scholarly journals Fertility Preservation and Sexual Health After Cancer Therapy

2017 ◽  
Vol 13 (10) ◽  
pp. 643-651 ◽  
Author(s):  
Nigel Pereira ◽  
Glenn L. Schattman

Recent developments in cancer diagnostics and treatments have considerably improved long-term survival rates. Despite improvements in chemotherapy regimens, more focused radiotherapy and diverse surgical options, cancer treatments often have gonadotoxic side-effects that can manifest as loss of fertility or sexual dysfunction, particularly in young cancer survivors. In this review, we focus on two pertinent quality-of-life issues in female cancer survivors of reproductive age—fertility preservation and sexual function. Fertility preservation encompasses all clinical and laboratory efforts to preserve a woman’s chance to achieve future genetic motherhood. These efforts range from well-established protocols such as ovarian stimulation with cryopreservation of embryos or oocytes, to nascent clinical trials involving cryopreservation and re-implantation of ovarian tissue. Therefore, fertility preservation strategies are individualized to the cancer diagnosis, time interval until initiation of treatments must begin, prognosis, pubertal status, and maturity level of patient. Some patients choose not to pursue fertility preservation, and the conversation then centers around other quality of life issues. Not all cancer treatments cause loss of fertility; however, most treatments can directly impact the physical and psychosocial aspects of sexual function. Cancer treatment is also associated with fear, anxiety, and depression, which can further decrease sexual desire, function, and frequency. Sexual dysfunction after cancer treatment is generally ascertained by compassionate inquiry. Strategies to promote sexual function after cancer treatment include pelvic floor exercises, clitoral therapy devices, pharmacologic agents, as well as couples-based psychotherapeutic and psycho-educational interventions. Quality-of-life issues in young cancer survivors are often best addressed by utilizing a multidisciplinary team consisting of physicians, nurses, social workers, psychiatrists, sex educators, counselors, or therapists.

2021 ◽  
Vol 39 (15_suppl) ◽  
pp. 3587-3587
Author(s):  
Laura Diane Porter ◽  
Ronit Yarden ◽  
Kim Lynn Newcomer ◽  
Negeen Fathi ◽  

3587 Background: Colorectal cancer is the third-most commonly diagnosed cancer and the second-leading cause of cancer death in men and women combined in the United States. Young-onset colorectal cancer refers to individuals diagnosed under the age of 50. In recent years, the incidence has increased by 2.2% annually in individuals younger than 50 years and 1% in individuals 50-64, in contrast to a 3.3% decrease in adults 65 years and older. Young-onset (YO) CRC patients and survivors face unique clinical challenges with fertility and sexual dysfunctions, but this risk is not well quantified. There is limited data and public discussion on the long-term effects of colorectal cancer treatments on fertility and sexual dysfunction and the long-term impact on the quality of life. Methods: To explore the unique challenges and unmet needs of the young-adult patient population, a cross-sectional study was conducted. Colorectal cancer patients and survivors (N = 884) diagnosed between the ages of 20 to 50 years old (median age 42 ± 7.0) completed an online questionnaire based on established instruments EORTC-QOL-30, EORTC-CR-29, and EORTC-SHC-22. Results: Thirty-one percent of respondents stated that a medical professional spoke to them about fertility preservation at the time of diagnosis and during treatment. Only 31% were referred to a reproductive endocrinologist, even though 37% of women and 16% of men reported that treatment left them infertile or sterile. Among survey respondents, 12% of women had an egg retrieval procedure, and 36% of men had their sperm preserved prior to the start of treatment. Fifty-three percent of women reported treatment led to premature menopause. Sixty-five percent of respondents suffer from some level of sexual dysfunction due to treatment. In patients who received radiation therapy, women were 12% less likely than men to have discussed sexual side effects with the provider before treatment. Patients who have an ostomy reported more severe sexual dysfunction (17.8%). Rectal cancer patients were 2.5 times more likely than those with colon cancer to report severe dysfunction after their treatment. More than 25% of the respondents said they would have considered alternative treatment if they would have known the risks of sexual dysfunction. Conclusions: Our survey demonstrates inadequate communications between patients and providers about the irreversible fertility and sexual effects of colorectal cancer treatments. Younger patients and survivors face unique long-term challenges and require further information about fertility preservation options and emotional support regarding their sexuality post-treatment. Other studies are needed to assess the physical and psychological side effects endured by young-onset CRC patients and survivors.


