Physician Referral for Fertility Preservation in Oncology Patients: A National Study of Practice Behaviors

2009 ◽  
Vol 27 (35) ◽  
pp. 5952-5957 ◽  
Author(s):  
Gwendolyn P. Quinn ◽  
Susan T. Vadaparampil ◽  
Ji-Hyun Lee ◽  
Paul B. Jacobsen ◽  
Gerold Bepler ◽  
...  
Keyword(s):  
Cancer Patients ◽  
Fertility Preservation ◽  
Cancer Survival ◽  
Survival Rates ◽  
The United States ◽  
National Study ◽  
Childbearing Age ◽  
Practice Behaviors ◽  
Patient Recall ◽  
American Society

Purpose Cancer survival rates are improving, and the focus is moving toward quality survival. Fertility is a key aspect of quality of life for cancer patients of childbearing age. Although cancer treatment may impair fertility, some patients may benefit from referral to a specialist before treatment. However, the majority of studies examining patient recall of discussion and referral for fertility preservation (FP) show that less than half receive this information. This study examined the referral practices of oncologists in the United States. Methods This study examined oncologists' referral practice patterns for FP among US physicians using the American Medical Association Physician Masterfile database. A 53-item survey was administered via mail and Internet to a stratified random sample of US physicians. Results Forty-seven percent of respondents routinely refer cancer patients of childbearing age to a reproductive endocrinologist. Referrals were more likely among female physicians (P = .004), those with favorable attitudes (P = .043), and those whose patients routinely ask about FP (odds ratio = 2.09; 95% CI, 1.31 to 3.33). Conclusion Less than half of US physicians are following the guidelines from the American Society of Clinical Oncology, which suggest that all patients of childbearing age should be informed about FP.

scholarly journals Current and Future Perspectives for Improving Ovarian Tissue Cryopreservation and Transplantation Outcomes for Cancer Patients

2021 ◽  
Author(s):  
Sanghoon Lee ◽  
Sinan Ozkavukcu ◽  
Seung-Yup Ku
Keyword(s):  
Cancer Treatment ◽  
Cancer Patients ◽  
Fertility Preservation ◽  
Cancer Survival ◽  
Ovarian Tissue ◽  
Survival Rates ◽  
Reproductive Age ◽  
Ovarian Tissue Cryopreservation ◽  
Tissue Cryopreservation ◽  
Transplantation Outcomes

AbstractAlthough advances in cancer treatment and early diagnosis have significantly improved cancer survival rates, cancer therapies can cause serious side effects, including ovarian failure and infertility, in women of reproductive age. Infertility following cancer treatment can have significant adverse effects on the quality of life. However, established methods for fertility preservation, including embryo or oocyte cryopreservation, are not always suitable for female cancer patients because of complicated individual conditions and treatment methods. Ovarian tissue cryopreservation and transplantation is a promising option for fertility preservation in pre-pubertal girls and adult patients with cancer who require immediate treatment, or who are not eligible to undergo ovarian stimulation. This review introduces various methods and strategies to improve ovarian tissue cryopreservation and transplantation outcomes, to help patients and clinicians choose the best option when considering the potential complexity of a patient’s situation. Effective multidisciplinary oncofertility strategies, involving the inclusion of a highly skilled and experienced oncofertility team that considers cryopreservation methods, thawing processes and devices, surgical procedures for transplantation, and advances in technologies, are necessary to provide high-quality care to a cancer patient.

Breast cancer survival rates among Chinese women born in East Asia and the United States

2005 ◽  
Vol 15 (8) ◽  
pp. 634-634
Author(s):  
S CHUANG ◽  
W CHEN ◽  
M HASHIBE ◽  
G LI ◽  
P GANZ ◽  
...  
Keyword(s):  
Breast Cancer ◽  
United States ◽  
East Asia ◽  
Cancer Survival ◽  
Chinese Women ◽  
Survival Rates ◽  
The United States ◽  
Breast Cancer Survival

Cancer Survival Is (Mostly) Improving

Pained ◽  
2020 ◽  
pp. 245-246
Author(s):  
Michael D. Stein ◽  
Sandro Galea
Keyword(s):  
Prostate Cancer ◽  
United States ◽  
Pancreatic Cancer ◽  
Survival Rate ◽  
Cancer Diagnosis ◽  
Cancer Survival ◽  
Prostate Cancer Screening ◽  
Survival Rates ◽  
The United States ◽  
Cervical Cancers

