Health-related quality of life, sexual function, psychological health, reproductive concerns and fertility outcome in young women treated with fertility-sparing surgery for ovarian tumors - A prospective longitudinal multicentre study.

OBJECTIVE: This study aimed to investigate health-related quality of life (HRQoL), sexual function, psychological-health, reproductive concerns, and fertility outcomes of women of reproductive age undergoing Fertility-Sparing Surgery (FSS) for treatment of ovarian cancer (OC) or borderline ovarian tumor (BOT), over a 2-year period. METHODS: Prospective longitudinal multicentre study including women 18-40 years undergoing FSS between 2016 and 2018 in Sweden. Clinical data at diagnosis, histopathological findings and 2-year follow-up regarding oncological and reproductive outcomes were collected. Participants completed the EORTC QLQ-C30 and OV-28, FSFI, HADS and study-specific items at time of diagnosis and at one- and two-years following FSS. Data were analysed using a model for repeated measures to investigate changes over time. RESULTS: Of 68 eligible women, 49 were included following exclusions due to benign pathology or subsequent radical surgery. During a mean follow-up of 20.5 months, two women experienced a recurrence and 82% reported regular menstruations. The majority (94%) had a strong desire to become biological mothers, which remained or increased over time. The conception-rate was 76%. HRQoL, psychological-health and sexual function improved over time and the proportion of women with sexual dysfunction decreased. At one-year follow-up 50% of nulliparous women had scores indicating sexual dysfunction compared to 0% of the women who had given birth either before or after surgery (p = 0.008). CONCLUSION: HRQoL, psychological-health and sexual function improved during two-year follow-up after FSS in young women presenting with OC or BOT. Women who had given birth prior to or after FSS reported improved sexual function compared to nulliparous women.

Reproductive Concerns Among Young Adult Women With Breast Cancer: A Systematic Review and Meta-Analysis.

OBJECTIVES: Systemic cancer treatments pose threats to fertility, leading to concerns regarding fertility and parenthood in young adult women with breast cancer (YAWBC). This systematic review aimed to synthesize existing evidence on reproductive concerns (RCs) among YAWBC and identify areas where further research in needed. METHODS: A systematic review was conducted. Nine English and Chinese databases were searched for studies from inception to June 2023. A meta-analysis was employed to pool RC levels measured using the Reproductive Concerns After Cancer scale (RCAC scale; possible total scores: 18-90). Narrative synthesis was conducted in cases where a meta-analysis could not be performed. RESULTS: Twenty-four cross-sectional studies across seven countries were included in this review. The prevalence of RCs among YAWBC ranged from 21.75% to 80%. The pooled mean total score on the overall RCAC scale was 55.84 (95% confidence interval: 53.26-58.43). "Personal health," "child's health," and "fertility potential" were the top three types of RCs among YAWBC. Sociodemographic, clinical, and psychosocial factors were found to be associated with RCs among YAWBC. Additionally, significant correlations among RCs, nonadherence to treatment, depression, and quality of life were also identified among YAWBC. CONCLUSION: RCs are a common issue among YAWBC, and age, parenthood status, fertility desire, and chemotherapy treatment are important factors associated with RCs among these women. Further research is needed to clarify RC-related factors to provide evidence aimed at tailoring interventions to mitigate RCs among YWBC.

Parents' Reproductive Concerns and Negativity Toward Their Child Disclosing a Minoritized Sexual Orientation.

