1
|
Dalkner N, Fleischmann E, Borgmann-Staudt A, Fürschuß C, Klco-Brosius S, Kepakova K, Kruseova J, Lackner H, Michel G, Mohapp A, Nagele E, Panasiuk A, Tamesberger M, Reininghaus EZ, Wiegele K, Balcerek M. Parenthood for childhood cancer survivors: unfounded fear of cancer development in offspring and related health behaviors. Front Psychol 2024; 14:1269216. [PMID: 38282841 PMCID: PMC10811955 DOI: 10.3389/fpsyg.2023.1269216] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2023] [Accepted: 12/22/2023] [Indexed: 01/30/2024] Open
Abstract
Current literature reveals no increased risk for adverse non-hereditary health outcomes in the offspring of childhood cancer survivors (CCS), yet survivors reported concerns regarding their offspring's health. To investigate how the fear of cancer development in offspring influences parental behavior related to health and prevention, survey reports from 256 European adult CCS and 256 age- and sex-matched siblings who participated in a multicenter study on offspring health were analyzed in the present study. Analyses of covariance and chi-square tests were conducted to test for differences between CCS and siblings in outcome variables (all related to healthy parenting behavior). CCS reported higher fear levels (p = 0.044, Partial η2 = 0.01) and less alcohol consumption (p = 0.011, Phi = 0.12) and smoking (p = 0.022, Phi = 0.11) during pregnancy than siblings. In survivor families, children were breastfed less often (p < 0.001, Phi = 0.18). Partial correlation analyses showed that CCS' fear levels decreased with increasing age (r = -0.16, p = 0.014), time since oncological therapy (r = -0.19, p = 0.003), and number of children (r = -0.21, p = 0.001). Overall, due to their own experiences with cancer, many CCS harbor misperceptions regarding the health outcomes of their offspring. Although the fear decreases with increasing distance from the active disease, any fear should be taken seriously, even if unfounded, and combated through targeted educational measures.
Collapse
Affiliation(s)
- Nina Dalkner
- Department of Psychiatry and Psychotherapeutic Medicine, Medical University of Graz, Graz, Austria
| | - Eva Fleischmann
- Department of Psychiatry and Psychotherapeutic Medicine, Medical University of Graz, Graz, Austria
| | - Anja Borgmann-Staudt
- Department of Pediatric Oncology and Hematology, Charité Berlin, Berlin, Germany
| | - Christine Fürschuß
- Division of Paediatric Haematology/Oncology, Medical University of Graz, Graz, Austria
| | | | - Katerina Kepakova
- Czech Republic and International Clinical Research Center (FNUSA-ICRC), University Hospital Brno, Brno, Czechia
| | - Jarmila Kruseova
- Department of Pediatric Haematology and Oncology, University Hospital Motol Prague, Prague, Czechia
| | - Herwig Lackner
- Division of Paediatric Haematology/Oncology, Medical University of Graz, Graz, Austria
| | - Gisela Michel
- Faculty of Health Sciences and Medicine, University of Lucerne, Lucerne, Switzerland
| | - Andrea Mohapp
- Division of Paediatric Haematology/Oncology, Medical University of Graz, Graz, Austria
| | - Eva Nagele
- Division of Paediatric Haematology/Oncology, Medical University of Graz, Graz, Austria
| | - Anna Panasiuk
- Bone Marrow Transplantation Unit, Medical University of Wroclaw, Wrocław, Poland
| | - Melanie Tamesberger
- Department of Pediatric Oncology, Kepler Universitätsklinikum, Linz, Austria
| | - Eva Z. Reininghaus
- Department of Psychiatry and Psychotherapeutic Medicine, Medical University of Graz, Graz, Austria
| | - Karin Wiegele
- Division of Paediatric Haematology/Oncology, Medical University of Graz, Graz, Austria
| | - Magdalena Balcerek
- Department of Pediatric Oncology and Hematology, Charité Berlin, Berlin, Germany
- Berlin Institute of Health, Berlin, Germany
| |
Collapse
|
2
|
Sleimann M, Balcerek M, Cytera C, Richter F, Borgmann-Staudt A, Wörmann B, Kronziel LL, Calaminus G, Kock-Schoppenhauer AK, Grabow D, Baust K, Neumann A, Langer T, Gebauer J. Implementation of a clinical long-term follow-up database for adult childhood cancer survivors in Germany: a feasibility study at two specialised late effects clinics. J Cancer Res Clin Oncol 2023; 149:12855-12866. [PMID: 37462771 PMCID: PMC10587240 DOI: 10.1007/s00432-023-05145-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2023] [Accepted: 07/08/2023] [Indexed: 10/20/2023]
Abstract
PURPOSE Childhood cancer survivors (CCS) are at risk for increased morbidity and reduced quality of life associated with treatment-related late effects. In Germany, however, only a few of the more than 40,000 CCS registered in the German Childhood Cancer Registry (GCCR) currently benefit from adequate clinical long-term follow-up (LTFU) structures. To establish a comprehensive knowledge base on CCS' long-term health in Germany, a database was developed in cooperation with the GCCR. Following a first evaluation phase at two German university centres, this database will be implemented more widely within Germany allowing longitudinal documentation of clinical LTFU data. METHODS The feasibility study cohort comprised 208 CCS aged 18 or older whose medical, mental and psychosocial health data were collected during routine LTFU or first clinic visits in adult care. CCS were enrolled from 04/2021 to 12/2022, and data entry was completed by 03/2023. Descriptive data analysis was conducted. All CCS were stratified into three risk groups (RG) based on their individual risk for developing late effects resulting from their respective diagnoses and treatments. RESULTS Chronic health conditions of various organ systems associated with late and long-term effects of cancer therapy affected CCS in all RG supporting the clinical relevance of risk-adapted LTFU. Enrolment into the database was feasible and broadly accepted amongst CCS. CONCLUSION Implementation of a clinical follow-up care infrastructure and database in Germany will pave the way to collect clinically evaluated and regularly updated health data of potentially over 40,000 German CCS and facilitate future national and international cooperation.
Collapse
Affiliation(s)
- Madelaine Sleimann
- Medizinische Klinik 1, Abteilung für Endokrinologie, Diabetologie und Stoffwechselmedizin, Universitätsklinikum Schleswig-Holstein, Campus Lübeck, Ratzeburger Allee 160, 23538 Lübeck, Germany
- Department of Paediatric Oncology and Haematology, Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, Berlin Institute of Health, Campus Virchow-Klinikum, Augustenburger Platz 1, Mittelallee 6A, 13353 Berlin, Germany
| | - Magdalena Balcerek
- Department of Paediatric Oncology and Haematology, Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, Berlin Institute of Health, Campus Virchow-Klinikum, Augustenburger Platz 1, Mittelallee 6A, 13353 Berlin, Germany
| | - Chirine Cytera
- Klinik für Kinder- und Jugendmedizin, Pädiatrische Onkologie und Hämatologie, Universitätsklinikum Schleswig-Holstein, Campus Lübeck, Ratzeburger Allee 160, Haus A, 23538 Lübeck, Germany
| | - Franziska Richter
- Klinik für Kinder- und Jugendmedizin, Pädiatrische Onkologie und Hämatologie, Universitätsklinikum Schleswig-Holstein, Campus Lübeck, Ratzeburger Allee 160, Haus A, 23538 Lübeck, Germany
| | - Anja Borgmann-Staudt
- Department of Paediatric Oncology and Haematology, Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, Berlin Institute of Health, Campus Virchow-Klinikum, Augustenburger Platz 1, Mittelallee 6A, 13353 Berlin, Germany
| | - Bernhard Wörmann
- Department of Haematology, Oncology and Tumor Immunology, Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, Berlin Institute of Health, Campus Virchow-Klinikum, Augustenburger Platz 1, Mittelallee 11, 13353 Berlin, Germany
| | - Lea Louisa Kronziel
- Institut für Medizinische Biometrie und Statistik (IMBS), Universität zu Lübeck, Universitätsklinikum Schleswig-Holstein, Campus Lübeck, Ratzeburger Allee 160, V24, 23562 Lübeck, Germany
| | - Gabriele Calaminus
- Pädiatrische Hämatologie/Onkologie, Zentrum für Kinder- und Jugendmedizin, Universitätsklinikum Bonn, Venusberg-Campus 1, 53127 Bonn, Germany
| | | | - Desiree Grabow
- Division of Childhood Cancer Epidemiology/German Childhood Cancer Registry, Institute of Medical Biostatistics, Epidemiology and Informatics (IMBEI), University Medical Centre of the Johannes Gutenberg University Mainz, 55101 Mainz, Germany
| | - Katja Baust
- Pädiatrische Hämatologie/Onkologie, Zentrum für Kinder- und Jugendmedizin, Universitätsklinikum Bonn, Venusberg-Campus 1, 53127 Bonn, Germany
| | - Anke Neumann
- IT Center for Clinical Research, Lübeck, Universität zu Lübeck, Haus 32, Ratzeburger Allee 160, 23562 Lübeck, Germany
| | - Thorsten Langer
- Klinik für Kinder- und Jugendmedizin, Pädiatrische Onkologie und Hämatologie, Universitätsklinikum Schleswig-Holstein, Campus Lübeck, Ratzeburger Allee 160, Haus A, 23538 Lübeck, Germany
| | - Judith Gebauer
- Medizinische Klinik 1, Abteilung für Endokrinologie, Diabetologie und Stoffwechselmedizin, Universitätsklinikum Schleswig-Holstein, Campus Lübeck, Ratzeburger Allee 160, 23538 Lübeck, Germany
| |
Collapse
|
3
|
Borgmann-Staudt A, Jantke A, Hinz S, Beckmann M, Dittrich R, Lotz L, Balcerek M. S1 Guideline: Impairment of gonadal function After Cancer in Childhood and Adolescence. Klin Padiatr 2023; 235:317-321. [PMID: 37673091 DOI: 10.1055/a-2081-0605] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 09/08/2023]
Abstract
A possible negative consequence of cancer treatment is the fertility impairment of young cancer survivors. However, most former patients express the wish to have biological children. Fertility-preserving measures are available and are - under certain circumstances - financed by health insurance. Separate information at the time of diagnosis and during follow-up care should be adapted to the individual risk and enable those affected to make a self-determined decision about cryopreservation of germ cells or germ cell tissue. Hyopgonadotropic hypogonadism can be treated by the pulsatile administration of gonadotropins. Affected individuals can be reassured. A health restriction of the offspring due to the cancer treatment is not to be expected, even after artificial insemination.
