, Lee JS, Yoon JS, Kim KS, Kim YS, Kim Z, Min JW, Shim EJ, Lee I, Lee MH, Park S. Prognosis of pregnancy after breast cancer diagnosis according to the type of treatment: A population-based study in Korea by the SMARTSHIP group. Breast 2022; 63:46-53. [PMID: 35299034 PMCID: PMC8927839 DOI: 10.1016/j.breast.2022.03.005] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2022] [Revised: 03/09/2022] [Accepted: 03/10/2022] [Indexed: 01/07/2023] Open
Abstract
Backgrounds In this study, we evaluated the incidence and outcomes of pregnancy after breast cancer was diagnosed in women of childbearing age. Additionally, we evaluated the prognosis of patients who became pregnant after breast cancer, according to the treatment. Methods This was a retrospective cohort study of women aged 20–45 years who were surgically treated for breast cancer between 2004 and 2014 using the Korean National Health Insurance database. The patients were classified into six groups according to the treatment. Propensity score matching was applied to the cohort to analyze the risk of breast cancer-associated mortality after pregnancy and childbirth. Results Of the 45,765 patients who had been newly diagnosed with breast cancer, 1826 (4%) became pregnant after breast cancer diagnosis. Among the pregnant group, the HR of the risk of death was 0.15 (95% CI, 0.06 to 0.36) for patients who became pregnant ≥49 months after the diagnosis. In patients who received endocrine therapy and chemotherapy, the pregnant group had better prognosis than the non-pregnant group. There was no significant difference between the pregnant group and the non-pregnant group in patients who received chemotherapy and trastuzumab with or without endocrine therapy. Conclusion The risk of death was low in women who became pregnant ≥49 months after the diagnosis of breast cancer. The prognosis of pregnant women was non-inferior to that of non-pregnant women, even in women who received trastuzumab. These findings provide reassurance to patients with HER2-positive cancer who are considering future pregnancy. The risk of death was low in women who became pregnant ≥49 months after the diagnosis of breast cancer. In patients who received endocrine therapy and chemotherapy, the pregnant group had better prognosis than the non-pregnant group. The prognosis of pregnant women was non-inferior to that of non-pregnant women, even in women who received trastuzumab.
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Affiliation(s)
- Soo Youn Bae
- Department of Surgery, The Catholic University of Korea Seoul St. Mary's Hospital, Republic of Korea
| | - Jihyoun Lee
- Department of Surgery, Soonchunhyang University Seoul Hospital, Seoul, Republic of Korea
| | - Ji Sung Lee
- Clinical Research Center, Asan Institute for Life Sciences, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
| | - Jae Sun Yoon
- Korea University, Department of Biostatistics, Seoul, South Korea
| | - Ku Sang Kim
- Department of Surgery, Kosin University Gospel Hospital, Busan, Republic of Korea
| | - Yoo Seok Kim
- Department of Surgery, Chosun University College of Medicine, Gwangju, Republic of Korea
| | - Zisun Kim
- Department of Surgery, Soonchunhyang University Bucheon Hospital, Bucheon, Republic of Korea
| | - Jun Won Min
- Department of Surgery, Dankook University College of Medicine, Cheonan, Republic of Korea
| | - Eun-Jung Shim
- Department of Psychology, Pusan National University, Busan, Republic of Korea
| | - Ilkyun Lee
- Department of Surgery, Catholic Kwandong University International St. Mary's Hospital, Incheon, Republic of Korea
| | - Min Hyuk Lee
- Department of Surgery, Soonchunhyang University Seoul Hospital, Seoul, Republic of Korea
| | - Sungmin Park
- Department of Surgery, Chungbuk National University Hospital, College of Medicine, Chungbuk National University, Cheongju-si, Republic of Korea.
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Hours A, Toussaint A, De Castelbajac V, Sautter C, Borghese J, Frank S, Coussy F, Laas E, Grandal B, Dumas E, Daoud E, Guerin J, Balezeau T, Feron JG, Fourchotte V, Kirova Y, Lerebours F, Pierga JY, Guillot E, Santulli P, Grynberg M, Sonigo C, Reyrat E, Soibinet-Oudot P, Reyal F, Hamy AS. Factors Associated With the Discussion of Fertility Preservation in a Cohort of 1,357 Young Breast Cancer Patients Receiving Chemotherapy. Front Oncol 2021; 11:701620. [PMID: 34650912 PMCID: PMC8507557 DOI: 10.3389/fonc.2021.701620] [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: 04/28/2021] [Accepted: 08/31/2021] [Indexed: 11/13/2022] Open
Abstract
PURPOSE Female breast cancer (BC) patients exposed to gonadotoxic chemotherapy are at risk of future infertility. There is evidence of disparities in the discussion of fertility preservation for these patients. The aim of the study was to identify factors influencing the discussion of fertility preservation (FP). MATERIAL AND METHODS We analyzed consecutive BC patients treated by chemotherapy at Institut Curie from 2011-2017 and aged 18-43 years at BC diagnosis. The discussion of FP was classified in a binary manner (discussion/no discussion), based on mentions present in the patient's electronic health record (EHR) before the initiation of chemotherapy. The associations between FP discussion and the characteristics of patients/tumors and healthcare practitioners were investigated by logistic regression analysis. RESULTS The median age of the 1357 patients included in the cohort was 38.7 years, and median tumor size was 30.3 mm. The distribution of BC subtypes was as follows: 702 luminal BCs (58%), 241 triple-negative breast cancers (TNBCs) (20%), 193 HER2+/HR+ (16%) and 81 HER2+/HR- (6%). All patients received chemotherapy in a neoadjuvant (n=611, 45%) or adjuvant (n= 744, 55%) setting. A discussion of FP was mentioned for 447 patients (33%). Earlier age at diagnosis (discussion: 34.4 years versus no discussion: 40.5 years), nulliparity (discussion: 62% versus no discussion: 38%), and year of BC diagnosis were the patient characteristics significantly associated with the mention of FP discussion. Surgeons and female physicians were the most likely to mention FP during the consultation before the initiation of chemotherapy (discussion: 22% and 21%, respectively). The likelihood of FP discussion increased significantly over time, from 15% in 2011 to 45% in 2017. After multivariate analysis, FP discussion was significantly associated with younger age, number of children before BC diagnosis, physicians' gender and physicians' specialty. CONCLUSION FP discussion rates are low and are influenced by patient and physician characteristics. There is therefore room for improvement in the promotion and systematization of FP discussion.
