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  1. Article ; Online: Risk Factors Associated With Distress Among Postoperative Patients in an Academic Gynecologic Oncology Practice.

    Gross, Maya E / Sobecki, Janelle N / Park, Chan / Yu, Menggang / Wallace, Sumer K

    Journal of the National Comprehensive Cancer Network : JNCCN

    2024  Volume 22, Issue 2, Page(s) 91–97

    Abstract: Background: Distress among gynecologic oncology patients correlates with poor clinical outcomes and decreased quality of life. The purpose of this study was to determine risk factors for elevated NCCN Distress Thermometer (DT) results among ... ...

    Abstract Background: Distress among gynecologic oncology patients correlates with poor clinical outcomes and decreased quality of life. The purpose of this study was to determine risk factors for elevated NCCN Distress Thermometer (DT) results among postoperative gynecologic oncology patients.
    Patients and methods: We performed a retrospective chart review of all postoperative visits over a 5-year period. NCCN DT results were analyzed as both discretized values (DT ≤3 = low distress; DT 4-8 = moderate distress; DT ≥9 = high distress) and continuous variables. Patients with a DT score ≥4 were referred to social work. Univariate and multivariate regression analyses were performed to compare NCCN DT results with clinical and sociodemographic variables. Statistical significance was P<.05.
    Results: In total, 1,795 NCCN DT results were included, with uterine (37.72%) being the most common disease site. Benign pathology was known prior to completion of the NCCN DT in 13.15% of patients. Most patients (71.75%) endorsed low levels of distress. Moderate/High levels of distress were reported by 28.25% of patients. Increasing levels of distress were significantly associated with younger age (P=.006), history of depression (P≤.001), status as a current smoker (P=.028), and history of asthma (P=.041). Knowledge of benign pathology was associated with low levels of distress (P=.002). Procedure type and disease site were not associated with distress.
    Conclusions: More than one-fourth of postoperative patients in a gynecologic oncology practice reported moderate or high distress. Distress was highest among those with malignancy regardless of disease site or surgical intervention. Benign pathology correlated with decreased distress. Identified associations with distress provide opportunities for prevention, early intervention, and tailored counseling.
    MeSH term(s) Humans ; Female ; Genital Neoplasms, Female/surgery ; Genital Neoplasms, Female/complications ; Retrospective Studies ; Quality of Life ; Stress, Psychological/epidemiology ; Stress, Psychological/etiology ; Stress, Psychological/psychology ; Neoplasms/complications ; Risk Factors ; Surveys and Questionnaires
    Language English
    Publishing date 2024-02-16
    Publishing country United States
    Document type Journal Article
    ZDB-ID 2250759-0
    ISSN 1540-1413 ; 1540-1405
    ISSN (online) 1540-1413
    ISSN 1540-1405
    DOI 10.6004/jnccn.2023.7093
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  2. Article ; Online: Patient reported improvement in sexual health outcomes following care in a sexual health clinic for women with cancer.

    Rash, Joanne K / Seaborne, Lori A / Peterson, Megan / Kushner, David M / Sobecki, Janelle N

    Supportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer

    2023  Volume 31, Issue 3, Page(s) 171

    Abstract: Purpose: Sexual health concerns are common among female cancer survivors. Few data exist regarding patient-reported outcomes following interventions in this population. We aimed to determine patient-reported adherence and impact of interventions ... ...