Collapse
Affiliation(s)
- Anja Borgmann-Staudt
- Paediatric Oncology/Haematology, Charité Universitätsmedizin Berlin, Berlin, Germany
| | - Andreas Jantke
- Department of Gynaecology, Charité Universitätsmedizin Berlin, Berlin, Germany
| | - Stefan Hinz
- Clinic of Urology, Vivantes Klinikum Am Urban, Berlin, Germany
| | - Matthias Beckmann
- Department of Obstetrics and Gynaecology, Erlangen University Hospital, Erlangen, Germany
| | - Ralf Dittrich
- Department of Obstetrics and Gynaecology, Erlangen University Hospital, Erlangen, Germany
| | - Laura Lotz
- Department of Obstetrics and Gynaecology, Erlangen University Hospital, Erlangen, Germany
| | - Magdalena Balcerek
- Paediatric Oncology, Haematology and Stem Cell Transplantation, Charité Universitatsmedizin Berlin, Berlin, Germany
| |
Collapse
|
4
|
Radauer-Plank AC, Diesch-Furlanetto T, Schneider M, Sommerhäuser G, Friedrich LA, Salow V, Dülberg J, Diepold M, Rovó A, Njue LM, Drexler B, Infanti L, Kroiss S, Merki R, Scheinemann K, Eisenreich B, Hegemann I, Mandic L, Kager L, Borgmann-Staudt A, Schilling R, Roll S, Balcerek M. Desire for biological parenthood and patient counseling on the risk of infertility among adolescents and adults with hemoglobinopathies. Pediatr Blood Cancer 2023; 70:e30359. [PMID: 37057367 DOI: 10.1002/pbc.30359] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/01/2023] [Revised: 03/04/2023] [Accepted: 03/26/2023] [Indexed: 04/15/2023]
Abstract
BACKGROUND Both diagnosis and treatment of hemoglobinopathies have been associated with an increased risk of fertility impairment. German guidelines recommend annual monitoring of fertility parameters to enable early detection of fertility impairment and/or to offer fertility preservation (FP) when indicated. We explored the general desire for parenthood, the frequency of recalling fertility counseling and testing, and the utilization of FP in adolescents and adults with hemoglobinopathies. PROCEDURE In a cross-sectional study, patients aged 12-50 years, treated in Germany, Austria, or Switzerland, were surveyed on fertility-related aspects. Medical data, including fertility testing results, were collected from patient records. RESULTS Overall, 116/121 eligible patients, diagnosed with sickle cell disease (70.7%), thalassemia (27.6%), or other hemoglobinopathy (1.7%), participated in our study (57.8% female, median age 17.0 years, range 12-50 years). All participants required treatment of the underlying hemoglobinopathy: 68.1% received hydroxyurea, 25.9% required regular blood transfusions, and 6.0% underwent hematopoietic stem cell transplantation (HSCT). Most patients (82/108, 75.9%) stated a considerable to strong desire for (future) parenthood, independent of sex, education, diagnosis, or subjective health status. Fertility counseling was only recalled by 32/111 patients (28.8%) and least frequently by younger patients (12-16 years) or those treated with regular blood transfusions or hydroxyurea. While fertility testing was documented for 59.5% (69/116) in medical records, only 11.6% (13/112) recalled previous assessments. FP was only used by 5.4% (6/111) of patients. CONCLUSION Most patients with hemoglobinopathies wish to have biological children, yet only few recalled fertility counseling and testing. Adequate patient counseling should be offered to all patients at risk for infertility.
Collapse
Affiliation(s)
- Anne-Catherine Radauer-Plank
- Department of Pediatric Oncology and Hematology, Charité-Universitätsmedizin Berlin, Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany
| | - Tamara Diesch-Furlanetto
- Division of Pediatric Hematology and Oncology, University Children's Hospital Basel, Basel, Switzerland
| | - Monika Schneider
- Department of Pediatrics, St. Anna Children's Hospital, Medical University Vienna, Vienna, Austria
| | - Greta Sommerhäuser
- Department of Pediatric Oncology and Hematology, Charité-Universitätsmedizin Berlin, Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany
- Department of Hematology, Oncology and Cancer Immunology (CVK/CCM), Charité-Universitätsmedizin Berlin, Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany
| | - Lucía Alácan Friedrich
- Department of Pediatric Oncology and Hematology, Charité-Universitätsmedizin Berlin, Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany
| | - Vivienne Salow
- Department of Pediatric Oncology and Hematology, Charité-Universitätsmedizin Berlin, Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany
| | - Jill Dülberg
- Division of Pediatric Hematology and Oncology, University Children's Hospital Basel, Basel, Switzerland
| | - Miriam Diepold
- Department of Pediatric Hematology & Oncology, Inselspital, University Hospital Bern, Bern, Switzerland
| | - Alicia Rovó
- Department of Hematology and Central Hematology Laboratory, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
| | - Linet Muthoni Njue
- Department of Hematology and Central Hematology Laboratory, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
| | - Beatrice Drexler
- Department of Hematology, University Hospital Basel, Basel, Switzerland
| | - Laura Infanti
- Department of Hematology, University Hospital Basel, Basel, Switzerland
| | - Sabine Kroiss
- Department of Pediatric Hematology and Oncology, Children's Hospital Zurich, Zurich, Switzerland
| | - Ramona Merki
- Department of Oncology, Hematology and Transfusion Medicine, Cantonal Hospital Aarau, Aarau, Switzerland
| | - Katrin Scheinemann
- Division of Pediatric Oncology - Hematology, Department of Pediatrics, Kantonsspital Aarau AG, Aarau, Switzerland
- Department of Health Sciences and Medicine, University of Lucerne, Lucerne, Switzerland
- Department of Pediatrics, McMaster Children's Hospital and McMaster University, Hamilton, Canada
| | - Bernhard Eisenreich
- Department of Pediatric Oncology and Hematology, Cantonal Hospital Lucerne, Lucerne, Switzerland
| | - Inga Hegemann
- Department of Oncology and Hematology, University Hospital Zurich, Zurich, Switzerland
| | - Ljubica Mandic
- St. Anna Children's Cancer Research Institute, Vienna, Austria
| | - Leo Kager
- Department of Pediatrics, St. Anna Children's Hospital, Medical University Vienna, Vienna, Austria
- St. Anna Children's Cancer Research Institute, Vienna, Austria
| | - Anja Borgmann-Staudt
- Department of Pediatric Oncology and Hematology, Charité-Universitätsmedizin Berlin, Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany
| | - Ralph Schilling
- Institute of Social Medicine, Epidemiology and Health Economics, Charité-Universitätsmedizin Berlin, Freie Universität Berlin und Humboldt-Universität zu Berlin, Berlin, Germany
| | - Stephanie Roll
- Institute of Social Medicine, Epidemiology and Health Economics, Charité-Universitätsmedizin Berlin, Freie Universität Berlin und Humboldt-Universität zu Berlin, Berlin, Germany
| | - Magdalena Balcerek
- Department of Pediatric Oncology and Hematology, Charité-Universitätsmedizin Berlin, Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany
- Berlin Institute of Health (BIH), Anna-Louisa-Karsch-Straße 2, Berlin, Germany
| |
Collapse
|
5
|
Michael S, Borgmann-Staudt A, Sommerhäuser G, Kepakova K, Klco-Brosius S, Kruseova J, Nagele E, Panasiuk A, Vetsch J, Balcerek M. Educational pathways of childhood cancer survivors-a parental cohort. J Cancer Surviv 2023; 17:518-525. [PMID: 36459379 PMCID: PMC10036444 DOI: 10.1007/s11764-022-01303-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2022] [Accepted: 11/14/2022] [Indexed: 12/05/2022]
Abstract
PURPOSE Using the International Standard Classification of Education (ISCED), we examined the educational and vocational pathways of two comparable, parental cohorts: childhood cancer survivors (CCS) and their siblings. Both cohorts had previously entered parenthood. The aim of the study was to elucidate whether childhood cancer and treatment affect the educational pathways chosen by parents who are former patients. METHODS We analysed data that was collected from childhood cancer survivors and their siblings regarding their offspring's health within the FeCt Multicentre Offspring Study (conducted 2013-2016). We evaluated and compared the professional pathways of (i) all participating survivors and all participating siblings and those of (ii) survivors and their biological siblings. RESULTS Overall information on parental gender, age, and education were available from 1077 survivors and 246 siblings (group (i)). The majority of participants were female with a mean age of 35.2 (survivor) and 37.9 (sibling) years at time of survey. For subgroup (ii), analysis information was available on 191 survivors and 210 siblings. Fathers achieved university degrees significantly more often than mothers (p = 0.003 (i), p < 0.001 (ii)). The distribution of professional education was not significantly different between cancer survivors and siblings in either cohort (i) or (ii). CONCLUSIONS Regarding our research on the educational and vocational trajectory of CCS, patients can be reassured that family planning and vocational education are well compatible. Inequalities regarding gender-specific educational pathways remain to be addressed. IMPLICATIONS FOR CANCER SURVIVORS CCS should monitor their fertility status regularly and, if necessary, cryopreserve germ cells or tissue in order to optimize their family planning. Educational opportunities should be pursued as desired and with confidence. Local as well as European aftercare programs can assist with family planning and education.
