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Bentsen L, Aagesen M, Hjerming M, Jørgensen N, Pappot H. Navigating an uncertain future: a qualitative study exploring thoughts about fertility and oncofertility counseling among young men with cancer. Support Care Cancer 2024; 33:28. [PMID: 39672967 DOI: 10.1007/s00520-024-09066-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2024] [Accepted: 12/02/2024] [Indexed: 12/15/2024]
Abstract
PURPOSE This study aimed to explore the thoughts and experiences of young men with cancer regarding the risk of infertility and the oncofertility counseling they received at diagnosis and during their cancer trajectory. METHODS This qualitative study was conducted from October 2023 to February 2024 at the Copenhagen University Hospital-Rigshospitalet. Inclusion criteria were male adolescents and young adults with cancer aged 15-29 years. We conducted fourteen individual, semi-structured, qualitative interviews with male adolescents and young adults with either leukemia, lymphoma, or testicular cancer. Data were analyzed using thematic analysis. RESULTS Three themes were identified: (1) Young men with cancer have existential thoughts about future children; (2) young men call for information and communication about the risk of reduced fertility chances after cancer; (3) young men experience challenges related to cryopreservation of semen. CONCLUSION Young men desire children after cancer and fertility preservation offers reassurance. Psychological and physical fertility issues often impact body image and masculinity during cancer. Oncofertility counseling is limited, usually brief at diagnosis; however, discussions on treatment-related fertility challenges remain sparse during follow-up. Young men often experience stress related to fertility preservation at diagnosis, which they feel is not recognized by healthcare professionals. This underscores the need for better oncofertility education for healthcare professionals and closer collaboration between oncologists, hematologists, and fertility specialists.
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Affiliation(s)
- Line Bentsen
- Department of Oncology, Copenhagen University Hospital, Rigshospitalet, Blegdamsvej 9, 2100, Copenhagen, Denmark.
| | - Maria Aagesen
- Department of Oncology, Copenhagen University Hospital, Rigshospitalet, Blegdamsvej 9, 2100, Copenhagen, Denmark
- Occupational Science, Department of Public Health, User Perspectives and Community-based Interventions, University of Southern Denmark, Odense, Denmark
| | - Maiken Hjerming
- Department of Hematology, Copenhagen University Hospital, Rigshospitalet, Blegdamsvej 9, 2100, Copenhagen, Denmark
| | - Niels Jørgensen
- Department of Growth and Reproduction, Copenhagen University Hospital, Rigshospitalet, Blegdamsvej 9, 2100, Copenhagen, Denmark
| | - Helle Pappot
- Department of Oncology, Copenhagen University Hospital, Rigshospitalet, Blegdamsvej 9, 2100, Copenhagen, Denmark
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Kuntz H, Santucci J, Butts S, Dandekar S, Smink G, Van Scoy LJ, Rao P. Determinants of Decision Regret Regarding Fertility Preservation in Adolescent and Young Adult Cancer Survivors: A Systematic Review. J Adolesc Young Adult Oncol 2024; 13:726-737. [PMID: 38717190 DOI: 10.1089/jayao.2023.0191] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/12/2024] Open
Abstract
Given recent advances in cancer therapeutics, there is a growing population of adolescent and young adult (AYA) cancer survivors navigating the physical and psychological consequences of cancer treatment. Fertility preservation (FP) conversations are of increasing importance for these survivors. Decision regret (DR) is a measure of distress or remorse following a health care decision, and it is a useful tool to evaluate the impact of a treatment on quality of life. The aim of this systematic review is to culminate existing literature focused on determinants of FP DR among AYA cancer survivors and to propose future interventions to reduce DR among AYA cancer survivors. An electronic database search was performed using PubMed, Web of Science, and APA PsycINFO for articles published before December 2023 using the following search criteria: PubMed: "Fertility Preservation"[Mesh] AND decision regret, APA PsycINFO and Web of Science: Fertility Preservation AND decision regret. Articles were organized into five categories that emerged after initial review. Nineteen articles that focused on DR and FP in AYA cancer survivors aged ≤40 and ≥12 years were included. Article results were categorized into five categories pertaining to determinants of FP DR: Unmet Informational and Emotional Needs, Need for Developmentally Appropriate Conversations, Insufficiency of Provider Training, Quality and Timeliness of Fertility Preservation Discussions, and Societal Barriers. These results highlight the need for improved patient and provider education on FP, such as future longitudinal studies focused on standardization of FP-related protocols and the impact of their implementation on DR, especially for AYA cancer survivors.