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Affiliation(s)
- Alice Hours
- Department of Surgery, Institut Curie, University Paris, Paris, France
| | - Aullene Toussaint
- Department of Surgery, Institut Curie, University Paris, Paris, France
- Department of Medical Oncology, Institut Curie, University Paris, Paris, France
- Residual Tumor & Response to Treatment Laboratory, RT2Lab, Translational Research Department, INSERM, U932 Immunity and Cancer, Paris, France
| | - Victoire De Castelbajac
- Department of Medical Oncology, Institut Curie, University Paris, Paris, France
- Sénopole Hôpital Saint Louis, Assistance Publique - Hôpitaux de Paris, University Paris, Paris, France
| | - Camille Sautter
- Department of Surgery, Institut Curie, University Paris, Paris, France
| | - Julie Borghese
- Residual Tumor & Response to Treatment Laboratory, RT2Lab, Translational Research Department, INSERM, U932 Immunity and Cancer, Paris, France
| | - Sophie Frank
- Department of Medical Oncology, Institut Curie, University Paris, Paris, France
| | - Florence Coussy
- Department of Medical Oncology, Institut Curie, University Paris, Paris, France
| | - Enora Laas
- Department of Surgery, Institut Curie, University Paris, Paris, France
- Department of Medical Oncology, Institut Curie, University Paris, Paris, France
| | - Beatriz Grandal
- Residual Tumor & Response to Treatment Laboratory, RT2Lab, Translational Research Department, INSERM, U932 Immunity and Cancer, Paris, France
| | - Elise Dumas
- Residual Tumor & Response to Treatment Laboratory, RT2Lab, Translational Research Department, INSERM, U932 Immunity and Cancer, Paris, France
| | - Eric Daoud
- Residual Tumor & Response to Treatment Laboratory, RT2Lab, Translational Research Department, INSERM, U932 Immunity and Cancer, Paris, France
| | | | | | | | | | - Youlia Kirova
- Department of Radiation Therapy, Institut Curie, Paris, France
| | - Florence Lerebours
- Residual Tumor & Response to Treatment Laboratory, RT2Lab, Translational Research Department, INSERM, U932 Immunity and Cancer, Paris, France
| | - Jean-Yves Pierga
- Residual Tumor & Response to Treatment Laboratory, RT2Lab, Translational Research Department, INSERM, U932 Immunity and Cancer, Paris, France
| | - Eugénie Guillot
- Department of Surgery, Institut Curie, University Paris, Paris, France
| | - Pietro Santulli
- Department of Obstetrics and Gynecology, Hôpital Cochin, University Paris, Paris, France
| | - Michael Grynberg
- Department of Reproductive Medicine and Fertility Preservation, Hôpital Antoine Béclère, Hôpitaux Universitaires Paris Sud, Assistance Publique - Hôpitaux de Paris, Clamart, France
- Department of Reproductive Medicine and Fertility Preservation, Hôpital Jean Verdier, Bondy, France
| | - Charlotte Sonigo
- Department of Reproductive Medicine and Fertility Preservation, Hôpital Antoine Béclère, Hôpitaux Universitaires Paris Sud, Assistance Publique - Hôpitaux de Paris, Clamart, France
| | - Emmanuel Reyrat
- Department of Data and Informatics, Unicancer, Paris, France
| | | | - Fabien Reyal
- Department of Surgery, Institut Curie, University Paris, Paris, France
- Residual Tumor & Response to Treatment Laboratory, RT2Lab, Translational Research Department, INSERM, U932 Immunity and Cancer, Paris, France
| | - Anne-Sophie Hamy
- Department of Surgery, Institut Curie, University Paris, Paris, France
- Department of Medical Oncology, Institut Curie, University Paris, Paris, France
- Residual Tumor & Response to Treatment Laboratory, RT2Lab, Translational Research Department, INSERM, U932 Immunity and Cancer, Paris, France
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Corey B, Smania MA, Spotts H, Andersen M. Young Women With Breast Cancer: Treatment, Care, and Nursing Implications. Clin J Oncol Nurs 2021; 24:139-147. [PMID: 32196004 DOI: 10.1188/20.cjon.139-147] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
BACKGROUND Young women with breast cancer (YWBC) are more likely to have aggressive disease, carry mutations for hereditary cancer genes, and experience higher mortality. They also may face reduced fertility because of the toxicity of chemotherapy. OBJECTIVES This article aims to present a review of YWBC treatments, sequelae of treatment, and psychosocial challenges. METHODS The authors performed a review of guideline-supported treatment options, patient resources, and nursing implications. FINDINGS Because of high-risk cancers and a lack of specific treatment guidelines, healthcare providers may consider aggressive treatments for younger patients. However, studies indicate that the foundation for treatment decisions for YWBC are best based on disease stage and National Comprehensive Cancer Network guidelines.
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Sheng Y, Carpenter JS, Cohee AA, Storey S, Stump TE, Monahan PO, Cella D, Champion VL. Genitourinary Symptoms in Breast Cancer Survivors: Prevalence, Correlates, and Relationship With Sexual Functioning. Oncol Nurs Forum 2021; 48:229-241. [PMID: 33600393 DOI: 10.1188/21.onf.229-241] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
OBJECTIVES To evaluate (a) the prevalence of genitourinary symptoms, (b) which demographic and clinical factors predict genitourinary symptoms, and (c) the association between genitourinary symptoms and sexual functioning in breast cancer survivors. SAMPLE & SETTING A secondary analysis of cross-sectional, patient-reported outcomes data from 1,085 breast cancer survivors was conducted. METHODS & VARIABLES Prevalence and correlations with demographics, clinical factors, and sexual functioning were identified using descriptive analysis, multivariable logistic regression analysis, chi-square tests, t tests, and Pearson correlation coefficients. RESULTS Symptoms included vaginal/vulvar irritation, pelvic discomfort, problems with urinary control, vaginal infection, and vaginal bleeding. Younger age, more comorbidities, and taking treatment for menopausal symptoms were significantly related to reporting genitourinary symptoms. Experiencing more symptoms was associated with lower sexual functioning. IMPLICATIONS FOR NURSING The prevalence, correlates, and relationship of genitourinary symptoms with sexual functioning supports the assessment and treatment of these symptoms as part of routine care for breast cancer survivors.
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Groß SE, Weidner D, Cecon N, Pfaff H, Strauch C, Scholten N. Does basic information concerning nutrition improve the information needs of breast cancer patients? An evaluation. Support Care Cancer 2020; 28:5419-5427. [PMID: 32146546 PMCID: PMC7546988 DOI: 10.1007/s00520-020-05385-1] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2019] [Accepted: 02/26/2020] [Indexed: 01/04/2023]
Abstract
PURPOSE International and national studies have shown unmet information needs regarding nutrition in breast cancer patients. An intervention study has examined the question of the extent to which a fact sheet on the topic of nutrition is suitable to cover the need for information of breast cancer patients. METHOD The fact sheet with basic information on nutrition was distributed in 21 intervention breast care centres in 2017. The use of the fact sheets was evaluated in a quasi-experimental design as part of the annual breast cancer patients' survey of the University of Cologne. The breast cancer patients considered were being treated with primary breast carcinoma in a hospital in North Rhine-Westphalia. A multilevel analysis was carried out in order to quantify the effect of the intervention. RESULTS Unmet information needs are experienced more by younger and non-native German-speaking patients. With regard to education, patients without a graduation and a high grade of education express more unmet information needs. The multilevel analysis showed that patients who were treated at an intervention site and therefore possibly received the fact sheet have a significantly higher chance of their information needs being met (OR = 1.45; p ≤ 0.05). CONCLUSION The intervention study showed that a fact sheet with basic information on nutrition is a possible instrument to satisfy the information needs of breast cancer patients and therefore reduce unmet information needs regarding nutrition. This intervention study is a pragmatic example on how to reduce unmet information needs among breast cancer patients in Germany.