Collapse
Affiliation(s)
- S Michael
- Department of Pediatric Oncology and Hematology, Corporate Member of Freie Universität Berlin, Humboldt-Universität Zu Berlin, and Berlin Institute of Health, Charité-Universitätsmedizin Berlin Germany, Augustenburger Platz 1, 13353, Berlin, Germany
| | - A Borgmann-Staudt
- Department of Pediatric Oncology and Hematology, Corporate Member of Freie Universität Berlin, Humboldt-Universität Zu Berlin, and Berlin Institute of Health, Charité-Universitätsmedizin Berlin Germany, Augustenburger Platz 1, 13353, Berlin, Germany.
| | - G Sommerhäuser
- Department of Pediatric Oncology and Hematology, Corporate Member of Freie Universität Berlin, Humboldt-Universität Zu Berlin, and Berlin Institute of Health, Charité-Universitätsmedizin Berlin Germany, Augustenburger Platz 1, 13353, Berlin, Germany
- Department of Hematology, Oncology, and Cancer Immunology, Corporate Member of Freie Universität Berlin, Humboldt-Universität Zu Berlin, and Berlin Institute of Health, Charité-Universitätsmedizin Berlin Germany, Berlin, Germany
| | - K Kepakova
- University Hospital Brno, Brno, Czech Republic
| | - S Klco-Brosius
- Department of Pediatric Oncology and Hematology, Corporate Member of Freie Universität Berlin, Humboldt-Universität Zu Berlin, and Berlin Institute of Health, Charité-Universitätsmedizin Berlin Germany, Augustenburger Platz 1, 13353, Berlin, Germany
| | - J Kruseova
- University Hospital Motol, Prague, Czech Republic
| | - E Nagele
- Medical University Graz, Graz, Austria
| | - A Panasiuk
- Medical University Wroclaw, Wroclaw, Poland
| | - J Vetsch
- Department of Health Sciences and Health Policy, University of Lucerne, Lucerne, Switzerland
| | - M Balcerek
- Department of Pediatric Oncology and Hematology, Corporate Member of Freie Universität Berlin, Humboldt-Universität Zu Berlin, and Berlin Institute of Health, Charité-Universitätsmedizin Berlin Germany, Augustenburger Platz 1, 13353, Berlin, Germany
- Berlin Institute of Health (BIH), Berlin, Germany
| |
Collapse
|
6
|
Fernández-González MJ, Radauer-Plank AC, Stelzer C, Geiger W, Goranova I, Borgmann-Staudt A, Balcerek M, Wilkemeyer I. Sperm and testicular tissue cryopreservation and assisted reproductive technology outcomes in male cancer patients: a 15-year experience. J Cancer Res Clin Oncol 2022:10.1007/s00432-022-04488-y. [DOI: 10.1007/s00432-022-04488-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2022] [Accepted: 11/15/2022] [Indexed: 11/27/2022]
Abstract
Abstract
Objective
To explore the characteristics of cancer patients who cryopreserved sperm/testicular tissue samples in the Cryobank of Charité-Universitätsmedizin Berlin between 2004 and 2019, and the ART utilization rate with associated outcomes.
Methods
Retrospective data were available for 506 cancer patients, of which 46 (9.1%) had used their samples for artificial reproductive technologies (ART). Corresponding cycle information was collected from external fertility centers.
Results
Our cohort included 53/506 (10.5%) patients aged < 18 years at diagnosis. While adolescents and adults mainly banked sperm, adolescents showed higher rates of testicular tissue cryopreservation before (11.8%, 6/51 vs. 6.4%, 26/406) and after treatment (16.7%, 4/24 vs. 7.8%, 13/167). At study conduction, storage had been ended for 44.8% (269/601) of samples. The majority of samples used for ART were requested within the first 3 years after cryopreservation (71.5%, 28/39, range = 0–12 years). Pregnancy rate was 51.4% (19/37 cycles), resulting in 11 singleton births, 3 twin pairs, and 4 miscarriages.
Conclusion
With the new advantage of public health insurance coverage of fertility preservation (FP) in Germany, an increased utilization has already been noticed in our center, emphasizing the necessity of further knowledge for individual counseling. Adolescent cancer patients need to be addressed specifically, as these patients show especially low cryopreservation rates.
Collapse
|
7
|
Salow V, Borgmann-Staudt A, Diesselhorst V, Wörmann B, Balcerek M, Calaminus G, Gebauer J, Langer T. Spätfolgen und Nachsorge in der Pädiatrischen Onkologie. Monatsschr Kinderheilkd 2022. [DOI: 10.1007/s00112-022-01625-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
|
8
|
Wilkemeyer I, Fernández-González M, Radauer-Plank A, Borgmann-Staudt A, Geiger W, Stelzer C, Balcerek M. P-100 Quality of semen and testicular tissue samples collected before and after cancer treatment. Results from our 15 year monocentric experience at Charité-Universitätsmedizin Berlin. Hum Reprod 2022. [DOI: 10.1093/humrep/deac107.096] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Study question
To examine the influence of patient- and cancer treatment-related factors on the quality of semen and testicular tissue samples collected 2004-2019 in our centre.
Summary answer
Semen quality was reduced before cancer treatment in patients with a testicular or haematological malignancy and following any gonadotoxic-risk treatment when compared to no-risk treatment.
What is known already
Young men with cancer are at increased risk of fertility impairment. Therefore, cryopreservation of semen or testicular tissue is recommended. Usually, these steps are taken before cancer treatment. However, in some cases it may be necessary to undergo fertility protection following gonadotoxic treatment. The cancer diagnosis itself may have a negative impact on semen quality. Fertility impairment may occur especially following treatment with alkylating agents, radiotherapy to the pelvis/testes and high dose treatment as used in stem cell transplantation regimen. Risk groups have been defined according to the gonadotoxicity of cancer treatment in previous guidelines.
Study design, size, duration
In our centre, patients have been cryopreserving semen and/or testicular tissue samples for more than 15 years now. We conducted a retrospective cohort study between 01/2020 and 09/2021 in the subgroup of 506 cancer patients that had collected samples in our department between 03/2004 and 05/2019 and for whom cancer treatment data was available. In total, we included information on 601 samples (semen and testicular tissue) from these patients.
Participants/materials, setting, methods
Cancer treatment data and results from semen/testicular tissue analyses were collected from medical records. Cancer diagnoses were classified as brain, testicular or solid tumors in other locations or haematological malignancies. Samples were categorized as collected before or after the start of a gonadotoxic treatment (high/medium/low/no, defined according to existing guidelines). Descriptive analyses and multiple linear and logistic regression were conducted to determine influencing factors on the quality of cryopreservation in adolescent and adult cancer patients.
Main results and the role of chance
Over the period of 15 years, we observed an overall increase in sperm concentration and progressive motility in adolescent cancer samples, whereas concentrations remained stable during this period in adult samples. However, before cancer treatment, semen quality was already reduced in both adolescent (median sperm concentration 8x106/ml, IQR:6-116.8) and adult testicular cancer patients (median sperm concentration 18x106/ml, IQR:7-45) as well as in adolescents with a haematological malignancy (median sperm concentration: 10x106/ml, IQR:2.93±51.53; mean vitality: 55.19%, SD ± 22.85%; median progressive motility: 20%, IQR:7-50). Almost half (17/45, 38.7%) of adolescent and 18.5% (70/380) of adult samples showed oligoasthenoteratozoospermia prior to cancer treatment. Before start of treatment, adolescents who collected testicular tissue opted to cryopreserve their samples despite azoospermia to a higher rate than adults (50% vs. 20%). Not only high-risk gonadotoxic treatment, but also moderate- and low-risk treatment resulted in significant reduction of semen quality compared to cancer patients who did not receive a gonadotoxic treatment. When compared to patient samples collected before cancer treatment, sperm concentration and progressive motility significantly decreased in samples following high risk treatment in 60-70% of patients. Number of samples diagnosed with azoospermia was significantly higher in samples collected following high-risk treatment compared to samples collected before treatment.
Limitations, reasons for caution
We analysed retrospective data from our hospital records. We could not oversee how many cancer patients were treated during this time-period and who might have been eligible for cryopreservation. We were able to compare samples from before and after treatment only in a subgroup of patients.
Wider implications of the findings
Surveillance of fertility parameters, including regular spermiograms, following cancer treatment should be standard follow-up care to detect impairment, especially in men who have not cryopreserved samples previously. Even after moderate/low-risk gonadotoxic treatment, semen quality may be reduced. Simultaneously, these patients might be less likely to cryopreserve and therefore require attention.
Trial registration number
not applicable
Collapse
Affiliation(s)
- I Wilkemeyer
- Charité-Universitätsmedizin Berlin- cooperate member of Freie Universität Berlin- Humboldt-Universität zu Berlin- and Berlin Institute of Health, Clinic for Urology , Berlin, Germany
| | - M.J Fernández-González
- Charité-Universitätsmedizin Berlin- cooperate member of Freie Universität Berlin- Humboldt-Universität zu Berlin- and Berlin Institute of Health, Department of Pediatric Oncology and Hematology , Berlin, Germany
| | - A.C Radauer-Plank
- Charité-Universitätsmedizin Berlin- cooperate member of Freie Universität Berlin- Humboldt-Universität zu Berlin- and Berlin Institute of Health, Department of Pediatric Oncology and Hematology , Berlin, Germany
| | - A Borgmann-Staudt
- Charité-Universitätsmedizin Berlin- cooperate member of Freie Universität Berlin- Humboldt-Universität zu Berlin- and Berlin Institute of Health, Department of Pediatric Oncology and Hematology , Berlin, Germany
| | - W Geiger
- Charité-Universitätsmedizin Berlin- cooperate member of Freie Universität Berlin- Humboldt-Universität zu Berlin- and Berlin Institute of Health, Clinic for Urology , Berlin, Germany
| | - C Stelzer
- Charité-Universitätsmedizin Berlin- cooperate member of Freie Universität Berlin- Humboldt-Universität zu Berlin- and Berlin Institute of Health, Clinic for Urology , Berlin, Germany
| | - M Balcerek
- Charité-Universitätsmedizin Berlin- cooperate member of Freie Universität Berlin- Humboldt-Universität zu Berlin- and Berlin Institute of Health / Berlin Institute of Health BIH, Department of Pediatric Oncology and Hematology , Berlin, Germany
| |
Collapse
|
9
|
Fernández González M, Wilkemeyer I, Radauer-Plank A, Borgmann-Staudt A, Geiger W, Goranova I, Stelzer C, Balcerek M. P-461 “15 years of cryopreservation of semen and testicular tissue samples and outcomes of fertility treatments – a single centre experience at Charité-Universitätsmedizin Berlin”. Hum Reprod 2022. [DOI: 10.1093/humrep/deac107.433] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Study question
To explore practices of cryopreservation among male cancer patients and describe outcomes of fertility treatments with samples collected before and after cancer treatment.
Summary answer
Only 9.1% of cancer patients used their samples for fertility treatment (ART). Patients underwent ART mostly within the first two years and following high-risk treatment.
What is known already
Fertility preservation has become an important issue, due to the potential gonadotoxicity of oncological therapies. Most cancer patients who undergo gonadotoxic treatment desire to have children. Yet, cancer patients may suffer impaired spermatogenesis in more than a third to over two thirds of cases following standard or high dose cancer treatments, respectively. Identifying risk factors of infertility is therefore fundamental for individual and risk adapted patient counseling. Current guidelines recommend fertility preservation, especially cryopreservation of sperm/testicular tissue, in cancer patients who require gonadotoxic treatment. Rates of utilisation of cryopreserved samples for fertility treatment are low (often <10%).