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Affiliation(s)
- Hannah Kuntz
- Penn State College of Medicine, Hershey, Pennsylvania, USA
| | | | - Samantha Butts
- Department of Obstetrics and Gynecology, Division of Reproductive Endocrinology and Infertility, Penn State College of Medicine, Hershey, Pennsylvania, USA
| | - Smita Dandekar
- Department of Pediatrics, Division of Pediatric Hematology/Oncology, Penn State College of Medicine, Hershey, Pennsylvania, USA
| | - Gayle Smink
- Department of Pediatrics, Division of Pediatric Hematology/Oncology, Penn State College of Medicine, Hershey, Pennsylvania, USA
| | - Lauren Jodi Van Scoy
- Departments of Medicine, Humanities, and Public Health Sciences, Penn State College of Medicine, Hershey, Pennsylvania, USA
| | - Pooja Rao
- Department of Pediatrics, Division of Pediatric Hematology/Oncology, Penn State College of Medicine, Hershey, Pennsylvania, USA
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Streich-Tilles T, Morrison A, Schafer-Kalkhoff T, Gardner M, Suorsa-Johnson KI, Baskin A, Weidler EM, van Leeuwen K, Sandberg DE, Rutter MM. Defining Success in the Delivery of Fertility-Related Care for Patients with Differences of Sex Development. Horm Res Paediatr 2024:1-10. [PMID: 39186929 DOI: 10.1159/000541029] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/24/2024] [Accepted: 08/19/2024] [Indexed: 08/28/2024] Open
Abstract
INTRODUCTION Individuals with differences of sex development (DSD) experience complex, often competing, medical and psychosocial challenges surrounding fertility. The study aimed to characterize how "success" in fertility-related care is conceptualized and attained among individuals with a DSD, their parents or caregivers, healthcare providers, and other stakeholders. METHODS As part of a larger study, DSD stakeholders (n = 110) participated in semi-structured interviews covering the clinical care of patients with DSD. Primary questions included "What is a successful outcome in DSD care?" and "How do you achieve it?" with fertility as either a spontaneous or suggested topic of discussion. Transcripts were analyzed utilizing a phenomenological approach. This analysis focuses on the extracted themes related to fertility. RESULTS Fertility was discussed by 19/24 individuals with DSD, 12/19 parents or caregivers, 35/37 healthcare providers, and 19/30 other stakeholders. Components of successful fertility-related care included (1) specific discussions surrounding the relationship between DSD and fertility potential, options for fertility preservation, and options for non-biologic parenthood; (2) early and repeated introduction of these topics; and (3) consideration of age, developmental maturity, and cultural context on decisions around fertility. Challenges included the lack of fertility outcome data in this population and the irreversibility of gonadectomy. Trade-offs identified included anatomic typicality versus function, fertility preservation versus cancer risk reduction, and balancing the different priorities of stakeholders. DISCUSSION/CONCLUSIONS A wide range of DSD stakeholders highlighted the importance of addressing fertility concerns in achieving favorable outcomes for individuals with DSD. These stakeholder perspectives should inform fertility-related education, shared decision-making processes, and clinical care.