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Affiliation(s)
- Sophie E. Groß
- Institute of Medical Sociology, Health Services Research and Rehabilitation Science (IMVR), Faculty of Human Sciences and Faculty of Medicine, University of Cologne, Eupener Straße 129, 50933 Cologne, Germany
- LVR-Institute of Health Care Research, LVR Clinic Cologne, Wilhelm-Griesinger Str. 23, 51109 Cologne, Germany
| | - Doreen Weidner
- Institute of Medical Sociology, Health Services Research and Rehabilitation Science (IMVR), Faculty of Human Sciences and Faculty of Medicine, University of Cologne, Eupener Straße 129, 50933 Cologne, Germany
| | - Natalia Cecon
- Institute of Medical Sociology, Health Services Research and Rehabilitation Science (IMVR), Faculty of Human Sciences and Faculty of Medicine, University of Cologne, Eupener Straße 129, 50933 Cologne, Germany
| | - Holger Pfaff
- Institute of Medical Sociology, Health Services Research and Rehabilitation Science (IMVR), Faculty of Human Sciences and Faculty of Medicine, University of Cologne, Eupener Straße 129, 50933 Cologne, Germany
| | - Carmen Strauch
- Department of Integrated Oncology, Center of Integrated Oncology (CIO) Aachen, Bonn, Cologne, Düsseldorf (ABCD), University Hospital of Bonn, Venusberg-Campus 1, 53127 Bonn, Germany
| | - Nadine Scholten
- Institute of Medical Sociology, Health Services Research and Rehabilitation Science (IMVR), Faculty of Human Sciences and Faculty of Medicine, University of Cologne, Eupener Straße 129, 50933 Cologne, Germany
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Bryson MK, Taylor ET, Boschman L, Hart TL, Gahagan J, Rail G, Ristock J. Awkward Choreographies from Cancer's Margins: Incommensurabilities of Biographical and Biomedical Knowledge in Sexual and/or Gender Minority Cancer Patients' Treatment. THE JOURNAL OF MEDICAL HUMANITIES 2020; 41:341-361. [PMID: 30488328 PMCID: PMC7343748 DOI: 10.1007/s10912-018-9542-0] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 04/16/2023]
Abstract
Canadian and American population-based research concerning sexual and/or gender minority populations provides evidence of persistent breast and gynecologic cancer-related health disparities and knowledge divides. The Cancer's Margins research investigates the complex intersections of sexual and/or gender marginality and incommensurabilities and improvisation in engagements with biographical and biomedical cancer knowledge. The study examines how sexuality and gender are intersectionally constitutive of complex biopolitical mappings of cancer health knowledge that shape knowledge access and its mobilization in health and treatment decision-making. Interviews were conducted with a diverse group (n=81) of sexual and/or gender minority breast or gynecologic cancer patients. The LGBQ//T2 cancer patient narratives we have analyzed document in fine grain detail how it is that sexual and/or gender minority cancer patients punctuate the otherwise lockstep assemblage of their cancer treatment decision-making with a persistent engagement in creative attempts to resist, thwart and otherwise manage the possibility of discrimination and likewise, the probability of institutional erasure in care settings. Our findings illustrate the demands that cancer places on LGBQ//T2 patients to choreograph access to, and mobilization of knowledge and care, across significantly distinct and sometimes incommensurable systems of knowledge.
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Affiliation(s)
- Mary K Bryson
- Department of Language and Literacy Education, Faculty of Education, University of British Columbia, Vancouver, BC, Canada.
| | - Evan T Taylor
- Department of Language and Literacy Education, UBC, Vancouver, BC, Canada
| | - Lorna Boschman
- Department of Language and Literacy Education, UBC, Vancouver, BC, Canada
| | - Tae L Hart
- Department of Psychology, Ryerson University, Toronto, ON, Canada
| | - Jacqueline Gahagan
- School of Health and Human Performance, Dalhousie University, Halifax, NS, Canada
| | - Genevieve Rail
- Simone de Beauvoir Institute, Concordia University, Montréal, QC, Canada
| | - Janice Ristock
- Women's and Gender Studies, University of Manitoba, Winnipeg, MB, Canada
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Salakari M, Nurminen R, Sillanmäki L, Pylkkänen L, Suominen S. The importance of and satisfaction with sex life among breast cancer survivors in comparison with healthy female controls and women with mental depression or arterial hypertension: results from the Finnish nationwide HeSSup cohort study. Support Care Cancer 2020; 28:3847-3854. [PMID: 31836939 PMCID: PMC7316835 DOI: 10.1007/s00520-019-05228-8] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2019] [Accepted: 12/05/2019] [Indexed: 12/14/2022]
Abstract
INTRODUCTION Breast cancer (BC) and its treatment is associated with several physical and psychosocial changes that may influence sexuality for years after treatment. Women with BC show significantly greater rates of sexual dysfunction than do healthy women. The purpose of the study was to evaluate how a BC diagnosis associates with women's perceived sexuality and sexual satisfaction. MATERIAL AND METHODS The data of the ongoing prospective Health and Social Support (HeSSup) survey was linked with national health registries. Respondents with registry data confirmed BC (n = 66), mental depression (n = 612), arterial hypertension (n = 873), and healthy women (n = 9731) formed the study population. The importance of and satisfaction with sex life were measured by a self-report questionnaire modified from the Schover's and colleagues' Sexual History Form. RESULTS Women with BC considered sex life less important than did healthy women (p < 0.001). They were significantly less satisfied with their sex life than healthy women (p = 0.01) and women with arterial hypertension (p = 0.04). Living single or educational level did not explain the differences between the groups. CONCLUSIONS BC survivors depreciate their sex life and experience dissatisfaction with it. Sexuality can be a critical issue for the quality of life of women surviving from BC, and hence, the area deserves major attention in BC survivorship care. Health care professionals should regularly include sexual functions in the assessment of BC survivors' wellbeing.
