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Quality of life in female cancer survivors: is it related to ovarian reserve?

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Abstract

Purpose

The purpose of the study is to assess the quality-of-life scores and possible association with measures of ovarian reserve in female cancer survivors compared to healthy controls of similar age.

Methods

In this prospective cohort study, fifty-nine cancer survivors aged 16–39 years and 66 healthy, similarly aged unexposed women were recruited at the University of Pennsylvania. The primary outcome measures are the generic and cancer-specific domain scores on the Quality of Life in Adult Cancer Survivors (QLACS) instrument, early follicular phase serum hormones, follicle-stimulating hormone (FSH), luteinizing hormone (LH), estradiol (E2), inhibin B (INH), anti-Mullerian hormone (AMH), and ovarian ultrasound measurements [ovarian volume and antral follicle count (AFC)].

Results

Cancer survivors had significantly higher total and cancer-specific domain scores compared to unexposed participants. Serum AMH, INH, ovarian volume, and AFC were lower while serum FSH was higher in cancer survivors. Although survivors exhibited diminished ovarian reserve, these markers were not independently associated with total QLACS score. Cancer survivors with irregular menstrual function were found to have lower quality-of-life (QOL) scores than those with regular cycles.

Conclusions

We found that QOL appears to be significantly impaired in cancer survivors compared to controls, even when remote from initial cancer diagnosis. In addition, our study suggests that reproductive aging contributes to QOL in the setting of irregular menses and likely profound impairment of ovarian function.

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References

  1. Zeltzer, L. K., Recklitis, C., Buchbinder, D., Zebrack, B., Casillas, J., Tsao, J. C., et al. (2009). Psychological status in childhood cancer survivors: A report from the Childhood Cancer Survivor Study. Journal of Clinical Oncology, 27, 2396–2404.

    Article  PubMed Central  PubMed  Google Scholar 

  2. Schover, L. R. (2000). Psychosocial issues associated with cancer in pregnancy. Seminars in Oncology, 27, 699–703.

    PubMed  CAS  Google Scholar 

  3. Howard-Anderson, J., Ganz, P. A., Bower, J. E., & Stanton, A. L. (2012). Quality of life, fertility concerns, and behavioral health outcomes in younger breast cancer survivors: A systematic review. Journal of the National Cancer Institute, 104, 386–405.

    Article  PubMed  Google Scholar 

  4. Janson, C., Leisenring, W., Cox, C., Termuhlen, A. M., Mertens, A. C., Whitton, J. A., et al. (2009). Predictors of marriage and divorce in adult survivors of childhood cancers: A report from the Childhood Cancer Survivor Study. Cancer Epidemiology Biomarkers Prevent, 18, 2626–2635.

    Article  Google Scholar 

  5. Frobisher, C., Lancashire, E. R., Winter, D. L., Jenkinson, H. C., & Hawkins, M. M. (2007). British Childhood Cancer Survivor Study. Long-term population-based marriage rates among adult survivors of childhood cancer in Britain. International Journal of Cancer, 121, 846–855.

    Article  CAS  Google Scholar 

  6. Gracia, C. R., Sammel, M. D., Freeman, E., Prewitt, M., Carlson, C., Ray, A., Vance, A., & Ginsberg, J. P. (2012). Impact of cancer therapies on ovarian reserve. Fertility and sterility, 97, 134,40.e1.

    Google Scholar 

  7. Mann, E., Singer, D., Pitkin, J., Panay, N., & Hunter, M. S. (2012). Psychosocial adjustment in women with premature menopause: A cross-sectional survey. Climacteric, 15(5), 481–489.

    Article  PubMed  CAS  Google Scholar 

  8. Green, D. M., Kawashima, T., Stovall, M., Leisenring, W., Sklar, C. A., Mertens, A. C., et al. (2009). Fertility of female survivors of childhood cancer: A report from the childhood cancer survivor study. Journal of Clinical Oncology, 27, 2677–2685.

    Article  PubMed Central  PubMed  CAS  Google Scholar 

  9. Avis, N. E., Ip, E., & Foley, K. L. (2006). Evaluation of the Quality of Life in Adult Cancer Survivors (QLACS) scale for long-term cancer survivors in a sample of breast cancer survivors. Health Qual Life Outcomes, 4, 92.

    Article  PubMed Central  PubMed  Google Scholar 

  10. Avis, N. E., Smith, K. W., McGraw, S., Smith, R. G., Petronis, V. M., & Carver, C. S. (2005). Assessing quality of life in adult cancer survivors (QLACS). Quality of Life Research, 14, 1007–1023.

    Article  PubMed  Google Scholar 

  11. Pearce, N. J., Sanson-Fisher, R., & Campbell, H. S. (2008). Measuring quality of life in cancer survivors: A methodological review of existing scales. Psychooncology, 17, 629–640.

    Article  PubMed  Google Scholar 

  12. Schover, L. R. (2009). Patient attitudes toward fertility preservation. Pediatric Blood & Cancer, 53, 281–284.

    Article  Google Scholar 

  13. Schover, L. R., Brey, K., Lichtin, A., Lipshultz, L. I., & Jeha, S. (2002). Knowledge and experience regarding cancer, infertility, and sperm banking in younger male survivors. Journal of Clinical Oncology, 20, 1880–1889.