Parents often respond negatively when a child discloses their minoritized sexual orientation. We propose that parents' negativity in this context may be shaped by evolutionary concerns regarding their children's reproductive outcomes. We tested relevant hypotheses in a correlational study (Study 1) and two randomized experiments (Studies 2 and 3) that recruited parents with children under age 6 as participants. Study 1 (N = 386; 192 mothers and 194 fathers; 84.68% non-Hispanic White) revealed associations between parents' concerns regarding their children's reproductive outcomes and views toward a child disclosing a lesbian, gay, or bisexual (LGB) orientation in the future. The most negative views were reported by parents with elevated reproductive concerns and pessimistic beliefs about the possibility of reproduction for LGB individuals. Studies 2 (N = 327 mothers; 84.10% non-Hispanic White) and 3 (N = 279 fathers; 81.00% non-Hispanic White) tested whether information about reproductive assistance available to same-gender couples might promote more favorable views toward a child's hypothetical LGB orientation disclosure relative to control information. Parents who received reproductive versus control information reported more positive attitudes toward having an LGB child and toward the LGB community. These effects were statistically mediated by their more optimistic beliefs about the possibility of LGB reproduction. Taken together, this work suggests that reproductive concerns may influence parents' views toward their children's sexual orientation disclosures, and alleviating these concerns may be one way to improve parents' relationships with their sexually diverse children.

Reproductive concerns and its correlation with fear of recurrence and level of family support in patients of childbearing age with gynecologic malignancies.

BACKGROUND: To discuss the current status of reproductive concerns and its correlation with fear of recurrence and level of family support in patients of childbearing age with gynecologic malignancies. METHODS: A convenient sampling method was used to enroll 188 patients with gynecologic malignancies in Nanjing Maternity and Child Health Care Hospital, Nanjing Drum Tower Hospital, General Hospital of Ningxia Medical University, and Haian Hospital of Traditional Chinese Medicine Affiliated to Nanjing University of Chinese Medicine from September 2022 to April 2023. Patients were assessed using general information questionnaire, Reproductive Concerns After Cancer Scale (RCAC), Fear of Cancer Recurrence Inventory (FCRI) questionnaire, and Perceived Social Support-Family (PSS-FA) Scale. RESULTS: Among patients of childbearing age with gynecologic malignancies, the total RCAC score was (54.35 ± 7.52), indicating a moderate level of reproductive concerns. Patients scored (20.98 ± 4.51) on FCRI, implying a moderate level of fear of recurrence. The PSS-FA score was (9.57 ± 2.76), denoting a moderate level of family support. The total score and each dimensional score of RCAC were positively correlated with FCRI total score (P < 0.05), and negatively correlated with PSS-FA total score (P < 0.05). Fear of recurrence, family support level, number of children, educational background, treatment modality, and fertility intention were influencing factors for reproductive concerns in patients of childbearing age with gynecologic malignancies (all P < 0.05). CONCLUSION: The reproductive concerns, fear of recurrence and family support are all at moderate levels in patients of childbearing age with gynecologic malignancies, and reproductive concerns are positively correlated with fear of recurrence and negatively correlated with family support.

Latent Profiles of Fear of Cancer Recurrence in Breast Cancer Patients of Reproductive Age and Associations With Reproductive Concerns.

AIM: To identify distinct profiles of fear of cancer recurrence (FCR) among breast cancer patients of reproductive age, investigate the relationship between these profiles and reproductive concerns and explore potential risk factors encompassing sociodemographic, clinical and reproductive characteristics. DESIGN: A cross-sectional study was conducted from January 2022 to September 2022. METHODS: A convenience sample of 210 reproductive-aged breast cancer patients completed a questionnaire that included a general information section, the Fear of Progression Questionnaire-Short Form (FoP-Q-SF) and the Reproductive Concerns After Cancer Scale (RCAC). Latent profile analysis was conducted using the scores of the 12 items from the FoP-Q-SF as explicit variables, while univariate and multiple logistic regression analyses were employed for statistical analysis. RESULTS: Three latent variables were identified: low FCR-stable group (27.6%), moderate FCR-uneasy group (17.2%) and high FCR-intense group (55.2%). This study found that FCR was predicted by age, education level, cancer stage, chemotherapy and fertility intention. Furthermore, patients with heightened reproductive concerns exhibited a higher likelihood of belonging to the high FCR-intense group. CONCLUSION: These findings indicate that FCR varies among breast cancer patients of reproductive age and demonstrates individual differences. IMPLICATION: Early identification of FCR patterns in patients is crucial for medical professionals, with particular attention given to those in the high-intensity FCR group. Tailored prevention and care strategies should be implemented based on the unique characteristics and influencing factors associated with different potential categories of FCR among patients of childbearing age with breast cancer. PATIENT OR PUBLIC CONTRIBUTION: No patient or public contribution.