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Affiliation(s)
- Minna Salakari
- Department of Public Health, University of Turku, Joukahaisenkatu 3-5, 20520 Turku, Finland
| | - Raija Nurminen
- University of Applied Science Turku, Joukahaisenkatu 3-5, 20520 Turku, Finland
| | - Lauri Sillanmäki
- Department of Occupational Health, University of Helsinki, Mannerheimintie 172, 00300 Helsinki, Finland
| | - Liisa Pylkkänen
- Department of Oncology, University of Turku, Kiinamyllynkatu 4, 20520 Turku, Finland
| | - Sakari Suominen
- Department of Public Health, University of Turku, Joukahaisenkatu 3-5, 20520 Turku, Finland
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11
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Soussoko M, Salleron J, Desandes E, Lesur A. [Breast cancer management before 40 years: what change in one decade? A retrospective study at the "Institut de cancérologie de Lorraine": 2002-2012]. Bull Cancer 2020; 106:S60-S74. [PMID: 32008740 DOI: 10.1016/s0007-4551(20)30049-7] [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: 11/17/2022]
Abstract
INTRODUCTION Breast cancer of young women has medico-psychological issues, particularly in the perspective of "after cancer" period. The objective of the study was to analyze the changes in management, in a decade including the publication of Cancer Plans I and II. METHODS This retrospective unicentric study involved two populations of women aged 40 and treated at the "Institut de cancérologie de Lorraine" in 2002-2004 (P1) and 2012-2014 (P2). Epidemiological-demographic, histological, diagnostic and therapeutic sequences were analyzed. RESULTS 216 patients were included. The mean age was 35.7 years (range 22-40), with no significant epidemiological difference, except for an increased rate of obesity in P2. Preoperative biopsies became almost systematic and the pre-therapeutic care plan rate increased over the decade from 3.8% to 8% (p < 0.001). The rate of breast-conserving treatment remained stable. The sentinel lymph node rate increased from 4.4% in P1 to 31.9% in P2 (p < 0.001), while the rate of lymph node dissection decreased (p < 0.001) between the two periods. Resort to breast nurses, psycho-oncologists, fertility experts and oncogenetic consultations has also increased. CONCLUSION There is an improvement in the care and management of young women under 40 because of the first Cancer Plans. A study about the impact on the prognosis and a reflection to improve the experience of illness for these women are to lead.
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Affiliation(s)
- Mariam Soussoko
- Institut de cancérologie de Lorraine Alexis-Vautrin, Parcours sein, 6, avenue de Bourgogne, 54519 Vandœuvre-lès-Nancy cedex, France.
| | - Julia Salleron
- Cellule data biostatistique, Institut de cancérologie de Lorraine Alexis-Vautrin, 6, avenue de Bourgogne, 54519 Vandœuvre-lès-Nancy, France
| | - Emmanuel Desandes
- Service en charge des données de santé, Institut de cancérologie de Lorraine Alexis-Vautrin, Parcours sein, 6, avenue de Bourgogne, 54519 Vandoeuvre-lès-Nancy cedex, France
| | - Anne Lesur
- Institut de cancérologie de Lorraine Alexis-Vautrin, Parcours sein, 6, avenue de Bourgogne, 54519 Vandœuvre-lès-Nancy cedex, France
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12
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Villarreal-Garza C, Platas A, Miaja M, Mesa-Chavez F, Garcia-Garcia M, Fonseca A, Pineda C, de la Rosa-Pacheco S, Galvez-Hernandez CL, Bargallo-Rocha E, Castro J, Rodriguez-Gomez D, Cruz-Ramos M, Mohar A. Patients’ satisfaction with a supportive care program for young breast cancer patients in Mexico: Joven & Fuerte supports patients’ needs and eases their illness process. Support Care Cancer 2020; 28:4943-4951. [DOI: 10.1007/s00520-020-05334-y] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2019] [Accepted: 01/28/2020] [Indexed: 11/29/2022]
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13
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Mütsch J, Friedrich M, Leuteritz K, Sender A, Geue K, Hilbert A, Stöbel-Richter Y. Sexuality and cancer in adolescents and young adults - a comparison between reproductive cancer patients and patients with non-reproductive cancer. BMC Cancer 2019; 19:828. [PMID: 31438895 PMCID: PMC6704507 DOI: 10.1186/s12885-019-6009-2] [Citation(s) in RCA: 28] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2018] [Accepted: 08/02/2019] [Indexed: 12/21/2022] Open
Abstract
BACKGROUND Sexuality is an important aspect of quality of life for adolescent and young adults that remains understudied in cancer patients. Most current knowledge about how cancer and cancer treatments can affect patients' sexuality pertains to reproductive cancer patients (breast, gynecological, male reproductive organs), whereas only little is known about how the disease affects the sex lives of patients with other types of cancer. This study examined sexual satisfaction and sexual supportive care needs among adolescent and young adult cancer patients, with a particular focus on how the type of cancer a person has is associated with these issues differently. METHODS Five hundred seventy-seven (n = 424 females, 73.5%) patients between 18 and 39 years of age at diagnosis and representing all major tumor entities completed the standardized questionnaire. The analysis addressed the following topics: sexual satisfaction (Life Satisfaction Questionnaire), sexual supportive care needs (Supportive Care Needs Survey), and changes in sexuality (Questions on Life Satisfaction Modules). These topics were tested by mean differences between reproductive and non-reproductive cancer, equivalence testing and regression analyses. RESULTS About one third of the patients reported being dissatisfied with their sexuality and having supportive care needs in this area. Changes in sexuality were significantly more common in women with reproductive cancers than in those who had other types of cancer (t = - 2.693, p = .007), while both groups had equivalence in scores for sexual satisfaction and sexual supportive care needs. Reproductive cancers are not more associated with deterioration of sexual satisfaction (R2 = .002, p = .243), changes in sexuality (R2 = .006, p = .070) or increased sexual supportive care needs than non-reproductive cancers (R2 = .004, p = .131). CONCLUSIONS The results indicate that about a third of adolescents and young adults with both reproductive but also with non-reproductive cancer experience sexual dissatisfaction in similar measure. An equal percentage of these patients also express a desire to receive supportive care in this area. Consequently, health care professionals should address issues of sexuality and cancer as a matter of routine when caring for young adults even when patients have a non-reproductive cancer.
