Fertility preservation in women affected by gynaecological cancer: the importance of an integrated gynaecological and psychological approach

Rosa, Valentina Lucia La; Garzon, Simone; Gullo, Giuseppe; Fichera, Michele; Sisti, Giovanni; Gallo, Pasquale; Riemma, Gaetano; Schiattarella, Antonio

doi:10.3332/ecancer.2020.1035

Cited by 58 publications

(41 citation statements)

References 64 publications

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“… 30 The possible loss of fertility during treatment with cancer can be more distressing than cancer itself, according to recent reports where efforts to maintain fertility through techniques such as fertility-sparing surgery are essential in younger women diagnosed with gynecological cancers as they could lead to an improvement in quality of life. 31 Another recent study indicated high levels of psychological distress when diagnosed women reach childbearing age as menstrual function and fertility were lost. It is therefore important to monitor the progression of cancer but should also provide appropriate fertility preservation counselling.…”

Section: Discussionmentioning

confidence: 99%

Women Diagnosed with Ovarian Cancer: Patient and Carer Experiences and Perspectives

Boban¹,

Downs²,

Codde³

et al. 2021

PROM

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Purpose By directly engaging with women diagnosed with ovarian cancer, this study aimed to explore and identify their view of the health symptoms and outcomes that matter most to them as they traverse their disease pathway. Background Patient-reported outcome measures in ovarian cancer have tended to focus on physical symptoms rather than the more complex psychosocial aspects of living with the disease. Using a “ground-up approach”, this study sought to comprehensively understand the health concerns that matter most to women with ovarian cancer as a first step in generating items for development into an ovarian cancer–specific patient-reported outcome measure. Patients and Methods Following an extensive literature review, we sought to capture the “patient voice” through a qualitative descriptive approach including a community conversation with ovarian cancer patients, their carers and clinicians, and interviews and focus groups with women with ovarian cancer. Thirteen women were interviewed individually, and two focus groups were conducted. A template thematic analysis was used to analyze the data. Results Key themes included challenges related to clinical diagnosis, treatment phase, altered relationships with family/friends, financial issues, relationships with health professionals and coping strategies. Within each key theme, several sub-themes emerged that were identified as various challenges experienced by participants. Diagnostic delay, chemotherapy and surgery-related challenges, negative impact of sexual well-being on partner relationship, communicational challenges with health professionals were among the few issues identified. In addition, self-empowerment was identified as a coping mechanism among participants. Conclusion By identifying priorities for women diagnosed with ovarian cancer we have highlighted the need for strategies to reduce diagnostic delays and improve quality of life for these women. Data will inform the development of an ovarian cancer–specific patient-reported outcome measure.

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Section: Discussionmentioning

confidence: 99%

Women Diagnosed with Ovarian Cancer: Patient and Carer Experiences and Perspectives

Boban¹,

Downs²,

Codde³

et al. 2021

PROM

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“…In a fertility sparing approach, a multidisciplinary team, including a psychological support for the woman, is essential. Anxiety, depression and fear could harass the patient during the therapeutic path; enhancing her quality of life through a psychological support is crucial in order to improve the efficacy of the treatment (85)(86)(87).…”

Section: First Histological Sample Second Histological Sample Third Histological Sample Initial Assessmentmentioning

confidence: 99%

Hysteroscopy in the management of endometrial hyperplasia and cancer in reproductive aged women: new developments and current perspectives

