open access: Cancer, Fertility Preservation, and Future Pregnancy: A Comprehensive Review

Cancer, Fertility Preservation, and Future Pregnancy: A Comprehensive Review

Obstetrics and Gynecology International
Volume 2012 (2012), Article ID 953937, 11 pages
doi:10.1155/2012/953937 Review Article Cancer, Fertility Preservation, and Future Pregnancy: A Comprehensive Review

• Abstract
• Introduction
• Methods and Materials
• Results and Discussion
• Options for Fertility Preservation
• Additional Considerations
• Pregnancy after Cancer

Conclusions 

Given the relatively high incidence of cancer in reproductive age women and improvements in 5-year survival, an increasing number of women are presenting for discussion of fertility preservation and pregnancy after cancer treatment. The ASCO published recommendations in 2006 on fertility preservation in cancer patients. These guidelines state that oncologists should address the possibility of infertility with cancer patients and be prepared to discuss possible fertility preservation options or refer the patient to a reproductive specialist. Part of the difficulty in counseling patients regarding the risk of infertility and/or subsequent pregnancy complications is that the risks are dependent on several factors. These risks include the dose and duration of treatment, other risk factors for infertility, the age of the patient, and the patient’s baseline ovarian reserve at the time of initiation of treatment.

abstract: A systematic review of large-scale surveys of cancer survivors conducted in North America, 2000-2011.

A systematic review of large-scale surveys of cancer survivors conducted in North America, 2000-2011.

INTRODUCTION:

Many large surveys collect data on cancer survivors, but few encompass the full spectrum of domains relevant to survivorship ranging from cancer care to quality of life to late- and long-term effects of cancer and its treatment. Here, we review large data sources in North America collecting cancer survivor-reported health information, and catalogue the domains of cancer survivorship each includes.

METHODS:

We identified surveys of cancer survivors through a comprehensive web search of federal government agencies, non-profit organizations, and related societies that support health care research or provide health care services, as well as a systematic review of literature indexed on PubMed from 2000-2011.

RESULTS:

A total of 57 surveys were identified, 26 nationally representative surveys and 31 regional, state, or provincial surveys. Thirty-four surveys specifically targeted cancer survivors, and an additional two surveys had supplements or modules targeted at cancer survivors. Among the nationally representative surveys, general medical characteristics and medical conditions were the most frequently reported cancer survivorship domains, and information on cancer-related costs was least frequently reported.

DISCUSSION/CONCLUSION:

Our review demonstrates that a large and growing number of surveys across the U.S. and Canada are collecting data on cancer survivors. These surveys differ in design, geographic region, primary population of interest, cancer site, and research areas of interest. They address a wide range of survivorship issues. Future cancer survivorship research should concentrate on understudied areas in order to better understand the challenges faced by this growing population.

abstract: All’s Well That Ends Well? Quality of Life and Physical Symptom Clusters in Long-Term Cancer Survivors Across Cancer Types (EORTC QLQ-C30)

Blogger's Note: per abstract it does not appear ovarian cancer patients were included in this study, full access requires subscription ($$$) 

 Conclusion

Contrary to expectations, no symptom clusters specific to one type of cancer were identified and survivors reported few cancer-related symptoms and high QoL. These results convey a strong “good news” message, providing health professionals with a sound foundation for making encouraging predictions about their patients’ long-term physical recovery after cancer. Cancer patients also will welcome the news that only a minority of five-year survivors experience long-term and late effects.

Online Poll Results (unscientific) Survey: conducted prior to Ovarian Cancer Debate conferences in Detroit/Toronto (results compiled for Ovarian Cancer debate purposes)

Number of U.S. Cancer Survivors Grows to Nearly 12 Million

Thursday, March 10, 2011 2:31 PM

From:

"Centers for Disease Control & Prevention"

The number of cancer survivors in the United States increased from 3 million in 1971 to 11.7 million in 2007, according to a new study by CDC and the National Cancer Institute.
A cancer survivor is defined as anyone who has been diagnosed with cancer, from the time of diagnosis through the balance of his or her life. Cancer survivors largely consist of people who are 65 years of age or older and women. Many people with cancer live a long time after diagnosis; more than a million people were alive in 2007 after being diagnosed with cancer 25 years or more earlier.
Of the 11.7 million people living with cancer in 2007—

• 7 million were 65 years of age or older.
• 6.3 million were women.
• 4.7 million were diagnosed 10 years earlier or more.

The largest groups of cancer survivors were—

• Breast cancer survivors (22%).
• Prostate cancer survivors (19%).
• Colorectal cancer survivors (10%).

Source: Centers for Disease Control and Prevention (CDC). Cancer survivors—United States, 2007. MMWR 2011;60(9):269–272.

http://www.cdc.gov/mmwr/preview/mmwrhtml/mm6009a1.htm 

TABLE. Estimated number of living persons ever diagnosed with cancer, by age group and cancer type --- United States, January 1, 2007
Cancer type	Age group (yrs)					Overall
	0--19	20--39	40--64	65--84	≥85	No.	(%)
Ovary	1,033	10,357	79,225	73,230	13,315	177,162	(1.5)