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Affiliation(s)
- Julian Mütsch
- Department of Mental Health, Medical Psychology and Medical Sociology, University of Leipzig, Philipp-Rosenthal-Str. 55, 04103 Leipzig, Germany
| | - Michael Friedrich
- Department of Mental Health, Medical Psychology and Medical Sociology, University of Leipzig, Philipp-Rosenthal-Str. 55, 04103 Leipzig, Germany
| | - Katja Leuteritz
- Department of Mental Health, Medical Psychology and Medical Sociology, University of Leipzig, Philipp-Rosenthal-Str. 55, 04103 Leipzig, Germany
| | - Annekathrin Sender
- Department of Mental Health, Medical Psychology and Medical Sociology, University of Leipzig, Philipp-Rosenthal-Str. 55, 04103 Leipzig, Germany
| | - Kristina Geue
- Department of Mental Health, Medical Psychology and Medical Sociology, University of Leipzig, Philipp-Rosenthal-Str. 55, 04103 Leipzig, Germany
| | - Anja Hilbert
- Departments of Medical Psychology and Medical Sociology and Psychosomatic Medicine and Psychotherapy, Integrated Research and Treatment Center AdiposityDiseases, Behavioral Medicine, University of Leipzig, Philipp-Rosenthal-Str. 27, 04103 Leipzig, Germany
| | - Yve Stöbel-Richter
- Faculty of Managerial and Cultural Studies, University of Applied Sciences Zittau / Goerlitz, P. O. Box 30 06 48, 02811 Goerlitz, Germany
- Departments of Medical Psychology and Medical Sociology and Psychosomatic Medicine and Psychotherapy, Integrated Research and Treatment Center AdiposityDiseases, Behavioral Medicine, University of Leipzig, Philipp-Rosenthal-Str. 27, 04103 Leipzig, Germany
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14
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Abstract
Breast cancer is the most commonly diagnosed cancer in women. As long-term survival rates have improved, there has been a concurrent increase in quality of life considerations, of which fertility preservation is of utmost importance. A number of fertility preservation options are available to women diagnosed with breast cancer, including administration of a GnRH agonist during chemotherapy in an attempt to minimize ovarian damage, oocyte or embryo cryopreservation prior to the administration of chemotherapy, in vitro maturation of oocytes or ovarian tissue cryopreservation. The safety of pregnancy after a diagnosis of breast cancer has been confirmed in numerous studies.
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Affiliation(s)
- Rachael J Rodgers
- School of Women's and Children's Health University of New South Wales, Sydney, Australia -
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15
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Villarreal‐Garza C, López‐Martínez EA, Martínez‐Cannon BA, Platas A, Castro‐Sánchez A, Miaja M, Mohar A, Monroy A, Águila C, Gálvez‐Hernández CL. Medical and information needs among young women with breast cancer in Mexico. Eur J Cancer Care (Engl) 2019; 28:e13040. [DOI: 10.1111/ecc.13040] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2018] [Revised: 12/13/2018] [Accepted: 03/25/2019] [Indexed: 11/29/2022]
Affiliation(s)
- Cynthia Villarreal‐Garza
- Research and Breast Tumors Department Instituto Nacional de Cancerología Mexico City Mexico
- Breast Cancer Center Hospital Zambrano Hellion, Tecnológico de Monterrey San Pedro Garza Garcia Mexico
| | - Edna A. López‐Martínez
- Breast Cancer Center Hospital Zambrano Hellion, Tecnológico de Monterrey San Pedro Garza Garcia Mexico
- Joven & Fuerte: Program for the Care and Research of Young Women with Breast Cancer in Mexico Mexico City Mexico
| | - Bertha A. Martínez‐Cannon
- Breast Cancer Center Hospital Zambrano Hellion, Tecnológico de Monterrey San Pedro Garza Garcia Mexico
- Joven & Fuerte: Program for the Care and Research of Young Women with Breast Cancer in Mexico Mexico City Mexico
| | - Alejandra Platas
- Research and Breast Tumors Department Instituto Nacional de Cancerología Mexico City Mexico
- Joven & Fuerte: Program for the Care and Research of Young Women with Breast Cancer in Mexico Mexico City Mexico
| | - Andrea Castro‐Sánchez
- Joven & Fuerte: Program for the Care and Research of Young Women with Breast Cancer in Mexico Mexico City Mexico
- Cátedras CONACYT Instituto Nacional de Cancerología Mexico City Mexico
| | - Melina Miaja
- Breast Cancer Center Hospital Zambrano Hellion, Tecnológico de Monterrey San Pedro Garza Garcia Mexico
- Joven & Fuerte: Program for the Care and Research of Young Women with Breast Cancer in Mexico Mexico City Mexico
| | - Alejandro Mohar
- Research and Breast Tumors Department Instituto Nacional de Cancerología Mexico City Mexico
- Joven & Fuerte: Program for the Care and Research of Young Women with Breast Cancer in Mexico Mexico City Mexico
| | - Alejandra Monroy
- Research and Breast Tumors Department Instituto Nacional de Cancerología Mexico City Mexico
| | | | - Carmen Lizette Gálvez‐Hernández
- Joven & Fuerte: Program for the Care and Research of Young Women with Breast Cancer in Mexico Mexico City Mexico
- Cátedras CONACYT Instituto Nacional de Cancerología Mexico City Mexico
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16
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Hubbs JL, Dickson Michelson EL, Vogel RI, Rivard CL, Teoh DGK, Geller MA. Sexual quality of life after the treatment of gynecologic cancer: what women want. Support Care Cancer 2019; 27:4649-4654. [PMID: 30941579 DOI: 10.1007/s00520-019-04756-7] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2018] [Accepted: 03/18/2019] [Indexed: 12/19/2022]
Abstract
PURPOSE While the incidence of sexual dysfunction after treatment for gynecologic malignancies is well documented, few studies describe how patients want healthcare providers to address these concerns. The objective of this study was to evaluate changes in sexual function and describe patient preferences regarding healthcare provider roles in addressing and treating sexual dysfunction in gynecologic cancer survivors. METHODS Patients undergoing gynecologic cancer treatment from 2013 to 2014 at a single University-based Gynecologic Cancer clinic were surveyed using a modified Changes in Sexual Function Questionnaire (CSFQ), along with questions relating to healthcare provider interactions and preferences. RESULTS Among 277 eligible patients approached to participate, 85 (30.7%) completed the survey. The mean age was 52.2 ± 12.3 years; most were non-Hispanic White (78.8%), partnered (73.2%), had endometrial or ovarian cancer (30.6% and 44.7%, respectively), and were in surveillance (57.3%). Most women (64.7%) reported much or great sexual enjoyment 1 year prior to cancer treatment which decreased to 27.4% currently; 33.3% report only rare sexual activity. There were no statistically significant differences in mean total CSFQ scores by treatment modality. A minority wanted healthcare providers to initiate sexual health discussions (25.3%); the remaining reported not wanting sexual health addressed or preferred raising the issue themselves. The most commonly cited barrier to communication was the feeling that there are more important issues to discuss with their oncology providers (46.2%). CONCLUSIONS While gynecologic cancer patients report changes in sexual function following cancer therapy, many believe there are other issues more paramount to be addressed. Further studies are warranted to develop better strategies for addressing sexual health in women receiving treatment for gynecologic cancers.
