Abstract
Introduction
Although physician discussion with patients regarding fertility preservation (FP) options prior to cancer treatment can provide important information for survivors concerning their future fertility, little is known about the extent to which physicians discuss FP with patients. This qualitative study sought to identify current physician FP communication practices and determine factors that may impact communication efforts regarding FP.
Materials and methods
Qualitative data were collected using semi structured interviews with 16 physicians practicing at a major cancer center in the South.
Results
All providers were board certified in medical oncology, radiation oncology or surgical oncology. The main factors that emerged from qualitative analysis included distinct variations in quality of discussion about FP, knowledge of FP resources, attitudes, practice behaviors and perceptions of patient characteristics.
Discussion
While most physicians discussed potential fertility loss as a side effect of cancer treatment, few provided information to patients about preserving fertility. Patient characteristics such as gender and cancer site may impact the discussion, as well as system factors such as costs of procedures and access to FP resources. Education and training for physicians about FP options for cancer patients, particularly females, may promote discussion of FP. In addition, system barriers related to availability and affordability of FP resources must also be addressed.
Implications for cancer survivors
Physicians should consider providing patients with timely, understandable information related to their FP options, prior to the administration of treatment. Such discussions may lead to improved quality of life for individuals as they transition from patients to survivors.
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References
Amory, J. K. (2004). Case 15-2004: Cancer therapy and sperm banking. New England Journal of Medicine, 351, 510 (Author Reply 510).
Bahadur, G. (2000). Fertility issues for cancer patients. Molecular and Cellular Endocrinology, 169, 117–122.
Burnett, A. F. (2006). Radical trachelectomy with laparoscopic lymphadenectomy: Review of oncologic and obstetrical outcomes. Current Opinion in Obstetrics & Gynecology, 18, 8–13.
Cabana, M. D., Rand, C. S., Powe, N. R., Wu, A. W., Wilson, M. H., Abboud, P. A., et al. (1999). Why don’t physicians follow clinical practice guidelines? A framework for improvement. JAMA, 282(15), 1458–1465.
Goodwin, T., Oosterhuis, E. B., Kiernan, M., Hudson, M. M., & Dahl, G. V. (2006). Attitudes and practices of pediatric oncology providers regarding fertility issues. Pediatric Blood and Cancer, 48, 80–85.
Hartmann, J. T., Albrecht, C., Schmoll, H. J., Kuczyk, M. A., Kollmannsberger, C., & Bokemeyer, C. (1999). Long-term effects on sexual function and fertility after treatment of testicular cancer. British Journal of Cancer, 80, 801–807.
Hovatta, O. (2001). Cryopreservation of testicular tissue in young cancer patients. Human Reproduction Update, 7, 378–383.
Kim, S. S., Radford, J., Harris, M., Varley, J., Rutherford, A. J., Lieberman, B., et al. (2001). Ovarian tissue harvested from lymphoma patients to preserve fertility may be safe for autotransplatation. Human Reproduction, 16, 2056–2060.
Lee, S. J., Schover, L. R., Partridge, A. H., Patrizio, P., Wallice, W. H., Hagerty, K., et al. (2006). American Society of Clinical Oncology recommendations on fertility preservation in cancer patients. Journal of Clinical Oncology, 24, 2917–2931.
Newton, H. (1998). The cryopreservation of ovarian tissue as a strategy for preserving the fertility of cancer patients. Human Reproduction Update, 4, 237–247.
Partridge, A. H., Gelber, S., Peppercorn, J., Sampson, E., Knudsen, K., Laufer, M., et al. (2004). Web-based survey of fertility issues in young women with breast cancer. Journal of Clinical Oncology, 22, 4174–4183.
Patton, M. Q. (2002). Qualitative research and evaluation methods. Newbury Park, CA: Sage.
Pfeifer, S. M., & Coutifaris, C. (1999). Reproductive technologies 1998: Options available for the cancer patient. Medical and Pediatric Oncology, 33, 34–40.
Punch, K. (2005). Introduction to social research: Quantitative and qualitative approaches. Thousand Oaks, CA: Sage.
Reebals, J. F., Brown, R., & Buckner, E. B. (2006). Nurse practice issues regarding sperm banking in adolescent male cancer patients. Journal of Pediatric Oncology Nursing, 23, 182–188.
Rieker, P. P., Fitzgerald, E. M., & Kalish, L. A. (1990). Adaptive behavioral responses to potential infertility among survivors of testis cancer. Journal of Clinical Oncology, 8, 347–355.
Schover, L. R. (1999). Psychosocial aspects of infertility and decisions about reproduction in young cancer survivors: A review. Medical and Pediatric Oncology, 33, 53–59.
Schover, L. R., Brey, K., Lichtin, A., Lipshultz, L. I., & Jeha, S. (2002). Knowledge and experience regarding cancer, infertility, and sperm banking in younger male survivors. Journal of Clinical Oncology, 20, 1880–1889.
Schover, L. R., Brey, K., Lichtin, A., Lipshultz, L. I., & Jeha, S. (2002). Oncologists’ attitudes and practices regarding banking sperm before cancer treatment. Journal of Clinical Oncology, 20, 1890–1897.
Schover, L. R., Rybicki, L. A., Martin, B. A., & Bringelsen, K. A. (1999). Having children after cancer. A pilot survey of survivors’ attitudes and experiences. Cancer, 86, 697–709.
Sonmezer, M., & Oktay, K. (2004). Fertility preservation in female patients. Human Reproduction Update, 10, 251–266.
Wallace, W. H., Anderson, R. A., & Irvine, D. S. (2005). Fertility preservation for young patients with cancer: Who is at risk and what can be offered? Lancet Oncology, 6, 209–218.
Acknowledgements
This work is supported in part by the American Cancer Society Institutional Research Grant # 93-032-10.
The authors wish to thank Thomas Sellers, Ph.D., MPH and Michael Feuerstein, Ph.D., MPH, ABPP for editing early drafts of the manuscript.
The work contained within this publication was supported in part by the Survey Methods Core Facility at the H. Lee Moffitt Cancer Center & Research Institute.
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Quinn, G.P., Vadaparampil, S.T., Gwede, C.K. et al. Discussion of fertility preservation with newly diagnosed patients: oncologists’ views. J Cancer Surviv 1, 146–155 (2007). https://doi.org/10.1007/s11764-007-0019-9
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DOI: https://doi.org/10.1007/s11764-007-0019-9