Defining and measuring reproductive concerns of female cancer survivors

Abstract

Although women diagnosed with cancer during their childbearing years are at significant risk for infertility, we know little about the relationship between infertility and long-term quality of life (QOL). To examine these relationships, we assessed psychosocial and reproductive concerns and QOL in 231 female cancer survivors. Greater reproductive concerns were significantly associated with lower QOL on numerous dimensions (P<.001). In a multiple regression model, social support, gynecologic problems, and reproductive concerns accounted for 63% of the variance in QOL scores. Women who reported wanting to conceive after cancer, but were not able to, reported significantly more reproductive concerns than those who were able to reproduce after cancer (P<.001). These preliminary data suggest that at least for vulnerable subgroups, the issue of reproductive concerns is worthy of additional investigation to assist cancer survivors living with the threat or reality of infertility.

Fig. 1

Reproductive concerns (RCS) scale means and standard error bars for controls and survivor groups. Higher means indicate more reproductive concerns (range = 0–56). Survivors > Controls (P<.001). No significant difference between three survivor groups. GTT; Gestational trophoblastic tumors.

Fig. 2

Reproductive concerns scale (RCS) means and standard error bars based on presence and absence of children prior to and after cancer. Higher means indicate more reproductive concerns (range = 0–56). A) Survivors who did not check “very much” and who had children before and after cancer diagnosis (n = 33) (mean = 4.30). B) Survivors who did not check “very much” and who had children only after cancer diagnosis (n = 49) (mean = 5.28). C) Survivors who did not check “very much” and who had children only before cancer diagnosis (n = 101) (mean = 7.11). D) Survivors who did not check “very much” and who never had children (n = 41) (mean = 12.32). A1) Survivors who “very much” wanted children and who had children before and after cancer diagnosis (n = 23) (mean = 5.47). B1) Survivors who “very much” wanted children and who had children only after cancer diagnosis (n = 42) (mean = 7.19). C1) Survivors who “very much” wanted children and who had children only before cancer diagnosis (n = 14) (mean = 27.36). D1) Survivors who “very much” wanted children and who never had children (n = 10) (mean = 25.20). C1 > A1; B1 (P<.001); D1 > A1; B1 (P<.001); D > A, B, C (P<.05).