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Affiliation(s)
- Tara Streich-Tilles
- Division of Pediatric and Adolescent Gynecology, Department of Surgery, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio, USA
| | - Aimee Morrison
- Division of Pediatric and Adolescent Gynecology, Department of Surgery, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio, USA
| | - Tara Schafer-Kalkhoff
- Division of Endocrinology, Cincinnati Children's Hospital Medical Center, University of Cincinnati, Cincinnati, Ohio, USA
| | - Melissa Gardner
- Susan B. Meister Child Health Evaluation and Research Center, Department of Pediatrics, University of Michigan Medical School, Ann Arbor, Michigan, USA
| | - Kristina I Suorsa-Johnson
- Division of Psychiatry and Behavioral Health, Department of Pediatrics, University of Utah Spencer Fox Eccles School of Medicine, Salt Lake City, Utah, USA
| | - Alison Baskin
- Susan B. Meister Child Health Evaluation and Research Center, Department of Pediatrics, University of Michigan Medical School, Ann Arbor, Michigan, USA
| | - Erica M Weidler
- Division of Pediatric Surgery, Phoenix Children's, Phoenix, Arizona, USA
- Department of Child Health, University of Arizona College of Medicine, Phoenix, Arizona, USA
| | - Kathleen van Leeuwen
- Division of Pediatric Surgery, Phoenix Children's, Phoenix, Arizona, USA
- Department of Child Health, University of Arizona College of Medicine, Phoenix, Arizona, USA
| | - David E Sandberg
- Susan B. Meister Child Health Evaluation and Research Center, Department of Pediatrics, University of Michigan Medical School, Ann Arbor, Michigan, USA
| | - Meilan M Rutter
- Division of Endocrinology, Cincinnati Children's Hospital Medical Center, University of Cincinnati, Cincinnati, Ohio, USA
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4
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Campbell P, Riazzi A, Spitznagel E, Schulte M, Frias O, Daugherty M, Vanderbrink B, DeFoor W, Minevich E, Reddy P, Streich-Tilles T, Burns K, Strine A. Time to therapy and safety of testicular tissue cryopreservation in children undergoing gonadotoxic treatment or hematopoietic stem cell transplant. J Pediatr Urol 2024; 20:747.e1-747.e7. [PMID: 38782681 DOI: 10.1016/j.jpurol.2024.05.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/16/2024] [Revised: 04/17/2024] [Accepted: 05/09/2024] [Indexed: 05/25/2024]
Abstract
BACKGROUND With the use of multimodal treatments and hematopoietic stem cell transplant, the majority of children diagnosed with malignancies and hematologic diseases are now surviving into adulthood. Due to the gonadotoxic effects and potential for future infertility associated with many of these treatments, fertility counseling with sperm cryopreservation prior to starting therapy is the standard of care for post-pubertal males. Unfortunately, the options are limited for pre-pubertal patients or those unable to provide a specimen. Testicular tissue cryopreservation (TTC) is an investigational method to surgically obtain germ cells from testicular tissue and potentially restore future spermatogenesis. While TTC has been shown to be safe, little is reported on the time to treatment following the procedure to ensure adequate wound healing and avoid delays in definitive therapy. OBJECTIVES The primary outcome was the time to initiation of treatment following TTC. Secondary outcomes were complication rates, delays in treatment due to TTC, and presence of germ cells. METHODS We conducted a single-institution retrospective cohort study of patients undergoing TTC between 2017 and 2023. Patients at significant risk for treatment related infertility based on established criteria were eligible for TTC. Patients were excluded if they received their oncology or hematology care elsewhere. All patients were enrolled in an IRB approved research protocol with 75% of the tissue submitted for cryopreservation and 25% for research purposes. Time to therapy was defined as the first receipt of gonadotoxic treatment following TTC. RESULTS A total of 122 patients (53 = malignant, 69 = non-malignant) underwent TTC with a median age of 5.9 years (IQR 2.3-9.35). Germ cells were identified in 115 (94%) specimens. A total of 109 (89%) patients underwent concomitant procedures. The median time to initiation of therapy was 5 (IQR 1.0-7.0) and 7 days (IQR 6.0-13.0) for malignant and non-malignant disease, respectively. The 30-day surgical complication rate was 2.5% and was similar between malignant vs non-malignant diagnoses (p = 0.58). All surgical complications were managed non-operatively. No patients had a delay in definitive treatment due to concern for wound healing or complications. DISCUSSION Our surgical complication rates are similar to previous studies and are not affected by the time to treatment following TTC. Limitations of the study are its retrospective design, single institution, and short-term follow up. CONCLUSION TTC can be performed safely, efficiently, and in conjunction with other necessary procedures without resulting in delays of definitive treatment. TTC affords the opportunity for fertility preservation in children who have no other options.