This chapter discusses how the 5-year survival rates for the most common cancers in the United States improved by nearly 20% since the 1970s. While promising overall, low survival rates persist for pancreatic, liver, lung, esophageal, brain, and many other cancers. Meanwhile, 5-year survival for uterine and cervical cancers worsened. Pancreatic cancer has the lowest 5-year survival rate at 8.2%. In contrast, prostate cancer had the greatest 5-year survival increase from 67.8% to 98.6%, most likely reflecting a substantial uptick in prostate cancer screening and early detection. Five-year survival with leukemia also improved significantly, from 34.2% to 60.6%, likely resulting from improved treatments. As such, in both detection and treatment, the United States is making progress. For the millions of Americans who face a cancer diagnosis, this is cause for hope.

scholarly journals Advances in the Treatment and Prevention of Chemotherapy-Induced Ovarian Toxicity

2020 ◽  
Vol 21 (20) ◽  
pp. 7792
Author(s):  
Hyun-Woong Cho ◽  
Sanghoon Lee ◽  
Kyung-Jin Min ◽  
Jin Hwa Hong ◽  
Jae Yun Song ◽  
...  
Keyword(s):  
Cancer Patients ◽  
Fertility Preservation ◽  
Ovarian Tissue ◽  
Alkylating Agents ◽  
Survival Rates ◽  
Chemotherapeutic Agents ◽  
Reproductive Age ◽  
Experimental Techniques ◽  
Ovarian Tissue Cryopreservation

Due to improvements in chemotherapeutic agents, cancer treatment efficacy and cancer patient survival rates have greatly improved, but unfortunately gonadal damage remains a major complication. Gonadotoxic chemotherapy, including alkylating agents during reproductive age, can lead to iatrogenic premature ovarian insufficiency (POI), and loss of fertility. In recent years, the demand for fertility preservation has increased dramatically among female cancer patients. Currently, embryo and oocyte cryopreservation are the only established options for fertility preservation in women. However, there is growing evidence for other experimental techniques including ovarian tissue cryopreservation, oocyte in vitro maturation, artificial ovaries, stem cell technologies, and ovarian suppression. To prevent fertility loss in women with cancer, individualized fertility preservation options including established and experimental techniques that take into consideration the patient’s age, marital status, chemotherapy regimen, and the possibility of treatment delay should be provided. In addition, effective multidisciplinary oncofertility strategies that involve a highly skilled and experienced oncofertility team consisting of medical oncologists, gynecologists, reproductive biologists, surgical oncologists, patient care coordinators, and research scientists are necessary to provide cancer patients with high-quality care.

scholarly journals A National Study of Oncology Nurses Discussing Cancer Clinical Trials With Patients

2019 ◽  
Vol 41 (12) ◽  
pp. 1747-1760
Author(s):  
Susan A. Flocke ◽  
Nora L. Nock ◽  
Sarah Fulton ◽  
Seunghee Margevicius ◽  
Sharon Manne ◽  
...  
Keyword(s):  
Clinical Trials ◽  
Cancer Patients ◽  
Behavioral Control ◽  
The United States ◽  
Subjective Norms ◽  
Oncology Nurses ◽  
Equation Modeling ◽  
National Study ◽  
Perceived Behavioral Control ◽  
Oncology Nurse

In the United States less than 10% of cancer patients engage in clinical trials. Although most oncology nurses have multiple opportunities to discuss clinical trials with patients, barriers including attitudes and social norms may impede these discussions. Guided by the Theory of Planned Behavior, we developed and evaluated measures for attitudes, subjective norms, and perceived behavioral control of nurses for discussing clinical trials with cancer patients. Of the 18,000 Oncology Nurse Society members invited, 1,964 completed the survey. Structural equation modeling and internal consistency reliability were used to evaluate items and constructs. We found that overall model fit and reliability was good: Confirmatory Fit Index (CFI) = 0.91, Root Mean Square Error of Approximation (RMSEA) = 0.05; attitudes, 21 items, alpha = 0.84; perceived behavioral control, 10 items, alpha = 0.85; and subjective norms, 9 items, alpha = 0.89. These measures of attitudes, subjective norms, and perceived behavioral control show good reliability and initial evidence of validity.

scholarly journals Fertility Preservation in Female Cancer Patients

2012 ◽  
Vol 2012 ◽  
pp. 1-6 ◽  
Author(s):  
Chung-Hoon Kim ◽  
Gyun-Ho Jeon
Keyword(s):  
Cancer Patients ◽  
Fertility Preservation ◽  
Survival Rates ◽  
Young Patients ◽  
Gynecologic Surgery ◽  
Embryo Cryopreservation ◽  
Future Fertility ◽  
Female Cancer Patients ◽  
Gestational Surrogacy