Vitale¹,

Riemma²,

Carugno³

et al. 2020

Transl Cancer Res TCR

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Over the last twenty years, the incidence of early endometrial cancer (EC) and atypical endometrial hyperplasia (AEH) among women of reproductive age is increasing rapidly, likely due to a combination of factors including increased prevalence of obesity and delayed of childbirths. Regarding preoperative diagnosis of endometrial neoplasia, it is still debated which is the most accurate and reliable method to obtain endometrial histopathological samples with fractional dilatation and curettage (D&C) having been considered, for a long time, as the method of choice. Nowadays, the advent of in-office endometrial biopsy with or without hysteroscopy has radically changed the approach, giving the opportunity to perform the endometrial biopsy under direct visualization. However, the lack of agreement about its diagnostic accuracy is still relevant. Since a significant number of women with AEH and/or EC are of childbearing age, a fertility-sparing diagnostic and therapeutic approach should be considered in all cases.The feasibility, safety and efficacy of fertility-sparing strategies involving hysteroscopic focal resections in conjunction with hormonal therapies have been evaluated and beneficial effects have been confirmed in several studies and one meta-analysis. Both local and systemic administration of hormonal therapies are currently used. Oral progestin, including medroxyprogesterone acetate (MPA) and megestrol acetate, are the most commonly used therapies. Nowadays, new therapeutic approaches, such as levonorgestrel intrauterine systems (LNG-IUS), gonadotropin-releasing hormone (GnRH) agonists, combined megestrol acetate and metformin, and other combinations of therapies are also used as first line therapies or after the hysteroscopic resection of the lesion. However, it is still unclear which approach provides higher clinical response with lower relapse rate, in addition to preserving fertility in women desiring to conceive. The aim of this narrative review is to summarize the available evidence regarding the evaluation and management with fertility-sparing treatments options of women with AEC and EC.

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“…Early diagnosis of ovarian cancer through relevant basic research will maximize fertility preservation. This will significantly reduce the impact on sexual function, mental health, quality of life, and other aspects [ 1 ].…”

Section: Introductionmentioning

confidence: 99%

miR-29c-3p regulates proliferation and migration in ovarian cancer by targeting KIF4A

Feng

Luo

et al. 2020

World J Surg Onc

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Background Increasing evidence suggested that microRNA and kinesin superfamily proteins play an essential role in ovarian cancer. The association between KIF4A and ovarian cancer (OC) was investigated in this study. Methods We performed bioinformatics analysis in the GEO database to screen out the differentially expressed miRNAs (DEmiRNAs) associated with ovarian cancer prognosis. Upstream targeting prediction for KIF4A was acquired by using the mirDIP database. The potential regulatory factor miR-29c-3p for KIF4A was obtained from the intersection of the above all miRNAs. The prognosis of KIF4A and target-miRNA in OC was obtained in the subsequent analysis. qRT-PCR and Western blot detected KIF4A expression level in IOSE80 (human normal ovarian epithelial cell line). In the meantime, the gene expression level was detected in A2780, HO-8910PM, COC1, and SKOV3 cell lines (human ovarian carcinoma cell line). MTT and colony formation assays were used to detect cell proliferation of SKOV3 cell line. The following assays detected cell migration through the use of transwell and wound heal assays. Targeted binding relationship between KIF4A and miRNA was detected by using the dual-luciferase reporter assay. Results Both high expression of KIF4A and lower expression of miR-29c-3p could be used as biomarkers indicating poor prognosis in OC patients. Cellular function tests confirmed that when KIF4A was silenced, it inhibited the proliferation and migration of OC cells. In addition, 3′-UTR of KIF4A had a direct binding site with miR-29c-3p, which indicated that the expression of KIF4A could be regulated by miR-29c-3p. In subsequent assays, the proliferation and migration of OC cells were inhibited by the overexpression of miR-29c-3p. At the same time, rescue experiments also confirmed that the promotion of KIF4A could be reversed by miR-29c-3p. Conclusion In a word, our data revealed a new mechanism for the role of KIF4A in the occurrence and development of OC.

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Fertility preservation in women affected by gynaecological cancer: the importance of an integrated gynaecological and psychological approach

Cited by 58 publications

References 64 publications

Women Diagnosed with Ovarian Cancer: Patient and Carer Experiences and Perspectives

Women Diagnosed with Ovarian Cancer: Patient and Carer Experiences and Perspectives

Hysteroscopy in the management of endometrial hyperplasia and cancer in reproductive aged women: new developments and current perspectives

miR-29c-3p regulates proliferation and migration in ovarian cancer by targeting KIF4A

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