2017 ◽  
Vol 35 (5_suppl) ◽  
pp. 123-123 ◽  
Author(s):  
Emily Jo Rajotte ◽  
K. Scott Baker ◽  
Leslie Heron ◽  
Karen Leslie Syrjala

123 Background: Sexual dysfunction is a common treatment sequela across numerous cancer diagnoses and treatments, causing increased distress, discomfort and negatively impacting quality of life. Methods: Before their survivorship-focused clinic appointment, adult cancer survivors were asked to complete a comprehensive patient -eported outcomes survey that included detailed questions on their health status including sexual function. Results: Between April 2015 to July 2016, 94 patients completed the survey. They were 66% female, mean age 45 years (SD 16, range 21-82) and 34% leukemia/lymphoma, 18% breast cancer, and 12% genitourinary cancer survivors. Patients were a mean of 6.7 years (SD 7.9, range 0-42) from their cancer diagnosis at the time of clinic appointment. Nearly half (48%) were married or living with a partner and 49% were living alone (single, divorced, widowed). 70.2% reported being sexually active (alone or with a partner) in the last year: of these only half (55.3%) reported being sexually active in the last month. For those who were not sexually active the most commonly cited reasons included lack of interest (24.5%) and not having a partner (30.9%), with 12.8% reporting not being sexually active due to a physical problem. Survivors rated their sexual satisfaction in the past month as a 5.0 (SD 3.7; scale of 0-10, 0=not at all satisfying 10=extremely satisfying). An independent samples t-test revealed a statistically significant difference in sexual satisfaction between survivors under 45 years in age and ≥45 years in age (t=4.4, df=68.0, p < 0.05). Older survivors (mean=3.71, SD=3.7) reported significantly lower levels of sexual satisfaction than did younger survivors (mean=7.11, SD=2.8). The most commonly reported sexual function issues for women included vaginal dryness (23.4%) and for men included difficulty getting an erection (7.4%). Conclusions: Sexual dysfunction is a common long-term effect of cancer across diagnoses and most treatments, warranting widespread implementation of targeted interventions to manage sexual dysfunction and improve quality of life for these survivors.


2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 649-650
Author(s):  
Heather Derry ◽  
Claire Conley ◽  
Kelly Trevino

Abstract By 2040, there will be an estimated 26.1 million cancer survivors in the United States, with 73% over age 65. Compared to younger survivors and those without cancer, older adult cancer survivors have an elevated comorbidity burden. Lifestyle interventions can play a key role in preventing and managing chronic health conditions and promoting quality of life during and after cancer treatment. Yet, behavioral interventions for maximizing health are under-utilized in older adults with cancer. At times, older adults may have unique needs that require tailoring to increase accessibility, optimization, and uptake of behavioral interventions. This symposium will showcase innovative approaches for enhancing health among older adult cancer survivors during and after cancer treatment. Dr. Bluethmann will discuss design considerations for using geriatric assessment in an ongoing exercise trial to manage side effects of aromatase inhibitors. Dr. Gell will present data on older survivors’ preferences regarding text messaging to support physical activity maintenance from an intervention study. Dr. Leach will discuss the use of technology to facilitate lifestyle change in older cancer survivors, presenting data on older adults’ user preferences and benefits from an eHealth tool. The discussant, Dr. Trevino, will summarize how these interventions can be leveraged to promote engagement in managing older survivors’ health and to inform next steps in intervention development. Collectively, this multidisciplinary group of speakers will provide practical information and “lessons learned” from designing behavioral and technology-based interventions, and highlight the promise that these approaches hold for improving quality of life in aging cancer survivors. Cancer and Aging Interest Group Sponsored Symposium.


2017 ◽  
Vol 108 (3) ◽  
pp. e90 ◽  
Author(s):  
N. Sinha ◽  
J. Letourneau ◽  
S. Chan ◽  
E. Niemasik ◽  
P. Xiong ◽  
...  

2016 ◽  
Vol 34 (3_suppl) ◽  
pp. 222-222 ◽  
Author(s):  
Kenneth Tercyak ◽  
Darren Mays ◽  
Andrea Johnson ◽  
Sarah Murphy ◽  
Aziza T. Shad