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Affiliation(s)
- Paul Campbell
- Cincinnati Children's Hospital Medical Center, Department of Urology, 3333 Burnet Avenue, Cincinnati, OH 45229, USA.
| | - Abbey Riazzi
- Cincinnati Children's Hospital Medical Center, Department of Urology, 3333 Burnet Avenue, Cincinnati, OH 45229, USA.
| | - Elizabeth Spitznagel
- Cincinnati Children's Hospital Medical Center, Department of Urology, 3333 Burnet Avenue, Cincinnati, OH 45229, USA.
| | - Marion Schulte
- Cincinnati Children's Hospital Medical Center, Department of Urology, 3333 Burnet Avenue, Cincinnati, OH 45229, USA.
| | - Olivia Frias
- Cincinnati Children's Hospital Medical Center, Department of Pediatric and Adolescent Gynecology, 3333 Burnet Avenue, Cincinnati, OH 45229, USA.
| | - Michael Daugherty
- Cincinnati Children's Hospital Medical Center, Department of Urology, 3333 Burnet Avenue, Cincinnati, OH 45229, USA.
| | - Brian Vanderbrink
- Cincinnati Children's Hospital Medical Center, Department of Urology, 3333 Burnet Avenue, Cincinnati, OH 45229, USA.
| | - William DeFoor
- Cincinnati Children's Hospital Medical Center, Department of Urology, 3333 Burnet Avenue, Cincinnati, OH 45229, USA.
| | - Eugene Minevich
- Cincinnati Children's Hospital Medical Center, Department of Urology, 3333 Burnet Avenue, Cincinnati, OH 45229, USA.
| | - Pramod Reddy
- Cincinnati Children's Hospital Medical Center, Department of Urology, 3333 Burnet Avenue, Cincinnati, OH 45229, USA.
| | - Tara Streich-Tilles
- Cincinnati Children's Hospital Medical Center, Department of Pediatric and Adolescent Gynecology, 3333 Burnet Avenue, Cincinnati, OH 45229, USA.
| | - Karen Burns
- Cincinnati Children's Hospital Medical Center, Department of Oncology, 3333 Burnet Avenue, Cincinnati, OH 45229, USA.
| | - Andrew Strine
- Cincinnati Children's Hospital Medical Center, Department of Urology, 3333 Burnet Avenue, Cincinnati, OH 45229, USA.
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Vogt C, Malhotra NR. Fertility Preservation in Children and Adolescents: Where We Are and Where We Are Going. Curr Urol Rep 2024; 25:133-140. [PMID: 38727983 DOI: 10.1007/s11934-024-01204-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/04/2024] [Indexed: 06/26/2024]
Abstract
PURPOSE OF REVIEW This review will describe current pediatric and adolescent fertility preservation methodologies and the ethical concerns surrounding these procedures, as well as highlight recent research that may pave the way for the development of new fertility preservation options. RECENT FINDINGS Research is ongoing to allow prepubertal patients, particularly those with testes, to be able to have biologic children in the future. Studies on sperm in vitro maturation highlight the importance of supporting the spermatogonial stem cell niche for the development of mature sperm. The live birth of a rhesus macaque from in vitro fertilization using prepubertal testicular tissue and in vivo matured sperm gives hope to future human births. For patients with ovaries, prior work has led to successful fertility but further research is underway to refine these techniques and optimize outcomes. Organoid scaffolds have shown promise when being used for in vitro oocyte maturation. For children and adolescents undergoing gonadotoxic treatment, such as chemotherapy, or hormonal treatment, such as gender-affirming hormone therapy, future fertility potential may be negatively impacted. It is recommended that fertility preservation (FP) be offered to these patients and families prior to undergoing treatment. Fertility preservation for postpubertal patients mimics that in adults. For prepubertal children, however, the options are limited and in some cases still experimental. It is essential that this work continues so that we may offer children and adolescents the right to an open future and preserve their fertility potential.
