Fertility Preservation Options for Patients with Cancer

2010 ◽  
Vol 06 (01) ◽  
pp. 31
Author(s):  
Melissa C Hulvat ◽  
Jacqueline S Jeruss ◽  
◽  
Keyword(s):  
Cancer Patients ◽  
Fertility Preservation ◽  
Term Survival ◽  
Demographic Groups ◽  
Patients With Cancer ◽  
Current State ◽  
Realistic Possibility ◽  
Life Threatening ◽  
Children And Young Adults ◽  
State Of The Science

Improving survival for many cancers that affect children and young adults, together with advances in fertility preservation, make a cancer-free future that includes a family a realistic possibility for patients who desire this option. Although it is difficult for many clinicians and patients to reconcile fears surrounding a life-threatening diagnosis with hope for long-term survival and even a future family, addressing this vital survivorship issue early in the course of diagnosis and treatment is imperative if the fullest range of fertility-preserving options is to be offered. Oncological therapies, including chemotherapy, radiation and surgery, pose various threats to fertility. Children, adolescents and young men and women with cancer have different options for maintaining their ability to have biological children. The current state of the science for fertility preservation in each of these demographic groups is discussed in this article. A multidisciplinary approach to the care of young cancer patients, a timely assessment of threats to fertility and opportunities for intervention provide young cancer patients with the best chance for a healthy future that includes biological offspring.

Current State of Fertility Preservation in Cancer Patients—What is Established and What is Still Controversial?

2016 ◽  
Vol 12 (01) ◽  
pp. 33
Author(s):  
Kutluk Oktay ◽  
Giuliano Bedoschi ◽  
◽  
◽  
◽  
...  
Keyword(s):  
Cancer Patients ◽  
Fertility Preservation ◽  
Cancer Care ◽  
Testicular Tissue ◽  
Semen Cryopreservation ◽  
Young Females ◽  
Current State ◽  
Preservation Method ◽  
Prepubertal Boys ◽  
Straightforward Approach

Fertility Preservation is an essential part of cancer care when treating young females and men. While semen cryopreservation is a straightforward approach for postpubertal men and there is the option of experimental testicular tissue freezing for prepubertal boys, the options for females are more tumultuous. The last 17 years brought us established approaches such the embryo and oocyte cryopreservation and the ovarian cryopreservation is ready to join the list. However, there still is no proven medical fertility preservation method and the controversy around the utility of GnRHa continues.

scholarly journals Fertility Preservation for Cancer Patients: A Review

2010 ◽  
Vol 2010 ◽  
pp. 1-9 ◽  
Author(s):  
Tosin Ajala ◽  
Junaid Rafi ◽  
Peter Larsen-Disney ◽  
Richard Howell
Keyword(s):  
Cancer Patients ◽  
Fertility Preservation ◽  
Cancer Care ◽  
Ethical Issues ◽  
Fertility Treatment ◽  
Term Survival ◽  
Long Term Survival ◽  
Valid Consent ◽  
Cure Rates

Infertility can arise as a consequence of treatment of oncological conditions. The parallel and continued improvement in both the management of oncology and fertility cases in recent times has brought to the fore-front the potential for fertility preservation in patients being treated for cancer. Oncologists must be aware of situations where their treatment will affect fertility in patients who are being treated for cancer and they must also be aware of the pathways available for procedures such as cryopreservation of gametes and/or embryos. Improved cancer care associated with increased cure rates and long term survival, coupled with advances in fertility treatment means that it is now imperative that fertility preservation is considered as part of the care offered to these patients. This can only be approached within a multidisciplinary setting. There are obvious challenges that still remain to be resolved, especially in the area of fertility preservation in prepubertal patients. These include ethical issues, such as valid consent and research in the area of tissue retrieval, cryopreservation, and transplantation.

scholarly journals Application of Ultrasound-Guided Intranodal Lymphangiography and Embolization in Cancer Patients With Postoperative Lymphatic Leakage

2020 ◽  
Author(s):  
Xingwei Sun ◽  
Feng Zhou ◽  
Xuming Bai ◽  
Qiang Yuan ◽  
Mingqing Zhang ◽  
...  
Keyword(s):  
Cancer Patients ◽  
Operation Time ◽  
Chylous Ascites ◽  
Pelvic Surgery ◽  
Ultrasound Guided ◽  
Technical Success Rate ◽  
Patients With Cancer ◽  
Life Threatening ◽  
Low Incidence ◽  
Intranodal Lymphangiography

