Reproductive health importance in oncology care

2009 ◽  
Vol 27 (15_suppl) ◽  
pp. e20744-e20744
Author(s):  
H. A. Zaren ◽  
A. Patel ◽  
E. K. Radeke ◽  
A. B. Uy
Keyword(s):  
Reproductive Health ◽  
Fertility Preservation ◽  
Health Care Providers ◽  
Cancer Care ◽  
Case Series ◽  
Improve Patient Care ◽  
Information Provision ◽  
Reproductive Age ◽  
Care Providers ◽  
Health Goals

e20744 Background: Based on a case series of patients, we recognized a disparity between patients’ reproductive health goals and conveyed health information by providers on reproductive health issues. The objective of this study was to assess the reproductive health interest amongst cancer care providers. Methods: This observational study was performed using a 13 item questionnaire that was administered to 15 healthcare professionals in oncology and allied health fields. The items in the questionnaire related to information regarding the importance of cancer care, sexuality, fertility preservation and contraception. Results: Of the providers surveyed, 11 were medical doctors, 3 were nurses, and 1 was indicated as other. On a scale of 0 to 10, 86.6% (n=13) rated cancer care as extremely important (10), 33% (n=5) felt the same for fertility preservation, and 46.6% (n=7) for sexuality. In a rank of importance, cancer care was first, followed by sexuality, fertility, and contraception. Only 33% (n=5) of providers always asked patients about interest in fertility preservation and with regards to contraception, only 33% (n=5) offer contraception to reproductive age patients. Conclusions: Although most providers felt that sexuality and fertility are important to women diagnosed with cancer, their practice and information provision does not reflect these findings. This highlights the significance of bringing closer together the goals of the health care providers with their actual practice to improve patient care. No significant financial relationships to disclose.

Oncocontraception in cancer care.

2017 ◽  
Vol 35 (15_suppl) ◽  
pp. e18018-e18018 ◽  
Author(s):  
Erika K. Radeke ◽  
Lindsay Zimmerman ◽  
Rebecca Bridge ◽  
Megan Adam ◽  
Ashlesha Patel
Keyword(s):  
Family Planning ◽  
Reproductive Health ◽  
Health Care Providers ◽  
Cancer Diagnosis ◽  
Cancer Care ◽  
Reproductive Age ◽  
Care Providers ◽  
Family Planning Clinic ◽  
Reproductive Life ◽  
Study Population

e18018 Background: Focus on fertility preservation has overshadowed other aspects of reproductive health including sexuality and contraception in cancer care. Regardless of future childbearing interest, the first 18-months post-diagnosis of cancer are considered suboptimal for childbearing. We have coined the term, oncocontraception, for the application of contraception in cancer care. To address this need at our institution, we used the novel Family Planning Quotient/Reproductive Life Index (FPQ/RepLI) which allows providers to better understand patients’ reproductive health goals and counsel them towards appropriate family planning services. These tools aid providers in implementing clinical care to prevent pregnancy during this critical time. They are routinely utilized at Stroger Hospital in the Family Planning Clinic for women within the reproductive age, between the ages of 18 and 55. Methods: FPQ and RepLI were adapted for use with oncology patients. They were used to visually depict and quantify a woman’s reproductive life plan and assist health care providers in speaking to a woman regarding family planning as it pertains to and aligns with her cancer treatment. Results: During our study period, 36 reproductive aged women were seen in our family planning clinic after a cancer diagnosis. Our study population was comprised of mostly Hispanic/Latino women (58.3.0%) and 50.0% were between the ages of 31-40. The majority of the study group had breast cancer (77.8%) and were being treated with chemotherapy (52.8%). Among the study population, 80.6% received a form of contraception (44.8% short-term, 55.2% long-term). Conclusions: We established a link between the Oncology and Family Planning Clinics to incorporate contraceptive counseling as an essential piece of comprehensive cancer care. Approximately 45% of the women newly diagnosed with cancer are in the reproductive age range. With improvements in treatments and prognosis, quality of life factors are of increasing importance for these women. With this essential clinical relationship, patient counseling and provider-patient communication regarding contraceptive care in the context of cancer diagnosis will continue to grow and improve.