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Affiliation(s)
- Campbell Vogt
- Icahn School of Medicine at Mount Sinai, New York, USA
| | - Neha R Malhotra
- Icahn School of Medicine at Mount Sinai, New York, USA.
- Mount Sinai Kravis Children's Hospital, New York, USA.
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Hanna MT, Handa N, Laronda MM, Rowell EE. Efficacy of Video-based Education in Improving Understanding of Pediatric Fertility Preservation. J Pediatr Hematol Oncol 2023; 45:e487-e495. [PMID: 36716087 DOI: 10.1097/mph.0000000000002611] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/13/2022] [Accepted: 11/08/2022] [Indexed: 01/31/2023]
Abstract
Eighty percent of children diagnosed with cancer in childhood survive into adulthood. Fertility preservation (FP) is an important consideration, and procedures are available to reduce the risk of infertility following gonadotoxic therapies. Discussing FP options eases decision-making and minimizes regret; however, poor comprehension of these topics remains a challenge. This study evaluates if video-based educational tools increase understanding of FP options among pediatric patients and families. Videos were first tested among participants not at risk of infertility to ensure objective utility and optimize quality. In part 1, parents of pediatric surgical patients were randomized to view 2 publicly available educational videos on FP in differing orders. Each group completed pre-surveys and post-surveys assessing the comprehension and perception of video quality. In part 2, the parent and patient participants completed a comprehension assessment before and after viewing our institution-specific educational video, designed based on participant feedback from part 1. Part 1 results demonstrated a significant increase in participant knowledge and perceived understanding after viewing the videos ( P <0.001), regardless of order. In part 2, the post-test comprehension scores were significantly improved for all participants and all subgroups, P <0.01. Results suggest that video-based educational tools may help to reduce barriers to FP in pediatric oncology.
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Affiliation(s)
- Maria T Hanna
- Ann & Robert H. Lurie Children's Hospital of Chicago
- Department of Surgery
| | - Nicole Handa
- Ann & Robert H. Lurie Children's Hospital of Chicago
- Department of Surgery
| | - Monica M Laronda
- Department of Pediatrics, Feinberg School of Medicine, Northwestern University
- Stanley Manne Children's Research Institute, Chicago, IL
| | - Erin E Rowell
- Ann & Robert H. Lurie Children's Hospital of Chicago
- Department of Surgery
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Simon PJ, Pyke-Grimm KA, Nasr AS. Assessing the Needs of Adolescents and Young Adults Receiving Cancer Treatment: A Mixed Methods Study. J Adolesc Young Adult Oncol 2023; 12:43-52. [PMID: 35575715 DOI: 10.1089/jayao.2021.0195] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Purpose: This study was designed to assess the most salient health care needs of adolescents and young adults (AYAs) who undergo cancer treatment. Understanding their age-related needs helps providers offer appropriate support when support is vital: as they accept diagnosis and undergo treatment. Methods: A mixed methods design was used to obtain quantitative and qualitative data on the overall needs of AYA cancer patients. Participants, aged 16-29, who enrolled early in their cancer treatment, completed the Stanford Adolescent and Young Adult Cancer (SAYAC) Program survey and a subsequent one-on-one semistructured interview. Results: The quantitative and qualitative data were analyzed separately. The data revealed that AYAs adjusted and adapted to their cancer diagnosis to meet their health care needs. Three themes emerged from the data: acquisition of knowledge and experience, participation in decision-making and self-management behaviors, and gaining perspectives on life inside and outside of the hospital. The quantitative data revealed that the participants agreed or strongly agreed on the importance of being involved in the decision-making process, incorporating hopes and dreams into their treatment, and feeling supported by their family. Conclusion: Understanding the needs of AYAs who undergo cancer treatment is vital to their overall well-being. Using different data collection methods, including interviews, can clarify AYA needs and lead to improved individualized care.
