70 research outputs found

    strategies for fertility preservation in young early breast cancer patients

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    Diagnosis of breast cancer in young women poses a threat to fertility. Due to a recent trend of delaying pregnancy, an increasing number of breast cancer patients in reproductive age wish to bear children. Health care providers have the responsibility to know how to manage fertility issues in cancer survivors. Oncofertility counseling is of great importance to many young women diagnosed with cancer and should be managed in a multi-disciplinary background. Most of young breast cancer patients are candidate to receive chemotherapy, which could lead to premature ovarian failure. A baseline evaluation of ovarian reserve may help in considering the different fertility preservation options. The choice of the suitable strategy depends also on age, type of chemotherapy, partner status and patients' motivation. Various options are available, some established such as embryo and oocyte cryopreservation, some still experimental such as ovarian tissue cryopreservation and ovarian suppression with GnRHa during chemotherapy. An early referral to a reproductive specialist should be offered to patients at risk of infertility who are interested in fertility preservation

    Biology, staging, and treatment of breast cancer during pregnancy: reassessing the evidences

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    Breast cancer is one of the most frequently diagnosed malignancies during pregnancy. Here, we review the management of women with breast cancer during pregnancy (BCP), focusing on biology, diagnosis and staging, local and systemic treatments, obstetric care and long-term follow-up of children with prenatal exposure to anticancer treatments

    Medical treatment of early stage and rare histological variants of epithelial ovarian cancer

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    Epithelial ovarian cancer is often considered a single pathological entity, but increasing evidence suggests that it is rather a group of different neoplasms, each with unique pathological characteristics, molecular features, and clinical behaviours. This heterogeneity accounts for the different sensitivity to antineoplastic drugs and makes the treatment of ovarian tumours a challenge. For early-stage disease, as well as for heavily pre-treated patients with recurrent ovarian cancer, the benefit of chemotherapy remains uncertain. Clear-cell, mucinous, low-grade serous, and endometrioid carcinomas show different molecular characteristics, which require different therapeutic approaches. In the era of personalised cancer medicine, understanding the pathogenesis and the genetic background of each subtype of epithelial ovarian tumour may lead to a tailored therapy, maximising the benefits of specific treatments and possibly reducing the side effects. Furthermore, personal factors, such as the patient’s performance status, should be taken into account in the management of ovarian cancer, with the aim of safeguarding the patients’ quality of life

    The regulatory impact of a harmonized artificial intelligence regulation proposal on the clinical research landscape in the European Union

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    CC BY-NC-ND 4.0This article offers a critical analysis of how the proposed Artificial Intelligence Act (AIA) will support the rights, safety, dignity, and well-being of clinical research participants and ensure the availability of reliable and robust data as described in Clinical Trials Regulation (EU) No. 536/2014. Analysis is focused on how the proposed regulation will impact clinical research conducted within the European Union. The proposed artificial intelligence regulation is evaluated based on what it will bring to the multiple stakeholders in clinical research – including sponsors, investigators, patients, society – and how it would align with the core principles of the Clinical Trials Regulation

    Cancer and Pregnancy: becoming parents after an oncological diagnosis in women

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    The issue of cancer and pregnancy will be increasingly topical giving the rising trend of women diagnosed with cancer during childbearing period. Although oncological progress has allowed women who receive cancer diagnosis before or during pregnancy to satisfy their desire for maternity and to carry on gestation, there is still few awareness. In this chapter we present our research project and results carry out to date. The aim is to better understand challenges of women who experience pregnancy after or during cancer compared with non-oncological sample. We focus on the impact of cancer in the construction of prenatal attachment and related psychological aspects. We study resilience considered as a protective factor in the construction of mother-fetus relationship. Then, we present the results of a qualitative study conducted in order to have a deeper understanding of the psychological dynamics that help women with cancer diagnosis to develop their maternal identity. We explore the topic of breastfeeding in women with cancer history, investigating how the feeding method is related to mother’s mood states. Finally, we present the results about the cortisol concentration measurement during pregnancy. Our results show how it is very important to give women with oncological diagnosis the adequate support during puerperium