    Abstract Purpose: Sexual health concerns are common among female cancer survivors. Few data exist regarding patient-reported outcomes following interventions in this population. We aimed to determine patient-reported adherence and impact of interventions provided in an academic specialty clinic for treatment of sexual health problems.
    Methods: A cross-sectional quality improvement survey regarding sexual problems, adherence with recommended therapies, and improvement following intervention was administered to all women seen at the Women's Integrative Sexual Health (WISH) program at the University of Wisconsin-Madison between November 2013 and July 2019. Descriptive and Kruskal-Wallis tests were used to explore differences between groups.
    Results: Two hundred twenty women (median age at first visit = 50 years, 53.1% breast cancer) were identified; N =113 surveys were completed (response rate = 49.6%). The most common presenting complaints were pain with intercourse (87.2%), vaginal dryness (85.3%), and low libido (82.6%). Menopausal women were more likely than premenopausal women to present with vaginal dryness (93.4% vs. 69.7%, p = .001) and pain with intercourse (93.4% vs. 76.5%, p = .02). Nearly all women adhered to recommendations for vaginal moisturizers/lubricants (96.9-100%) and vibrating vaginal wands (82.4-92.3%). A majority found recommended interventions helpful regardless of menopausal status or cancer type and reported persistent improvement. Nearly all women had improvement in understanding sexual health (92%) and would recommend the WISH program to others (91%).
    Conclusion: Women with cancer report integrative sexual health care to address sexual problems that are helpful and result in long-term improvement. Patients are overall highly adherent to recommended therapies, and nearly all would recommend the program to others.
    Implications for cancer survivors: Dedicated care to address sexual health in women after cancer treatment improves patient-reported sexual health outcomes across all cancer types.
    MeSH term(s) Female ; Humans ; Middle Aged ; Sexual Health ; Cross-Sectional Studies ; Breast Neoplasms/therapy ; Breast Neoplasms/epidemiology ; Surveys and Questionnaires ; Pain ; Patient Reported Outcome Measures ; Outcome Assessment, Health Care ; Sexual Behavior
    Language English
    Publishing date 2023-02-16
    Publishing country Germany
    Document type Journal Article
    ZDB-ID 1134446-5
    ISSN 1433-7339 ; 0941-4355
    ISSN (online) 1433-7339
    ISSN 0941-4355
    DOI 10.1007/s00520-023-07635-4
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  3. Article ; Online: Bone health and osteoporosis screening in gynecologic cancer survivors.

    Sobecki, Janelle N / Rice, Laurel W / Hartenbach, Ellen M

    Gynecologic oncology

    2020  Volume 160, Issue 2, Page(s) 619–624

    Abstract: Cancer treatment-induced bone loss is a known side effect of cancer therapy that increases the risk of osteoporosis and bone fracture. Women with gynecologic cancer are at increased risk of bone loss secondary to the combined effect of oophorectomy and ... ...

    Abstract Cancer treatment-induced bone loss is a known side effect of cancer therapy that increases the risk of osteoporosis and bone fracture. Women with gynecologic cancer are at increased risk of bone loss secondary to the combined effect of oophorectomy and adjuvant therapies. Data regarding bone loss in women with gynecologic cancers are overall lacking compared to other cancer populations. Consequently, guidelines for osteoporosis screening in women with cancer are largely based on data generated among non-gynecologic cancer survivors. This article reviews current available data of bone health in women with gynecologic cancer, summarizes best-available guidelines for screening for osteoporosis in women with cancer, and provides guidance for osteoporosis screening in women with gynecologic cancers based on best available evidence.
    MeSH term(s) Absorptiometry, Photon ; Antineoplastic Agents, Hormonal/adverse effects ; Bone Density/drug effects ; Bone Density/physiology ; Bone Density/radiation effects ; Cancer Survivors/statistics & numerical data ; Chemotherapy, Adjuvant/adverse effects ; Chemotherapy, Adjuvant/methods ; Evidence-Based Medicine/standards ; Female ; Genital Neoplasms, Female/complications ; Genital Neoplasms, Female/mortality ; Genital Neoplasms, Female/therapy ; Humans ; Mass Screening/standards ; Menopause/drug effects ; Menopause/metabolism ; Menopause/radiation effects ; Osteoporosis/diagnosis ; Osteoporosis/epidemiology ; Osteoporosis/etiology ; Osteoporosis/metabolism ; Ovary/drug effects ; Ovary/metabolism ; Ovary/radiation effects ; Ovary/surgery ; Practice Guidelines as Topic ; Radiotherapy, Adjuvant/adverse effects ; Risk Factors ; Salpingo-oophorectomy/adverse effects ; Survivorship
    Chemical Substances Antineoplastic Agents, Hormonal
    Language English
    Publishing date 2020-12-11
    Publishing country United States
    Document type Journal Article ; Review
    ZDB-ID 801461-9
    ISSN 1095-6859 ; 0090-8258
    ISSN (online) 1095-6859
    ISSN 0090-8258
    DOI 10.1016/j.ygyno.2020.11.028
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  4. Article: BRCA-2 (+) high-grade serous fallopian tube cancer diagnosed as an isolated breast mass by mammography.