Reproductive health and pregnancy experiences of women with spina bifida: A qualitative study

2021 ◽  
pp. 1-12
Author(s):  
Asia L. van Buuren ◽  
Susan E. O’rinn ◽  
Hayley Lipworth ◽  
Paige Church ◽  
Anne Berndl
Keyword(s):  
Health Care ◽  
Reproductive Health ◽  
Spina Bifida ◽  
Health Care Providers ◽  
Structured Interview ◽  
Reproductive Age ◽  
Care Providers ◽  
Care Needs ◽  
Health Experiences ◽  
Experiences Of Women

PURPOSE: Despite an increasing number of individuals with spina bifida reaching reproductive age, there has been a paucity of research into their reproductive health care needs. The objective of this study was to better understand the reproductive health experiences of self-identified women with spina bifida using qualitative methodology. METHODS: A phenomenological study design was used to address this objective. Women with spina bifida identified their interest in participating in a semi-structured interview after completing an online reproductive health survey. Interviews were recorded and transcribed verbatim. Qualitative analysis followed a phenomenological approach using Dedoose software. RESULTS: Twelve self-identified women with spina bifida participated. They described experiences in four domains: sexual education, pregnancy, labor and delivery, and postpartum. In addition, an intersecting domain of social justice and advocacy emerged. Numerous themes are described, including a lack of tailored sexual health information, impact of pregnancy on function, attitudes towards delivery method, and parenting challenges. CONCLUSION: This study explored the continuum of reproductive health experiences of women with spina bifida. They face unique reproductive health challenges that provide an opportunity for health care providers to offer more holistic care.

scholarly journals Fertility Preservation for Patients With Cancer: American Society of Clinical Oncology Clinical Practice Guideline Update

2013 ◽  
Vol 31 (19) ◽  
pp. 2500-2510 ◽  
Author(s):  
Alison W. Loren ◽  
Pamela B. Mangu ◽  
Lindsay Nohr Beck ◽  
Lawrence Brennan ◽  
Anthony J. Magdalinski ◽  
...  
Keyword(s):  
Health Care ◽  
Fertility Preservation ◽  
Clinical Oncology ◽  
Health Care Providers ◽  
Randomized Clinical Trials ◽  
Case Series ◽  
Cochrane Collaboration ◽  
Embryo Cryopreservation ◽  
Care Providers ◽  
American Society

Purpose To update guidance for health care providers about fertility preservation for adults and children with cancer. Methods A systematic review of the literature published from March 2006 through January 2013 was completed using MEDLINE and the Cochrane Collaboration Library. An Update Panel reviewed the evidence and updated the recommendation language. Results There were 222 new publications that met inclusion criteria. A majority were observational studies, cohort studies, and case series or reports, with few randomized clinical trials. After review of the new evidence, the Update Panel concluded that no major, substantive revisions to the 2006 American Society of Clinical Oncology recommendations were warranted, but clarifications were added. Recommendations As part of education and informed consent before cancer therapy, health care providers (including medical oncologists, radiation oncologists, gynecologic oncologists, urologists, hematologists, pediatric oncologists, and surgeons) should address the possibility of infertility with patients treated during their reproductive years (or with parents or guardians of children) and be prepared to discuss fertility preservation options and/or to refer all potential patients to appropriate reproductive specialists. Although patients may be focused initially on their cancer diagnosis, the Update Panel encourages providers to advise patients regarding potential threats to fertility as early as possible in the treatment process so as to allow for the widest array of options for fertility preservation. The discussion should be documented. Sperm and embryo cryopreservation as well as oocyte cryopreservation are considered standard practice and are widely available. Other fertility preservation methods should be considered investigational and should be performed by providers with the necessary expertise.

scholarly journals Best Practices in Counseling Young Female Cancer Survivors on Reproductive Health

2017 ◽  
Vol 35 (04) ◽  
pp. 378-389 ◽  
Author(s):  
Ksenya Shliakhtsitsava ◽  
Deepika Suresh ◽  
Tracy Hadnott ◽  
H. Su
Keyword(s):  
Reproductive Health ◽  
Cancer Survivors ◽  
Health Care Providers ◽  
Chromosomal Abnormalities ◽  
The United States ◽  
Reproductive Age ◽  
Care Providers ◽  
History Of ◽  
Adverse Pregnancy ◽  
History Of Cancer