Study design, size, duration
In our retrospective study, we collected data from 506 cancer patients who cryopreserved semen/testicular tissue samples between 2004 and 2019 in our centre and for who oncological treatment data was available. Additionally, former patients who had used their previously cryopreserved samples were asked for informed consent to collect information on fertility treatment from the respective fertility centre in which they were treated.
Participants/materials, setting, methods
We collected oncologic and cryopreservation data from medical records, and fertility treatment data from external clinics. Patients were stratified according to age at diagnosis (<18 or ≥ 18 years old), diagnosis (brain, testicular or solid tumors in other locations or hematologic malignancy) and time-point of cryopreservation (before or after gonadotoxic treatment). We assessed the following fertility outcomes: fertilisation, pregnancy, miscarriage and live birth rate as well as perinatal outcomes (gestational age, weight and height at delivery).
Main results and the role of chance
The majority of the 506 cancer patients (including 10.5% adolescents) had suffered from a testicular or hematological malignancy. The number of patients that underwent cryopreservation annually in our centre had increased over time. On average, patients collected one sample (1.2±0.4, range:1-3). The majority of samples were collected before oncologic treatment (460/600, 76.7%) and were semen samples (554/601, 92.2%). The rate of cryopreserved tissue was higher in adolescents compared to adults. At the time-point of our study, only 46 patients (9.1%) had used their samples (15,2% tissue samples) for fertility treatment after a median of 18 months following cryopreservation (IQR:7.25±27.5). We received fertility cycle information on 21 patients. Eleven couples (55.0%) had only required one cycle to achieve a pregnancy (range:1-3 cycles, n = 38). Between 70-80% of couples, depending on the cancer diagnosis, achieved at least one pregnancy. Out of 16 patients who had successfully achieved a pregnancy, thirteen succeeded using cryopreserved sperm, one patient required to change from fresh to cryopreserved sperm in the third cycle and two patients used fresh sperm. Rate of pregnancy per e mbryo transfer (ET) was 51.4% (19/37), including eleven singletons, three twin pairs, four miscarriages (in two patients) and one pregnancy with unknown outcome.
Limitations, reasons for caution
Bias might be caused by the restrospective study design and the fact that recommendations for clinical practice have changed over time. We could not collect information on patients who would have been eligible but did not perform cryopreservation, whose partners conceived spontaneously or who used tissue samples for ART.
Wider implications of the findings
This study supports sperm and tissue cryopreservation as effective methods for fertility preservation. The rate of ART utilisation is still low, however results from ART cycles are reassuring, also when cryopreserved semen samples are used. Upcoming high-risk treatment is a predictor for ART utilisation, whereas follow-up time is not.
Trial registration number
Our study was approved by the ethics committee of Charité-Universitätsmedizin Berlin (EA4/158/19).
Collapse
Affiliation(s)
- M.J Fernández González
- Charité-Universitätsmedizin Berlin- cooperate member of Freie Universität Berlin- Humboldt-Universität zu Berlin- and Berlin Institute of Health-, Department of Pediatric Oncology and Hematology , Berlin, Germany
| | - I Wilkemeyer
- Charité-Universitätsmedizin Berlin- cooperate member of Freie Universität Berlin- Humboldt-Universität zu Berlin- and Berlin Institute of Health-, Clinic for Urology , Berlin, Germany
| | - A.C Radauer-Plank
- Charité-Universitätsmedizin Berlin- cooperate member of Freie Universität Berlin- Humboldt-Universität zu Berlin- and Berlin Institute of Health, Department of Pediatric Oncology and Hematology , Berlin, Germany
| | - A Borgmann-Staudt
- Charité-Universitätsmedizin Berlin- cooperate member of Freie Universität Berlin- Humboldt-Universität zu Berlin- and Berlin Institute of Health, Department of Pediatric Oncology and Hematology , Berlin, Germany
| | - W Geiger
- Charité-Universitätsmedizin Berlin- cooperate member of Freie Universität Berlin- Humboldt-Universität zu Berlin- and Berlin Institute of Health, Clinic for Urology , Berlin, Germany
| | - I Goranova
- Charité-Universitätsmedizin Berlin- cooperate member of Freie Universität Berlin- Humboldt-Universität zu Berlin- and Berlin Institute of Health, Clinic for Urology , Berlin, Germany
| | - C Stelzer
- Charité-Universitätsmedizin Berlin- cooperate member of Freie Universität Berlin- Humboldt-Universität zu Berlin- and Berlin Institute of Health, Clinic for Urology , Berlin, Germany
| | - M Balcerek
- Charité-Universitätsmedizin Berlin- cooperate member of Freie Universität Berlin- Humboldt-Universität zu Berlin- and Berlin Institute of Health, Berlin Institute of Health BIH and Department of Pediatric Oncology and Hematology , Berlin, Germany
| |
Collapse
|
10
|
Sommerhäuser G, Borgmann-Staudt A, Schilling R, Frey E, Hak J, Janhubová V, Kepakova K, Kepak T, Klco-Brosius S, Krawczuk-Rybak M, Kruseova J, Lackner H, Luks A, Michel G, Panasiuk A, Tamesberger M, Vetsch J, Balcerek M. Health of children born to childhood cancer survivors: Participant characteristics and methods of the Multicenter Offspring Study. Cancer Epidemiol 2021; 75:102052. [PMID: 34710669 DOI: 10.1016/j.canep.2021.102052] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2021] [Revised: 10/04/2021] [Accepted: 10/14/2021] [Indexed: 11/24/2022]
Abstract
INTRODUCTION Research on childhood cancer survivor offspring has been limited to genetic disease occurrence, malformations or non-hereditary cancers. However, previous surveys indicated that survivors harbor fears about their (prospective) children's overall health. Our Multicenter Offspring Study examined extensive health aspects in children born to survivors and their siblings providing comprehensive information to be used in patient counseling to elucidate and alleviate existing concerns. METHODS Using a specifically designed questionnaire, childhood cancer survivors and their siblings were surveyed on their offspring's health (Supplementary material). Recruitment strategies depended on local infrastructures and standards of participating centers, including registry-based and direct approaches. Group differences were tested non-parametrically and effect sizes were calculated. RESULTS In total, 1126 survivors reported on 1780 offspring and 271 siblings reported on 441 offspring. Response rates ranged from 32.1% (Czech Republic) to 85.0% (Austria). Respondents were more likely to be female (p = .007), older at time of survey (p < .001), diagnosed 1980-1999 (p < .001) and treated with chemotherapy (p < .001). Compared to siblings, survivors were younger at time of survey (35 years vs. 39 years, p < .001) and at first birth (29 years vs. 30 years, p < .001). Survivor and sibling offspring only differed in terms of age at survey (6.3 years vs. 8.9 years, p < .001). CONCLUSION The Multicenter Offspring Study investigates a wide variety of health aspects in offspring born to survivors and their siblings in five European countries. Our study cohorts form a solid basis for future analyses; yet, certain limitations, due to differences in approach among participating centers, must be considered when interpreting findings.
Collapse
Affiliation(s)
- Greta Sommerhäuser
- Charité-Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Department of Paediatric Oncology and Haematology, Germany
| | - Anja Borgmann-Staudt
- Charité-Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Department of Paediatric Oncology and Haematology, Germany
| | - Ralph Schilling
- Charité-Universistätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Institute of Social Medicine, Epidemiology and Health Economics, Germany; Charité-Univesristätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Institute of Biometry and Clinical Epidemiology (iBiKE), Germany
| | - Eva Frey
- St. Anna Kinderspital Vienna, Austria
| | - Jiri Hak
- University Hospital Hradec Králové, Czech Republic
| | | | | | | | - Stephanie Klco-Brosius
- Charité-Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Department of Paediatric Oncology and Haematology, Germany
| | | | | | | | - Ales Luks
- University Hospital Motol, Prague, Czech Republic
| | - Gisela Michel
- University of Lucerne, Department of Health Sciences and Medicine, Switzerland
| | | | | | - Janine Vetsch
- University of Lucerne, Department of Health Sciences and Medicine, Switzerland; Eastern Switzerland University of Applied Sciences, Department of Health Sciences, Institute of Applied Nursing Science, St. Gallen, Switzerland
| | - Magdalena Balcerek
- Charité-Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Department of Paediatric Oncology and Haematology, Germany; Berlin Institute of Health (BIH), Berlin, Germany.
| |
Collapse
|
11
|
Balcerek M, Sommerhäuser G, Schilling R, Hölling H, Klco-Brosius S, Borgmann-Staudt A. Health-related quality of life of children born to childhood cancer survivors in Germany. Psychooncology 2021; 30:1866-1875. [PMID: 34156134 DOI: 10.1002/pon.5752] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2021] [Revised: 05/17/2021] [Accepted: 06/15/2021] [Indexed: 11/06/2022]
Abstract
OBJECTIVE Rising childhood cancer survival rates have increased the importance of health-related quality of life (HRQL) assessment. While survivors show comparable HRQL to peers, concerns that cancer treatment could impact the health of prospective children were reported. No previous publications address HRQL of childhood cancer survivor offspring. METHODS We assessed survivor offspring HRQL using the parental KINDL questionnaire. Matched-pair analysis was conducted with data from the general population (KiGGS study) using age, gender and education (1:1, n = 1206 cases). Multivariate analyses were conducted to detect the influence of parental diagnose and treatment on offspring HRQL. RESULTS Overall, within KINDL dimensions, survivors reported comparable to higher HRQL for their children than the general population. Survivor parents reported significantly (p < 0.001) higher psychological (86.7% vs. 83.0%, Cohen's d = 0.3) and self-esteem (79.1% vs. 73.3%, Cohen's d = 0.5) well-being scores for younger children (3-6-year-olds). As time since diagnosis increased, parents reported higher well-being scores. Accordingly, recently diagnosed survivors reported significantly lower psychological well-being scores (p = 0.28; OR = 0.457; 95% CI = 0.228-0.918) for their children. With increasing age, average HRQL scores decreased in both cohorts; yet, this drop was less pronounced for survivor offspring. The biggest difference between age groups (7-10- vs. 14-17-year-olds) was found for school-specific well-being (6.2-point drop in survivor offspring vs. 18.2-point drop in KiGGS offspring). CONCLUSION Comparable to higher parentally assessed HRQL was reported for survivor offspring compared to peers. These findings are reassuring and consistent with self-reported HRQL in childhood cancer survivors. Type of parental cancer diagnosis and treatment showed no negative impact on offspring HRQL.
