Depressive symptoms among young breast cancer survivors: the importance of reproductive concerns

Gorman, Jessica R.; Malcarne, Vanessa L.; Roesch, Scott C.; Madlensky, Lisa; Pierce, John P.

doi:10.1007/s10549-010-0768-4

Cited by 132 publications

(150 citation statements)

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“…Reproductive concerns are very important to many young survivors and associated with poorer quality of life, depressive symptoms and distress [14][15][16]. Patient informational needs regarding fertility and parenthood issues are not being adequately addressed among YA survivors, a medically underserved population in which these issues may be particularly important [10,[29][30][31][32].…”

Section: Discussionmentioning

confidence: 99%

“…Despite professional society guidelines recommending a discussion of fertility risks with cancer patients, YA female survivors have significant unmet medical and informational needs regarding their fertility and parenthood options [8][9][10][11], which are associated with poorer quality of life in survivorship [7,[12][13][14][15][16][17][18]. Furthermore, their concerns extend beyond biological fertility potential to include concerns about recurrence, living long enough to raise children, and the health of their (potential) children [8][9][10][11][19][20][21][22].…”

Section: Introductionmentioning

confidence: 99%

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A Multidimensional Scale to Measure the Reproductive Concerns of Young Adult Female Cancer Survivors

Gorman¹,

Su²,

Roberts³

et al. 2013

PsycEXTRA Dataset

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Purpose-Concerns about fertility and parenthood are important to many young adult (YA) female cancer survivors and are associated with poorer quality of life. We aimed to develop a new scale to comprehensively measure these concerns so that they can be better addressed.Methods-Scale development involved: 1) seven focus groups to identify reproductive concerns among YA female cancer survivors and develop potential scale items followed by pilot testing and cognitive interviews to refine items, 2) administering surveys to 204 YA female survivors and conducting principal components analysis (PCA) with oblique rotation to identify underlying factors in the multidimensional scale, and 3) identification of preliminary construct validity evidence.Results-We subjected 37 potential scale items to PCA, which indicated a six-factor solution. After removing low-loading and cross-loading items, we selected the three top loading items representing each factor. The 18-item Reproductive Concerns After Cancer (RCAC) scale (α = 0.82) assesses concerns about fertility potential, partner disclosure, child's health, personal health, acceptance, and becoming pregnant. As hypothesized, women who wanted to have a baby (p < 0.001) and those for whom having a biological child was very important (p < 0.05) had higher mean scores, indicating higher concerns.Conclusions-The scale demonstrated good internal consistency and evidence of construct validity and holds promise for future clinical and research applications.Implications for Cancer Survivors-An effective tool to identify concerns related to fertility and parenthood is essential for meeting the long-term reproductive health needs of young women who have survived cancer.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

A Multidimensional Scale to Measure the Reproductive Concerns of Young Adult Female Cancer Survivors

Gorman¹,

Su²,

Roberts³

et al. 2013

PsycEXTRA Dataset

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“…High levels of stress were found especially in young women with breast and gynecologic cancer, followed by significant psychological morbidity (Gorman, Malcarne, Roesch, Madlensky & Pierce, 2010;Carter et al, 2005). The physical and psychosocial morbidity related with diagnosis and treatments can impair the performance of social roles (Dunn & Steginga, 2000;Gorman et al, 2010).…”

mentioning

confidence: 99%

Reproductive concerns and psychosocial adjustment of young breast and gynecologic cancer patients

