Annekathrin Sender

Motivations for having children after cancer--a systematic review of the literature.

Over the last decade, fertility-related issues have come to the fore of clinical oncology. The majority of research though has focused on a medical perspective without considering reproductive motivations that influence decisions on fertility-preserving options. In order to identify specific parenthood motivations in young survivors of various types of cancer, a systematic review of the literature was conducted. Relevant literature was searched manually and using databases (Medline/PubMed, PsycInfo). Of 4848 articles retrieved, 20 studies met a priori defined inclusion criteria. Cancer was found to have a likely effect on reproductive intentions. All studies reported on specific reproductive concerns, mostly related to negative consequences for the patient or on the future child. Pregnancy concerns were overrepresented in breast cancer survivors. Practical barriers to post-cancer parenthood were financial or partner-referred. Overall, fewer incentives than disincentives for post-cancer parenthood were reported. They included the importance of parenthood, achieving normality and a desire to focus on the positive. As reproductive motivations and concerns affect the majority of cancer survivors of reproductive age, they should be assessed as early as possible post-diagnosis. While researchers should focus on the development of appropriate assessment methods, clinicians might address specific reproductive concerns.

How do young adults with cancer perceive social support? A qualitative study

ABSTRACT The social support of adolescents and young adults (AYA) has been studied very little. 18 interviews were conducted and evaluated with content analysis (inter-rater reliability = 0.87). All of the young adult cancer patients interviewed reported having received social support from at least two people (family, friends, and/or partner). Forms of emotional and instrumental support were more often reported than informational support. 12 participants described having received nonhelpful support, especially in areas of dealing with their situation, limited social participation, and distancing of friends. The participants considered social exchanges with other young adult cancer patients an important source of social support. AYA cancer patient networking should be improved.

Krebs und Karriere? – Eine qualitative Untersuchung zur beruflichen Situation und Integration junger Erwachsener mit Krebs

Purpose: To examine the impact of cancer on work and education for AYA. Collect information about AYAs return to work/return to study. Methods: 18 AYA (10 female) aged 18 to 39 (m=27 years) at time of diagnosis completed a semi-structured interview. Qualitative content analysis was used to generate results. Results: 11 of 18 AYA had already returned to work/study. Flexible structures and emotional support of colleagues and managers were reported being helpful. 10 AYA planed or had already reduced job tasks, hours of work or further education. This was mostly compelled by physical disabilities due to cancer or treatment. Most AYA asked for more support within the social insurance system. Conclusions: Cancer often leads to changes in work or education. More social and vocational counseling to support AYAs rehabilitation process seems to be necessary.

Die Thematisierung des Kinderwunsches und der Fertilität in der Hämato-Onkologie – eine qualitative Ärztebefragung

OBJECTIVES Adolescent and young adult patients in hemato-oncology have often not fulfilled their desire to have a child, which is threatened by the malignancy and its treatment. The oncologists have to inform their patients about possible infertility and fertility preservation. METHODS 25 oncologists were interviewed to discuss the desire to have a child and fertility issues with the patients. Afterwards the semi-structured interviews were transcribed and analyzed according to the qualitative content analysis of Mayring. RESULTS The following issues could be identified in the interviews: current desire to have a child; possible threat of fertility; fertility preservation and their implementation; contact to a reproduction facility; sexuality and contraception during therapy. Most of the oncologists (n=19) stated to discuss the fertility aspects in the first session. 14 oncologists stated that they have enough knowledge about fertility preservation. To improve the conditions for a discussion the oncologists wished to have more information (n=10) or patient leaflets (n=11) about fertility preservation. DISCUSSION Addressing the desire to have a child and fertility aspects of adolescent and young adult patients in hemato-oncology have already a high priority. Further studies should analyze the discussion from patient perspective and determine patient needs in this regard.

Life Satisfaction in Young Adults With Cancer and the Role of Sociodemographic, Medical, and Psychosocial Factors: Results of a Longitudinal Study.

Being diagnosed with and treated for cancer often has a strong impact on the life satisfaction (LS) of adolescents and young adults (AYAs). The current study investigated LS in AYA patients with cancer and determined associated factors.