Abstract Background: Traumatic lymphatic leakage is a rare but potentially life-threatening complication. The purpose of this study was to introduce the technique of ultrasound-guided intranodal lymphangiography and embolization in the postoperative lymphatic leakage in patients with cancer.Methods: During January 2018 and June 2020, seven cancer patients (three males, four females, aged 59-75 years [mean 67.57 ± 6.11 years]) developed lymphatic leakage after abdominal or pelvic surgery, with drainage volume ranging from 550 to 1200 mL per day. The procedure and follow-up of ultrasound-guided intranodal lymphangiography and embolization were recorded. This study retrospectively analysed the technical success rate, operation time, hospital stay, clinical efficacy, and complications.Results：The operation was technically successful in all patients. Angiography revealed leakage and embolization was performed in all the seven patients (7/7, 100%). The operative time of angiography and embolization was 41 to 68 minutes, with an average time of 53.29 ± 10.27 minutes. The mean length of stay was 3.51±1.13 days. Lymph node embolization was finally clinically successful in five patients (5/7, 71.43%), with a significant reduction in or disappearance of chylous ascites. The other two patients received surgical treatment 2 weeks later due to poor results after embolization. All patients were followed-up for 2 weeks. No serious complications or only minor complications were found in all the patients.Conclusions：Ultrasound-guided intranodal lymphangiography and embolization are easy to tolerance, with a low incidence of complications. Early intervention is recommended for cancer patients with postoperative lymphatic leakage.

Social distancing to avoid SARS-Cov-2 infection in cancer and non-cancer patients.

2021 ◽  
Vol 39 (15_suppl) ◽  
pp. e18697-e18697
Author(s):  
Goetz H. Kloecker ◽  
Jason Ellis ◽  
Leslie Korbee ◽  
Joseph Nolan ◽  
Royce Calhoun ◽  
...  
Keyword(s):  
Cancer Patients ◽  
Chi Square ◽  
Social Distancing ◽  
Patients With Cancer ◽  
White Collar Workers ◽  
Immunosuppressed Patients ◽  
Life Threatening ◽  
Risk Of Exposure ◽  
Motivating Factor ◽  
Electronic Questionnaires

e18697 Background: Social distancing has been recommended by the CDC to avoid exposure to SARS-CoV-2. Cancer patients on or after active therapy appear to be more prone to COVID being symptomatic and life threatening. When evaluating cancer patients’ risk of acquiring COVID it is essential to know the behavior of cancer patients that will affect their risk of exposure. However, it is not known to what degree social distancing is practiced by cancer patients compared to non-cancer patients and what factors lead to the decision to distance oneself. Methods: After a pilot phase using patients MyChart messaging, links to the electronic questionnaires were texted to patients using Twillio. Responses were stored on REDCap. Six questions about their social distancing behavior and mask wearing were posed and responses were compared between cancer and non-cancer patients. Demographics, comorbidities and a questionnaire about anxiety (GAD-7 scale for Generalized Anxiety Disorder) were recorded. To assess differences between cancer and non-cancer groups Bonferroni-corrected chi-square tests and proportions confidence intervals were used. Results: The pilot survey was sent in mid-2020 and the full survey followed in January 2021 during a high community COVID incidence. 387 cancer patients (32.4% responded and 503 non-cancer (22.9% responded) patients completed the survey. Questions about leaving their house, driving, shopping, friends and family indicated that patients with cancer are more cautious (p < 0.001). Cancer patients were up to 20% more likely to distance themselves. No evidence of a difference was seen in wearing a mask, at least 85 % most of the time. A majority of respondents were female (63% vs 71%). Cancer patients were older ( > 60 years, 69 % vs 45%) and less likely to work (52% vs 31%) or less likely to be white collar workers (21% vs 38%). There was no difference of the anxiety score in both groups (not at all anxious, 54%). Conclusions: Cancer patients’ responses revealed a distancing behavior that would likely lower the risk exposure to SARS-CoV-2. It is unclear, which of the demographic differences would account for this behavior, although remarkably anxiety was not a clear motivating factor. The high acceptance of masks is encouraging. Early publications during the pandemic and patient education suggesting a higher COVID risk for cancer patients may have reduced risk prone behavior. Considering COVID’s impact on the vulnerable cancer population and uncertainty in immunosuppressed patients about clearing the virus or adequately responding to a vaccine, further studies about health behavior and health promotion during the pandemic are needed.