    Article  PubMed  Google Scholar 

  14. Schover, L. R., Rybicki, L. A., Martin, B. A., & Bringelsen, K. A. (1999). Having children after cancer. A pilot survey of survivors’ attitudes and experiences. Cancer, 86, 697–709.

    Article  PubMed  CAS  Google Scholar 

  15. Letourneau, J. M., Ebbel, E. E., Katz, P. P., Katz, A., Ai, W. Z., Chien, A. J., et al. (2012). Pretreatment fertility counseling and fertility preservation improve quality of life in reproductive age women with cancer. Cancer, 118, 1710–1717.

    Article  PubMed Central  PubMed  Google Scholar 

  16. Partridge, A. H., Gelber, S., Peppercorn, J., Sampson, E., Knudsen, K., Laufer, M., et al. (2004). Web-based survey of fertility issues in young women with breast cancer. Journal of Clinical Oncology, 22, 4174–4183.

    Article  PubMed  Google Scholar 

  17. Ferrell, B. R., Grant, M. M., Funk, B. M., Otis-Green, S. A., & Garcia, N. J. (1998). Quality of life in breast cancer survivors: Implications for developing support services. Oncology Nursing Forum, 25, 887–895.

    PubMed  CAS  Google Scholar 

  18. Carver, C. S., Smith, R. G., Petronis, V. M., & Antoni, M. H. (2006). Quality of life among long-term survivors of breast cancer: Different types of antecedents predict different classes of outcomes. Psychooncology, 15, 749–758.

    Article  PubMed  Google Scholar 

  19. Freeman, E. W., Sammel, M. D., Lin, H., Liu, Z., & Gracia, C. R. (2011). Duration of menopausal hot flushes and associated risk factors. Obstetrics and Gynecology, 117, 1095–1104.

    Article  PubMed Central  PubMed  Google Scholar 

  20. Carpenter, J. S., Andrykowski, M. A., Cordova, M., Cunningham, L., Studts, J., McGrath, P., et al. (1998). Hot flashes in postmenopausal women treated for breast carcinoma: Prevalence, severity, correlates, management, and relation to quality of life. Cancer, 82, 1682–1691.

    Article  PubMed  CAS  Google Scholar 

  21. Zebrack, B. J., Foley, S., Wittmann, D., & Leonard, M. (2010). Sexual functioning in young adult survivors of childhood cancer. Psychooncology, 19, 814–822.

    Article  PubMed Central  PubMed  Google Scholar 

  22. van Dijk, E. M., van Dulmen-den Broeder, E., Kaspers, G. J., van Dam, E. W., Braam, K. I., & Huisman, J. (2008). Psychosexual functioning of childhood cancer survivors. Psychooncology, 17, 506–511.

    Article  PubMed  Google Scholar 

  23. Grant, M. D., Piotrowski, Z. H., & Chappell, R. (1995). Self-reported health and survival in the Longitudinal Study of Aging, 1984–1986. Journal of Clinical Epidemiology, 48, 375–387.

    Article  PubMed  CAS  Google Scholar 

  24. Ferrell, B. R., Dow, K. H., & Grant, M. (1995). Measurement of the quality of life in cancer survivors. Quality of Life Research, 4, 523–531.

    Article  PubMed  CAS  Google Scholar 

Download references

Acknowledgments

Supported by NIH T32 HD007440 and NIH 5K12HD001271-12 (LAK); Doris Duke Clinical Research Fellowship (KED); NIH K01 L1-CA-133839-03 and 1R01HD062797 (CRG, MDS).

Conflict of interest

None.

Author information

Authors and Affiliations

  1. Division of Reproductive Endocrinology and Infertility, Department of Obstetrics and Gynecology, University of Colorado Anschutz Medical Campus, Aurora, CO, 80045, USA

    Laxmi A. Kondapalli

  2. Division of Reproductive Endocrinology and Infertility, Department of Obstetrics and Gynecology, University of Pennsylvania, Philadelphia, PA, 19104, USA

    Laxmi A. Kondapalli, Katherine E. Dillon & Clarisa R. Gracia

  3. Center for Clinical Epidemiology and Biostatistics, University of Pennsylvania, Philadelphia, PA, 19104, USA

    Mary D. Sammel

  4. Center for Research in Reproduction and Women’s Health, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, 19104, USA

    Anushree Ray & Maureen Prewitt

  5. Division of Oncology, Department of Pediatrics, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, 19104, USA

    Jill P. Ginsberg

Authors
  1. Laxmi A. Kondapalli
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  2. Katherine E. Dillon
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  3. Mary D. Sammel
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  4. Anushree Ray
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  5. Maureen Prewitt
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  6. Jill P. Ginsberg
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  7. Clarisa R. Gracia
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Correspondence to Laxmi A. Kondapalli.

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Kondapalli, L.A., Dillon, K.E., Sammel, M.D. et al. Quality of life in female cancer survivors: is it related to ovarian reserve?. Qual Life Res 23, 585–592 (2014). https://doi.org/10.1007/s11136-013-0473-y

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  • DOI: https://doi.org/10.1007/s11136-013-0473-y

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