Differentiating gender-based reproductive concerns among adolescent and young adult cancer patients: A mixed methods study.

INTRODUCTION: Few studies have examined the distinct reproductive concerns (RC) of men and women in the adolescent and young adult (AYA) cancer patient population. The purpose of this mixed-methods study was to explore and differentiate the RC of AYAs. METHODS: Participants completed the Reproductive Concerns After Cancer (RCAC) scale and participated in a semistructured interview. Interviews were deductively coded based on an analytic schema derived from the RCAC. RESULTS: After identifying participants through the electronic health record, 27 younger AYAs, ages 12-25, enrolled in the study. Four inductive themes emerged and differed by gender. These include differential temporality, acceptance, and openness to alternatives, partner influence, and parental/guardian influence. AYA men reported fewer RC (M = 49.4, SD = 9.6) compared to AYA women (M = 56.8, SD = 8.4). CONCLUSIONS: Oncofertility care providers are advised to account for short- and long-ranging concerns based on AYAs' gender. Future evaluations of patient-reported outcome measures specific to AYA RC are recommended.

Factors associated with reproductive concerns among young female patients with colorectal cancer: A cross-sectional study.

AIMS AND OBJECTIVES: The aim of this study was to describe the prevalence of reproductive concerns among young female patients with colorectal cancer and explore the associated factors. BACKGROUND: With the trend of longer survival and younger age at diagnosis of colorectal cancer patients, reproductive concerns have become increasingly prevalent among young female colorectal cancer patients. DESIGN: Cross-sectional design. METHODS: The study included 150 young female patients with colorectal cancer who completed cancer treatment at 2 hospitals in Guangzhou, China, between November 2020 and December 2021 completed an investigation comprising A general questionnaire, The Reproductive Concerns After Cancer scale, The Family Adaptation and Cohesion Evaluation Scale II and unmet fertility information needs questionnaire. Multivariable linear regression analysis was performed in order to identify factors that influence reproductive concerns. This study was prepared and is reported according to the STROBE checklist. RESULTS: The mean (SD) score on the Reproductive Concerns After Cancer scale was 54.78 ± 8.97. The highest score was for the children's health subscale (3.84 ± .92) and the lowest was for acceptance (2.24 ± .70). Multiple regression analysis showed that patients with fewer children, female children, lower education level (less than undergraduate degree), earlier disease stage, lower family function and higher unmet need for fertility information had more reproductive concerns, which explained 26.9% of the total variation of the model. CONCLUSIONS: The patients with fewer children, female children, low cultural degree (less than bachelor), early clinical patients, poorer family function and higher unmet fertility information needs had higher reproductive concerns. RELEVANCE TO CLINICAL PRACTICE: These findings can guide the development of interventions to mitigate reproductive concerns, including understand and meet their fertility information needs, improve the level of family function. PATIENT OR PUBLIC CONTRIBUTION: Survey questionnaires were completed by participants among young female with colorectal cancer in this study.

The psychological impact of gestational trophoblastic disease: a prospective observational multicentre cohort study.