Collapse
Affiliation(s)
- Magdalena Balcerek
- Department of Paediatric Oncology and Haematology, Charité-Universitätsmedizin Berlin, Berlin, Germany.,Berlin Institute of Health (BIH), Berlin, Germany
| | - Greta Sommerhäuser
- Department of Paediatric Oncology and Haematology, Charité-Universitätsmedizin Berlin, Berlin, Germany
| | - Ralph Schilling
- Institute of Biometry and Clinical Epidemiology, Charité-Univseristätsmedzin Berlin, Berlin, Germany.,Institute of Social Medicine, Epidemiology and Health Economics, Charité-Universitätsmedizin Berlin, Berlin, Germany
| | - Heike Hölling
- Division of Epidemiology and Health Monitoring, Robert Koch-Institute Berlin, Berlin, Germany
| | - Stephanie Klco-Brosius
- Department of Paediatric Oncology and Haematology, Charité-Universitätsmedizin Berlin, Berlin, Germany
| | - Anja Borgmann-Staudt
- Department of Paediatric Oncology and Haematology, Charité-Universitätsmedizin Berlin, Berlin, Germany
| |
Collapse
|
12
|
Korte E, Schilling R, Balcerek M, Campbell H, Dirksen U, Herrmann G, Kepakova K, Kepak T, Klco-Brosius S, Kruseova J, Kunstreich M, Lackner H, Langer T, Panasiuk A, Stefanowicz J, Strauß G, Ranft A, Byrne J, Goldbeck L, Borgmann-Staudt A. Fertility education for adolescent cancer patients: Gaps in current clinical practice in Europe. Eur J Cancer Care (Engl) 2020; 29:e13279. [PMID: 32567091 DOI: 10.1111/ecc.13279] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2019] [Revised: 12/20/2019] [Accepted: 04/16/2020] [Indexed: 01/20/2023]
Abstract
OBJECTIVE As adolescent cancer patients may suffer from infertility following treatment, fertility counselling is essential. Our aim was to explore the current situation in four European countries in terms of (I) education about the risk for infertility, (II) counselling on fertility preservation, (III) patients' knowledge on fertility, (IV) sufficiency of information and (V) uptake of cryopreservation. METHODS In total, 113 patients (13-20 years) at 11 study centres completed a self-report questionnaire three and six months after cancer diagnosis. Multivariate logistic regression was used to estimate odds ratios (OR) with 95% confidence intervals (CI). RESULTS As many as 80.2% of participants reported having received education about the risk for infertility prior to treatment, 73.2% recalled counselling on fertility preservation. Only 52.3% stated they felt sufficiently informed to make a decision. Inability to recall counselling on fertility preservation (OR = 0.03, CI: 0.00-0.47) and female gender (OR = 0.11, CI: 0.03-0.48) was associated with lower use of cryopreservation, whereas older age was associated with higher use. CONCLUSION Fertility counselling was available to a relatively high proportion of patients, and it did influence the utilisation of cryopreservation. However, many patients did not feel sufficiently informed. Further improvement is needed to enable adolescent cancer patients to make an informed decision on fertility preservation.
Collapse
Affiliation(s)
- Elisabeth Korte
- Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, Berlin Institute of Health (BIH), Berlin, Germany
| | - Ralph Schilling
- Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, Berlin Institute of Health (BIH), Berlin, Germany
| | - Magdalena Balcerek
- Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, Berlin Institute of Health (BIH), Berlin, Germany.,Berlin Institute of Health, BIH, Berlin, Germany
| | | | - Uta Dirksen
- University Hospital Essen Pediatrics III, West German Cancer Centre, Essen, Germany.,German Cancer Research Centre (DKTK), Heidelberg, Germany
| | - Gloria Herrmann
- Department of Paediatrics and Adolescent Medicine, University Medical Center Ulm, Ulm, Germany
| | - Katerina Kepakova
- University Hospital Brno & International Clinical Research Center (FNUSA-ICRC), Masaryk University, Brno, Czech Republic
| | - Tomas Kepak
- University Hospital Brno & International Clinical Research Center (FNUSA-ICRC), Masaryk University, Brno, Czech Republic
| | | | | | - Marina Kunstreich
- Department of Paediatric Oncology, Haematology and Immunology, Medical Faculty, Heinrich-Heine-University of Düsseldorf, Düsseldorf, Germany
| | - Herwig Lackner
- Department of Paediatrics and Adolescent Medicine, Medical University of Graz, Graz, Austria
| | - Thorsten Langer
- Paediatric Oncology and Hematology, University Hospital for Children and Adolescents, University of Lübeck, Lübeck, Germany
| | | | - Joanna Stefanowicz
- Department of Pediatrics, Hematology and Oncology, Medical University of Gdansk, Gdansk, Poland
| | - Gabriele Strauß
- Helios Kliniken Berlin-Buch, Klinik für Kinder- und Jugendmedizin, Chemnitz, Germany
| | - Andreas Ranft
- University Hospital Essen Pediatrics III, West German Cancer Centre, Essen, Germany.,German Cancer Research Centre (DKTK), Heidelberg, Germany
| | | | - Lutz Goldbeck
- Department of Paediatrics and Adolescent Medicine, University Medical Center Ulm, Ulm, Germany
| | - Anja Borgmann-Staudt
- Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, Berlin Institute of Health (BIH), Berlin, Germany
| |
Collapse
|
13
|
Schuster T, Borgmann-Staudt A, König CJ, Sommerhäuser G, Korte E, Hölling H, Schilling R, Balcerek M. Vaccinations and Screening Examinations – Prevention Awareness Among Children of Childhood Cancer Survivors in Germany. Klin Padiatr 2020; 232:143-150. [PMID: 32176936 DOI: 10.1055/a-1114-6350] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
Abstract
Background Immunisation levels and attendance of preventive screening examinations indicate primary health prevention awareness. We investigated participation among German childhood cancer survivors’ (CCS’) offspring in our national offspring study.
Patients and methods CCS with biological children were surveyed on their offspring’s vaccination levels and attendance of preventive screening examinations by questionnaire. Data from the German general population was available for matched-pair analysis (KiGGS study, Robert Koch-Institute, n=17,641).
Results Overall, 852/1,299 (65,6%) CCS completed 1,340 questionnaires regarding their childrenʼs health. In comparison with the general population, coverage of tetanus, diphtheria and pertussis inoculations were similar (tetanus 99,1 vs. 98,4%). Measles, mumps and rubella vaccinations were carried out significantly more often by CCS’ offspring (rubella 96,1 vs. 91,7%). Throughout all age groups, preventive screening examinations were attended significantly more often by CCS’ offspring. Parentʼs anxiety regarding their offspring’s health was identified to be a confounding variable for vaccination rates.
Discussion and conclusion CCS’ offspring showed comparable to significantly higher participation levels of recommended vaccinations and screening examinations than their peers from the German general population. In contrast to the general population the attendance of CCS’ offspring did not decrease with rising age. CCS’ own experiences and increased worry about their children’s health may lead to a higher prevention awareness. This should be considered in counselling parents with a cancer history.
