1
|
Di Mattei VE, Taranto P, Perego G, Desimone S, Rancoita PMV, Catarinella A, Cioffi R, Mangili G, Vanni VS, Candiani M. Identification of Psychological Profiles of Cancer Patients Undergoing Fertility Preservation Counseling. J Clin Med 2023; 12:4011. [PMID: 37373703 DOI: 10.3390/jcm12124011] [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: 05/08/2023] [Revised: 05/29/2023] [Accepted: 06/09/2023] [Indexed: 06/29/2023] Open
Abstract
Gonadotoxicity is one of the most distressing side effects of cancer treatment. Fertility preservation strategies should be included during the treatment pathway to prevent the risk of infertility, but the decision to preserve fertility often represents a challenging process that carries an emotional decision-making burden. The aim of this study is to characterize the psychological profiles of women undergoing fertility preservation counseling and to better understand their features. Eighty-two female cancer patients were included in the study. They were asked to complete a battery of self-administered tests which evaluated socio-demographic characteristics, defense mechanisms, depression, anxiety, and representations regarding the importance of parenthood. Based on the psychometric variables, cluster analysis identified four groups which showed significantly different combinations of these psychological characteristics. An additional analysis was performed to evaluate if sociodemographic variables were associated with the four groups, but the results did not show significant differences. These results suggest that very diverse psychological profiles may lead cancer patients to attend oncofertility counseling and choose fertility preservation. For this reason, all patients in childbearing age should have the opportunity to receive appropriate fertility preservation counseling in order to make an informed decision that could have an important impact on their long-term quality of life.
Collapse
Affiliation(s)
- Valentina Elisabetta Di Mattei
- School of Psychology, Vita-Salute San Raffaele University, 20132 Milan, Italy
- Clinical and Health Psychology Unit, IRCCS San Raffaele Scientific Institute, 20132 Milan, Italy
| | - Paola Taranto
- Clinical and Health Psychology Unit, IRCCS San Raffaele Scientific Institute, 20132 Milan, Italy
| | - Gaia Perego
- School of Psychology, Vita-Salute San Raffaele University, 20132 Milan, Italy
- Clinical and Health Psychology Unit, IRCCS San Raffaele Scientific Institute, 20132 Milan, Italy
| | - Serena Desimone
- Clinical and Health Psychology Unit, IRCCS San Raffaele Scientific Institute, 20132 Milan, Italy
| | - Paola Maria Vittoria Rancoita
- University Centre for Statistics in Biomedical Sciences (CUSSB), Vita-Salute San Raffaele University, 20132 Milan, Italy
- School of Medicine, Vita-Salute San Raffaele University, 20132 Milan, Italy
| | - Antonio Catarinella
- School of Psychology, Vita-Salute San Raffaele University, 20132 Milan, Italy
- Clinical and Health Psychology Unit, IRCCS San Raffaele Scientific Institute, 20132 Milan, Italy
| | - Raffaella Cioffi
- Obstetrics and Gynecology Unit, IRCCS San Raffaele Scientific Institute, 20132 Milan, Italy
| | - Giorgia Mangili
- Obstetrics and Gynecology Unit, IRCCS San Raffaele Scientific Institute, 20132 Milan, Italy
| | - Valeria Stella Vanni
- Obstetrics and Gynecology Unit, IRCCS San Raffaele Scientific Institute, 20132 Milan, Italy
| | - Massimo Candiani
- School of Medicine, Vita-Salute San Raffaele University, 20132 Milan, Italy
- Obstetrics and Gynecology Unit, IRCCS San Raffaele Scientific Institute, 20132 Milan, Italy
| |
Collapse
|
2
|
Cioffi R, Pagliardini L, Quartucci A, Papaleo E, Vanni VS, Provenzano S, Bertulli R, Candiani M, Mangili G. Response to Controlled Ovarian Stimulation Is Not Impaired in Young Patients with a Sarcoma: Results from a Monocentric Case-Control Study. Cancers (Basel) 2023; 15:3141. [PMID: 37370751 DOI: 10.3390/cancers15123141] [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: 05/18/2023] [Revised: 06/06/2023] [Accepted: 06/09/2023] [Indexed: 06/29/2023] Open
