Menopause management as part of the cancer care pathway for premenopausal women undergoing allogenic stem cell transplant

Overview:

Women who are rendered prematurely menopausal due to allogenic stem cell transplants are referred to gynaecology on average 9 months after their symptoms begin. During the challenging time of cancer treatment, this care gap reduces quality of life while exposing them to longterm adverse health outcomes.

Ninety percent of premenopausal women undergoing allotransplant are at risk of premature menopause (Tauchmanova et al. 2003). Without anticipatory management of cancer therapy-induced premature menopause - currently absent in the conventional cancer care pathway - premature menopause has long-lasting sequellae on the patient’s physical and emotional health (Rosenberg & Patridge, 2013). Quality of life issues include vasomotor symptoms, dyspareunia, incontinence, and weight gain, while longstanding health repercussions include infertility, cardiovascular disease, and osteoporosis (Muscari, Aikin, & Good, 1999). Currently, the approach to premature ovarian insufficiency in oncology waits for symptoms or diseases to develop before addressing the problem. In contrast to a reactive approach, we suggest a proactive identification of these patients early in their cancer journey to diagnose and treat their menopause, thereby preventing these short- and longterm consequences from developing. We propose a need for this anticipatory management in place of the current standard care. If proven effective, the next step in the translational pathway is in the implementation of these standards for premenopausal women at risk for oncology-treatment induced premature menopause.

Capstone Team: 

Michelle Jacobson

 

Capstone Advisory Committee:

Dr. Joanne Kotsopoulos
Richard Sugarman
Dr. Wendy Wolfman

 

TRP Faculty Lead:

Dr. Joseph Ferenbok