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Affiliation(s)
- J L Hubbs
- Department of Obstetrics, Gynecology and Women's Health, Division of Gynecologic Oncology, University of Minnesota, Minneapolis, MN, USA
| | | | - R I Vogel
- Department of Obstetrics, Gynecology and Women's Health, Division of Gynecologic Oncology, University of Minnesota, Minneapolis, MN, USA
- Biostatistics Core, Masonic Cancer Center, University of Minnesota, Minneapolis, MN, USA
| | - C L Rivard
- Department of Obstetrics, Gynecology and Women's Health, Division of Gynecologic Oncology, University of Minnesota, Minneapolis, MN, USA
| | - D G K Teoh
- Department of Obstetrics, Gynecology and Women's Health, Division of Gynecologic Oncology, University of Minnesota, Minneapolis, MN, USA
| | - Melissa A Geller
- Department of Obstetrics, Gynecology and Women's Health, Division of Gynecologic Oncology, University of Minnesota, Minneapolis, MN, USA.
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17
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Madrigal JM, Atluri M, Radeke EK, Patel A. Looking Through the Lens of a Family Planner to Prioritize Reproductive Health Among Women With Cancer. J Oncol Pract 2019; 15:e141-e152. [PMID: 30763204 DOI: 10.1200/jop.18.00429] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
PURPOSE Prioritization of cancer treatment initiation in women of reproductive age may underscore potential implications on reproductive health. This study describes a family planning quotient (FPQ) and reproductive life index (RepLI) tool designed to help providers to discuss effectively reproductive health with women with cancer. METHODS We tailored the FPQ/RepLI tool for patients with cancer after development in the family planning setting and piloted it with 36 oncology patients referred to our family planning clinic. Each patient completed the FPQ/RepLI with a health educator or medical student and then met with a physician to create a reproductive life plan. A subsample evaluated the tool by rating satisfaction using a Likert scale. Summary statistics were calculated overall and by childbearing status. RESULTS Of the 36 women, 22 did not desire additional children and received contraception. One third (n = 14) had not completed childbearing, four of whom continued with fertility preservation counseling. Women who desired childbearing were less likely to already have children ( P = .02), and more than one half were using long-term contraception. All agreed that the FPQ/RepLI helped them to talk to their provider about their reproductive goals. Only 44.4% agreed that their oncologist knew how many children they desired, and 88.9% found the tool helpful and would use it for future tracking of their reproductive goals. CONCLUSION The FPQ/RepLI is useful for assessing the reproductive health of young women with a new cancer diagnosis, understanding desires of future childbearing, and providing effective contraception. We recommend the incorporation of this tool into practice to better understand patients' reproductive needs.
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Affiliation(s)
- Jessica M Madrigal
- 1 John H. Stroger, Jr Hospital of Cook County, Chicago, IL.,2 University of Illinois at Chicago, Chicago, IL
| | - Mokshasree Atluri
- 1 John H. Stroger, Jr Hospital of Cook County, Chicago, IL.,3 A.T. Still University of Health Sciences, Mesa, AZ
| | - Erika K Radeke
- 1 John H. Stroger, Jr Hospital of Cook County, Chicago, IL
| | - Ashlesha Patel
- 1 John H. Stroger, Jr Hospital of Cook County, Chicago, IL.,4 Northwestern University, Chicago, IL
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18
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Lukas I, Kohl-Schwartz A, Geraedts K, Rauchfuss M, Wölfler MM, Häberlin F, von Orelli S, Eberhard M, Imthurn B, Imesch P, Leeners B. Satisfaction with medical support in women with endometriosis. PLoS One 2018; 13:e0208023. [PMID: 30496315 PMCID: PMC6264517 DOI: 10.1371/journal.pone.0208023] [Citation(s) in RCA: 30] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2018] [Accepted: 11/11/2018] [Indexed: 12/17/2022] Open
Abstract
Endometriosis affects various aspects of women's lives. We searched for predictors for patient satisfaction with medical support (PSwMS) in women with endometriosis. The study was designed as a multi-centre retrospective cohort study. We approached women with histologically confirmed endometriosis from 2010 until 2016, comparing women satisfied to women dissatisfied with medical support. We analysed data on characteristics of endometriosis, PSwMS and the influence of disease characteristics on PSwMS. Information on satisfaction with medical support was collected through a standardized questionnaire. After exclusion of 73 women because of inchoately filled in questionnaires, data from 498 women was evaluated. Altogether, it was observed that 54.6% (n = 272) of the study participants were satisfied with medical support and 45.4% (n = 226) were not. Feeling adequately informed by the time of diagnosis (p < 0.001), taking women's mental troubles seriously (p < 0.001) and supporting women in handling their pain (p < 0.001) were significantly associated with satisfaction. We found adequate information to be the most distinctive indicator for PSwMS. Further, acknowledging psychological distress and supporting women in handling their symptoms rather than to alleviate them, positively affect PSwMS. To achieve PSwMS, healthcare providers have to give adequate information on endometriosis and its management.
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Affiliation(s)
- Ilona Lukas
- Department of Reproductive Endocrinology, University Hospital Zurich, Zurich, Switzerland
| | - Alexandra Kohl-Schwartz
- Department of Reproductive Endocrinology, University Hospital Zurich, Zurich, Switzerland
- Division of Gynecological Endocrinology and Reproductive Medicines, University Women’s Hospital, Berne, Switzerland
| | - Kirsten Geraedts
- Department of Reproductive Endocrinology, University Hospital Zurich, Zurich, Switzerland
| | | | - Monika M. Wölfler
- Department of Gynecology and Obstetrics, University Hospital Graz, Graz, Austria
| | - Felix Häberlin
- Department of Gynecology and Obstetrics, Canton Hospital St. Gallen, St. Gallen, Switzerland
| | - Stephanie von Orelli
- Department of Gynecology and Obstetrics, Triemli Hospital Zurich, Zurich, Switzerland
| | - Markus Eberhard
- Department of Gynecology and Obstetrics, Canton Hospital Schaffhausen, Schaffhausen, Switzerland
| | - Bruno Imthurn
- Department of Reproductive Endocrinology, University Hospital Zurich, Zurich, Switzerland
| | - Patrick Imesch
- Department of Gynecology, University Hospital Zurich, Zurich, Switzerland
| | - Brigitte Leeners
- Department of Reproductive Endocrinology, University Hospital Zurich, Zurich, Switzerland
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19
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White V, Farrelly A, Pitcher M, Hill D. Does access to an information-based, breast cancer specific website help to reduce distress in young women with breast cancer? Results from a randomised trial. Eur J Cancer Care (Engl) 2018; 27:e12897. [PMID: 30137657 DOI: 10.1111/ecc.12897] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2017] [Revised: 06/18/2018] [Accepted: 07/05/2018] [Indexed: 02/04/2023]
Abstract
To assess the effectiveness of a purpose-built information-based website to reduce distress among young women with breast cancer. A total of 337 participants (Intervention Group [IG] n = 202; Usual Care Group [UCG] n = 177) returned the completed baseline questionnaires (T1). Details regarding accessing the website were provided to IG participants. Follow-up questionnaires were completed: (a) 3 months (T2) and (b) 6 months after baseline (T3). Outcomes included anxiety and depression (primary outcomes), quality of life (QoL) and unmet information needs. About 70% of the IG accessed the website, typically only once (median: 1, range 1-15), spending a median of 19 min (range: 1-315) on the site. Mean levels of anxiety and depression did not differ between the two groups at T1, T2 or T3. While improvement in total QoL was greater in the IG than UCG between T1 and T2, QoL scores did not differ between groups at T3. The number of unmet needs did not differ between the two groups at T3. The intervention was not effective in reducing anxiety, or depression in this group of women. As a high number of unmet needs were identified, other strategies for addressing these needs of young women with breast cancer are needed.
