Fertility-Related Concerns and Uncertainties in Adolescent and Young Adult Childhood Cancer Survivors

Jardim, Fabrine Aguilar; Lopes-Júnior, Luí­s Carlos; Nascimento, Lucila Castanheira; Neves, Eliane Tatsch; Lima, Regina Aparecida Garcia de

doi:10.1089/jayao.2020.0058

Cited by 21 publications

(83 citation statements)

References 36 publications

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“…Five studies used a self‐designed scale to examine reproductive concerns 8,57–60 . Reproductive concerns were also discussed by survivors in qualitative studies 9,27,43,54,61–68 …”

Section: Resultsmentioning

confidence: 99%

Reproductive concerns among adolescent and young adult cancer survivors: A scoping review of current research situations

et al. 2022

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Fertility is a significant concern among adolescent and young adult (AYA) cancer survivors and their caregivers, especially after their completion of cancer treatment programs. Concerns about fertility affect not only cancer patients' psychological well-being, but also all aspects of their medical treatments, including treatment protocol, decision-making, and treatment adherence. In this scoping review, the PubMed, CINAHL, Web of Science, Embase, CNKI, and Wanfang electronic databases were searched according to the guidelines of the Preferred Reporting Items for Systematic Reviews and Meta-Analysis Extension for Scoping Reviews. The searches identified 669 articles, 54 of which met the inclusion criteria. Reviewers extracted the data on the study characteristics, measurements, positive factors, negative factors, and additional themes. This scoping review included studies from 10 countries. Most studies were quantitative using a cross-sectional design. The prevalence of reproductive concerns among AYA cancer survivors ranged from 44% to 86%, and 28% to 44% of the survivors experienced moderate to severe concerns. The specific implementation of fertility consultation, including timing, consult frequency, and content, deserves ongoing exploration.

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“…Five studies used a self‐designed scale to examine reproductive concerns 8,57–60 . Reproductive concerns were also discussed by survivors in qualitative studies 9,27,43,54,61–68 …”

Section: Resultsmentioning

confidence: 99%

Reproductive concerns among adolescent and young adult cancer survivors: A scoping review of current research situations

et al. 2022

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“…It has been reported that most male cancer patients/survivors do not feel sufficiently informed and postpubertal boys strongly desire information on FP options 26,27 . Similarly, female cancer patients feel it is important to discuss fertility, preferably shortly after diagnosis 28‐32 . A recently published guideline by the International Guideline Harmonization Group (IGHG) states that current standard care should include informing all pediatric cancer patients and their families on their relative risk of gonadal damage, including the low‐risk group 10,11,33 .…”

Section: Overview Of the Issue Of Fertility Importance To Cancer Pati...mentioning

confidence: 99%

White paper: Oncofertility in pediatric patients with Wilms tumor

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et al. 2022

Intl Journal of Cancer

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The survival of childhood Wilms tumor is currently around 90%, with many survivors reaching reproductive age. Chemotherapy and radiotherapy are established risk factors for gonadal damage and are used in both COG and SIOP Wilms tumor treatment protocols. The risk of infertility in Wilms tumor patients is low but increases with intensification of treatment including the use of alkylating agents, whole abdominal radiation or radiotherapy to the pelvis. Both COG and SIOP protocols aim to limit the use of gonadotoxic treatment, but unfortunately this cannot be avoided in all patients. Infertility is considered one of the most important late effects of childhood cancer treatment by patients and their families. Thus, timely discussion of gonadal damage risk and fertility preservation options is important. Additionally, irrespective of the choice for preservation, consultation with a fertility preservation (FP) team is associated with decreased patient and family regret and better quality of life. Current guidelines recommend early discussion of the impact of therapy on potential fertility. Since most patients with Wilms tumors are prepubertal, potential FP methods for this group are still considered experimental. There are no proven methods for FP for prepubertal males (testicular biopsy for cryopreservation is experimental), and there is just a single option for prepubertal females (ovarian tissue cryopreservation), posing both technical and ethical challenges. Identification of genetic markers of susceptibility to gonadotoxic therapy may help to stratify patient risk of gonadal damage and identify patients most likely to benefit from FP methods.

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“…However, there is a higher risk for miscarriage in these situations [22]; therefore, there are some necessary prerequisites that should be considered when supporting a pregnancy after cancer. The interval between treatment and conception is one of the most important considerations, since women who conceived less than one year after chemotherapy, had higher risks of preterm birth than women who conceived 2 years or more after treatment [23].…”

Section: Effects Of Anticancer Treatments On Fertilitymentioning

confidence: 99%

“…infertility seems to be associated with high levels of distress, anxiety, and depression [12], and lower quality of life [1]. it has also been identified as an experience marked by feelings of grief and loss, even in women who have fulfilled their family wishes before cancer [22]. Especially young and childless women, revealed higher levels of psychological distress, lower self-esteem, uncertainty, relationship problems, more intrusive thoughts, and more avoidance strategies [1,12,25,42], regardless of the cancer site.…”

Section: Impact Of the Risk Of Infertility On The Patient's Quality Of Lifementioning

confidence: 99%

“…it is important to mention that some studies revealed that even women who already had children and who did not think about having more children after cancer, also face the risk of fertility loss as an emotionally draining experience [22,25,42]. Even though 70% of patients revealed that the disease had no impact on their desire to have children, 13% to 15% stated that cancer diagnosis increased their desire to be mothers again and the value given to parenting [42].…”

Section: Impact Of the Risk Of Infertility On The Patient's Quality Of Lifementioning

confidence: 99%

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On Becoming a Mother After Cancer Survival: A Comprehensive Literature Review

2021

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Problem identification: The desire for motherhood is one of the top priorities for most female young cancer survivors. The risk of infertility after cancer therapy is an important concern with several physical and emotional consequences. This comprehensive literature review aims to summarize and contextualize recent research that has been carried out on female fertility after cancer, suggesting future research and clinical directions. Literature search: Searches included the keywords “cancer”, “female”, “adults”, and “fertility”. Studies were selected if focused on infertility issues in female cancer survivors. Data synthesis: Eight themes were identified: the effects of anticancer treatments on fertility; fertility preservation methods; international recommendations regarding infertility risk; health professionals’ attitudes towards fertility preservation; patient’s concerns regarding the risk of infertility; patients' information needs; and the impact of the risk of infertility in patient’s quality of life. Conclusions: Psycho-oncologists should be integrated in the oncofertility teams to assess patients’ needs before cancer treatment initiation.

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Fertility-Related Concerns and Uncertainties in Adolescent and Young Adult Childhood Cancer Survivors

Cited by 21 publications

References 36 publications

Reproductive concerns among adolescent and young adult cancer survivors: A scoping review of current research situations

Reproductive concerns among adolescent and young adult cancer survivors: A scoping review of current research situations

White paper: Oncofertility in pediatric patients with Wilms tumor

On Becoming a Mother After Cancer Survival: A Comprehensive Literature Review

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