    Sobecki, Janelle N / Dryer, Kathryn A / Mahajan, Aparna M / Spencer, Ryan J

    Gynecologic oncology reports

    2020  Volume 35, Page(s) 100690

    Abstract: Ovarian cancer typically presents at advanced stage with intra-abdominal metastases. Rarely, ovarian cancer presents with distant metastases with little to no intra-abdominal disease burden. The patient was a BRCA-2 germline mutation carrier diagnosed ... ...

    Abstract Ovarian cancer typically presents at advanced stage with intra-abdominal metastases. Rarely, ovarian cancer presents with distant metastases with little to no intra-abdominal disease burden. The patient was a BRCA-2 germline mutation carrier diagnosed with a Stage IVB high-grade carcinoma of the fallopian tube following discovery of a right axillary breast mass on screening mammography. Pre-operative imaging was without evidence of metastatic disease in the abdomen or pelvis. She underwent surgical staging followed by adjuvant chemotherapy and maintenance poly-ADP ribose polymerase (PARP) inhibition. She is without evidence of disease 24 months following her surgical staging procedure. An isolated oligo metastasis in the axilla is a rare presentation of ovarian carcinoma. Extra-abdominal metastases can present a diagnostic challenge in ovarian cancer necessitating thorough pathologic and radiologic work-up, particularly in the absence of intra-abdominal disease.
    Language English
    Publishing date 2020-12-25
    Publishing country Netherlands
    Document type Case Reports
    ZDB-ID 2818505-5
    ISSN 2352-5789
    ISSN 2352-5789
    DOI 10.1016/j.gore.2020.100690
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  5. Article ; Online: Postoperative venous thromboembolism in gynecologic oncology patients undergoing minimally invasive surgery: Does modality matter?

    Wagar, Matthew K / Sobecki, Janelle N / Chandereng, Thevaa / Hartenbach, Ellen M / Wallace, Sumer K

    Gynecologic oncology

    2021  Volume 162, Issue 3, Page(s) 751–755

    Abstract: Objectives: Minimally invasive surgery (MIS) is increasingly utilized for gynecologic cancers. While incidence of venous thromboembolism (VTE) after MIS is low, some guidelines recommend extended chemoprophylaxis for these patients undergoing MIS. Our ... ...

    Abstract Objectives: Minimally invasive surgery (MIS) is increasingly utilized for gynecologic cancers. While incidence of venous thromboembolism (VTE) after MIS is low, some guidelines recommend extended chemoprophylaxis for these patients undergoing MIS. Our objectives were to determine incidence of postoperative VTE in patients undergoing MIS, evaluate differences in the incidence by MIS modality and assess the need for extended chemoprophylaxis.
    Methods: We conducted a retrospective cohort study including all patients undergoing MIS (robot-assisted, multi-port laparoscopy, single-port laparoscopy) for gynecologic cancers between January 2014 and December 2018 at our institution. Demographic and perioperative variables were collected. Patients <18 years, with benign pathology, or on preoperative anticoagulation were excluded. Chi-square, Fisher's exact test, and one-way ANOVA were performed to determine risk factors related to VTE occurrence.
    Results: We identified 806 patients who underwent MIS with median age 61. Most had Stage I disease (81.5%) and uterine cancer (81.5%). Five VTE events occurred within 90 days following surgery (0.6%). Incidence of 90-day VTE did not differ between MIS modalities (p = 0.6). Patients with longer OR times (p = 0.004) were more likely to experience VTE. Age, smoking status, BMI, type of cancer and stage were not significant risk factors for VTE.
    Conclusions: The incidence of postoperative VTE in patients with gynecologic cancers undergoing MIS is low and does not appear to differ by MIS modality. Given the very low incidence of postoperative VTE, extended chemoprophylaxis is unlikely to benefit patients with gynecologic malignancies undergoing MIS procedures.
    MeSH term(s) Aged ; Female ; Humans ; Middle Aged ; Minimally Invasive Surgical Procedures/adverse effects ; Minimally Invasive Surgical Procedures/statistics & numerical data ; Ovarian Neoplasms/epidemiology ; Ovarian Neoplasms/surgery ; Postoperative Complications/epidemiology ; Postoperative Complications/etiology ; Retrospective Studies ; Uterine Cervical Neoplasms/epidemiology ; Uterine Cervical Neoplasms/surgery ; Venous Thromboembolism/epidemiology ; Venous Thromboembolism/etiology
    Language English
    Publishing date 2021-06-17
    Publishing country United States
    Document type Journal Article
    ZDB-ID 801461-9
    ISSN 1095-6859 ; 0090-8258
    ISSN (online) 1095-6859
    ISSN 0090-8258
    DOI 10.1016/j.ygyno.2021.06.011
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  6. Article ; Online: What we don't talk about when we don't talk about sex: results of a national survey of U.S. obstetrician/gynecologists.