Abstract
Sarcomas are relatively common in the young and their treatment can impair fertility. Fertility preservation can be achieved via the cryopreservation of gametes after controlled ovarian stimulation before cancer treatment. A reduced response to hormonal stimulation in patients suffering from certain types of malignancy is reported. The purpose of this study was to assess the performance of oocyte cryopreservation in patients with sarcoma by comparing their outcomes with those of a population without cancer. Patients were matched by age with control women undergoing hormonal stimulation for isolated male factor infertility. The population included 84 women with a sarcoma and 355 controls. In the final analysis, 37 patients with sarcoma were matched in a 1:3 ratio with 109 healthy controls. Patients with sarcoma were generally younger and were stimulated with lower FSH doses. They did not perform worse than controls during stimulation, with an average retrieval of 10.6 oocytes vs. 8.1 in the controls. Linear regression on the number of retrieved mature oocytes confirmed that patients with sarcoma performed comparably to controls. In conclusion, patients with sarcoma can expect retrieval outcomes comparable to those of patients without cancer.
Collapse
Affiliation(s)
- Raffaella Cioffi
- Department of Obstetrics and Gynaecology, San Raffaele Scientific Institute, 20132 Milan, Italy
| | - Luca Pagliardini
- Department of Obstetrics and Gynaecology, San Raffaele Scientific Institute, 20132 Milan, Italy
- Department of Brain and Behavioral Sciences, University of Pavia, 27100 Pavia, Italy
| | - Antonio Quartucci
- Department of Obstetrics and Gynaecology, San Raffaele Scientific Institute, 20132 Milan, Italy
| | - Enrico Papaleo
- Department of Obstetrics and Gynaecology, San Raffaele Scientific Institute, 20132 Milan, Italy
| | - Valeria Stella Vanni
- Department of Obstetrics and Gynaecology, San Raffaele Scientific Institute, 20132 Milan, Italy
| | - Salvatore Provenzano
- Medical Oncology Department, Fondazione IRCCS Istituto Nazionale dei Tumori, 20133 Milan, Italy
| | - Rossella Bertulli
- Medical Oncology Department, Fondazione IRCCS Istituto Nazionale dei Tumori, 20133 Milan, Italy
| | - Massimo Candiani
- Department of Obstetrics and Gynaecology, San Raffaele Scientific Institute, 20132 Milan, Italy
| | - Giorgia Mangili
- Department of Obstetrics and Gynaecology, San Raffaele Scientific Institute, 20132 Milan, Italy
| |
Collapse
|
3
|
Perelli F, Vizzielli G, Cavaliere AF, Restaino S, Scambia G, Zannoni GF, Arciuolo D, Gallotta V. Large Pelvic Mass in a Female Adolescent: Atypical Presentation and Successful Treatment of Extraskeletal Ewing Sarcoma. Healthcare (Basel) 2023; 11:healthcare11101373. [PMID: 37239656 DOI: 10.3390/healthcare11101373] [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: 03/19/2023] [Revised: 04/29/2023] [Accepted: 05/09/2023] [Indexed: 05/28/2023] Open
Abstract
Extraskeletal Ewing sarcoma is a rare soft tissue tumor primarily affecting pediatric patients. The treatment is currently based on a multidisciplinary approach which allows, in cases of localized disease, good survival rates. We report the case of a 15-year-old female patient with a rapidly growing suspected pelvic mass misdiagnosed following the preliminary radiological exams, which assessed the findings as a mass of ovarian origin. The girl underwent surgery and, thanks to histopathological, immunohistochemical and real-time polymerase chain reaction (RT-PCR) examinations, it was possible to make the right diagnosis and to administer the best treatment in terms of surgery, chemotherapy and radiotherapy, obtaining a long disease-free interval and no recurrence to date.