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Affiliation(s)
- Victoria White
- Centre for Behavioural Research in Cancer, Cancer Council Victoria, Melbourne, Victoria, Australia.,School of Psychology, Deakin University, Burwood, Victoria, Australia
| | - Ashley Farrelly
- Centre for Behavioural Research in Cancer, Cancer Council Victoria, Melbourne, Victoria, Australia
| | - Meron Pitcher
- General & Breast Surgery Unit, Western Health, Gordon, Victoria, Australia
| | - David Hill
- Centre for Behavioural Research in Cancer, Cancer Council Victoria, Melbourne, Victoria, Australia.,The University of Melbourne, Melbourne, Victoria, Australia
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20
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Ussher JM, Parton C, Perz J. Need for information, honesty and respect: patient perspectives on health care professionals communication about cancer and fertility. Reprod Health 2018; 15:2. [PMID: 29304873 PMCID: PMC5756327 DOI: 10.1186/s12978-017-0441-z] [Citation(s) in RCA: 43] [Impact Index Per Article: 7.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2017] [Accepted: 12/05/2017] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Individuals affected by cancer report a need for information about fertility from health care professionals (HCPs), in order to inform decision making and alleviate anxiety. However, there is evidence that many health professionals do not engage in such discussions. METHOD A mixed method design was used to examine the construction and subjective experience of communication with health professionals about fertility in the context of cancer, from the perspective of patients. A survey was completed by 693 women and 185 men, across a range of cancer tumour types and age groups, and in-depth one-to-one interviews conducted with a purposively selected subsample of survey respondents, 61 women and 17 men. The chi square test for independence was used to test for group differences between women and men on closed survey items. Thematic analysis was used to examine the open ended survey responses and interviews. RESULTS Significantly more women (57%, n = 373) than men (46%, n = 80) (X2(2517) = 6.54, p = .011) reported that they had discussed fertility with a HCP since diagnosis of cancer. Satisfaction with the discussion was reported by 65% (n = 242) of women and 69% (n = 54) (ns) of men. This discussion was reported to have been initiated by the patient or their partner in 44% (n = 165) of women and 47% (n = 37) (ns) of men. In the interviews and open ended surveys three themes were identified: Feeling heard and informed about fertility after cancer: Positive experiences of HCP communication; "I was never given full disclosure": HCP silence or reticence about discussing fertility after cancer, including the sub-theme "Their primary concern is getting me cancer free": Constructions of absence of fertility communication by HCPs; and Confusion and lack of compassion: Unsatisfactory information provision about fertility and cancer. CONCLUSION Discussion with a HCP about fertility concerns, and satisfaction with the discussion, was associated with reports of lower patient distress, greater knowledge and understanding of the consequences of cancer on fertility, involvement in the decision making process about fertility preservation, and satisfaction with health care.
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Affiliation(s)
- Jane M. Ussher
- Translational Health Research Institute, School of Medicine, Western Sydney University, Locked Bag 1797, Penrith South, 2751 Australia
| | - Chloe Parton
- Translational Health Research Institute, School of Medicine, Western Sydney University, Locked Bag 1797, Penrith South, 2751 Australia
| | - Janette Perz
- Translational Health Research Institute, School of Medicine, Western Sydney University, Locked Bag 1797, Penrith South, 2751 Australia
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21
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Reese JB, Bober SL, Daly MB. Talking about women's sexual health after cancer: Why is it so hard to move the needle? Cancer 2017; 123:4757-4763. [PMID: 29116655 PMCID: PMC5716835 DOI: 10.1002/cncr.31084] [Citation(s) in RCA: 30] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2017] [Revised: 09/22/2017] [Accepted: 09/22/2017] [Indexed: 01/06/2023]
Abstract
Despite increasing calls to integrate sexual health into routine cancer care, the majority of women diagnosed with cancer do not receive information about how their cancer treatments will affect their sexual health. With the significant challenges that exist to clinical discussion of sexual health, efforts on multiple fronts are needed to close the gap in the care of women diagnosed with cancer.
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Affiliation(s)
- Jennifer Barsky Reese
- Cancer Prevention and Control Program, Fox Chase Cancer Center
- Department of Social and Behavioral Sciences, College of Public Health, Temple University
| | - Sharon L. Bober
- Department of Psychosocial Oncology and Palliative Care, Dana-Farber Cancer Institute
| | - Mary B. Daly
- Department of Clinical Genetics, Fox Chase Cancer Center
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22
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Gorman JR, Julian AK, Roberts SA, Romero SAD, Ehren JL, Krychman ML, Boles SG, Mao J, Irene Su H. Developing a post-treatment survivorship care plan to help breast cancer survivors understand their fertility. Support Care Cancer 2017; 26:589-595. [PMID: 28913697 DOI: 10.1007/s00520-017-3871-9] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2017] [Accepted: 09/04/2017] [Indexed: 12/19/2022]
Abstract
PURPOSE Reproductive-aged breast cancer survivors (BCS) who have completed initial cancer treatment frequently want to know about their future fertility potential. The purpose of this qualitative study was to assess if the fertility-related content presented in the survivorship care plan prototype met the informational needs of post-treatment BCS and to provide an opportunity for the target audience to review and react to the proposed content and design. METHODS We conducted and analyzed transcripts from seven focus groups with BCS to evaluate their reactions to the survivorship care plan prototype. We independently coded transcripts for consistent themes and sub-themes and used a consensus-building approach to agree on interpretation of results. RESULTS We identified five themes that describe the post-treatment BCS' responses to the prototype survivorship care plan in the context of their informational needs and experiences: (1) the prototype's fertility-related information is relevant; (2) desire for clinical parameters to help survivors understand their infertility risk; (3) fertility-related information is important throughout survivorship; (4) evidence-based content from a neutral source is trustworthy; and (5) the recommendation to see a fertility specialist is helpful, but cost is a barrier. CONCLUSIONS BCS have concerns and needs related to their fertility potential after initial breast cancer treatment. The evidence-based information offered in our prototype survivorship care plan was acceptable to BCS and has significant potential to address these needs. Additional primary data that identify post-cancer treatment indicators of fertility would advance this effort.