With improved survival rates among cancer patients, fertility preservation is now being recognized as an issue of great importance. There are currently several methods of fertility preservation available in female cancer patients and the options and techniques via assisted reproduction and cryopreservation are increasing, but some are still experimental and continues to be evaluated. The established means of preserving fertility include embryo cryopreservation, gonadal shielding during radiation therapy, ovarian transposition, conservative gynecologic surgery such as radical trachelectomy, donor embryos/oocytes, gestational surrogacy, and adoption. The experimental methods include oocyte cryopreservation, ovarian cryopreservation and transplantation, in vitro maturation, and ovarian suppression. With advances in methods for the preservation of fertility, providing information about risk of infertility and possible options of fertility preservation to all young patients with cancer, and discussing future fertility with them should be also considered as one of the important parts of consultation at the time of cancer diagnosis.

Characteristics and outcomes of cancer patients ≥80 years treated with chemotherapy at a comprehensive cancer center

2006 ◽  
Vol 24 (18_suppl) ◽  
pp. 8548-8548
Author(s):  
P. Jiang ◽  
M. Choi ◽  
D. Smith ◽  
L. Heilbrun ◽  
S. M. Gadgeel
Keyword(s):  
Cancer Patients ◽  
Solid Tumors ◽  
Solid Tumor ◽  
Hematologic Malignancy ◽  
Survival Rates ◽  
The United States ◽  
Comprehensive Cancer Center ◽  
Cancer Center ◽  
Tumor Patients ◽  
Hematologic Cancer

8548 Background: The percentage of cancer patients ≥ 80 years old is expected to rise in the United States. However data are limited on use of chemotherapy in this group of patients. Methods: Retrospective identification of patients who received systemic chemotherapy at our cancer center between 1/1/2000 to 12/31/2004 was performed using the computer generated pharmacy data and medical records. Patients who had diagnosis of cancer and ≥ 80 years were included in the study; patients receiving only supportive care, hormonal therapy, or oral chemotherapy were excluded. The protocol for this study was approved by the Wayne State University IRB. Results: A total of 133 patients ≥ 80 years who received chemotherapy was analyzed. The median age was 83 and 31% of the patients were ≥ 85 years. There were more females (61%) than males (39%). The gender distribution was more even (47% v. 53%) after excluding gender specific tumors. The racial distribution was diverse- Whites 65 (49%); Blacks 41 (31%); Other 18 (13%); Unknown 9 (7%). 16% of the patients had hematologic malignancy and 84% had solid tumors. Gynecological cancers (32%) followed by aerodigestive cancers (26%) were the most common solid tumors. Solid tumor patients primarily had regional (48%) or distant (45%) disease. During the first regimen, 512 cycles of chemotherapy was delivered with a median of 3 cycles per patient (range 1–24 cycles); 40% of patients received only 2 cycles of chemotherapy. 64% of patients were able to receive chemotherapy without 2nd cycle delay. The distribution of single or multidrug regimens was fairly similar; Solid tumors 52% v. 48%; Hematologic cancers 43% v. 57%. Carboplatin and paclitaxel (22%) was the most common regimen among solid tumor patients. 26% of all patients received a second regimen. The 1 year survival rates among hematologic cancer and solid tumor patients were 65% and 48%, respectively. Stage of disease was the only statistically significant factor predicting survival. Conclusions: In this diverse group of cancer patients ≥ 80 years old and selected for chemotherapy, the treatment was feasible. The survival outcomes in this elderly population were comparable to those of a younger patient population suggesting that the treatment is beneficial. No significant financial relationships to disclose.

Surgical management trends of penile cancer in the United States between 2000 and 2010.

2014 ◽  
Vol 32 (4_suppl) ◽  
pp. 379-379 ◽  
Author(s):  
Elizabeth Kate Ferry ◽  
Hui Zhu
Keyword(s):  
Surgical Management ◽  
Penile Cancer ◽  
Cancer Survival ◽  
Radical Surgery ◽  
Survival Rates ◽  
The United States ◽  
Stage I ◽  
Community Hospitals ◽  
Nccn Guidelines ◽  
Teaching Research

