Doctors Hesitate to Discuss Fertility Preservation With Cancer Patients

	Tweet

Although some teenagers and young adults become infertile following cancer treatment, physicians are hesitant to discuss options to preserve fertility with patients, according to a new Florida study.

In their discussions with 24 pediatric oncologists, researchers at the Moffitt Cancer Center found that some physicians did not want to bring up the topic for fear of worrying their patients about the expense of egg and sperm storage. Other doctors cited a lack of appropriate resources and guidelines to help their patients with this difficult decision.

Several doctors said they felt the topic was not one to bring up when patients’ and their parents’ primary concern was surviving cancer, noted study co-authors Gwendolyn Quinn, Ph.D., and Susan Vadaparampil, Ph.D. 

Their study appears online in the Journal of Adolescent Health.

“About half of the physicians said the cancer diagnosis is such a shock that an issue like fertility is often put on the back burner,” Quinn said.

Talking with young cancer patients about fertility can be a challenge, in part because physicians are used to speaking with teens in a “jocular manner” in an attempt to “ease the pain of an ill child,” the researchers found. Yet, this manner of speaking might not be the best way to broach the sensitive topic of fertility with the patients, they said.

Moreover, the parents of children with cancer “tend to be more focused on treatment options and survival, and discussions of fertility often do not arise,” the researchers noted.

Physicians who participated in the study “commented that the discussion could be awkward because the parents and the patient are essentially discussing reproduction and sexuality, with parents making decisions about the reproductive future of their child,” Quinn said.

Many physicians interviewed for the study said they did not bring up egg or sperm banking because patients and their families usually pay for such procedures out of pocket. As one doctor said, “Our policy is that we offer them the possibility of banking, but since it is not paid for by insurance, it is expensive and a big hassle for them, and they often end up not doing it.”

Still, the study authors point to surveys suggesting that patients do not see cost as a barrier, at least for sperm banking. National nonprofit organizations such as FertileHope offer fertility preservation discounts to cancer patients and, “perhaps more importantly, the American Society of Clinical Oncologists suggests all patients should be informed about these options,” Quinn said.

The 2006 ASCO guidelines acknowledge that the first visit after a patient’s diagnosis might not be the best time to talk about fertility preservation, but they recommend that the discussion take place “at the earliest possible opportunity.”

“It may be impossible for physicians to know how important fertility preservation is to their patients unless they ask, since many patients may not bring up the topic,” said Kutluk Oktay, M.D., the medical director of the Institute for Fertility Preservation at the Center for Human Reproduction, who worked on the 2006 guidelines.

Journal of Adolescent Health: Contact Tor Berg at (415) 502-1373 or or visit jahonline.org

Quinn GP, Vadaparampil ST. Fertility preservation and adolescent/young adult cancer patients: physician communication challenges. J Adolesc Health online, 2008.

Source: Health Behavior News Service

RELATED STORIES:
Researchers Develop and Improve Techniques for Treating Cancer   Music-based “Play” Helps Young Cancer Patients Cope   Tiny molecules linked to cancer development   Evidence strengthens link between NSAIDs and reduced cancer metastasis   Low Molecular Weight Heparin Use in Cancer Treatment   Cancer: The good news   Cancer: “Primitive” Gene Discovered   Researcher Investigates Ultrasound Use to Treat Cancer   Quality of life with cancer can be preserved   New imaging technique accurately finds cancer cells, fast   Drug Could Effectively Treat, Prevent the Spread of Breast Cancer   Regimen May Hike Survival in Advanced Cancer   Blocking common gateway to inflammation suppresses cancer   Why Do People with Down Syndrome Have Less Cancer?   How sunlight causes skin cells to turn cancerous   Using a molecular switch to turn on cancer vaccines   Immune system can drive cancers into dormant state   Cancer Cells Need Normal, Non-mutated Genes to Survive   Exercise eases fatigue in cancer patients on chemo   Blocking cell movement for cancer, MS treatment   Mechanism for invasion of tumorous cells discovered by Hebrew University researchers   Green tea boosts production of detox enzymes, rendering cancerous chemicals harmless

Comments

[ + Post Your Own ]

Now you're in the public comment zone. What follows is not Armenian Medical Network's stuff; it comes from other people and we don't vouch for it. A reminder: By using this Web site you agree to accept our Terms of Service. Click here to read the Rules of Engagement.

There are no comments for this entry yet. [ + Comment here + ]