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      The Knowledge, Attitude, and Self-Reported Behaviors of Oncology Physicians Regarding Fertility Preservation in Adult Cancer Patients

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          Abstract

          Abstract

          There is a growing concern about the fertility preservation for adult cancer patients of reproductive age. Very little literature exists about fertility preservation of cancer survivors in Chinese text. This study is first to describe the knowledge level, attitude, and practice behaviors among physicians concerning fertility preservation in adult cancer patients in China. A cross-sectional survey with 30-item was conducted to assess Chinese oncology physicians’ knowledge, attitude, and behaviors regarding fertility issues. Of 360 oncology physicians, 206 (57.2%) submitted valid questionnaires. With possible overall scores for knowledge and attitude of 9 and 15, respectively, physicians’ responses to the questionnaires were 3.91 ± 1.67 and 12.29 ± 1.23. Only 49.5% of physicians routinely informed their cancer patients of childbearing age about the risk of infertility with cancer treatment. The knowledge score of the men physicians was 2-fold that of the women. Physicians aged 20–29 years were significantly more likely than other age groups to prioritize cancer treatment over fertility concerns. Men physicians were significantly more comfortable than the women discussing fertility preservation issues and cooperating with fertility specialists. The oncology physicians in China had limited knowledge of fertility preservation and rarely discussed these issues with their patients, although their attitude was positive. Results suggest that oncology physicians would welcome an in-house fertility-related training program.

          Key Messages

          This is the first study to address the topic of fertility preservation as it relates to the care that oncologists provide to cancer patients in China. These results revealed the importance of providing fertility-related training program to oncology physicians. Moreover, this study should provide useful information for other Asian countries, and highlight both the similarities and differences between China and Western countries concerning the reproductive rights of patients. This study should encourage international cooperation with institutions of scientific research and education.

          Electronic supplementary material

          The online version of this article (10.1007/s13187-019-01567-6) contains supplementary material, which is available to authorized users.

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          Most cited references24

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          Chemokine signaling via the CXCR2 receptor reinforces senescence.

          Cells enter senescence, a state of stable proliferative arrest, in response to a variety of cellular stresses, including telomere erosion, DNA damage, and oncogenic signaling, which acts as a barrier against malignant transformation in vivo. To identify genes controlling senescence, we conducted an unbiased screen for small hairpin RNAs that extend the life span of primary human fibroblasts. Here, we report that knocking down the chemokine receptor CXCR2 (IL8RB) alleviates both replicative and oncogene-induced senescence (OIS) and diminishes the DNA-damage response. Conversely, ectopic expression of CXCR2 results in premature senescence via a p53-dependent mechanism. Cells undergoing OIS secrete multiple CXCR2-binding chemokines in a program that is regulated by the NF-kappaB and C/EBPbeta transcription factors and coordinately induce CXCR2 expression. CXCR2 upregulation is also observed in preneoplastic lesions in vivo. These results suggest that senescent cells activate a self-amplifying secretory network in which CXCR2-binding chemokines reinforce growth arrest.
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            Cancer, pregnancy and fertility: ESMO Clinical Practice Guidelines for diagnosis, treatment and follow-up.

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              Fertility preservation for patients with cancer: American Society of Clinical Oncology clinical practice guideline update.

              To update guidance for health care providers about fertility preservation for adults and children with cancer. A systematic review of the literature published from March 2006 through January 2013 was completed using MEDLINE and the Cochrane Collaboration Library. An Update Panel reviewed the evidence and updated the recommendation language. There were 222 new publications that met inclusion criteria. A majority were observational studies, cohort studies, and case series or reports, with few randomized clinical trials. After review of the new evidence, the Update Panel concluded that no major, substantive revisions to the 2006 American Society of Clinical Oncology recommendations were warranted, but clarifications were added. As part of education and informed consent before cancer therapy, health care providers (including medical oncologists, radiation oncologists, gynecologic oncologists, urologists, hematologists, pediatric oncologists, and surgeons) should address the possibility of infertility with patients treated during their reproductive years (or with parents or guardians of children) and be prepared to discuss fertility preservation options and/or to refer all potential patients to appropriate reproductive specialists. Although patients may be focused initially on their cancer diagnosis, the Update Panel encourages providers to advise patients regarding potential threats to fertility as early as possible in the treatment process so as to allow for the widest array of options for fertility preservation. The discussion should be documented. Sperm and embryo cryopreservation as well as oocyte cryopreservation are considered standard practice and are widely available. Other fertility preservation methods should be considered investigational and should be performed by providers with the necessary expertise.
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                Author and article information

                Contributors
                zhanghanfeng0727@163.com
                wangguorong_000@163.com
                1953613177@qq.com
                21716339@qq.com
                569458942@qq.com
                269792421@qq.com
                2495385419@qq.com
                545583549@qq.com , 514653361@qq.com
                Journal
                J Cancer Educ
                J Cancer Educ
                Journal of Cancer Education
                Springer US (New York )
                0885-8195
                1543-0154
                29 June 2019
                29 June 2019
                2020
                : 35
                : 6
                : 1119-1127
                Affiliations
                [1 ]GRID grid.54549.39, ISNI 0000 0004 0369 4060, Department of Radiation Oncology, Sichuan Cancer Hospital & Institute, Sichuan Cancer Center, Radiation Oncology Key Laboratory Of Sichuan Province, School of Medicine, , University of Electronic Science and Technology of China, ; Chengdu, China
                [2 ]GRID grid.257022.0, ISNI 0000 0000 8711 3200, Division of Nursing Science, Graduate School of Biomedical and Health Sciences, , Hiroshima University, ; Hiroshima, Japan
                [3 ]GRID grid.54549.39, ISNI 0000 0004 0369 4060, Department of Nursing, Sichuan Cancer Hospital & Institute, Sichuan Cancer Center, Radiation Oncology Key Laboratory Of Sichuan Province, School of Medicine, , University of Electronic Science and Technology of China, ; 55, 4th Section of Renmin South Road, Chengdu, 610040 Sichuan Province China
                Article
                1567
                10.1007/s13187-019-01567-6
                7679324
                31256354
                2b69e09f-d3e0-4f46-a7e9-0ff8e246ed3c
                © The Author(s) 2019

                Open Access This article is distributed under the terms of the Creative Commons Attribution 4.0 International License ( https://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made.

                History
                Funding
                Funded by: Sichuan Province Science and Technology Support Projects
                Award ID: 2016SZ0066
                Categories
                Article
                Custom metadata
                © American Association for Cancer Education 2020

                Oncology & Radiotherapy
                fertility preservation,cancer survivor,oncology physician,knowledge,attitude,practice behavior

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