379 Background: Penile cancer may cause significant morbidities to those who are treated with aggressive surgery. Conversely, there has been no improvement in penile cancer survival rates since 1990. While the causes for this stagnation may be multifactorial, one potential cause is undertreatment of high-risk disease. This study aimed to examine both the trend in the stage-dependent surgical treatment for penile cancer from 2000 to 2010 and the patterns of possible over and/or undertreatment during this period. Methods: The National Cancer Database (NCDB) Datalinks Portal was queried. Diagnosis by year, first course surgery by stage, in all hospitals from 2000-2010 was first obtained. Data was grouped into no surgery, penile sparing, and radical surgery. Data was also obtained for first course surgery by stage in community hospitals (C), comprehensive centers (CC), and teaching research hospitals (TR), individually. Groups were similar as above, with the exclusion of the no surgery group. Results: There were 1,405 patients with recorded first course surgical treatments in community hospitals, 3,930 in comprehensive hospitals, and 3,667 in teaching research hospitals from 2000 to 2010. Graphically, there has been no change in the trend in the pattern of surgical management of penile cancer from 2000 to 2010 in high or low stage penile cancers. Consistent overtreatment of stage I penile cancer with radical surgery was observed in all hospitals during this period. A variable, but high, percentage of penile-sparing surgery was observed for advanced stages among all hospital types. Conclusions: Corresponding to the stagnation in the survival rates of penile cancer, the surgical management trends ded not change between 2000 and 2010. Contrary to the 2013 National Comprehensive Cancer Network (NCCN) Guidelines, penile-sparing surgery continues to be performed in all types of treating hospitals for higher stage penile cancers, which may represent an undertreatment of potentially fatal penile cancers. Conversely, there was a persistent pattern of overtreatment of stage I penile cancer. [Table: see text]

Fertility preservation for cancer patients: Role of nursing attitudes.

2016 ◽  
Vol 34 (3_suppl) ◽  
pp. 110-110
Author(s):  
Maria C. Grabowski ◽  
Deborah Spitzer ◽  
Shaghayegh Rezale ◽  
Catherine Close ◽  
Sonja Stutzman ◽  
...  
Keyword(s):  
Cancer Patients ◽  
Fertility Preservation ◽  
Online Survey ◽  
Phase 1 ◽  
Survey Method ◽  
Newly Diagnosed ◽  
Childbearing Age ◽  
Survey Tool ◽  
Quality Guidelines ◽  
Oncology Practice

110 Background: Nurses play a pivotal role in ensuring adherence to quality guidelines. The 2006 American Society of Clinical Oncology - Quality Oncology Practice Initiative guidelines state that infertility risks should be discussed prior to initiation of fertility-reducing therapies for patients in their reproductive years. Despite this guideline on fertility preservation (FP), national compliance is only 6% (Tallent, 2013). Research is lacking in the understanding of nurses’ attitudes and behaviors towards FP and no tools exist from which to examine this problem. The purpose of this study is to gain increased understanding of potential barriers for nurses to recommend FP as an option for newly diagnosed patients. Methods: This instrument development study was developed by content experts and field tested with staff nurses. Next, an online survey method was used to examine factors associated with nursing recommendation for FP of newly diagnosed cancer patients. An anonymous online survey was sent to oncology nurses at UT Southwestern and members of the Oncology Nursing Society (Dallas Fort Worth Chapter). The endpoint of the study is a sound survey to assess nursing behaviors toward FP in diagnosed cancer patients. Standardized descriptive measures of central tendency were used to describe baseline characteristics for the sample. Factor analysis was completed using SAS v9.3 with orthogonal rotation. Scree plot was examined for factors and loading > 0.30 were retained. Results: Analysis of the first 67 returned surveys (Phase 1) supports a 15-item (5-factor) survey tool. Preliminary results suggested the need for education, referral availability, and system refinement. Phase 2 surveys of additional 200 was initiated in August 2015, with an expected close of enrollment date of December 2015. Conclusions: Cancer patients of childbearing age worry how treatment will affect their ability to have a child. This survey may be beneficial in identifying nursing attitudes regarding FP. All members of the care team should be sensitive to this concern and should recommend appropriate action. This study will identify nursing barriers to patient education, and will support system-wide implementation of a comprehensive FP program.

scholarly journals A Review of Oncologist’s Knowledge and Awareness Regarding Fertility Preservation

2021 ◽  
Vol 6 (3) ◽  
pp. 1-4
Author(s):  
Ghina Ghazeeri ◽  
Keyword(s):  
Quality Of Life ◽  
Cancer Patients ◽  
Fertility Preservation ◽  
Survival Rates ◽  
Reproductive Age ◽  
The Core

The recent quantum leaps in various management modalities in oncology have led to unanticipated survival rates. This has constituted a plea for amelioration in the quality of life of cancer patients of reproductive age, at the core of which is Fertility Preservation (FP).

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