Collapse
Affiliation(s)
- Federica Perelli
- Obstetrics and Gynecology Unit, Ospedale Santa Maria Annunziata, USL Toscana Centro, Bagno a Ripoli, 50012 Firenze, Italy
| | - Giuseppe Vizzielli
- Clinic of Obstetrics and Gynecology, S. Maria della Misericordia University Hospital, Azienda Sanitaria Universitaria Friuli Centrale (ASUFC), 33100 Udine, Italy
- Medical Area Department (DAME), University of Udine, 33100 Udine, Italy
| | - Anna Franca Cavaliere
- Obstetrics and Gynaecology Unit, Dipartimento Centro di Eccellenza Donna e Bambino Nascente, Fatebenefratelli Gemelli Isola Tiberina, 00168 Rome, Italy
| | - Stefano Restaino
- Clinic of Obstetrics and Gynecology, S. Maria della Misericordia University Hospital, Azienda Sanitaria Universitaria Friuli Centrale (ASUFC), 33100 Udine, Italy
| | - Giovanni Scambia
- Dipartimento per le Scienze Della Salute Della Donna, del Bambino e di Sanità Pubblica, UOC Ginecologia Oncologica, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, 00168 Rome, Italy
| | - Gian Franco Zannoni
- Pathology Unit, Department of Woman and Child's Health and Public Health Sciences, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, 00168 Rome, Italy
- Pathology Institute, Catholic University of Sacred Heart, 00168 Rome, Italy
| | - Damiano Arciuolo
- Pathology Unit, Department of Woman and Child's Health and Public Health Sciences, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, 00168 Rome, Italy
| | - Valerio Gallotta
- Dipartimento per le Scienze Della Salute Della Donna, del Bambino e di Sanità Pubblica, UOC Ginecologia Oncologica, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, 00168 Rome, Italy
| |
Collapse
|
4
|
Di Mattei VE, Perego G, Taranto P, Mazzetti M, Ferrari F, Derna N, Peccatori FA, Mangili G, Candiani M. Psychological issues in breast cancer survivors confronted with motherhood: Literature review and a call to action. Front Psychol 2023; 14:1133204. [PMID: 36960007 PMCID: PMC10029924 DOI: 10.3389/fpsyg.2023.1133204] [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: 12/28/2022] [Accepted: 02/15/2023] [Indexed: 03/06/2023] Open
Abstract
Breast cancer is currently the most common cancer among women worldwide; in 15-25% of cases, patients are premenopausal at the time of diagnosis, and 50% of women desire pregnancy after cancer diagnosis. Motherhood after breast cancer involves complex psychological challenges with long-term consequences, though it is safely pursuable with adequate support. The purpose of this mini-review is to analyze the psychological implications surrounding pregnancy and motherhood after breast cancer and promote action in addressing the challenges that might affect women facing these life events.