222 Background: Although infertility risks due to childhood cancer treatment are well-documented, research on the psychosocial impact of treatment-associated infertility risks among adolescent and young adult (AYA) cancer survivors is limited. This study examined AYA pediatric cancer survivors’ perceptions of oncofertility and cancer treatment-associated infertility risks and associations with patient-reported quality of life (QoL). Methods: Patients ages 12 to 25 (n= 70, M age 19.4, 74% white, 57% female, a majority leukemia/lymphoma survivors) were recruited from a pediatric hematology/oncology clinic and local pediatric cancer survivor support organizations. Patients reported knowledge and beliefs about treatment-related fertility risks and reproductive health, and oncofertility information and support needs, and completed the Pediatric Oncology Quality of Life (QoL) scale. Results: Patients’ knowledge about infertility risks and fertility preservation options was low (M 13.5, SD 8.6, range 0-42): patients’ attitudes indicated treatment-related infertility risks was important (M 21.7, SD 7.0, range 0-40), they perceived they were at-risk for infertility (M 3.8, SD 1.0 range 1-5), and expressed unmet needs for supportive resources on reproductive health (M 13.6, SD 4.8, range 1-24). Greater perceived risks of infertility (r = .34, p = .004) and importance of fertility risks (r = .34, p = .004) were associated with lower QoL. In a multivariable model adjusting for patient age and gender, beliefs that reproductive health was important was associated with lower QoL (B = .68, p = .041). Conclusions: Population data demonstrate few AYA cancer survivors have opportunities to discuss fertility preservation with providers. Our findings indicate AYA cancer survivors perceive treatment-related infertility risks as important, associated with QoL, and with needs for more information about reproductive health and fertility preservation. Care models addressing AYA survivors’ infertility risks are needed as part of the diagnosis, treatment, and long-term follow-up of these patients.


2014 ◽  
Vol 18 (3) ◽  
pp. 323-328 ◽  
Author(s):  
Winnie K.W. So ◽  
Ka Ming Chow ◽  
Helen Y.L. Chan ◽  
Kai Chow Choi ◽  
Rayman W.M. Wan ◽  
...  

2008 ◽  
Vol 14 (8) ◽  
pp. 1131-1136 ◽  
Author(s):  
DK Tepavcevic ◽  
J Kostic ◽  
ID Basuroski ◽  
N Stojsavljevic ◽  
T Pekmezovic ◽  
...  

Objective Sexual dysfunction (SD) is a common but often overlooked symptom in multiple sclerosis (MS). The aim of this study was to estimate the frequency, type, and intensity of SD in our patients with MS and to investigate its influence on all the domains of quality of life. Methods The study population comprised a cohort of 109 patients with MS (McDonald's criteria, 2001). SD was quantified by a Szasz sexual functioning scale. Health-related quality of life was measured by a disease-specific instrument MSQoL-54 (Serbian version). Results The presence of at least one symptom of SD was found in about 84% of the men and in 85% of the women. The main complaints in women were reduced libido, difficulties in achieving orgasm, and decreased vaginal lubrication; in men, the main complaints were reduced libido, incomplete erections, and premature ejaculation. In women, statistically significant negative correlations between the presence and level of SD and quality of life domains were reached for all subscales ( P < 0.01), except for the Pain subscale ( P = 0.112). In men, negative correlations were also observed for all domains, but they were statistically significant for physical health, physical role limitations, social function, health distress, sexual function, and sexual function satisfaction ( P < 0.01). We found that the presence of all the analyzed types of sexual problems statistically significantly lowered scores on the sexual function and the sexual function satisfaction subscales in both men and women ( P < 0.01). The most prominent impact on both domains was observed for the total loss of erection in men and for anorgasmia in women. Conclusions Our results reveal that frequent occurrence of SD in MS patients prominently affects all aspects of their quality of life.


2020 ◽  
Author(s):  
Tayah M. Liska ◽  
Angie Kolen

Abstract Purpose: As a result of a cancer diagnosis and treatment, many cancer survivors experience persistent physical, mental, and emotional symptoms that affect their quality of life. Physical activity has been identified as an intervention that may help to manage the side effects of a cancer diagnosis and its treatment. The purpose of this study was to investigate the role of physical activity on overall quality of life in adult cancer survivors. Methods: One-on-one semi structured interviews were conducted in person or via telephone with 13 adult (≥18 yrs) cancer survivors who had completed cancer treatment. Results: These cancer survivors described their physical activity as improving their physical functioning and mental health, as a means of positive social engagement, and adding positivity to their daily life. Conclusion: These results support the role of physical activity to enhance cancer survivors’ quality of life regardless of the individuals’ treatment(s) type, duration, or time since the end of active cancer treatment. Further research is warranted to (a) expand this research with a larger sample, (b) examine healthcare providers’ knowledge and application of exercise guidelines to cancer survivors in cancer care, and (c) explore implementation strategies for greater advocacy for healthcare providers to share the exercise recommendations with cancer survivors.


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