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Affiliation(s)
- Jessica R Gorman
- School of Social and Behavioral Health Sciences, Oregon State University College of Public Health and Human Sciences, Corvallis, OR, 97331, USA.
| | - Anne K Julian
- School of Social and Behavioral Health Sciences, Oregon State University College of Public Health and Human Sciences, Corvallis, OR, 97331, USA
| | - Samantha A Roberts
- Moores Cancer Center, University of California San Diego, La Jolla, CA, 92093, USA
| | - Sally A D Romero
- Memorial Sloan Kettering Cancer Center, New York, NY, 10065, USA
| | | | - Michael L Krychman
- Southern California Center for Sexual Health and Survivorship Medicine, Newport Beach, CA, 92663, USA.,Department of Obstetrics and Gynecology, University of California, Irvine, CA, 92697, USA
| | - Sarah G Boles
- Moores Cancer Center, University of California San Diego, La Jolla, CA, 92093, USA
| | - Jun Mao
- Memorial Sloan Kettering Cancer Center, New York, NY, 10065, USA
| | - H Irene Su
- Moores Cancer Center, University of California San Diego, La Jolla, CA, 92093, USA
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23
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Logan S, Perz J, Ussher J, Peate M, Anazodo A. A systematic review of patient oncofertility support needs in reproductive cancer patients aged 14 to 45 years of age. Psychooncology 2017; 27:401-409. [DOI: 10.1002/pon.4502] [Citation(s) in RCA: 83] [Impact Index Per Article: 11.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2017] [Revised: 06/28/2017] [Accepted: 07/17/2017] [Indexed: 12/22/2022]
Affiliation(s)
- S. Logan
- School of Women and Children's Health; Faculty of Medicine, UNSW; Sydney New South Wales Australia
| | - J. Perz
- Centre for Health Research, School of Medicine; Western Sydney University; Sydney New South Wales Australia
| | - J.M. Ussher
- Centre for Health Research, School of Medicine; Western Sydney University; Sydney New South Wales Australia
| | - M. Peate
- Psychosocial Health and Wellbeing (emPoWeR) Unit, Department of Obstetrics and Gynaecology, Royal Women's Hospital; University of Melbourne; Melbourne Victoria Australia
| | - A. Anazodo
- School of Women and Children's Health; Faculty of Medicine, UNSW; Sydney New South Wales Australia
- Sydney Children's Hospital; Sydney New South Wales Australia
- Prince of Wales Hospital; Sydney New South Wales Australia
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Abstract
PURPOSE OF REVIEW Sexual dysfunction is associated with many medical disorders. Lack of recognition of sexual dysfunction commonly occurs in medical practice. The impact of unrecognized sexual dysfunction affects quality of life, which in turn affects the recovery from medical illness. This article reviews the recent literature regarding sexual dysfunction in medical practice published in PubMed, Clinical key, Scopus, Google scholar from November 2014 to May 2016. RECENT FINDINGS New findings suggest that sexual dysfunction is associated with most of the disorders affecting various systems. Sexual dysfunction associated with medical disorders, apart from having effects on patients, also has impact on spouses. Sexual dysfunction may also be a predictor of future major adverse event. Prevelance of sexual dysfunction in various major illness is in the range of 20-75%. Phosphodiesterase-5 inhibitors which are first line drugs to treat erectile dysfunction cause no increase in myocardial infarction or death. SUMMARY Sexual functioning is impaired in neurological, endocrinal, cardiovascular, pelvic, dermatological, and other disorders. Stroke, epilepsy, traumatic brain injury, and other neurological disorders cause significant impairment in sexual functioning. Though exact correlation between androgen and sexual functioning cannot be made, androgen plays important role various phases of sexual cycle in both men and women. Diabetes has impact on all the phases of sexual cycle. Hypertension, as well as certain drugs used to treat hypertension also causes sexual dysfunction, judicious use of hypotensive drugs is recommended.
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Leila M, Nada C, Kais C, Jawaher M. Sexuality after breast cancer: cultural specificities of Tunisian population. Pan Afr Med J 2016; 25:17. [PMID: 28154709 PMCID: PMC5268796 DOI: 10.11604/pamj.2016.25.17.10399] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2016] [Accepted: 08/25/2016] [Indexed: 01/22/2023] Open
Abstract
INTRODUCTION Women's sexuality may be particularly affected after breast cancer. The objectives of this study were to evaluate the changes in sexual life after treatment of breast cancer in Tunisian women and to identify the influence of demographic and clinical factors on sexuality. METHODS We recruited 50 patients who were in remission for at least 3 months after initial treatment of breast cancer. Sexuality and body image were evaluated using the Arabic version of the specific scale of breast cancer QLQ-BR23. Screening for emotional disorders has been done with the Arabic version of HAD scale (Hospital anxiety and depression scale). RESULTS Patients had poor sexual functioning and sexual satisfaction and the mean scores were respectively 45.3% and 43.9%. Only menopausal status and sexual difficulties in the partner was significantly related to poorer sexual satisfaction (p respectively 0.018 and 0.014). According to the HAD scale, 42% of patients had anxiety and 44% had depression. The sexual satisfaction was statistically associated with the presence of anxiety symptoms (p=0.0003). CONCLUSION Results suggest that the psychological side and the sexual difficulties in partner are the most important factors that appear to be involved in sexual satisfaction of Tunisian women after breast cancer. So, those factors need to be taken into account in therapeutic process and psychological counseling to maintain and enhance patient's psychological well-being.
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Affiliation(s)
- Mnif Leila
- Psychiatry Department, Hedi Chaker Hospital, Sfax, Tunisia
| | - Charfi Nada
- Psychiatry Department, Hedi Chaker Hospital, Sfax, Tunisia
| | - Chaabene Kais
- Gynecology Department, Hedi Chaker Hospital, Faculty of Medicine of Sfax, Tunisia
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26
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Menen RS, Hunt KK. Considerations for the Treatment of Young Patients with Breast Cancer. Breast J 2016; 22:667-672. [PMID: 27542172 DOI: 10.1111/tbj.12644] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
Breast cancer in the young patient, generally defined as younger than 40 years, is a rare but important problem. In the US, over 24,000 women under age 45 are diagnosed with breast cancer each year and nearly 2,500 young women die annually of the disease. This review is intended to address issues specific to caring for the young breast cancer patient including diagnosis, genetic counseling, tumor biology, surgery, and potential for development of contralateral breast cancer. Additionally, there are psychosocial considerations unique to this age group which should be addressed as part of a comprehensive, multi-disciplinary team approach including discussions about fertility, sexual function, behavioral health, and quality of life.
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Affiliation(s)
- Rhiana S Menen
- Department of Surgery, The University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Kelly K Hunt
- Department of Surgery, The University of Texas MD Anderson Cancer Center, Houston, Texas
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