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Affiliation(s)
- Pamela J Simon
- Stanford Adolescent and Young Adult Cancer Program, Stanford Children's Health, Palo Alto, California, USA
| | - Kimberly A Pyke-Grimm
- Department of Nursing Research and Evidence-Based Practice, Stanford Children's Health, Palo Alto, California, USA.,Department of Pediatrics, Stanford University School of Medicine, Palo Alto, California, USA
| | - Annette S Nasr
- Department of Nursing Research and Evidence-Based Practice, Stanford Children's Health, Palo Alto, California, USA.,Department of Pediatrics, Stanford University School of Medicine, Palo Alto, California, USA
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8
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Pyke-Grimm KA, Franck LS, Halpern-Felsher B, Goldsby RE, Rehm RS. Day-to-Day Decision Making by Adolescents and Young Adults with Cancer. JOURNAL OF PEDIATRIC HEMATOLOGY/ONCOLOGY NURSING 2022; 39:290-303. [PMID: 35538622 PMCID: PMC9807778 DOI: 10.1177/27527530211068718] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/17/2023]
Abstract
Background: Adolescents and young adults (AYAs) with cancer must negotiate the transition between childhood and adulthood while dealing with a life-threatening illness. AYA involvement in decision making varies depending on the type of decision and when decisions occur during treatment, and evidence suggests that AYAs want to be involved in decision making. Objective: To explore involvement of AYAs with cancer in day-to-day decisions affected by their cancer and treatment. Methods: This qualitative study used interpretive focused ethnography within the sociologic tradition, informed by symbolic interactionism. Semi-structured interviews and informal participant observation took place at two quaternary pediatric oncology programs. Results: Thirty-one interviews were conducted with 16 AYAs ages 15 to 20 years. Major day to day decision-making categories identified included: (1) mental mindset, (2) self-care practices, (3) self-advocacy, and (4) negotiating relationships. Participants described how they came to grips with their illness early on and decided to fight their cancer. They described decisions they made to protect their health, how they advocated for themselves and decisions they made about relationships with family and friends. Conclusions: Through day-to-day decisions, participants managed the impact of cancer and its treatment on their daily lives. Research should focus on developing and implementing interventions to empower AYAs to participate in day-to-day decisions that will affect how they manage their cancer, its treatment and ultimately their outcomes. Implications for Practice: Healthcare providers can facilitate AYA's participation in day-to-day decision making through encouraging autonomy and self-efficacy by providing support and through effective communication.
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Affiliation(s)
- Kimberly A. Pyke-Grimm
- Stanford Children's Health, Department of Nursing Research and
Evidence-Based Practice, Palo Alto, CA, USA,Division of Hematology/Oncology, Department of Pediatrics, Stanford
University School of Medicine,Department of Family Health Care Nursing, San Francisco School of
Nursing, University of California, San Francisco, CA, USA,Kimberly A. Pyke-Grimm, PhD, RN, CNS,
CPHON, Department of Nursing Research and Evidence-Based Practice, Stanford
Children's Health, 750 Welch Road, Palo Alto, CA 94304, USA.
| | - Linda S. Franck
- Department of Family Health Care Nursing, San Francisco School of
Nursing, University of California, San Francisco, CA, USA
| | - Bonnie Halpern-Felsher
- Department of Pediatrics, Division of Adolescent Medicine, Stanford University, School of Medicine, Stanford, CA, USA
| | | | - Roberta S. Rehm
- Department of Family Health Care Nursing, San Francisco School of
Nursing, University of California, San Francisco, CA, USA,*Professor Emeritus
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9
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Fertility preservation in male cancer patients: A mixed methods assessment of experiences and needs. Urol Oncol 2022; 40:385.e19-385.e25. [DOI: 10.1016/j.urolonc.2022.05.027] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2022] [Revised: 04/27/2022] [Accepted: 05/27/2022] [Indexed: 11/30/2022]
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10
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Quinn GP, Schabath MB. Quality of Life in Underrepresented Cancer Populations. Cancers (Basel) 2022; 14:cancers14143417. [PMID: 35884476 PMCID: PMC9325309 DOI: 10.3390/cancers14143417] [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: 07/11/2022] [Accepted: 07/11/2022] [Indexed: 02/05/2023] Open
Abstract
This series of six articles (five original articles and one review) is presented by international leaders in health disparities research [...]