AbstractIn the United States, there are more than 400,000 girls and young women of reproductive-age with a history of cancer. Cancer treatments including surgery, chemotherapy, targeted therapy, and radiation can adversely impact their reproductive health. This review discusses infertility, contraception, and adverse pregnancy and child health outcomes in reproductive-aged cancer survivors, to increase awareness of these health risks for survivors and their health care providers. Infertility rates are modestly higher, while rates of using contraception and using highly effective contraceptive methods are lower in cancer survivors than in women without a history of cancer. During pregnancy, preterm births are also more common in survivors, resulting in more low-birth-weight offspring. Children of cancer survivors do not have more childhood cancers, birth defects, or chromosomal abnormalities than the general population, with the exception of families with hereditary cancer. Reproductive risks in survivors depend on cancer treatment exposures. For example, women with prior abdominal or pelvic radiation have additional risks of spontaneous abortions, small-for-gestational-age offspring and stillbirths, while those with prior chest radiation or anthracycline exposures have higher risks of cardiomyopathy. To help survivors achieve their reproductive goals safely, family planning and preconception counseling are central to survivorship care.

scholarly journals An Educational Need Regarding Treatment-Related Infertility and Fertility Preservation: a National Survey Among Members of the Dutch Society for Medical Oncologists

2021 ◽  
Author(s):  
E. M. Krouwel ◽  
E. M. L. Birkhoff ◽  
M. P. J. Nicolai ◽  
S. Osanto ◽  
H. Putter ◽  
...  
Keyword(s):  
Cancer Treatment ◽  
Fertility Preservation ◽  
Nationwide Survey ◽  
Information Provision ◽  
Reproductive Age ◽  
Care Providers ◽  
Dutch Society ◽  
Childbearing Age ◽  
Education Practice ◽  
Medical Oncologists

Abstract Cancer diagnosis and treatment may influence reproductive planning and impact fertility in patients of reproductive age. Although guidelines have been established in the past decade, education, practice, and attitudes of medical oncologists regarding fertility preservation remain undecided. A nationwide survey was performed among members of the Dutch Society for Medical Oncology. Demographics, practice, knowledge, and barriers were measured regarding information provision of fertility preservation towards cancer patients of childbearing age. From 392 members, 120 oncologists completed the questionnaire (30.6%). Majority of oncologists was convinced it is their responsibility to discuss impact of cancer treatment to fertility (93.2%), yet 68.3% discussed the subject often or always (n = 82). Oncologists employed in district general hospitals were less likely to discuss fertility (p = 0.033). On average, 44.6% of reproductive men and 28.9% of reproductive women is referred to fertility specialists. Half of the respondents declared to possess sufficient knowledge regarding fertility preservation (n = 57, 47.5%). Poor prognosis (53%), unlikely survival (43.1%), and high chances on fertility recovery (28.7%) were identified as barriers to discussing fertility preservation. Among oncologists, impact of cancer treatment on fertility is a well-accepted responsibility to counsel. Despite, self-reported knowledge regarding fertility preservation is strongly varying. In practice, fertility is discussed to some extent, influenced by several barriers and depending on prognosis and type of hospital. Patients benefit from knowledge improvement among oncology care providers concerning fertility effects of cancer treatment. Education during medical school, residency, and among practicing oncologists may raise awareness, together with enhancement of referral possibilities.

scholarly journals Gender-specific aspects related to type of fertility preservation strategies and access to fertility care

ESMO Open ◽  
2020 ◽  
Vol 5 (Suppl 4) ◽  
pp. e000771 ◽  
Author(s):  
Marta Perachino ◽  
Claudia Massarotti ◽  
Maria Grazia Razeti ◽  
Francesca Parisi ◽  
Luca Arecco ◽  
...  
Keyword(s):  
Fertility Preservation ◽  
Health Care Providers ◽  
Cancer Care ◽  
Safety Data ◽  
Young Patients ◽  
Ovarian Tissue Cryopreservation ◽  
Embryo Cryopreservation ◽  
Care Providers ◽  
Patients With Cancer ◽  
Age Related