OBJECTIVE: To evaluate the short-term psychological consequences of gestational trophoblastic disease (GTD). DESIGN: A prospective observational multicentre cohort study. SETTING: Nationwide in the Netherlands. POPULATION: GTD patients. METHODS: Online questionnaires directly after diagnosis. MAIN OUTCOME MEASURES: Hospital Anxiety and Depression Scale (HADS), Distress Thermometer (DT), Impact of Event Scale (IES) and Reproductive Concerns Scale (RCS). RESULTS: Sixty GTD patients were included between 2017 and 2020. Anxious feelings (47%) were more commonly expressed than depressive feelings (27%). Patients experienced moderate to severe adaptation problems in 88%. Patients who already had children were less concerned about their reproductivity than were patients without children (mean score 10.4 versus 15.0, P = 0.031), and patients with children experienced lower distress levels (IES mean score 25.7 versus 34.7, P = 0.020). In addition, patients with previous pregnancy loss scored lower for distress compared with patients without pregnancy loss (IES mean score 21.1 versus 34.2, P = 0.002). DISCUSSION: We recommend that physicians monitor physical complaints and the course of psychological wellbeing over time in order to provide personalised supportive care in time for patients who have high levels of distress at baseline. CONCLUSIONS: GTD patients experience increased levels of distress, anxiety and depression, suggesting the diagnosis has a substantial effect on the psychological wellbeing of patients. The impact of GTD diagnosis on intrusion and avoidance seems to be ameliorated in patients who have children or who have experienced previous pregnancy loss. TWEETABLE ABSTRACT: Patients with gestational trophoblastic disease (GTD) experience short-term psychological consequences such as distress, anxiety and depression, suggesting that the diagnosis GTD has a substantial effect on the psychological wellbeing of patients. Various patient characteristics affect the impact of GTD diagnosis.

Higher reproductive concerns associated with fertility consultation: a cross-sectional study of young adult male cancer survivors.

PURPOSE: This study examined associations between fertility consultation (FC) and multiple dimensions of reproductive concerns among young adult (YA) male cancer survivors. METHODS: One hundred and seventy YA male cancer survivors (age 18 to 35) across the USA completed an online survey between 2016 and 2018. Participants reported demographics, receipt of FC, and reproductive concerns. Reproductive concerns were measured multidimensionally using the Reproductive Concerns after Cancer-Male scale. We used log binomial regression to examine associations between FC and high reproductive concerns across multiple domains. RESULTS: In multivariate analyses adjusting for desire for children, FC was associated with higher likelihood of having at least one high reproductive concern (relative risk [RR] 1.4, 95% CI 1.2-1.7). Across subscales, FC was associated with greater likelihood of having high concerns about fertility potential (RR 1.7, 95% CI 1.0-3.0), achieving pregnancy (RR 3.5, 95% CI 1.3-9.5), their (potential) child's health (RR 1.5, 95% CI 1.1-2.2), and disclosing infertility to a partner (RR 2.7, 95% CI 1.8-4.1). In contrast, associations were not observed between FC and likelihood of high concerns about personal health (RR 1.4, 95% CI 0.5-3.8) or acceptance of infertility (RR 1.8, 95% CI 0.8-3.9). CONCLUSIONS: YA male cancer survivors who received FC were more likely to have high reproductive concerns than those who did not receive FC. Men who seek out FC after cancer diagnosis may need additional support for their reproductive concerns. Research is needed to identify strategies to alleviate these concerns among this population.

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

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 (Pinteraction = .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.

Sexual Dysfunction and Reproductive Concerns in Young Men Diagnosed With Testicular Cancer: An Observational Study.