    Sobecki, Janelle N / Curlin, Farr A / Rasinski, Kenneth A / Lindau, Stacy Tessler

    The journal of sexual medicine

    2012  Volume 9, Issue 5, Page(s) 1285–1294

    Abstract: Introduction: Sexuality is a key aspect of women's physical and psychological health. Research shows both patients and physicians face barriers to communication about sexuality. Given their expertise and training in addressing conditions of the female ... ...

    Abstract Introduction: Sexuality is a key aspect of women's physical and psychological health. Research shows both patients and physicians face barriers to communication about sexuality. Given their expertise and training in addressing conditions of the female genital tract across the female life course, obstetrician/gynecologists (ob/gyns) are well positioned among all physicians to address sexuality issues with female patients. New practice guidelines for management of female sexual dysfunction and the importance of female sexual behavior and function to virtually all aspects of ob/gyn care, and to women's health more broadly, warrant up-to-date information regarding ob/gyns' sexual-history-taking routine.
    Aims: To determine ob/gyns' practices of communication with patients about sexuality, and to examine the individual and practice-level correlates of such communication.
    Method: A population-based sample of 1,154 practicing U.S. ob/gyns (53% male; mean age 48 years) was surveyed regarding their practices of communication with patients about sex.
    Main outcome measures: Self-reported frequency measures of ob/gyns' communication practices with patients including whether or not ob/gyns discuss patients' sexual activities, sexual orientation, satisfaction with sexual life, pleasure with sexual activity, and sexual problems or dysfunction, as well as whether or not one ever expresses disapproval of or disagreement with patients' sexual practices. Multivariable analysis was used to correlate physicians' personal and practice characteristics with these communication practices.
    Results: Survey response rate was 65.6%. Sixty-three percent of ob/gyns reported routinely assessing patients' sexual activities; 40% routinely asked about sexual problems. Fewer asked about sexual satisfaction (28.5%), sexual orientation/identity (27.7%), or pleasure with sexual activity (13.8%). A quarter of ob/gyns reported they had expressed disapproval of patients' sexual practices. Ob/gyns practicing predominately gynecology were significantly more likely than other ob/gyns to routinely ask about each of the five outcomes investigated.
    Conclusion: The majority of U.S. ob/gyns report routinely asking patients about their sexual activities, but most other areas of patients' sexuality are not routinely discussed.
    MeSH term(s) Adult ; Attitude of Health Personnel ; Data Collection ; Female ; Gynecology/methods ; Gynecology/statistics & numerical data ; Humans ; Male ; Middle Aged ; Obstetrics/methods ; Obstetrics/statistics & numerical data ; Physician-Patient Relations ; Practice Patterns, Physicians'/standards ; Practice Patterns, Physicians'/statistics & numerical data ; Sex Factors ; Sexual Behavior ; Sexual Dysfunction, Physiological/diagnosis ; Sexuality ; Surveys and Questionnaires ; United States
    Language English
    Publishing date 2012-03-22
    Publishing country Netherlands
    Document type Journal Article ; Research Support, N.I.H., Extramural ; Research Support, Non-U.S. Gov't
    ZDB-ID 2251959-2
    ISSN 1743-6109 ; 1743-6095
    ISSN (online) 1743-6109
    ISSN 1743-6095
    DOI 10.1111/j.1743-6109.2012.02702.x
    Database MEDical Literature Analysis and Retrieval System OnLINE

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