Cândido¹,

Bártolo²,

Monteiro

2016

European Proceedings of Social &Amp; Behavioural Sciences

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Confrontation with breast and gynecologic cancer causes difficulties of psychological adaptation. In young women, the reproductive and gynecologic consequences of the disease and treatments emerge as an additional threat. This study aimed to: (i) analyze depressive symptoms, anxiety, quality of life and reproductive concerns in young women with breast or gynecologic cancer, in comparison with healthy women; (ii) explore the mediator effect of depression and anxiety symptoms on the relation reproductive concerns → quality of life in women with cancer. This transversal study was conducted in "Centro Hospitalar Baixo Vouga II", Aveiro, and through various Facebook pages supporting women with cancer. The sample included 95 women, 52 with breast or gynecologic cancer diagnosis and 43 healthy controls. Participants completed the Reproductive Concerns Scale, the Hospital Anxiety and Depression Scale (HADS) and the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire Core-30 (EORTC QLQ-C30). Diagnosed women reported more depressive symptoms, anxiety and reproductive concerns than healthy women (p<0.001). An effect mediation of depressive symptoms (p=0.001) was found. Reproductive concerns affected the quality of life in this population, by being associated with more depression and anxiety symptoms. Although there is currently a careful selection of treatments to preserve fertility, our findings show that the diagnosis of breast or gynecologic cancer in phase I to III leads to concerns and beliefs associated with impaired fertility. This fact results in difficulties of psychological adaptation. Thus, we emphasize the importance of directing the psychological interventions towards this aspect.

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“…Even women who regain menses after cytotoxic chemotherapy ± antihormonal therapy are likely to have undergone significant follicle depletion and reproductive aging of 10 years or more (16)(17)(18)(19). As mortality from breast cancer including breast cancer under the age of 40 continues to decrease (20,21), fertility preservation has become a major survivorship issue for young women developing breast cancer (22)(23)(24)(25).…”

mentioning

confidence: 99%

“…Only half of young women feel that their concerns about fertility are addressed adequately at the time of a breast cancer diagnosis (6). Failure to discuss fertility fuels later feelings of grief and regret (22)(23)(24)(25). Therefore, it is important to address issues related to fertility preservation options at the time discussions of type and sequencing of gonadotoxic cancer treatment are taking place.…”

mentioning

confidence: 99%

Breast cancer and fertility preservation

Fabian¹,

Klemp²

2011

Principles and Practice of Fertility Preservation

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Objective-To review the benefits of adjuvant systemic therapy given to women with breast cancer of reproductive age, its effects on fertility, and options for fertility preservation.Design-Publications relevant to fertility preservation and breast cancer were identified through a PubMed database search. Conclusion(s)-Mostwomen who develop invasive breast cancer under age 40 will be advised to undergo adjuvant chemotherapy with or without extended antihormonal therapy to reduce the risk of recurrence and death from breast cancer. Adjuvant chemotherapy particularly with alkylating agents such as cyclophosphamide is gonadotoxic and markedly accelerates the rate of age-related ovarian follicle loss. Although loss of fertility is an important issue for young cancer survivors, there is often little discussion about fertility preservation before initiation of adjuvant therapy. Greater familiarity with prognosis and effects of different types of adjuvant therapy on the part of infertility specialists and fertility preservation options such cryopreservation of embryos, oocytes, and ovarian tissue on the part of oncologists would facilitate these discussions. Establishment of rapid fertility consultation links within cancer survivorship programs can help ensure that every young woman who is likely to undergo gonadotoxic cancer treatment is counseled about the effects of therapy and options available to her to increase the likelihood of childbearing after cancer treatment. KeywordsBreast cancer; fertility preservation; embryo cryopreservation; oocyte cryopreservation; ovarian tissue cryopreservation; ovarian transplantation; GnRH agonist; chemotherapy; cancer survivorshipIn the United States, 5%-7% of cases of invasive breast cancer (~11,000/year) occur in women who are under age 40 at diagnosis (www.seer.cancer.gov.2008), most between the ages of 30 and 40 (1). As almost one quarter of first live births in the United States occur between the ages of 30 and 40, many of these women will not have had the opportunity to bear a child (2). Less than 10% of women who develop invasive breast cancer under age 40 have children postdiagnosis (3-5), despite survey results suggesting about half desire to do so (6) and observational studies that do not indicate an increased risk of relapse or death for women who become pregnant after a breast cancer diagnosis (7-9). Receipt of cytotoxic chemotherapy is a major factor in the low rate of live births after a diagnosis of breast

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Depressive symptoms among young breast cancer survivors: the importance of reproductive concerns

Cited by 132 publications

References 58 publications

A Multidimensional Scale to Measure the Reproductive Concerns of Young Adult Female Cancer Survivors

A Multidimensional Scale to Measure the Reproductive Concerns of Young Adult Female Cancer Survivors

Reproductive concerns and psychosocial adjustment of young breast and gynecologic cancer patients

Breast cancer and fertility preservation

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