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209,211 Cancer diagnosed during pregnancy generates high levels of anxiety and distress. The literature in this area predominantly relates to testicular cancer, with few studies about other cancer types or heterogeneous cancer populations. 226 Infertility distress substantially alters the patient’s quality of life. 227 While the connection between sexual dysfunction and infertility is often not made for older men, re-partnering and delayed reproduction can make it an important issue for this population also.

The precise emotional needs of patients who are cured have been less clearly defined. 341 This research highlights the need to be aware of the physical, emotional and social impact of cancer even in the longer-term, incorporating an understanding of the unique meaning of the cancer experience to the individual. 3). It is important to recognise that, in many cases, the cancer survivor has not returned to their pre-cancer level of physical functioning. 2). 127 Sexual symptoms are also commonly reported by patients who have undergone bone marrow transplantation.

188 There is emerging evidence that pain arising from head and neck cancer can be severe and chronic, persisting beyond completion of treatment. 190 Pain may vary depending on the stage of the disease or treatment, and is common among people with advanced cancer. Pain has an adverse effect on general well-being and compounds psychological distress in patients with cancer. 163 Pain also has an emotional dimension. 215 Female fertility and pregnancy issues Fertility and pregnancy issues are an under-recognised source of distress for women with cancer.

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