Collapse
Affiliation(s)
- Valentina Elisabetta Di Mattei
- School of Psychology, Vita-Salute San Raffaele University, Milan, Italy
- Clinical and Health Psychology Unit, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Gaia Perego
- School of Psychology, Vita-Salute San Raffaele University, Milan, Italy
- Clinical and Health Psychology Unit, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Paola Taranto
- Clinical and Health Psychology Unit, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Martina Mazzetti
- Clinical and Health Psychology Unit, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | | | - Noemi Derna
- Clinical and Health Psychology Unit, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Fedro Alessandro Peccatori
- Fertility and Procreation Unit, Division of Gynecologic Oncology, Department of Gynecology, European Institute of Oncology IRCCS, Milan, Italy
| | - Giorgia Mangili
- Obstetrics and Gynecology Unit, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Massimo Candiani
- Obstetrics and Gynecology Unit, IRCCS San Raffaele Scientific Institute, Milan, Italy
- School of Medicine, Vita-Salute San Raffaele University, Milan, Italy
| |
Collapse
|
5
|
Varlas VN, Borș RG, Pop AL, Năsui BA, Bacalbasa N, Bohîlțea R, Vlădăreanu R, Manolea C. Oncofertility and COVID-19: At the Crossroads between Two Time-Sensitive Fields. J Clin Med 2022; 11:jcm11051221. [PMID: 35268312 PMCID: PMC8911324 DOI: 10.3390/jcm11051221] [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: 12/19/2021] [Revised: 02/22/2022] [Accepted: 02/22/2022] [Indexed: 02/04/2023] Open
Abstract
Background: COVID-19 infection has dominated our lives and left its mark on it. The impact on fertility is major, and the long-term consequences may be disastrous. When we talk about oncofertility, we are talking about those patients worried about the delay in receiving medical services (possible cancelation of surgery, decreased availability of medical services, reorientation of medical resources) due to COVID-19. Finally, patients’ worsening biological and reproductive statuses, associated with high levels of anxiety and depression, are closely related to social restrictions, economic impact, reorientation of medical resources, health policies, and fears of SARS-CoV-2 infection. Aim: We reviewed the current literature on fertility during the COVID-19 pandemic and its effect on cancer patients. Specifically, how cancer treatment can affect fertility, the options to maintain fertility potential, and the recovery options available after treatment are increasingly common concerns among cancer patients. Methods: A systematic literature search was conducted using two main central databases (PubMed®/MEDLINE, and Web of Science) to identify relevant studies using keywords SARS-CoV-2, COVID-19, oncofertility, young cancer patient, cryopreservation, assisted reproductive techniques (ART), psychosocial, telemedicine. Results: In the present study, 45 papers were included, centered on the six main topics related to COVID-19. Conclusions: Fertility preservation (FP) should not be discontinued, but instead practiced with adjustments to prevent SARS-CoV-2 transmission. The increased risk of SARS-CoV-2 infection in cancer patients requires screening for COVID-19 before FP procedures, among both patients and medical staff in FP clinics, to prevent infection that would rapidly worsen the condition and lead to severe complications.
Collapse
Affiliation(s)
- Valentin Nicolae Varlas
- Carol Davila University of Medicine and Pharmacy, 8 Eroii Sanitari Blvd., 050474 Bucharest, Romania; (V.N.V.); (A.L.P.); (N.B.); (R.V.); (C.M.)
- Department of Obstetrics and Gynaecology, Filantropia Clinical Hospital, 011171 Bucharest, Romania
| | - Roxana Georgiana Borș
- Department of Obstetrics and Gynaecology, Filantropia Clinical Hospital, 011171 Bucharest, Romania
- Correspondence: (R.G.B.); (R.B.)
| | - Anca Lucia Pop
- Carol Davila University of Medicine and Pharmacy, 8 Eroii Sanitari Blvd., 050474 Bucharest, Romania; (V.N.V.); (A.L.P.); (N.B.); (R.V.); (C.M.)
- Department of Clinical Laboratory, Food Safety, Carol Davila University of Medicine and Pharmacy, 6 Traian Vuia Street, 020945 Bucharest, Romania
| | - Bogdana Adriana Năsui
- Department of Community Health, Iuliu Hațieganu University of Medicine and Pharmacy, 6 Louis Pasteur Street, 400349 Cluj-Napoca, Romania;
| | - Nicolae Bacalbasa
- Carol Davila University of Medicine and Pharmacy, 8 Eroii Sanitari Blvd., 050474 Bucharest, Romania; (V.N.V.); (A.L.P.); (N.B.); (R.V.); (C.M.)
- Department of Obstetrics and Gynaecology, Cantacuzino Clinical Hospital, 030167 Bucharest, Romania
| | - Roxana Bohîlțea
- Carol Davila University of Medicine and Pharmacy, 8 Eroii Sanitari Blvd., 050474 Bucharest, Romania; (V.N.V.); (A.L.P.); (N.B.); (R.V.); (C.M.)