Venous Thromboembolic Disease

2008 ◽  
Vol 6 (8) ◽  
pp. 716 ◽  
Author(s):  
_ _
Keyword(s):  
Cancer Patients ◽  
Perceived Risk ◽  
Common Life ◽  
Nccn Guidelines ◽  
Patients With Cancer ◽  
Venous Thromboembolic ◽  
Threatening Condition ◽  
Life Threatening ◽  
Risk For Bleeding ◽  
Work Up

Venous thromboembolism (VTE) is a common, life-threatening condition in patients with cancer, which includes both deep venous thrombosis (DVT) and pulmonary embolism. The occurrence of VTE has been reported to increase the likelihood of death for cancer patients by 2- to 8-fold. Pathophysiologic explanations for VTE in cancer include known hypercoagulability, vessel wall damage, and vessel stasis from direct compression, and the incidence of VTE in cancer is increased by additional risks factors. The NCCN guidelines specifically outline strategies to prevent and treat VTE in adult cancer patients. These guidelines are characterized by evaluations of the therapeutic advantages of pharmacologic anticoagulation measures based on both perceived risk for bleeding (i.e., contraindications to anticoagulation) and cancer status. Important updates for 2008 include new work-up recommendations and changes in the recommendations for outpatient prophylaxis and diagnosis and for treatment of heparin-induced thrombocytopenia. For the most recent version of the guidelines, please visit NCCN.org

Treatment and secondary prevention of venous thromboembolism in cancer patients

2012 ◽  
Vol 03 (03) ◽  
pp. 121-125
Author(s):  
I. Pabinger ◽  
C. Ay
Keyword(s):  
Clinical Trials ◽  
Venous Thromboembolism ◽  
Cancer Patients ◽  
Oral Anticoagulants ◽  
Factor Xa ◽  
New Oral Anticoagulants ◽  
Phase Iii ◽  
Patients With Cancer ◽  
Potential Use

SummaryCancer is a major and independent risk factor of venous thromboembolism (VTE). In clinical practice, a high number of VTE events occurs in patients with cancer, and treatment of cancerassociated VTE differs in several aspects from treatment of VTE in the general population. However, treatment in cancer patients remains a major challenge, as the risk of recurrence of VTE as well as the risk of major bleeding during anticoagulation is substantially higher in patients with cancer than in those without cancer. In several clinical trials, different anticoagulants and regimens have been investigated for treatment of acute VTE and secondary prophylaxis in cancer patients to prevent recurrence. Based on the results of these trials, anticoagulant therapy with low-molecular-weight heparins (LMWH) has become the treatment of choice in cancer patients with acute VTE in the initial period and for extended and long-term anticoagulation for 3-6 months. New oral anticoagulants directly inhibiting thrombin or factor Xa, have been developed in the past decade and studied in large phase III clinical trials. Results from currently completed trials are promising and indicate their potential use for treatment of VTE. However, the role of the new oral thrombin and factor Xa inhibitors for VTE treatment in cancer patients still has to be clarified in further studies specifically focusing on cancer-associated VTE. This brief review will summarize the current strategies of initial and long-term VTE treatment in patients with cancer and discuss the potential use of the new oral anticoagulants.

Thrombosis in Cancer Patients Treated with Hematopoietic Growth Factors - A Meta-Analysis

1996 ◽  
Vol 75 (02) ◽  
pp. 368-371 ◽  
Author(s):  
T Barbul ◽  
G Finazzi ◽  
A Grassi ◽  
R Marchioli
Keyword(s):  
Cancer Patients ◽  
Case Reports ◽  
Meta Analysis ◽  
Case Series ◽  
Hematopoietic Growth Factors ◽  
Patients With Cancer ◽  
Cytotoxic Treatment ◽  
Pertinent Data ◽  
Thrombotic Complications ◽  
Vascular Occlusions

SummaryHematopoietic colony-stimulating factors (CSFs) are largely used in patients with cancer undergoing cytotoxic treatment to accelerate neutrophil recovery and decrease the incidence of febrile neutropenia. Clinical practice guidelines for their use have been recently established (1), taking into account clinical benefit, but also cost and toxicity. Vascular occlusions have been recently reported among the severe reactions associated with the use of CSFs, in anedoctal case reports (2, 3), consecutive case series (4) and randomized clinical trial (5, 6). However, the role of CSFs in the pathogenesis of thrombotic complications is difficult to ascertain, because pertinent data are scanty and widely distributed over a number of heterogenous investigations. We report here a systematic review of relevant articles, with the aims to estimate the prevalence of thrombosis associated with the use of CSFs and to assess if this rate is significantly higher than that observed in cancer patients not receiving CSFs.

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