Background Endometrial cancer is rare in reproductive aged women. Standard surgical treatment can impact fertility. Non-standard conservative management with progestins can be used in very specific populations to give women an opportunity for childbearing.1 The treatment experiences of this cohort have not been well studied, and unmet needs not identified or explored. This study aims to explore the experiences of reproductive aged women with early endometrial cancer across diagnosis, decision making, treatment, fertility and survivorship.
Methodology A mixed methods retrospective cohort study was undertaken utilising an online survey and semi-structured interviews addressing themes of diagnosis, management decision making, treatment, fertility and survivorship. Women aged 18–40 years with early EAC, treated at the Royal Women’s Hospital (RWH), Melbourne, Australia were identified. Seventy-five women were invited to participate. Online survey links were distributed via mobile text message along with an invitation for interview. Survey responses were collated, and interview transcripts were thematically analyzed using a grounded theory approach.
Results Twenty-six surveys and 14 interviews were completed. Medical management: 20 surveyed 7 interviewed (mean age 33ys) Surgical management: 6 surveyed 7 interviewed (mean age 38 yrs). Responses highlight the shock of the diagnosis and improvements which could be made when communicating the diagnosis. Common themes also included a strong desire for women to be presented with treatment options, suboptimal information provision around treatment options and implications for fertility and long term survivorship as well as the significant emotional burden across all aspects of the treatment journey. Women consistently expressed they did not identify with the wider EAC cohort or other reproductive aged women with cancer and had a strong desire for specific cancer support services. Overall 20 themes across 5 domains were identified. Examples in figure 1.
Conclusion This study examines the experience of young women diagnosed with early EAC. It highlights unmet needs, particularly around available supports and provision of information. These needs should be considered in the future management of these cancer patients.
Acknowledgements To the participants for sharing their experiences.
Disclosures No authors have disclosures to report.
ESMO-ESGO-ESTRO Endometrial Consensus Conference Working Group. ESMO-ESGO-ESTRO Consensus Conference on Endometrial Cancer Diagnosis, Treatment and Follow-up. Internat J Gynaecol Cancer 26, 2016.
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