Collapse
Affiliation(s)
- Theresa Schuster
- Paediatric Oncology, Haematology and Stem Cell Transplantation, Charite Universitätsmedizin Berlin, Berlin
| | - Anja Borgmann-Staudt
- Paediatric Oncology, Haematology and Stem Cell Transplantation, Charite Universitätsmedizin Berlin, Berlin
| | - Charlotte Jessica König
- Paediatric Oncology, Haematology and Stem Cell Transplantation, Charite Universitätsmedizin Berlin, Berlin
| | - Greta Sommerhäuser
- Paediatric Oncology, Haematology and Stem Cell Transplantation, Charite Universitätsmedizin Berlin, Berlin
| | - Elisabeth Korte
- Paediatric Oncology, Haematology and Stem Cell Transplantation, Charite Universitätsmedizin Berlin, Berlin
| | - Heike Hölling
- Dptm. for Health Reports, Robert Koch Institut, Berlin
| | - Ralph Schilling
- Paediatric Oncology, Haematology and Stem Cell Transplantation, Charite Universitätsmedizin Berlin, Berlin.,Institut für Biometrie und Klinische Epidemiologie, Charite Universitätsmedizin Berlin, Berlin
| | - Magdalena Balcerek
- Paediatric Oncology, Haematology and Stem Cell Transplantation, Charite Universitätsmedizin Berlin, Berlin.,Berlin Institute of Health, (Junior) Clinician Scientist program, Berlin
| |
Collapse
|
14
|
Korte E, Schilling R, Balcerek M, Byrne J, Dirksen U, Herrmann G, Kepak T, Klco-Brosius S, Kruseova J, Kunstreich M, Langer T, Panasiuk A, Stefanowicz J, Strauß G, Wiegele K, Borgmann-Staudt A. Fertility-Related Wishes and Concerns of Adolescent Cancer Patients and Their Parents. J Adolesc Young Adult Oncol 2020; 9:55-62. [DOI: 10.1089/jayao.2019.0064] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/25/2023] Open
Affiliation(s)
- Elisabeth Korte
- Department of Pediatrics, Division of Oncology and Hematology, Charité - Universitätsmedizin Berlin, Berlin, Germany
| | - Ralph Schilling
- Department of Pediatrics, Division of Oncology and Hematology, Charité - Universitätsmedizin Berlin, Berlin, Germany
| | - Magdalena Balcerek
- Department of Pediatrics, Division of Oncology and Hematology, Charité - Universitätsmedizin Berlin, Berlin, Germany
- Berlin Institute of Health (BIH), Berlin, Germany
| | | | - Uta Dirksen
- Department of Pediatrics III, West German Cancer Centre, University Hospital Essen, Essen, Germany
- German Cancer Research Centre (DKTK), Heidelberg, Germany
| | - Gloria Herrmann
- Department of Paediatrics and Adolescent Medicine, University Medical Center Ulm, Ulm, Germany
| | - Tomas Kepak
- University Hospital Brno and International Clinical Research Center (FNUSA-ICRC), Masaryk University, Brno, Czech Republic
| | - Stephanie Klco-Brosius
- Department of Pediatrics III, West German Cancer Centre, University Hospital Essen, Essen, Germany
| | - Jarmila Kruseova
- Department of Pediatric Haematology and Oncology, Motol University Hospital, Prague, Czech Republic
| | - Marina Kunstreich
- Department of Paediatric Oncology, Haematology and Immunology, Medical Faculty, Heinrich-Heine-University of Düsseldorf, Düsseldorf, Germany
| | - Thorsten Langer
- Department of Paediatric Oncology and Hematology, University Hospital for Children and Adolescents, University of Lübeck, Lubeck, Germany
| | - Anna Panasiuk
- Department of Pediatric Oncology and Hematology, Medical University of Bialystok, Bialystok, Poland
| | - Joanna Stefanowicz
- Department of Pediatrics, Hematology and Oncology, Medical University of Gdansk, Gdansk, Poland
| | - Gabriele Strauß
- Klinik für Kinder- und Jugendmedizin, Helios Klinikum Berlin-Buch, Berlin, Germany
| | - Karin Wiegele
- Department of Paediatrics and Adolescent Medicine, Medical University of Graz, Graz, Austria
| | - Anja Borgmann-Staudt
- Department of Pediatrics, Division of Oncology and Hematology, Charité - Universitätsmedizin Berlin, Berlin, Germany
| | | |
Collapse
|
15
|
Balcerek M, Schilling R, Byrne J, Dirksen U, Cario H, Fernandez-Gonzalez MJ, Kepak T, Korte E, Kruseova J, Kunstreich M, Lackner H, Langer T, Sawicka-Zukowska M, Stefanowicz J, Strauß G, Borgmann-Staudt A. Determinants of utilization of cryopreservation of germ cells in adolescent cancer patients in four European countries. Eur J Pediatr 2020; 179:51-60. [PMID: 31493021 DOI: 10.1007/s00431-019-03459-9] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/18/2019] [Revised: 08/18/2019] [Accepted: 08/22/2019] [Indexed: 11/30/2022]
Abstract
Infertility is a relevant late-effect following cancer treatment; yet, a large proportion of survivors cannot recall having been informed of this risk. In an intervention study, we examined if and how supportive patient information material on fertility/fertility-preserving measures influences utilization of cryopreservation in adolescent cancer patients. The control group, recruited 03/2014-01/2016, received the usual patient education at initial diagnosis. The intervention group, recruited 04/2016-10/2017, received patient education supported by a fertility flyer and brochure. Patients and parents were each asked questions on utilization of cryopreservation in a questionnaire 3 and 6 months after initial diagnosis. Patient core and therapy data were obtained from medical records. Overall, cryopreservation rates showed no significant difference between the control (32.7%, n = 37/113) and intervention group (36.6%, n = 37/101). In the control group, cryopreservation was associated with gender (OR 0.100, CI 0.023-0.427), age (OR 1.559, CI 1.077-2.258) and recalling information on fertility protection (OR 33.663, CI 2.100-539.574); in the intervention group, cryopreservation was related to gender (OR 0.093, CI 0.026-0.330) and the estimated infertility risk (OR 43.665, CI 2.157-883.974).Conclusion: Cryopreservation rates did not overall increase following the intervention; however, the individual risk seemed to be brought into attention more: Those at risk, including younger patients, cryopreserved at higher rates.What is Known:•Infertility is a relevant late-effect following adolescent cancer.•Guidelines recommend to offer fertility protection before cancer treatment.•A relevant proportion of adolescents with cancer are not aware of this risk.•Fertility protection seems under-used in cancer patients at risk for infertility.What is New:•Information material on fertility and protection in adolescents did not increase overall rates of cryopreservation.•Cryopreservation rates were improved according to individual risk for infertility.•Our flyers and brochures on fertility in cancer patients are available in various languages.
Collapse
Affiliation(s)
- Magdalena Balcerek
- Charité - Universitätsmedizin, Berlin, Germany.,Berlin Institute of Health (BIH), Berlin, Germany
| | | | | | - Uta Dirksen
- West German Cancer Centre, University Hospital Essen Paediatrics III, Essen, Germany.,German Cancer Research Centre (DKTK), Heidelberg, Germany
| | - Holger Cario
- Department of Paediatrics and Adolescent Medicine, University Medical Centre, Ulm, Germany
| | | | | | | | | | - Marina Kunstreich
- Department of Paediatric Oncology, Haematology and Immunology, Medical Faculty, Heinrich-Heine, University of, Düsseldorf, Germany
| | | | | | | | - Joanna Stefanowicz
- Klinika Pediatrii, Hematologii I Onkologii Gdanski Uniwersytet, Gdansk, Poland
| | - Gabriele Strauß
- Helios Kliniken Berlin-Buch, Klinik für Kinder- und Jungendmedizin, Berlin, Germany
| | | | | |
Collapse
|
16
|
Borgmann‐Staudt A, Kunstreich M, Schilling R, Balcerek M, Dirksen U, Cario H, Kepakova K, Klco‐Brosius S, Korte E, Kruseova J, Lackner H, Langer T, Roslan K, Stefanowicz J, Strauß G, Byrne J. Fertility knowledge and associated empowerment following an educational intervention for adolescent cancer patients. Psychooncology 2019; 28:2218-2225. [DOI: 10.1002/pon.5210] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2019] [Revised: 08/16/2019] [Accepted: 08/18/2019] [Indexed: 11/08/2022]
Affiliation(s)
| | - Marina Kunstreich
- Department of Paediatric Oncology, Haematology and ImmunologyMedical FacultyHeinrich‐Heine‐University of Düsseldorf Düsseldorf Germany
| | | | - Magdalena Balcerek
- Charité‐Universitätsmedizin Berlin Berlin Germany
- Berlin Institute of Health (BIH) Berlin Germany
| | - Uta Dirksen
- University Hospital Essen Pediatrics IIIWest German Cancer Centre Essen Germany
- German Cancer Research Centre (DKTK) Heidelberg Germany
| | - Holger Cario
- Department of Pediatrics and Adolescent MedicineUniversity Medical Center Ulm Ulm Germany
| | - Katerina Kepakova
- University Hospital Brno and International Clinical Research Centre (FNUSA‐ICRC)Masaryk University Brno Czech Republic
| | | | | | | | | | | | | | - Joanna Stefanowicz
- Department of Pediatrics, Hematology and OncologyMedical University of Gdansk Gdańsk Poland
| | - Gabriele Strauß
- Helios Kliniken Berlin‐Buch, Klinik für Kinder‐ und Jugendmedizin Berlin Germany
| | | | | |
Collapse
|
17
|
Schuster T, Korte E, Schilling R, Hölling H, Balcerek M, Borgmann-Staudt A. Ambulant health care utilisation among children of childhood cancer survivors in Germany. Support Care Cancer 2019; 28:787-795. [DOI: 10.1007/s00520-019-04861-7] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2018] [Accepted: 05/09/2019] [Indexed: 10/26/2022]
|
18
|
Dittrich R, Kliesch S, Schüring A, Balcerek M, Baston-Büst DM, Beck R, Beckmann MW, Behringer K, Borgmann-Staudt A, Cremer W, Denzer C, Diemer T, Dorn A, Fehm T, Gaase R, Germeyer A, Geue K, Ghadjar P, Goeckenjan M, Götte M, Guth D, Hauffa BP, Hehr U, Hetzer F, Hirchenhain J, Hoffmann W, Hornemann B, Jantke A, Kentenich H, Kiesel L, Köhn FM, Korell M, Lax S, Liebenthron J, Lux M, Meißner J, Micke O, Nassar N, Nawroth F, Nordhoff V, Ochsendorf F, Oppelt PG, Pelz J, Rau B, Reisch N, Riesenbeck D, Schlatt S, Sender A, Schwab R, Siedentopf F, Thorn P, Wagner S, Wildt L, Wimberger P, Wischmann T, von Wolff M, Lotz L. Fertility Preservation for Patients with Malignant Disease. Guideline of the DGGG, DGU and DGRM (S2k-Level, AWMF Registry No. 015/082, November 2017) - Recommendations and Statements for Girls and Women. Geburtshilfe Frauenheilkd 2018; 78:567-584. [PMID: 29962516 PMCID: PMC6018069 DOI: 10.1055/a-0611-5549] [Citation(s) in RCA: 31] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2018] [Revised: 04/15/2018] [Accepted: 04/17/2018] [Indexed: 12/17/2022] Open
Abstract
Aim
The aim of this official guideline published by the German Society of Gynecology and Obstetrics (DGGG) and coordinated with the German Society of Urology (DGU) and the German Society of Reproductive Medicine (DGRM) is to provide consensus-based recommendations, obtained by evaluating the relevant literature, on counseling and fertility preservation for prepubertal girls and boys as well as patients of reproductive age. Statements and recommendations for girls and women are presented below. Statements or recommendations for boys and men are not the focus of this guideline.
Methods
This S2k guideline was developed at the suggestion of the guideline commission of the DGGG, DGU and DGRM and represents the structured consensus of representative members from various professional associations (n = 40).
Recommendations
The guideline provides recommendations on counseling and fertility preservation for women and girls which take account of the patientʼs personal circumstances, the planned oncologic therapy and the individual risk profile as well as the preferred approach for selected tumor entities.