    Fertility Preservation in Female Cancer Patients

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    With improved survival rates among cancer patients, fertility preservation is now being recognized as an issue of great importance. There are currently several methods of fertility preservation available in female cancer patients and the options and techniques via assisted reproduction and cryopreservation are increasing, but some are still experimental and continues to be evaluated. The established means of preserving fertility include embryo cryopreservation, gonadal shielding during radiation therapy, ovarian transposition, conservative gynecologic surgery such as radical trachelectomy, donor embryos/oocytes, gestational surrogacy, and adoption. The experimental methods include oocyte cryopreservation, ovarian cryopreservation and transplantation, in vitro maturation, and ovarian suppression. With advances in methods for the preservation of fertility, providing information about risk of infertility and possible options of fertility preservation to all young patients with cancer, and discussing future fertility with them should be also considered as one of the important parts of consultation at the time of cancer diagnosis

    Knowledge and attitudes towards clinical trials among women with ovarian cancer: results of the ACTO study

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    Background Despite several initiatives by research groups, regulatory authorities, and scientific associations to engage citizens/patients in clinical research, there are still obstacles to participation. Among the main discouraging aspects are incomplete understanding of the concepts related to a clinical trial, and the scant, sometimes confused, explanations given. This observational, cross-sectional multicenter study investigated knowledge, attitudes and trust in clinical research. We conducted a survey among women with ovarian cancer at their first follow-up visit or first therapy session, treated in centers belonging to the Mario Negri Gynecologic Oncology (MaNGO) and Multicenter Italian Trials in Ovarian Cancer (MITO) groups. A questionnaire on knowledge, attitudes and experience was assembled ad hoc after a literature review and a validation process involving patients of the Alliance against Ovarian Cancer (ACTO). Results From 25 centers 348 questionnaire were collected; 73.5% of responders were 56 years or older, 54.8% had a high level of education, more than 80% had no experience of trial participation. Among participants 59% knew what clinical trials were and 71% what informed consent was. However, more than half did not know the meaning of the term randomization. More than half (56%) were in favor of participating in a clinical trial, but 35% were not certain. Almost all responders acknowledged the doctor's importance in decision-making. Patients' associations were recognized as having a powerful role in the design and planning of clinical trials. Conclusions This study helps depict the knowledge and attitudes of women with ovarian cancer in relation to clinical trials, suggesting measures aimed at improving trial "culture", literacy and compliance, and fresh ways of communication between doctors and patients

    A View from the Past Into our Collective Future: The Oncofertility Consortium Vision Statement

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    Today, male and female adult and pediatric cancer patients, individuals transitioning between gender identities, and other individuals facing health extending but fertility limiting treatments can look forward to a fertile future. This is, in part, due to the work of members associated with the Oncofertility Consortium. The Oncofertility Consortium is an international, interdisciplinary initiative originally designed to explore the urgent unmet need associated with the reproductive future of cancer survivors. As the strategies for fertility management were invented, developed or applied, the individuals for who the program offered hope, similarly expanded. As a community of practice, Consortium participants share information in an open and rapid manner to addresses the complex health care and quality-of-life issues of cancer, transgender and other patients. To ensure that the organization remains contemporary to the needs of the community, the field designed a fully inclusive mechanism for strategic planning and here present the findings of this process. This interprofessional network of medical specialists, scientists, and scholars in the law, medical ethics, religious studies and other disciplines associated with human interventions, explore the relationships between health, disease, survivorship, treatment, gender and reproductive longevity. The goals are to continually integrate the best science in the service of the needs of patients and build a community of care that is ready for the challenges of the field in the future

    GnRH analogue for chemotherapy-induced ovarian damage: too early to say?

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    Managing pregnancy-associated breast cancer: Is more really better?

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    SCOPUS: ed.jinfo:eu-repo/semantics/publishe
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