Psychological aspects of gestational cancer: A systematic review

Abstract

Objective: Gestational cancer is defined as any type of cancer diagnosed during pregnancy or within 12 months of delivery. To date, existing studies on the psychological aspects of this type of cancer have not been evaluated for methodological quality. The aim of this systematic review was to identify the psychological aspects of gestational cancer. Methods: Five journal databases were searched to identify peer-reviewed articles reporting upon the psychological aspects of women with gestational cancer. Studies published from journal inception to December 2019 were included, and Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) guidelines were followed. The Mixed-Method Appraisal Bias Tool was used, to assess the methodological quality of the studies. A narrative description was developed for the psychological outcomes reported in quantitative studies. Qualitative data was synthesized using thematic analysis. Results: Five papers were eligible for inclusion (two qualitative and three quantitative studies). Factors that contributed to women's psychological distress during gestational cancer included disease characteristics, sociodemographic factors, the baby's health, pregnancy-related factors and cognitive emotion regulation. Four main themes emerged from the qualitative studies; concerns about the baby's health, lost opportunities, "not fitting in," and healthcare decision-making. Conclusions: These findings suggest that (a) women with gestational cancer experience psychological distress that is associated with concerns about their babies' health, and (b) their healthcare experiences are affected by communication within multidisciplinary care teams.

Cancer and Pregnancy: A Comprehensive Review

“…Similar mood changes were observed in women diagnosed with cancer in pregnancy: 51.5% of pregnant women were clinically distressed, while the distress was mostly experienced as intrusive thoughts [ 92 ]. Positive coping strategies were associated with decreased level of concern [ 112 ]. Vandenbroucke et al reported a high level of distress (in both parents) related to concerns regarding the child’s health, the cancer diagnosis and treatment, the outcome of the pregnancy and the delivery [ 113 ].…”

“…Vandenbroucke et al reported a high level of distress (in both parents) related to concerns regarding the child’s health, the cancer diagnosis and treatment, the outcome of the pregnancy and the delivery [ 113 ]. During the ongoing pregnancy, nulliparous women showed more concerns than multiparous, and in general, women were concerned about the effects of the chemotherapy on the progeny [ 112 ]. Pregnant women tended to overestimate the impact of antenatal chemotherapy on short-term and long-term effects on the offspring [ 112 ].…”

“…During the ongoing pregnancy, nulliparous women showed more concerns than multiparous, and in general, women were concerned about the effects of the chemotherapy on the progeny [ 112 ]. Pregnant women tended to overestimate the impact of antenatal chemotherapy on short-term and long-term effects on the offspring [ 112 ]. Additionally, a more advanced disease stage was correlated with increased concerns, but not with an increased wish for termination of pregnancy [ 112 ].…”

“…Pregnant women tended to overestimate the impact of antenatal chemotherapy on short-term and long-term effects on the offspring [ 112 ]. Additionally, a more advanced disease stage was correlated with increased concerns, but not with an increased wish for termination of pregnancy [ 112 ].…”

Experiences of health professionals treating women diagnosed with cancer during pregnancy and proposals for service improvement

“…The role of comprehensive cancer care coordination in optimizing patient outcomes is recognised in Australia[7], but there is little research within the context of GC. The limited information available suggests that meeting the challenges of the complexity of care inherent in this group is central to perceived quality of care and wellbeing [4,14,15]. No previous study has investigated the experiences of the HPs treating this population; perspectives which are needed to better understand the barriers to comprehensive GC care.…”