Oncofertility and quality of life among adolescent and young adult survivors of childhood cancer.

2016 ◽  
Vol 34 (3_suppl) ◽  
pp. 222-222 ◽  
Author(s):  
Kenneth Tercyak ◽  
Darren Mays ◽  
Andrea Johnson ◽  
Sarah Murphy ◽  
Aziza T. Shad
Keyword(s):  
Quality Of Life ◽  
Young Adult ◽  
Reproductive Health ◽  
Cancer Survivors ◽  
Cancer Treatment ◽  
Childhood Cancer ◽  
Fertility Preservation ◽  
Pediatric Cancer ◽  
Adolescent And Young Adult

222 Background: Although infertility risks due to childhood cancer treatment are well-documented, research on the psychosocial impact of treatment-associated infertility risks among adolescent and young adult (AYA) cancer survivors is limited. This study examined AYA pediatric cancer survivors’ perceptions of oncofertility and cancer treatment-associated infertility risks and associations with patient-reported quality of life (QoL). Methods: Patients ages 12 to 25 (n= 70, M age 19.4, 74% white, 57% female, a majority leukemia/lymphoma survivors) were recruited from a pediatric hematology/oncology clinic and local pediatric cancer survivor support organizations. Patients reported knowledge and beliefs about treatment-related fertility risks and reproductive health, and oncofertility information and support needs, and completed the Pediatric Oncology Quality of Life (QoL) scale. Results: Patients’ knowledge about infertility risks and fertility preservation options was low (M 13.5, SD 8.6, range 0-42): patients’ attitudes indicated treatment-related infertility risks was important (M 21.7, SD 7.0, range 0-40), they perceived they were at-risk for infertility (M 3.8, SD 1.0 range 1-5), and expressed unmet needs for supportive resources on reproductive health (M 13.6, SD 4.8, range 1-24). Greater perceived risks of infertility (r = .34, p = .004) and importance of fertility risks (r = .34, p = .004) were associated with lower QoL. In a multivariable model adjusting for patient age and gender, beliefs that reproductive health was important was associated with lower QoL (B = .68, p = .041). Conclusions: Population data demonstrate few AYA cancer survivors have opportunities to discuss fertility preservation with providers. Our findings indicate AYA cancer survivors perceive treatment-related infertility risks as important, associated with QoL, and with needs for more information about reproductive health and fertility preservation. Care models addressing AYA survivors’ infertility risks are needed as part of the diagnosis, treatment, and long-term follow-up of these patients.

scholarly journals Perspectives Regarding Fertility in Female Adolescent and Young Adult Childhood Cancer Survivors

Blood ◽  
2014 ◽  
Vol 124 (21) ◽  
pp. 1271-1271
Author(s):  
Pooja Rao ◽  
Priya Hirway ◽  
Jennifer JG Welch ◽  
Cindy L Schwartz
Keyword(s):  
Young Adult ◽  
Cancer Survivors ◽  
Cancer Treatment ◽  
Childhood Cancer ◽  
Fertility Preservation ◽  
Cancer Diagnosis ◽  
Childhood Cancer Survivors ◽  
Female Adolescent ◽  
Life Goals ◽  
Adolescent And Young Adult

Abstract Introduction: Reproductive system injury, particularly ovarian failure, can be a devastating consequence of cancer treatment for female childhood cancer survivors. Recent advances in reproductive technology offer new fertility preservation techniques such as oocyte and ovarian tissue cryopreservation in addition to ovarian transposition and embryo cryopreservation. With rapid expansion of these reproductive technologies, it is imperative that we understand the personal perspectives regarding fertility of young female cancer patients. Better understanding of their attitudes will enable care providers to better counsel patients and families about options. We designed our study to evaluate the perspectives of female adolescent and young adult childhood cancer survivors regarding (a) fertility preservation procedures at the time of cancer diagnosis and (b) their prioritization of life goals, including fertility and motherhood. Methods: This study was a cross-sectional survey of female adolescent and young adult cancer survivors between 15-25 years of age at Hasbro Children's Hospital. Surveys were mailed to participants and followed with a reminder postcard and $5 incentive for participation. Written informed consent and assent were obtained. The primary study outcomes were responses to: (1) potential interest in fertility-sparing surgery at cancer diagnosis and (2) whether they would have waited to start cancer treatment if it increased future chances of becoming pregnant. Covariates included demographics (age at diagnosis, current age, race, ethnicity, education level) as well as prioritization of life goals, including fertility and motherhood, on a Likert scale from 0-5. Stata 12.0 (College Station, TX) was used to conduct chi-squared or t-tests for bivariate analysis. Logistic regression was used to calculate crude and adjusted odds ratios. Results: Sixty-five completed surveys were returned, with a 42% response rate. The mean age of subjects was 20.1 years (SD, 2.8). The majority (83.1%) were White, and non-Hispanic (92%). The most common participant cancer diagnoses were acute lymphoblastic leukemia, brain tumors, sarcomas and neuroblastoma. After adjusting for confounders including age at diagnosis and race, the odds of wanting surgery was higher (OR 2.41, 95% CI 1.42-4.09) for those who ranked pregnancy highly (> 4) and for those who ranked being a mother highly (OR 2.62, 95% CI 1.46-4.69) vs. those who did not. The adjusted odds of being willing to postpone cancer treatment for those who ranked pregnancy and motherhood highly (> 4) also remained statistically significant (OR 2.81, 95% CI 1.15-6.90; OR 3.73, 95% CI 1.14-12.6), respectively. Conclusion: Fertility and motherhood are important to female adolescent and young adult childhood cancer survivors. This study shows these young women would be interested in pursuing fertility preservation procedures at the time of cancer diagnosis, even if it meant a delay in starting cancer treatment. Pediatric oncologists should use this information to advise patients and families regarding fertility preservation options. A caveat remains however that patients would need to be counseled regarding the risks of such decisions in consideration of their specific illness. Disclosures No relevant conflicts of interest to declare.

