Cancer frequently disrupts women's ability to have children because of treatment-related infertility, concern about health risks during pregnancy, and/or fear of having a child with a birth defect or high lifetime risk of cancer. Little is known about the impact of disrupted childbearing on survivors' emotional well-being or quality of life. Infertile women who have not had cancer, however, suffer long-term consequences of anxiety and depression after failed attempts at pregnancy or adoption. We will survey 2,091 women from the UT M. D. Anderson Cancer Center tumor registry, diagnosed before the age of 40, during the years 1992 to 1997, with either breast cancer, invasive cervical cancer, Hodgkin's disease, or non-Hodgkin's lymphoma. Women will be contacted by letter and then by phone to invite participation. We expect at least a 50 percent response rate. Participants will complete a brief set of written questionnaires, taking about 20 minutes, and after they have mailed these back, will be interviewed by phone for about 60 minutes with a semi-structured protocol about their reproductive history after cancer, including attitudes and emotions. Both genetic and social parenthood will be explored. Outcome measures include health-related quality of life (SF-12), emotional distress (BSI-18), stress response related to cancer and childbearing (Impact of Event Scale), and a new scale that measures anxiety related to cancer and childbearing issues. Based on the model that cancer followed by interrupted childbearing is a repeated trauma, causing long-term distress, we have the following specific hypotheses: 1) Women whose cancer interfered with desired childbearing will have significantly more general distress and infertility-specific distress, and poorer quality of life than women who had already completed their families before diagnosis. 2) Within the group who wanted children at diagnosis, breast cancer survivors will be more distressed than others because of their added concerns about hormonal stimulation of cancer recurrence and inherited cancer syndromes. 3) Within the group that wanted children after cancer, those who achieve genetic parenthood will be the least distressed, followed by those who become social parents (donated egg, adoption, stepchildren), and the most distressed will be those who have no children after cancer, particularly those childless at diagnosis. We plan to use these data to create an intervention to reduce distress and provide information to women whose childbearing is interrupted by cancer.
| Canada, Andrea L; Schover, Leslie R (2012) The psychosocial impact of interrupted childbearing in long-term female cancer survivors. Psychooncology 21:134-43 |
| Canada, Andrea L; Murphy, Patricia E; Fitchett, George et al. (2008) A 3-factor model for the FACIT-Sp. Psychooncology 17:908-16 |