INTRODUCTION: The survival rates for testicular cancer are excellent; still, there is a lack of knowledge regarding important survivorship issues, such as sexual dysfunction and reproductive concerns. AIM: The aim of this study was to investigate the prevalence and predictors of sexual dysfunction and reproductive concerns and the potential association between these issues in young men ∼2 years after a diagnosis of testicular cancer. METHODS: Data were collected from 111 men (response rate = 50%) diagnosed with testicular cancer at age 16-39. Patients were identified via the Swedish National Quality Registry for Testicular Cancer and approached with a survey, including standardized measures of sexual function, reproductive concerns, body image, and health-related quality of life. The survey was sent to participants approximately 2 years after their cancer diagnosis. Clinical variables were collected from the registry. Predictors were identified by multivariable linear regression analyses. MAIN OUTCOME MEASURES: The main outcomes were sexual function, assessed with the Patient-Reported Outcomes Measurement Information System Sexual Function and Satisfaction measure version 2.0, and reproductive concerns, assessed with the Reproductive Concerns After Cancer scale. RESULTS: Sexual dysfunction was reported by 26% of men, and a high level of reproductive concerns was reported by 28%. Lower satisfaction with sex life was associated with older age (ß = -0.41), negative body image (ß = -0.42), not having a partner (ß = 4.8), and dissatisfaction with sex life before cancer (ß = 8.31). Negative body image was associated with reproductive concerns in the dimensions of fertility potential (ß = 0.06), partner disclosure (ß = 0.08), and child's health (ß = 0.07), whereas having had fertility preservation predicted higher levels of concerns with regard to personal health (ß = 0.52) and achieving pregnancy (ß = 0.53). Clinical variables did not predict either sexual function or reproductive concerns. CLINICAL IMPLICATIONS: Our results show that the majority of young men diagnosed with testicular cancer do not report sexual dysfunction or reproductive concerns 2 years after diagnosis. A sizeable minority, however, does report dysfunction or reproductive concerns, which should be recognized in the follow-up care of this population. STRENGTHS & LIMITATIONS: A strength of the study is the use of high-quality registry data and validated instruments. The lack of Swedish norms for sexual function and reproductive concerns is a possible limitation. CONCLUSION: A subgroup of young men treated for testicular cancer report sexual dysfunction or reproductive concerns approximately 2 years after diagnosis. Factors associated with these issues seem to mainly be psychological, rather than medical, nature. Ljungman L, Eriksson LE, Flynn KE, et al. Sexual Dysfunction and Reproductive Concerns in Young Men Diagnosed With Testicular Cancer: An Observational Study. J Sex Med 2019;16:1049-1059.

Revisiting the Reproductive Concerns After Cancer (RCAC) scale.

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.

Systematic review of fertility-related psychological distress in cancer patients: Informing on an improved model of care.

OBJECTIVE: Cancer patients experience reproductive concerns from diagnosis through to survivorship. However, research has yet to investigate the degree of fertility-related psychological distress at different treatment time points: diagnosis, treatment, and survivorship. Currently, cancer patients are offered fertility counselling at the time of diagnosis, to assist fertility preservation decision making. A systematic review of the short-term and long-term psychological impact of infertility in cancer patients would inform on an improved, longitudinal model of psychological care. METHODS: A systematic review of the literature was conducted in January 2018 utilising electronic databases Medline, EMBASE, PSYCH Info, Web of Science, and SCOPUS. An initial search identified 708 potentially relevant studies. Literature was assessed that reported on fertility-related psychological distress experienced by male and female cancer patients of reproductive age (<45 years) across oncology treatment time points. RESULTS: A total of 47 papers were included within the final review. Fertility-related psychological distress persists from diagnosis through to survivorship, with cancer patients reporting a range of negative emotional experiences brought about by threatened infertility. In survivorship, reproductive concerns, unfulfilled desire for a child, nulliparous status, and early menopause were linked to higher rates of mental health disorders and psychological distress. CONCLUSIONS: Fertility-related psychological distress is prevalent and persistent in cancer patients and survivors. As such, patients and survivors would greatly benefit from fertility-related psychological support implemented into standard practice from diagnosis through to survivorship. A revised model of care is proposed.

Sexual dysfunction and reproductive concerns in young women with breast cancer: Type, prevalence, and predictors of problems.

OBJECTIVE: A dearth of studies focusing on young women (<40 years) with breast cancer have hampered the understanding of the type, prevalence, and predictors of sexual dysfunction and reproductive concerns in this population. METHODS: Data were collected from 181 women (response rate = 60%) diagnosed with breast cancer approximately 2 years previously (age 21-39) using the Swedish National Quality Registry for Breast Cancer and a survey including standardized measures of sexual dysfunction, reproductive concerns, body image, and health-related quality of life. Multivariable logistic binary regression analyses were used to identify predictors of sexual dysfunction and reproductive concerns. RESULTS: Sexual dysfunction in at least one domain was reported by 68% of the women, and a high level of reproductive concerns in at least one dimension was reported by 58%. Model results showed that current endocrine treatment was a significant predictor of dysfunction related to lubrication (OR 3.8, 95% CI 1.2-12.1) and vaginal discomfort (OR 8.7, 95% CI 1.5-51.5). Negative body image was related to satisfaction with sex life (OR 1.1, 95% CI 1.0-1.2). A high level of reproductive concerns was predicted by a wish for (additional) children in the future (OR 3.4, 95% CI 1.1-10.2) and by previous chemotherapy (OR 2.5, 95% CI 1.1-5.9). CONCLUSIONS: Sexual dysfunction and reproductive concerns are common in young women with breast cancer. Current endocrine treatment, previous chemotherapy, a negative body image, and a wish for children in the future predict higher level of problems.

