PDF(Sci-hub)
Abstract：
By 2030, WHO estimates that 1.4 million reproductive-aged women will be diagnosed with cancer annually. Fortunately, cancer is no longer considered an incurable disease in many cases. From 2008-2014, 85% of women under the age of 45 years diagnosed with cancer survived. This increase in survival rate has shifted attention from focusing exclusively on preserving life to focusing on preserving quality of life after treatment. One aspect of this is preserving the ability to have a biological family. Oncofertility, the field that bridges oncology and reproductive endocrinology with the goal of preserving fertility, offers these patients hope. Though it is clear that ASCO and ASRM recognize the importance of fertility preservation as an aspect of comprehensive oncology care, there are not yet unified guidelines for oncologists and fertility specialists for treating oncofertility patients. First, we identify the need for reproductive counseling prior to cancer treatment, as many patients report that their fertility preservation concerns are not addressed adequately. We then delineate multi-modal fertility preservation options that are available and appropriate for different patients with corresponding outcomes using different treatments. We discuss the unique challenges and considerations, including ethical dilemmas, for delivering timely and comprehensive care specifically for oncofertility patients. Finally, we address the multidisciplinary team that includes oncologists, reproductive endocrinologists, surgeons as well as their staff, nurses, genetic counselors, mental health professionals, and more. Since oncofertility patient care requires the coordination of both physician teams, one set of unified guidelines will greatly improve quality of care.
摘要：
到2030年，世卫组织估计每年将有140万育龄妇女被诊断患有癌症。幸运的是,在许多情况下，癌症不再被认为是不治之症。从2008年到2014年，85％的45岁以下被诊断患有癌症的女性存活下来。存活率的这种提高已经将注意力从只关注保存生命转移到关注保存治疗后的生活质量。这样做的一个方面是保持拥有生物家族的能力。生育，将肿瘤学和生殖内分泌学与保持生育能力目标联系起来的领域，给这些患者带来希望。尽管很明显ASCO和ASRM认识到保留生育力作为综合肿瘤学护理的一个方面的重要性，目前尚无统一的肿瘤学家和生育专家指南来治疗癌症病人。首先,我们确定在癌症治疗之前需要生殖咨询，因为许多患者报告说他们的生育力保护问题没有得到充分解决。然后，我们描述了多模式的生育力保存选项，这些选项适用于使用不同治疗方法具有相应结局的不同患者。我们讨论了独特的挑战和考虑因素，包括道德困境，为生育患者提供及时和全面的护理。最后,我们面向包括肿瘤学家在内的多学科团队，生殖内分泌学家，外科医生和他们的工作人员，护士,遗传咨询师,心理健康专业人士,还有更多.由于生育患者的护理需要两个医生团队的协调，一套统一的指南将大大提高护理质量.