Collapse
Affiliation(s)
- Ralf Dittrich
- Frauenklinik, Universitätsklinikum Erlangen, Friedrich-Alexander Universität Erlangen-Nürnberg, Erlangen, Germany
| | - Sabine Kliesch
- Centrum für Reproduktionsmedizin und Andrologie, Universitätsklinik Münster, Münster, Germany
| | | | - Magdalena Balcerek
- Pädiatrie mit Schwerpunkt Onkologie und Hämatologie, Charité Berlin, Berlin, Germany
| | | | | | - Matthias W Beckmann
- Frauenklinik, Universitätsklinikum Erlangen, Friedrich-Alexander Universität Erlangen-Nürnberg, Erlangen, Germany
| | | | - Anja Borgmann-Staudt
- Pädiatrie mit Schwerpunkt Onkologie und Hämatologie, Charité Berlin, Berlin, Germany
| | | | - Christian Denzer
- Kinder- und Jugendmedizin, Universitätsklinikum Ulm, Ulm, Germany
| | - Thorsten Diemer
- Klinik und Poliklinik für Urologie, Kinderurologie und Andrologie, Universitätsklinikum Gießen, Gießen, Germany
| | - Almut Dorn
- Praxis für Gynäkologische Psychosomatik, Hamburg, Germany
| | - Tanja Fehm
- Frauenklinik, Universitätsklinikum Düsseldorf, Düsseldorf, Germany
| | - Rüdiger Gaase
- Gemeinschaftspraxis für Frauenheilkunde, Worms, Germany
| | - Ariane Germeyer
- Frauenklinik, Universitätsklinikum Heidelberg, Heidelberg, Germany
| | - Kristina Geue
- Medizinische Psychologie und Medizinische Soziologie, Universitätsklinikum Leipzig, Leipzig, Germany
| | - Pirus Ghadjar
- Radioonkologie und Strahlentherapie, Charité Berlin, Berlin, Germany
| | | | - Martin Götte
- Frauenklinik, Universitätsklinikum Münster, Münster, Germany
| | - Dagmar Guth
- Praxis für Frauenheilkunde Plauen, Plauen, Germany
| | | | - Ute Hehr
- Zentrum für Humangenetik, Universitätsklinikum Regensburg, Regensburg, Germany
| | - Franc Hetzer
- Chirurgisches Departement, Spital Linth, Uznach, Switzerland
| | - Jens Hirchenhain
- Frauenklinik, Universitätsklinikum Düsseldorf, Düsseldorf, Germany
| | | | | | | | | | - Ludwig Kiesel
- Frauenklinik, Universitätsklinikum Dresden, Dresden, Germany
| | | | - Matthias Korell
- Frauenklinik, Johanna Etienne Klinikum Neuss, Neuss, Germany
| | - Sigurd Lax
- Institut für Pathologie, LKH Graz Süd-West, Graz, Austria
| | - Jana Liebenthron
- Gynäkologische Endokrinologie und Reproduktionsmedizin, Universitätsklinikum Bonn, Bonn, Germany
| | - Michael Lux
- Frauenklinik, Universitätsklinikum Erlangen, Friedrich-Alexander Universität Erlangen-Nürnberg, Erlangen, Germany
| | - Julia Meißner
- Hämatologie, Onkologie und Rheumatologie, Universitätsklinikum Heidelberg, Heidelberg, Germany
| | - Oliver Micke
- Strahlentherapie und Radioonkologie, Franziskus Hospital Bielefeld, Bielefeld, Germany
| | | | - Frank Nawroth
- Facharzt-Zentrum für Kinderwunsch, Pränatale Medizin, Endokrinologie und Osteologie, amedes MVZ Hamburg GmbH, Hamburg, Germany
| | - Verena Nordhoff
- Centrum für Reproduktionsmedizin und Andrologie, Universitätsklinik Münster, Münster, Germany
| | - Falk Ochsendorf
- Andrologie, Dermatologie, Venerologie und Allergologie, Universitätsklinikum Frankfurt, Frankfurt, Germany
| | - Patricia G Oppelt
- Frauenklinik, Universitätsklinikum Erlangen, Friedrich-Alexander Universität Erlangen-Nürnberg, Erlangen, Germany
| | - Jörg Pelz
- Allgemein-, Viszeral- und Gefäßchirurgie, Universitätsklinikum Würzburg, Würzburg, Germany
| | - Beate Rau
- Onkologische Chirurgie, Charité Berlin, Berlin, Germany
| | - Nicole Reisch
- Endokrinologie, Universitätsklinikum München, München, Germany
| | | | - Stefan Schlatt
- Centrum für Reproduktionsmedizin und Andrologie, Universitätsklinik Münster, Münster, Germany
| | - Annekathrin Sender
- Medizinische Psychologie und Medizinische Soziologie, Universitätsklinikum Leipzig, Leipzig, Germany
| | - Roxana Schwab
- Frauenklinik, Universitätsklinikum Mainz, Mainz, Germany
| | - Friederike Siedentopf
- Brustzentrum, Martin-Luther-Krankenhaus, Paul Gerhardt Diakonie, Berlin-Wilmersdorf, Germany
| | - Petra Thorn
- Praxis für psychosoziale Kinderwunschberatung, Paar- und Familientherapie, Mörfelden-Walldorf, Germany
| | | | - Ludwig Wildt
- Gynäkologische Endokrinologie und Reproduktionsmedizin, Universitätsklinikum Innsbruck, Innsbruck, Austria
| | | | - Tewes Wischmann
- Medizinische Psychologie, Universitätsklinikum Heidelberg, Heidelberg, Germany
| | - Michael von Wolff
- Gynäkologische Endokrinologie und Reproduktionsmedizin, Universitäts-Spital Bern, Bern, Switzerland
| | - Laura Lotz
- Frauenklinik, Universitätsklinikum Erlangen, Friedrich-Alexander Universität Erlangen-Nürnberg, Erlangen, Germany
| |
Collapse
|
19
|
Sikora G, Kepten E, Weron A, Balcerek M, Burnecki K. An efficient algorithm for extracting the magnitude of the measurement error for fractional dynamics. Phys Chem Chem Phys 2018; 19:26566-26581. [PMID: 28920611 DOI: 10.1039/c7cp04464j] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
Modern live-imaging fluorescent microscopy techniques following the stochastic motion of labeled tracer particles, i.e. single particle tracking (SPT) experiments, have uncovered significant deviations from the laws of Brownian motion in a variety of biological systems. Accurately characterizing the anomalous diffusion for SPT experiments has become a central issue in biophysics. However, measurement errors raise difficulty in the analysis of single trajectories. In this paper, we introduce a novel surface calibration method based on a fractionally integrated moving average (FIMA) process as an effective tool for extracting both the magnitude of the measurement error and the anomalous exponent for autocorrelated processes of various origins. This method is developed using a toy model - fractional Brownian motion disturbed by independent Gaussian white noise - and is illustrated on both simulated and experimental biological data. We also compare this new method with the mean-squared displacement (MSD) technique, extended to capture the measurement noise in the toy model, which shows inferior results. The introduced procedure is expected to allow for more accurate analysis of fractional anomalous diffusion trajectories with measurement errors across different experimental fields and without the need for any calibration measurements.
Collapse
Affiliation(s)
- G Sikora
- Faculty of Pure and Applied Mathematics, Hugo Steinhaus Center, Wroclaw University of Science and Technology, Wyspianskiego 27, 50-370 Wroclaw, Poland.
| | | | | | | | | |
Collapse
|
20
|
Balcerek M, Schuster T, Korte E, Seidel J, Schilling R, Hölling H, Borgmann-Staudt A. Health-Related Behaviour Among Children of Childhood Cancer Survivors in Germany. Klin Padiatr 2016; 229:118-125. [PMID: 27975342 DOI: 10.1055/s-0042-116151] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
Purpose: Childhood cancer survivors fear that previous therapy could not only impair their own but also their children's health. We examined whether health-related behaviour in children of childhood cancer survivors differs from the general population. Methods: Our first nationwide survey wave (2013-2014) surveyed offspring health in 396 German childhood cancer survivors known to have a child of their own. Answers about health behaviour were analysed using descriptive statistics. Data were collected for 418 offspring and 394 could be integrated for matched-pair analyses with data from the German general population (KIGGS, n=17 641). Results: Teeth-cleaning routine, body-mass-index or subjective body image evaluation by parents were no different from children in the general population. Parents who included a cancer survivor smoked less in the presence of their children (p=0.01). During pregnancy, mothers in cancer survivor parent pairs abstained from drinking alcohol more often (p=0.01) and smoked less (p=0.05). While the calculated effect sizes (Phi) were generally low (0.135-0.247), children from cancer survivors played less outdoors than peers did (p=0.01). Boys participated in sports outside a club more often (p=0.05) and watched less TV on weekdays (p=0.01) and girls spent more time on the computer during weekdays than peers did (p=0.01). Conclusions: This study provides the first data for health-related behaviour in cancer survivors' offspring and sheds light on differences to parenting in the general population. Multivariate analyses in a larger study population are needed to relate these differences to fear issues in cancer survivors.
Collapse
Affiliation(s)
- M Balcerek
- Department of Pediatric Oncology, Hematology and Stem Cell Transplantation, Charité-University Medicine Berlin, Germany.,Berlin Institute of Health (BIH), Berlin, Germany
| | - T Schuster
- Department of Pediatric Oncology, Hematology and Stem Cell Transplantation, Charité-University Medicine Berlin, Germany
| | - E Korte
- Department of Pediatric Oncology, Hematology and Stem Cell Transplantation, Charité-University Medicine Berlin, Germany
| | - J Seidel
- Department of Pediatric Oncology, Hematology and Stem Cell Transplantation, Charité-University Medicine Berlin, Germany
| | - R Schilling
- Department of Pediatric Oncology, Hematology and Stem Cell Transplantation, Charité-University Medicine Berlin, Germany
| | - H Hölling
- Department for Health Reports, Robert-Koch-Institute, Berlin, Germany
| | - A Borgmann-Staudt
- Department of Pediatric Oncology, Hematology and Stem Cell Transplantation, Charité-University Medicine Berlin, Germany
| |
Collapse
|
21
|
Balcerek M, Schilling R, Schlack R, Borgmann-Staudt A. Nationwide Survey on the Health of Offspring from Former Childhood Cancer Patients in Germany. Klin Padiatr 2015; 227:350-4. [PMID: 26600178 DOI: 10.1055/s-0035-1565082] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
BACKGROUND Increased risk for infertility from cancer treatment and fear of health impairment in their offspring may prevent survivors of childhood cancer from having own children. Even though most studies report no increased risk for malformations, in our German fertility study 2008 a higher occurrence of cleft lip and palate was found in offspring of former patients. METHODS Since 2010 we assess offspring's health in a survey-based multicenter study, comparing diseases, well-being, healthcare utilization and health-related behavior between offspring from survivors, siblings or the general population. Within a first nationwide survey wave survivors who were known to have at least one child by previous fertility studies, received a questionnaire supported by the German Childhood Cancer Registry. Questionnaires were based on the KiGGS study on children's health in the German general population conducted by the Robert-Koch Institute (n=17,641). RESULTS Questionnaires on 418 children were answered by 65% (254/393) of survivors contacted to participate in the first nationwide offspring study wave. Participants were more likely to be female (p<0.01), to have achieved higher educational levels (p<0.05) and to be a survivor of a soft tissue tumor (p<0.05). Former patients expressed moderate to high anxiety for the occurrence of cancer in 74% and feared other diseases in their children in 20%. CONCLUSION Offspring health is a topic of major relevance to former patients. Our offspring study is currently being extended to ~1500 offspring of childhood cancer survivors in Europe.