Psychometric properties of the Chinese version of the Reproductive Concerns After Cancer Scale (RCAC) for young female cancer survivors.

PURPOSE: This study aimed to translate, culturally adapt, and test the psychometric properties of the Reproductive Concerns After Cancer scale (RCAC) in young Chinese female cancer survivors. METHODS: The Chinese version of the RCAC was developed using the standard Functional Assessment of Chronic Illness Therapy (FACIT) translation methodology, and then 800 young Chinese female cancer survivors were recruited to complete the scale. The validation of the RCAC is as follows: (1) content validity was evaluated by a group of experts; (2) factor structure was assessed using confirmatory factor analysis and factorial invariance analysis; (3) convergent validity was determined by correlations with the Patient Health Questionnaire 9 (PHQ-9) and Functional Assessment of Cancer Therapy-General (FACT-G) scale; (4) internal consistency reliability was assessed using Cronbach's α coefficient; and (5) test-retest reliability was assessed using intra-class correlations. RESULTS: Internal consistency (Cronbach's alpha coefficients ranged from 0.71 to 0.81) and test-retest reliability (intra-class correlation coefficients ranged from 0.82 to 0.95) of the Chinese version of the RCAC were satisfactory. Results also indicated that the content validity index of the RCAC (Chinese version) was good. The Chinese version of the RCAC score was correlated with the PHQ-9 (r = 0.568, p < 0.01) and FACT-G (r = -0.524, p < 0.01) scores, which indicated acceptable convergent validity. Confirmatory factor analysis supported a six-factor structure of the Chinese version of the RCAC with a good model fit. Moreover, multi-group confirmatory factor analysis indicated factorial invariance (configural, metric, scalar, and strict invariance) of the RCAC across cancer types. CONCLUSIONS: The translation and cross-cultural adaption of the RCAC into Chinese was successful. The Chinese version of the RCAC has suitable factor structure and psychometric properties for reproductive concerns evaluation in young female cancer patients and is appropriate to use in clinical trials of Chinese patients.

The role of in-depth reproductive health counseling in addressing reproductive health concerns in female survivors of nongynecologic cancers.

The purpose of this study was to characterize reproductive concerns among female cancer survivors and determine the role of targeted counseling in improving overall reproductive quality of life (QOL). A survey was administered to women from the California Cancer Registry, ages 18-40, with nongynecologic cancers diagnosed from 1993 to 2007, who received fertility-compromising treatments. In total, 356 women completed the survey, which included questions regarding their reproductive health counseling history and the reproductive concerns scale (RCS), a validated reproductive QOL tool. Factors independently associated with higher RCS scores included a desire for children at the time of diagnosis, posttreatment infertility, treatment with chemoradiation or bone marrow transplant, and income less than $100,000 per year at diagnosis. Among the highest reported reproductive concerns were those related to loss of control over one's reproductive future and concerns about the effect of illness on one's future fertility. Across our population and independent of age, in-depth reproductive health counseling prior to cancer treatment was associated with significantly lower RCS scores. Our findings highlight the importance of early counseling and targeting high-risk groups for additional counseling after completion of cancer treatment. This approach may be an effective strategy for optimizing long-term reproductive QOL in this vulnerable population.

Exploring Strategies to Alleviate Reproductive Concerns in Cancer Survivors: A Comprehensive Scoping Review of International Research.