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Affiliation(s)
- Gwendolyn P. Quinn
- Department of Obstetrics and Gynecology, Grossman School of Medicine, New York, NY 10016, USA
- Correspondence:
| | - Matthew B. Schabath
- Department of Cancer Epidemiology, H. Lee Moffitt Cancer Center & Research Institute, Tampa, FL 33612, USA;
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11
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Stanek C, Theroux CI, Olsavsky AL, Hill KN, Rausch JR, O’Brien SH, Quinn GP, Gerhardt CA, Nahata L. Study protocol for fertility preservation discussions and decisions: A family-centered psychoeducational intervention for male adolescents and emerging adults newly diagnosed with cancer and their families. PLoS One 2022; 17:e0263886. [PMID: 35171948 PMCID: PMC8849538 DOI: 10.1371/journal.pone.0263886] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2022] [Accepted: 01/27/2022] [Indexed: 11/19/2022] Open
Abstract
Many childhood cancer survivors desire biological children but are at risk for infertility after treatment. One option for mitigating risk is the use of fertility preservation prior to gonadotoxic therapy. Adolescents and emerging adults may rely on their parents to help them decide whether to use fertility preservation. While this is often a collaborative process, it is currently unknown how parents can optimally support adolescents and emerging adults through this decision. To address this gap, we developed a family-centered, psychoeducational intervention to prompt adolescents and emerging adults to reflect on their future parenthood goals and attitudes towards fertility preservation, as well as to prompt their parents (or other caregivers) to reflect on their own and their child's perspectives on the topic. In this randomized controlled trial, families will be randomized to either the standard of care control group (fertility consult) or the intervention group. After their fertility consult, adolescents and emerging adults and parents in the intervention group will complete a fertility preservation values clarification tool and then participate in a guided conversation about their responses and the fertility preservation decision. The primary expected outcome of this study is that participation in the intervention will increase the use of fertility preservation. The secondary expected outcome is an improvement in decision quality. Chi-square analyses and t-tests will evaluate primary and secondary outcomes. The goal of this intervention is to optimize family-centered fertility preservation decision-making in the context of a new cancer diagnosis to help male adolescents and emerging adults achieve their future parenthood goals.
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Affiliation(s)
- Charis Stanek
- The Abigail Wexner Research Institute at Nationwide Children’s Hospital, Columbus, Ohio, United States of America
| | - Charleen I. Theroux
- The Abigail Wexner Research Institute at Nationwide Children’s Hospital, Columbus, Ohio, United States of America
| | - Anna L. Olsavsky
- The Abigail Wexner Research Institute at Nationwide Children’s Hospital, Columbus, Ohio, United States of America
| | - Kylie N. Hill
- The Abigail Wexner Research Institute at Nationwide Children’s Hospital, Columbus, Ohio, United States of America
| | - Joseph R. Rausch
- The Abigail Wexner Research Institute at Nationwide Children’s Hospital, Columbus, Ohio, United States of America
- The Ohio State University College of Medicine, Columbus, Ohio, United States of America
| | - Sarah H. O’Brien
- The Abigail Wexner Research Institute at Nationwide Children’s Hospital, Columbus, Ohio, United States of America
- The Ohio State University College of Medicine, Columbus, Ohio, United States of America
- Nationwide Children’s Hospital, Columbus, Ohio, United States of America
| | - Gwendolyn P. Quinn
- New York University Grossman School of Medicine, New York, New York, United States of America
| | - Cynthia A. Gerhardt
- The Abigail Wexner Research Institute at Nationwide Children’s Hospital, Columbus, Ohio, United States of America
- The Ohio State University College of Medicine, Columbus, Ohio, United States of America
| | - Leena Nahata
- The Abigail Wexner Research Institute at Nationwide Children’s Hospital, Columbus, Ohio, United States of America
- The Ohio State University College of Medicine, Columbus, Ohio, United States of America
- Nationwide Children’s Hospital, Columbus, Ohio, United States of America
- * E-mail:
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