Collapse
Affiliation(s)
- M Balcerek
- Paediatric Oncology, Haematology and Stem Cell Transplantation, Charité - University Medicine Berlin, Germany
| | - R Schilling
- Paediatric Oncology, Haematology and Stem Cell Transplantation, Charité - University Medicine Berlin, Germany
| | - R Schlack
- Robert Koch-Institute, Department for Epidemiology and Health Monitoring, Berlin, Germany
| | - A Borgmann-Staudt
- Paediatric Oncology, Haematology and Stem Cell Transplantation, Charité - University Medicine Berlin, Germany
| |
Collapse
|
22
|
Carr L, Balcerek M, Challa P, Dahiya A. Iterative Model Reconstruction (IMR) improves image quality and diagnostic performance in prospective ECG-Gated coronary CT Angiography (CTCA). Heart Lung Circ 2015. [DOI: 10.1016/j.hlc.2015.06.552] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
|
23
|
Patelski P, Stanisz M, Antczak A, Balcerek M, Pielech-Przybylska K, Sapinska E, Dziekonska U. Conversion of sugar beet leaf polysaccharides into single cell protein. RSC Adv 2015. [DOI: 10.1039/c4ra15930f] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
Conversion of low-cost sugar beet leaves into valuable yeast biomass was described.
Collapse
Affiliation(s)
- P. Patelski
- Lodz University of Technology
- Faculty of Biotechnology and Food Science
- 90-924 Lodz
- Poland
| | - M. Stanisz
- Lodz University of Technology
- Faculty of Biotechnology and Food Science
- 90-924 Lodz
- Poland
| | - A. Antczak
- Lodz University of Technology
- Faculty of Biotechnology and Food Science
- 90-924 Lodz
- Poland
| | - M. Balcerek
- Lodz University of Technology
- Faculty of Biotechnology and Food Science
- 90-924 Lodz
- Poland
| | - K. Pielech-Przybylska
- Lodz University of Technology
- Faculty of Biotechnology and Food Science
- 90-924 Lodz
- Poland
| | - E. Sapinska
- Lodz University of Technology
- Faculty of Biotechnology and Food Science
- 90-924 Lodz
- Poland
| | - U. Dziekonska
- Lodz University of Technology
- Faculty of Biotechnology and Food Science
- 90-924 Lodz
- Poland
| |
Collapse
|
24
|
Pfitzer C, Orawa H, Balcerek M, Langer T, Dirksen U, Keslova P, Zubarovskaya N, Schuster FR, Jarisch A, Strauss G, Borgmann-Staudt A. Dynamics of fertility impairment and recovery after allogeneic haematopoietic stem cell transplantation in childhood and adolescence: results from a longitudinal study. J Cancer Res Clin Oncol 2014; 141:135-42. [DOI: 10.1007/s00432-014-1781-5] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2014] [Accepted: 07/15/2014] [Indexed: 10/25/2022]
|
25
|
Koustenis E, Pfitzer C, Balcerek M, Reinmuth S, Zynda A, Stromberger C, Hohmann C, Keil T, Borgmann-Staudt A. Impact of Cranial Irradiation and Brain Tumor Location on Fertility: a Survey. Klin Padiatr 2013; 225:320-4. [DOI: 10.1055/s-0033-1353206] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Affiliation(s)
- E. Koustenis
- Paediatric Oncology/Haematology, Charité – Universitätsmedizin Berlin, Germany
| | - C. Pfitzer
- Paediatric Oncology/Haematology, Charité – Universitätsmedizin Berlin, Germany
| | - M. Balcerek
- Paediatric Oncology/Haematology, Charité – Universitätsmedizin Berlin, Germany
| | - S. Reinmuth
- Paediatric Oncology/Haematology, Charité – Universitätsmedizin Berlin, Germany
| | - A. Zynda
- Paediatric Oncology/Haematology, Charité – Universitätsmedizin Berlin, Germany
| | - C. Stromberger
- Department of Radiooncology and Radiotherapy, Charité – Universitätsmedizin Berlin, Germany
| | - C. Hohmann
- Institute for Social Medicine, Epidemiology and Health Economics, Charité – Universitätsmedizin Berlin, Germany
| | - T. Keil
- Institute of Clinical Epidemiology and Biometry, University of Würzburg, Germany
| | - A. Borgmann-Staudt
- Paediatric Oncology/Haematology, Charité – Universitätsmedizin Berlin, Germany
| |
Collapse
|
26
|
Wessel T, Balcerek M, Reinmuth S, Hohmann C, Keil T, Henze G, Borgmann-Staudt A. Age at menarche in childhood cancer survivors: results of a nationwide survey in Germany. Horm Res Paediatr 2012; 77:108-14. [PMID: 22441660 DOI: 10.1159/000336688] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/10/2011] [Accepted: 01/17/2012] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND/AIMS With rising cure rates of childhood cancer, side effects of treatment are attracting increasing interest. The present analysis evaluates the influence of tumor localization, radiotherapy and chemotherapy on the age of menarche. METHODS 4,689 former pediatric oncology patients, diagnosed 1980-2004, were contacted in collaboration with the German Childhood Cancer Registry. RESULTS 1,036 out of 1,461 female participants reported their age at menarche and had an oncological diagnosis before menarche. The median age at menarche was 13 years, compared to 12.8 years in the German general population. A significant delay of menarche was seen in patients with pituitary radiation doses of ≥30 Gy (mean 13.6 years, SD 2.2) compared to <30 Gy (mean 12.5 years, SD 1.4, p = 0.05). Patients with additional spinal radiation were even older at menarche (mean 14.4 years, SD 2.5). Pelvic and pelvic-near radiation significantly delayed onset of menarche (mean 14.0 years, SD 1.9 and mean 14.3, SD 2.6, respectively, p < 0.001). Only some chemotherapeutic agents (carboplatin/cisplatin, etoposide) were associated with a menarcheal delay of <1 year. CONCLUSION Overall, female childhood cancer survivors showed a normal menarcheal age. Pituitary radiation dosage of ≥30 Gy, spinal and pelvic radiotherapy were associated with a moderate delay in the occurrence of menarche.
Collapse
Affiliation(s)
- Theda Wessel
- Department of Pediatric Endocrinology, Charité University Hospital, Augustenburger Platz 1, Berlin, Germany
| | | | | | | | | | | | | |
Collapse
|
27
|
Balcerek M, Reinmuth S, Hohmann C, Keil T, Borgmann-Staudt A. Suspected infertility after treatment for leukemia and solid tumors in childhood and adolescence. Dtsch Arztebl Int 2012; 109:126-31. [PMID: 22427790 DOI: 10.3238/arztebl.2012.0126] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/13/2010] [Accepted: 10/24/2011] [Indexed: 11/27/2022]
Abstract
BACKGROUND With improved cure rates of cancer in children and adolescents, the long-term effects of oncological treatment, including impaired fertility, have become an important clinical issue. METHODS In 2008, we conducted a nationwide survey in Germany in which we asked 4689 female and male patients who had been treated for cancer in childhood or adolescence for information on menstruation, previous fertility testing (if any), attempts to conceive, and pregnancies. In a complementary study carried out in 2009, 748 former cancer patients in Berlin were offered hormone testing and sperm analysis. The defined criteria for suspected infertility were, in women, anti-muellerian hormone levels below 0.1 ng/mL; in men, FSH levels above 10 IU/L and inhibin B levels below 80 pg/mL, or azoospermia. RESULTS The respondents to the nationwide survey included 1476 leukemia survivors and 1278 persons who had had a solid tumor. 104 former leukemia patients and 96 former solid tumor patients had already undergone fertility testing, leading to the suspicion of infertility in 26% and 34% of the persons in these respective groups (95% confidence intervals [CI], 18%-34% and 25%-43%). The patients who were tested in the Berlin study included 59 leukemia survivors and 104 persons who had had a solid tumor. The frequency of suspected infertility in these two groups was 25% and 27%, respectively (95% CI, 14%-36% and 18%-36%). CONCLUSION Up to one-third of adults who undergo fertility testing after having been treated for cancer in childhood or adolescence have suspected infertility. Patients and their parents should be counseled about the possibility of infertility and about fertility-preserving measures.
Collapse
Affiliation(s)
- Magdalena Balcerek
- Department of Pediatrics, Division of Oncology and Hematology, Charité Berlin
| | | | | | | | | |
Collapse
|
28
|
Pieścikowska I, Klein P, Lukaszyk A, Górska-Rafińska L, Balcerek M, Ludwiczak H. Ketanserin, an antagonist of 5-HT2A receptor of serotonin, inhibits testosterone secretion by rat Leydig cells in vitro. Folia Histochem Cytobiol 1999; 37:223-4. [PMID: 10482255] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/13/2023] Open
Abstract
The effect of ketanserin, an antagonist of 5-HT2A receptor of serotonin, added to the culture medium, on basal and LH-stimulated testosterone secretion was studied in primary cultures of adolescent rat Leydig cells. Ketanserin decreased the basal secretion of testosterone but showed an insignificant influence on the LH-stimulated process. It can be concluded that ketanserin may affect the testosterone-secreting cells by an indirect action at the vascular level as well as directly at the level of Leydig cells, at least in adolescent rats, leading to down-regulation of the basal testosterone secretion.
Collapse
|
29
|
Sawiński P, Lukaszyk A, Balcerek M, Ludwiczak H. The influence of testicular and peritoneal macrophages on Leydig cell secretory function in co-culture. Folia Histochem Cytobiol 1997; 35:91-2. [PMID: 9151089] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023] Open
Affiliation(s)
- P Sawiński
- Department of Histology and Embryology, K. Marcinkowski University of Medical Sciences, Poznań, Poland
| | | | | | | |
Collapse
|
30
|
Pieścikowska I, Lukaszyk A, Balcerek M, Filipiak K, Ludwiczak H, Butowska W, Warchoł JB. An implication to the role of testicular serotonergic innervation. An in vitro study on serotonin effects in the control of Leydig cell secretory function. Folia Morphol (Warsz) 1996; 55:414-6. [PMID: 9243931] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Affiliation(s)
- I Pieścikowska
- Department of Histology and Embryology, K. Marcinkowski University of Medical Sciences, Poznań
| | | | | | | | | | | | | |
Collapse
|