Objective: This review aims to summarize existing interventions from the international literature addressing fertility concerns in cancer patients, providing theoretical and practical guidance for future interventions. Methods: In September 2023, a systematic search covering 13 databases was conducted using the methodology outlined by the Joanne Briggs Institute for a comprehensive systematic review. This search identified published English and Chinese-language papers. Results: A total of 20 studies meeting inclusion criteria were included in this review. The studies predominantly originated in China and the United States. A comprehensive synthesis of interventions from the included literature across three dimensions and seven aspects was conducted. The interventions primarily focused on psychological interventions and web-based self-help tools for patients. The Reproductive Concerns After Cancer Scale (RCAC) was the primary assessment tool employed. Conclusion: Addressing fertility concerns in cancer patients is a complex issue involving various stakeholders and diverse intervention strategies. Lessons from international research can inform the development of context-specific interventions tailored to individual needs.

Perceptions of Infertility and Reproductive Concerns in Adolescent and Young Adult Female Cancer Survivors.

This cross-sectional survey study explores the fertility perceptions of adolescent and young adult female cancer survivors (n = 111) and relationships to fertility counseling and reproductive distress. Satisfaction with post-treatment fertility counseling (ß = -0.20, p = 0.04), perceived consequences of cancer-related fertility changes (ß = 0.26, p = 0.03), and understanding of one's reproductive health (ß = -0.22, p = 0.03) correlated with reproductive distress, controlling for covariates (F(10, 88) = 3.50, p < 0.001). Findings suggest that post-treatment counseling may be important to addressing survivors' perceptions of fertility and reproductive potential, which influences levels of distress and to create a greater sense of control on their road to parenthood.

A qualitative research on reproductive concerns of the patients with Peutz-Jeghers syndrome.

OBJECTIVES: To gain a deeper understanding of the real experiences and needs of the patients of Peutz-Jeghers syndrome (PJS) with fertility concerns. DESIGN: A qualitative study. METHODS: Phenomenological research and Semi-structured method were conducted with the patients of PJS (N = 16), and the interview data were analyzed using inductive content analysis strategies. RESULTS: 16 patients were interviewed, including 13 women and 3 men partners. We identified 5 themes, including: (i) Heritability of disease, (ii) Potential risks of reproduction; (iii) The difficulties in raising children; (iv) family and social support. (V) Need support from multiple sources. CONCLUSION: The findings of this study demonstrate that patients with Peutz-Jeghers syndrome (PJS) who are of childbearing age experience various reproductive concerns and other manifestations. Therefore, it is essential to offer individualized psychological interventions for PJS patients at different psychological stages, with the support of healthcare professionals, family, and social networks.

Effectiveness of a narrative nursing intervention on reproductive concerns in women of childbearing age undergoing cervical cancer surgery: A randomized controlled trial.

OBJECTIVE: This study aims to explore the intervention effects of narrative nursing on the reproductive concerns of cervical cancer patients of childbearing age undergoing surgical treatment. METHODS: Patients undergoing cervical cancer surgery with moderate to severe levels of reproductive concerns, treated between January and December 2023 at a tertiary Grade-A oncology hospital in China, were selected as the research subjects. Patients were randomized into an intervention group and a control group, each consisting of 33 patients. The control group received standard nursing care, while the intervention group received a narrative nursing intervention in addition to standard care. The changes in the levels of reproductive concerns, post-traumatic growth, and quality of life scores before and after the intervention were compared between the two groups. RESULTS: After the intervention, the reproductive concerns scores of the cervical cancer patients in the intervention group (32.53 ± 4.77) were significantly lower than those in the control group (59.29 ± 3.24), with a statistically significant difference (t = 26.143, p < 0.001). The post-traumatic growth scores in the intervention group (86.78 ± 3.52) were significantly higher than those in the control group (68.06 ± 6.24), with a statistically significant difference (t = -14.595, p < 0.001). The quality of life scores in the intervention group (149.00 [IQR = 8.75]) were significantly higher than those in the control group (129.00 [IQR = 13.00]), with a statistically significant difference (z = -5.799, p < 0.001). CONCLUSION: Narrative nursing can effectively alleviate reproductive concerns in cervical cancer patients undergoing surgical treatment, promote positive psychological changes post-trauma, and improve patients' quality of life.