scholarly journals Female Reproductive Health After Childhood, Adolescent, and Young Adult Cancers: Guidelines for the Assessment and Management of Female Reproductive Complications

2013 ◽  
Vol 31 (9) ◽  
pp. 1239-1247 ◽  
Author(s):  
Monika L. Metzger ◽  
Lillian R. Meacham ◽  
Briana Patterson ◽  
Jacqueline S. Casillas ◽  
Louis S. Constine ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Young Adult ◽  
Reproductive Health ◽  
Hormonal Regulation ◽  
Pubertal Development ◽  
Adolescent And Young Adult ◽  
Primary Therapy ◽  
Ongoing Research

Purpose As more young female patients with cancer survive their primary disease, concerns about reproductive health related to primary therapy gain relevance. Cancer therapy can often affect reproductive organs, leading to impaired pubertal development, hormonal regulation, fertility, and sexual function, affecting quality of life. Methods The Children's Oncology Group Long-Term Follow-Up Guidelines for Survivors of Childhood, Adolescent, and Young Adult Cancer (COG-LTFU Guidelines) are evidence-based recommendations for screening and management of late effects of therapeutic exposures. The guidelines are updated every 2 years by a multidisciplinary panel based on current literature review and expert consensus. Results This review summarizes the current task force recommendations for the assessment and management of female reproductive complications after treatment for childhood, adolescent, and young adult cancers. Experimental pretreatment as well as post-treatment fertility preservation strategies, including barriers and ethical considerations, which are not included in the COG-LTFU Guidelines, are also discussed. Conclusion Ongoing research will continue to inform COG-LTFU Guideline recommendations for follow-up care of female survivors of childhood cancer to improve their health and quality of life.

scholarly journals Fertility Preservation and Sexual Health After Cancer Therapy

2017 ◽  
Vol 13 (10) ◽  
pp. 643-651 ◽  
Author(s):  
Nigel Pereira ◽  
Glenn L. Schattman
Keyword(s):  
Quality Of Life ◽  
Sexual Dysfunction ◽  
Sexual Function ◽  
Cancer Survivors ◽  
Cancer Treatment ◽  
Fertility Preservation ◽  
Cancer Treatments ◽  
Life Issues ◽  
After Cancer

Recent developments in cancer diagnostics and treatments have considerably improved long-term survival rates. Despite improvements in chemotherapy regimens, more focused radiotherapy and diverse surgical options, cancer treatments often have gonadotoxic side-effects that can manifest as loss of fertility or sexual dysfunction, particularly in young cancer survivors. In this review, we focus on two pertinent quality-of-life issues in female cancer survivors of reproductive age—fertility preservation and sexual function. Fertility preservation encompasses all clinical and laboratory efforts to preserve a woman’s chance to achieve future genetic motherhood. These efforts range from well-established protocols such as ovarian stimulation with cryopreservation of embryos or oocytes, to nascent clinical trials involving cryopreservation and re-implantation of ovarian tissue. Therefore, fertility preservation strategies are individualized to the cancer diagnosis, time interval until initiation of treatments must begin, prognosis, pubertal status, and maturity level of patient. Some patients choose not to pursue fertility preservation, and the conversation then centers around other quality of life issues. Not all cancer treatments cause loss of fertility; however, most treatments can directly impact the physical and psychosocial aspects of sexual function. Cancer treatment is also associated with fear, anxiety, and depression, which can further decrease sexual desire, function, and frequency. Sexual dysfunction after cancer treatment is generally ascertained by compassionate inquiry. Strategies to promote sexual function after cancer treatment include pelvic floor exercises, clitoral therapy devices, pharmacologic agents, as well as couples-based psychotherapeutic and psycho-educational interventions. Quality-of-life issues in young cancer survivors are often best addressed by utilizing a multidisciplinary team consisting of physicians, nurses, social workers, psychiatrists, sex educators, counselors, or therapists.

Quality of Life of Adolescent and Young Adult Survivors of Childhood Cancer

2009 ◽  
Vol 24 (5) ◽  
pp. 415-422 ◽  
Author(s):  
Marina Servitzoglou ◽  
Danai Papadatou ◽  
Ioannis Tsiantis ◽  
Helen Vasilatou-Kosmidis
Keyword(s):  
Quality Of Life ◽  
Young Adult ◽  
Childhood Cancer ◽  
Adult Survivors ◽  
Adolescent And Young Adult ◽  
Young Adult Survivors ◽  
Survivors Of Childhood Cancer
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