- Department of Obstetrics and Gynaecology, Filantropia Clinical Hospital, 011171 Bucharest, Romania
- Correspondence: (R.G.B.); (R.B.)
| | - Radu Vlădăreanu
- Carol Davila University of Medicine and Pharmacy, 8 Eroii Sanitari Blvd., 050474 Bucharest, Romania; (V.N.V.); (A.L.P.); (N.B.); (R.V.); (C.M.)
- Department of Obstetrics and Gynecology, Elias Clinical Hospital, 17 Mărăști Blvd., 011461 Bucharest, Romania
| | - Corina Manolea
- Carol Davila University of Medicine and Pharmacy, 8 Eroii Sanitari Blvd., 050474 Bucharest, Romania; (V.N.V.); (A.L.P.); (N.B.); (R.V.); (C.M.)
- Assisted Reproduction Department, Columna Medical Center, 021522 Bucharest, Romania
| |
Collapse
|
6
|
Di Mattei VE, Perego G, Taranto P, Rancoita PMV, Maglione M, Notarianni L, Mangili G, Bergamini A, Cioffi R, Papaleo E, Candiani M. Factors Associated With a High Motivation to Undergo Fertility Preservation in Female Cancer Patients. Front Psychol 2022; 12:782073. [PMID: 34975672 PMCID: PMC8716366 DOI: 10.3389/fpsyg.2021.782073] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2021] [Accepted: 11/30/2021] [Indexed: 12/27/2022] Open
Abstract
Objective: Fertility loss due to cancer treatment can be a devastating experience for women and the couple. Undergoing fertility preservation can be a complex decision from both a medical and emotional point of view. The aim of the present study was to evaluate which socio-demographic and psychological factors predict a high motivation to undergo fertility preservation. Methods: Fifty-eight female cancer patients who accessed an Oncofertility Unit completed: a questionnaire to collect socio-demographic characteristics and the level of motivation, the Beck-Depression Inventory-II, the State-Trait Anxiety Inventory-Y, and the Fertility Problem Inventory. Results: Almost half of the sample (44.8%) declared a high motivation. At multiple logistic regression analysis only the “Need for parenthood” subscale of the FPI predicted a high motivation. We alternatively evaluated as possible predictor the construct “Representations about the importance of parenthood” (i.e., the sum of the “Need for Parenthood” and “Rejection of childfree lifestyle” subscales) in place of the two separate subscales. At multiple logistic regression analysis, only this variable predicted a high motivation to undergo fertility preservation. Conclusion: The most important predictor of a high motivation to undergo fertility preservation is the individual desire for parenthood. This implies that, regardless of socio-demographic characteristics, any woman of childbearing age should receive an appropriate counseling about fertility preservation.
Collapse
Affiliation(s)
- Valentina Elisabetta Di Mattei
- School of Psychology, Vita-Salute San Raffaele University, Milan, Italy.,Clinical and Health Psychology Unit, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Gaia Perego
- Department of Psychology, University of Milano-Bicocca, Milan, Italy
| | - Paola Taranto
- Clinical and Health Psychology Unit, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Paola M V Rancoita
- University Centre for Statistics in the Biomedical Sciences (CUSSB), Vita-Salute San Raffaele University, Milan, Italy.,School of Medicine, Vita-Salute San Raffaele University, Milan, Italy
| | - Mariangela Maglione
- Clinical and Health Psychology Unit, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Lisa Notarianni
- Clinical and Health Psychology Unit, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Giorgia Mangili
- Obstetrics and Gynecology Unit, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Alice Bergamini
- Obstetrics and Gynecology Unit, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Raffaella Cioffi
- Obstetrics and Gynecology Unit, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Enrico Papaleo
- Obstetrics and Gynecology Unit, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Massimo Candiani
- School of Medicine, Vita-Salute San Raffaele University, Milan, Italy.,Obstetrics and Gynecology Unit, IRCCS San Raffaele Scientific Institute, Milan, Italy
| |
Collapse
|