Carrillo Rouse (genderpurple4)

With the increased availability of comprehensive genetic testing, the number of cases where secondary findings(SF)are identified has also increased. Since not only patients, but also healthcare professionals influence the decision‒making process in SF disclosure, understanding their attitude toward disclosure is vital. find more Therefore, a literature review using PubMed and Japan Medical Abstracts Society was conducted. We searched for original qualitative studies focusing on clinical genome analysis. Consequently, 12 articles that focus on 3 main stakeholders were identified patients and/or their families, genetics professionals, and the general public. Relevant findings were synthesized and chronologically categorized into 27 subcategories, 11 categories, and 3 main themes, namely(1)"at the time of consent,"(2)"when results are returned,"and(3) "after the return of results."All categories in theme(3)were found in patients. Most subcategories found in the general public were also present in patients. The general public is unique because they considered receiving SF for the first time after participating in the study. The result suggests that people are aware of what might happen after receiving SF at the time of providing consent. This awareness will improve patient attitude toward receiving SF. Therefore, it is important to inform patients about the continuous support at the time of providing consent.Fertility preservation for male cancer patients is gradually being recognized and the network for clinical practice has progressed, accompanied with the increasing number of local governments which give a subsidy for their sperm cryopreservation. Sperm cryopreservation is recommended, not only for the risk of azoospermia but also for the possibility of increased risk of malformation due to sperm DNA damage. On the other hand, there is no sufficient evidence for the necessity of contraception, its proper duration, and effects depending on the action sites of the corresponding cancer medicine, making it difficult for clinicians to achieve consensus. Here, we discuss the current and future informational provision of contraception and fertility preservation for male cancer patients.Many of oncology pharmaceuticals have ovotoxicity and/or genotoxicity. Ovarian reserve, numbers of healthy oocytes in the ovary, gradually decreases in aging, but abruptly decreases when young female cancer patients are exposed to ovotoxic pharmaceuticals. Therefore increasing number of young patients undergo fertility preservation in which oocytes or ovarian tissue are retrieved and cryopreserved before chemotherapy. The deterioration of the quality of oocytes in aging is called "oocyte aging", and the function of DNA repair in the oocytes are known to be deteriorated in aging. Similar to those from U. S. Food and Drug Administration and European Medicines Agency, labeling guidance in Japan recommends"5×T1/2 plus 6 months"of contraception period after the cessation of genotoxic pharmaceuticals, based on mouse model experiments. However, the teratogenicity of pharmaceuticals has been generally found when administered during the 4th to 10th weeks of pregnancy, and healthy children were born even when they originated from the oocytes or ovarian tissue which had been retrieved immediately after chemotherapy. We caregivers should carefully provide information to the female patients and their partners who get unexpectedly pregnant during the above‒mentioned contraception period.Most of the warnings about the contraceptive period when using medicines are described as"fixed period"in the package insert, and it is necessary for healthcare professionals to provide information on the specific contraceptive period when using medicines that require contraception. There are many situations where we have trouble. Furthermore, the presence or absence of a description that requires contraception and the contraceptive period differ even though the drugs are the same