Fertility information needs and concerns post-treatment contribute to lowered quality of life among young adult female cancer survivors

Benedict, Catherine; Thom, Bridgette; Friedman, Danielle Novetsky; Pottenger, Elaine; Raghunathan, Nirupa Jaya; Kelvin, Joanne Frankel

doi:10.1007/s00520-017-4006-z

Cited by 89 publications

(95 citation statements)

References 28 publications

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“…As a result of advances in early detection and improvements in treatment, people are living with cancer for longer (Foster, Calman, Richardson, Pimperton, & Nash, ). Although most patients recover well, a significant number of cancer survivors experience a variety of physical and psychosocial concerns that continue even after their treatment has ended (Recklitis & Syrjala, ), including cancer‐related fatigue (Jones et al, ), fertility problems (Benedict et al, ), chronic pain (Selove et al, ), symptoms of depression and anxiety (Philip & Merluzzi, ; Philip, Merluzzi, Zhang, & Heitzmann, ) and fear of cancer recurrence (FCR; Jimenez et al, ). To ensure that cancer survivors’ concerns are appropriately addressed, it is important to continually assess, predict and fulfil their needs.…”

Section: Introductionmentioning

confidence: 99%

Prevalence and factors associated with unmet needs in post‐treatment cancer survivors: A systematic review

et al. 2019

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Cancer survivors may experience unmet needs beyond the end of their treatment. This paper aimed to explore the prevalence and most frequently found unmet needs and to identify factors associated with higher levels of total unmet needs and with each domain separately. Five databases were searched using the keywords neoplasms, survivors, needs assessment, health services’ needs and demands. The results were presented based on the strength of the evidence (strong, moderate and weak association) and the categorisation of the pooled prevalence of at least one unmet need (high, moderate, low). Twenty‐six studies were included in the review. A higher prevalence of at least one reported unmet need was observed in survivors with less time since treatment and in women with breast cancer. The most frequently reported unmet needs were fear of cancer recurrence and requesting up to date information. Strong evidence was found for an association between a higher number of unmet needs and younger age, higher anxiety and poorer quality of life. Future studies on unmet needs should report how unmet needs are associated with each domain separately. This might solve the inconclusive evidence found for the stage of the disease at diagnosis and depression.

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Section: Introductionmentioning

confidence: 99%

Prevalence and factors associated with unmet needs in post‐treatment cancer survivors: A systematic review

et al. 2019

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“…While as many as two‐thirds of RAFCS experience reproductive concerns, their needs for services and information related to their reproductive health and family planning are often unmet . Related reproductive distress, including perceived signs of fertility problems (eg, irregular menstrual function) after cancer, is associated with increased psychological distress and poorer QOL . While specialized counseling by a fertility specialist can be helpful, many RAFCS could benefit from clinical and supportive care to manage their reproductive concerns across the course of survivorship …”

Section: Introductionmentioning

confidence: 99%

“…[10][11][12] Related reproductive distress, including perceived signs of fertility problems (eg, irregular menstrual function) after cancer, is associated with increased psychological distress and poorer QOL. 2,5,[13][14][15] While specialized counseling by a fertility specialist can be helpful, 16,17 many RAFCS could benefit from clinical and supportive care to manage their reproductive concerns across the course of survivorship. 5,13,18-23…”

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confidence: 99%

Revisiting the Reproductive Concerns After Cancer (RCAC) scale

et al. 2019

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Objective The aims of this study were to examine the factor structure and reliability of the multidimensional Reproductive Concerns After Cancer (RCAC) scale in a sample of female cancer survivors during their reproductive years, younger than age 45. Methods Female reproductive‐aged survivors (N = 238; current age, 18 to 44 y) with a variety of cancer diagnoses completed a web‐based survey that included the RCAC scale. Three structural models were examined via confirmatory factor analysis: (a) one‐factor, (b) higher‐order with one second‐order factor and six first‐order factors, and (c) oblique six‐factor. Reliability was examined using omega total and Revelle omega total. Results Only the oblique six‐factor model of the RCAC scale fits well. Omega total and Revelle omega total estimates for all of the six three‐item subscales were in the nearly satisfactory to good range (.66 to.87). Conclusions The RCAC scale was found to have satisfactory factor structure and reliability when measuring a range of reproductive concerns experienced by female reproductive‐aged survivors. The RCAC scale is a multidimensional measure of varying aspects of reproductive concerns, and results suggest that the scale may be best represented as a profile of subscale scores. The subscale scores would be useful for tailoring recommendations and interventions to more effectively address the diverse reproductive concerns of female reproductive‐aged survivors.

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“…[2][3][4][5] For example, although the overall proportion of infertile female childhood cancer survivors is 13%, those who underwent total body irradiation have a 28% risk. [6][7][8] Previous studies have shown that potential loss of fertility can be as painful as the cancer diagnosis itself, 9 and for some, the possibility of preserving fertility is instrumental to coping with the burden of cancer treatment. [6][7][8] Previous studies have shown that potential loss of fertility can be as painful as the cancer diagnosis itself, 9 and for some, the possibility of preserving fertility is instrumental to coping with the burden of cancer treatment.…”

Section: Introductionmentioning

confidence: 99%

Fertility counseling before cancer treatment and subsequent reproductive concerns among female adolescent and young adult cancer survivors

Young

Shliakhtsitsava

Natarajan

et al. 2018

Cancer

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BACKGROUND: Fertility counseling before cancer treatment has been advocated by clinical guidelines, though little is known about its long-term impact on the unique reproductive concerns of female adolescent and young adult (AYA) cancer survivors. The goal of this study was to measure the association between fertility counseling by fertility specialists before cancer treatment and subsequent reproductive concerns. METHOD: A cross-sectional analysis was performed among 747 AYA survivors aged 18-40 years who had been recruited from cancer registries and physician and advocacy group referrals between 2015 and 2017. Participants self-reported information on past fertility counseling at cancer diagnosis, cancer type and treatment, and current reproductive concerns, as measured using the multidimensional Reproductive Concerns After Cancer scale. Multivariable log-binomial regression models tested associations between fertility counseling and reproductive concerns. RESULTS: The mean age of the cohort was 33.0 years (standard deviation, 5.1 years), and the mean period since diagnosis was 7.7 years (standard deviation, 5.0 years). Seventy-three percent of participants were white, and 24% were Hispanic. Fertility counseling was reported by 19% of survivors; moderate to high overall reproductive concerns were reported by 44% of participants. In adjusted analysis, fertility counseling was significantly associated with moderate to high reproductive concerns (risk ratio, 1.22; 95% confidence interval, 1.02-1.45) and not modified by exposure to fertility-threatening treatments (P interaction = .23). CONCLUSION: A large proportion of AYA cancer survivors across cancer types and treatment exposures reported moderate to high reproductive concerns, suggesting that there is a need to address these cancer-specific reproductive health concerns after treatment. Higher concerns, even with counseling, suggests the need to improve the quality of fertility counseling throughout the cancer continuum. Cancer 2019;125:980-989.

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Fertility information needs and concerns post-treatment contribute to lowered quality of life among young adult female cancer survivors

Cited by 89 publications

References 28 publications

Prevalence and factors associated with unmet needs in post‐treatment cancer survivors: A systematic review

Prevalence and factors associated with unmet needs in post‐treatment cancer survivors: A systematic review

Revisiting the Reproductive Concerns After Cancer (RCAC) scale

Fertility counseling before cancer treatment and subsequent reproductive concerns among female adolescent and young adult cancer survivors

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