资讯与服务

    (周一至周日 9:00-21:00)
    微信:liu87712531
    微信:lin445385978

    邮箱:87712531@qq.com

    咨询电话:15321970583

网站服务

您当前位置:首页 -> 英语论文 -> 英语其它相关->详细(目前国内最大最全原创最多的免费论文中心)

客服QQ咨询:点击这里给我发消息 点击这里给我发消息

无忧论文,为您指导,让您轻松发表,轻松晋级!

字号大小:


The Influence of Endocrine Effects of Adjuvant Therapy on Quality of Life Outcomes in Younger Breast Cancer Survivors(六)

作者:来来来 整理:本网站论文网 录入时间:2011-12-13 23:15:34
ular damage resulting from chemotherapy is not an all-or-nothing phenomenon [13]. There is considerable uncertainty about the degree of damage because there is no way to measure follicular stores. If amenorrhea occurs, it may reverse, with a return to normal cycles, and those who develop irregular menses may subsequently ovulate in another cycle [78, 79]. Because of this variability and potential return of menstrual function even after a prolonged period of amenorrhea [30], serum hormone levels are not useful as predictors of permanent ovarian failure. Thus, contraceptive counseling is essential for women who experience menstrual changes associated with chemotherapy. Women on adjuvant endocrine therapy can become pregnant and should also be a targeted group for counseling. Pregnancy while on tamoxifen is not recommended because of possible teratogenic effects on the fetus, and women should be counseled to wait at least 12 weeks after discontinuation before attempting conception because of the half-life of the agent [80]. Barthelmes and Gateley [81] provide a review on the safety of pregnancy and tamoxifen. They identified six case reports of pregnancy in women on tamoxifen, an ongoing investigation by AstraZeneca of 50 known pregnancies associated with tamoxifen use, and a report of 85 women from the prevention trial who became pregnant. Of the six case reports, one case included a child with abnormalities of the genital tract, and an additional 10 children were reported to have fetal or neonatal disorders. Women must be informed of the potential effect of tamoxifen on the fetus and that there are no long-term data on possible late manifestations in children who were exposed in utero [81].

  Desire for Pregnancy: Communication and Decision Making

  The desire for biologic motherhood and genetically related children is an important issue for many cancer survivors [82, 83]. In breast cancer, many clinicians recommend that women wait to consider pregnancy for 23 years, whenthe highest risk for early recurrence has passed. Decision making about pregnancy in breast cancer survivors is associated with considerable uncertainty. Women have concerns about fear of recurrence and concerns about the potential effect of pregnancy on survival, and those who take endocrine therapy for 5 years have concerns about their fertility potential over time. In addition, there is a level of uncertainty among physicians about pregnancy after breast cancer treatment. A recent review of case control and cohort studies on pregnancy outcomes after breast cancer treatment suggests that there is no adverse effect on survival, but the authors conclude that there is still a lack of definitive evidence [84]. Breast cancer survivors who have successful pregnancies after treatment report that it helped normalize their life and the transition to wellness and that having children improved the quality of their lives [85].

  Fertility Preservation

  There is a reco

首页 上一页 3 4 5 6 7 8 9 下一页 尾页 6/12/12

上一篇APEC Summit in Shanghai
下一篇Overview of what is a bond and ..