Survivorship is an area of paramount importance to be addressed as early as possible after cancer diagnosis by all health care providers. On this regard, cancer care in young patients often poses several age-related considerations among which fertility and pregnancy-related issues have a crucial role. According to the available guidelines on the topic, all patients with cancer diagnosed during their reproductive years should be provided a proper oncofertility counselling before starting anticancer treatments. This is an important step in order to inform patients about the potential treatment-induced gonadotoxicity and the available strategies for fertility preservation so that they can be referred as early as possible to fertility specialists if potentially interested in these options.In this manuscript, we aim to provide an up to date overview on the available efficacy and safety data with the main strategies for fertility preservation in male and female cancer patients in order to help optimising the oncofertility counselling performed by healthcare providers involved in cancer care and dealing with young patients. In male patients with cancer, sperm cryopreservation is the standard technique for fertility preservation. Oocyte/embryo cryopreservation, ovarian tissue cryopreservation and temporary ovarian suppression with luteinising hormone-releasing hormone agonists during chemotherapy are the main options in female patients with cancer.A multidisciplinary management building a strong network between fertility and oncology/haematology units is crucial to properly address fertility care in all young patients with cancer, at both diagnosis and during oncologic follow-up. Discussing fertility and pregnancy-related issues with young patients with cancer has to be considered mandatory nowadays keeping in mind that returning to a normal life (including the possibility to have a family and to live with as few side effects as possible) should be considered an important ambition in cancer care in the 21st century .

scholarly journals What methods and challenges for taking account of context when transferring complex interventions?

2020 ◽  
Vol 30 (Supplement_5) ◽  
Author(s):  
S Villadsen ◽  
S Dias
Keyword(s):  
Public Health ◽  
Health Care ◽  
Reproductive Health ◽  
Health Care Providers ◽  
Complex Interventions ◽  
Health Interventions ◽  
Care Providers ◽  
Public Health Interventions ◽  
Reproductive Health Care

Abstract For complex public health interventions to be effective their implementation needs to adapt to the situation of those implementing and those receiving the intervention. While context matter for intervention implementation and effect, we still insist on learning from cross-country comparison of implementation. Next methodological challenges include how to increase learning from implementation of complex public health interventions from various context. The interventions presented in this workshop all aims to improve quality of reproductive health care for immigrants, however with different focus: contraceptive care in Sweden, group based antenatal care in France, and management of pregnancy complications in Denmark. What does these interventions have in common and are there cross cutting themes that help us to identify the larger challenges of reproductive health care for immigrant women in Europe? Issues shared across the interventions relate to improved interactional dynamics between women and the health care system, and theory around a woman-centered approach and cultural competence of health care providers and systems might enlighten shared learnings across the different interventions and context. Could the mechanisms of change be understood using theoretical underpinnings that allow us to better generalize the finding across context? What adaption would for example be needed, if the Swedish contraceptive intervention should work in a different European setting? Should we distinguish between adaption of function and form, where the latter might be less important for intervention fidelity? These issues will shortly be introduced during this presentation using insights from the three intervention presentations and thereafter we will open up for discussion with the audience.

scholarly journals Men’s perceptions of sexual and reproductive health education within the context of pregnancy and HIV in Zambia: a descriptive qualitative analysis

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Tulani Francis L. Matenga ◽  
Joseph Mumba Zulu ◽  
Sharon Nkwemu ◽  
Perfect Shankalala ◽  
Karen Hampanda
Keyword(s):  
Reproductive Health ◽  
Antenatal Care ◽  
Health Care Providers ◽  
Sexual And Reproductive Health ◽  
Decision Makers ◽  
Care Providers ◽  
Convenience Sample ◽  
Essential Information ◽  
Women Living With Hiv ◽  
The Family

Abstract Background Although health care providers are beginning to focus on men’s roles as fathers and husbands, there is limited understanding of how men view their ability to promote sexual and reproductive health in families affected by HIV and their experiences with receiving education through antenatal care. This paper aims to explore men’s perceptions of the education they need regarding sexual and reproductive health within the family in the context of HIV. Methods We interviewed a convenience sample of 18 male partners of pregnant women living with HIV in Lusaka, Zambia. Atlas.ti was used to facilitate data management and content analysis. Results Men reported being the primary decision-makers regarding sexual and reproductive issues in the family; however, they admitted far-reaching unmet needs in terms of information on sexual and reproductive health in the context of HIV. Most men felt that antenatal care was not a conducive setting to fully educate men on sexual and reproductive health because it is a woman’s space where their health concerns were generally neglected. There was a strong desire for more education that was specific to men’s sexual and reproductive health, especially because all the couples were affected by HIV. Men especially requested education on sexual preparedness, safe sex, the use of condoms in sero-concordant and sero-discordant relationships and general health information. Although men stated they were the main decision-makers regarding sexual and reproductive issues such as pregnancy, most men were not confident in their ability to promote sexual and reproductive health in the family because of limited knowledge in this area. Conclusion There is need to change the environment and messaging of antenatal care, as well as offer relevant education opportunities outside health facility settings to empower men with essential information for meaningful involvement in sexual and reproductive health in the context of HIV.

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