Experience of fertility preservation among younger people diagnosed with cancer

Abstract

Of the 293,600 cancers diagnosed annually in the UK, 11% occur in the 15- to 49-year age group. Fertility preservation options exist for those faced with the loss of fertility as a consequence of radiotherapy or chemotherapy. The aim of this study was to explore experiences, attitudes and perceptions of fertility advice and treatment among cancer survivors, and the subsequent impact upon their lives. Eighteen people aged 19-42 years with a diagnosis of cancer made more than 5 years earlier and, registered with general practices in North East England, were interviewed using a grounded approach. Survival was the universal focus of patients at the point of diagnosis and they commonly failed to appreciate the effect of treatment upon future fertility. A positive experience was linked to the quality of information about fertility preservation or action offered, but this needed to be tailored to the patients' age, stage in their life course, relationships and fears. Possible loss of future fertility only becomes important beyond survival but patients wanted their potential future fertility addressed sensitively at the time of diagnosis and backed up by access to written or web-based patient information, or a fertility specialist.

Cancer patients’ and professional caregivers’ needs, preferences and factors associated with receiving and providing fertility-related information: A mixed-methods systematic review

“…Twelve studies documented the average age at study participation, of which four reported a study population of 40 years and over (Armuand et al, 2012;Karaö z et al, 2010;Mancini et al, 2008;Nakayama et al, 2009). Half of the studies included patients with different types of cancer (Anderson et al, 2008;Armuand et al, 2012;Chapple et al, 2007;Crawshaw et al, 2009;Huyghe et al, 2009;Mancini et al, 2008;Penrose et al, 2012;Tschudin et al, 2010;Wilkes et al, 2010;Zebrack, 2008Zebrack, , 2009. Eight studies focused on breast cancer patients (Duffy et al, 2005;Gorman et al, 2011;Karaö z et al, 2010;Lee et al, 2011;Meneses et al, 2010;Peate et al, 2011;Thewes et al, 2003Thewes et al, , 2005.…”

“…One researcher (JG) extracted patient's individual demographics and performed basic statistical analyses by use of Excel. The following data were calculated: mean age and time since diagnosis (Wilkes et al, 2010), number of (post) pubertal girls informed about fertility (Anderson et al, 2008), and percentage of patients with a pre-treatment desire to have children (Nakayama et al, 2009).…”

A Review of the Oncology Patient's Challenges for Utilizing Fertility Preservation Services

“…29 Male survivors have reported regret over not discussing their fertility threat adequately, they did not feel a part of the decision-making process for future fertility, and they were not informed of the impact of their planned treatment regimen on their fertility. 30,31 For women, fertility concerns are often overlooked during initial diagnosis. 6,23,[31][32][33][34] Utilization rates of fertility preservation services for women cancer patients in the United States are low, ranging from 4% to 20%.…”

“…30,31 For women, fertility concerns are often overlooked during initial diagnosis. 6,23,[31][32][33][34] Utilization rates of fertility preservation services for women cancer patients in the United States are low, ranging from 4% to 20%. 35,36 There is an overwhelming level of frustration among female survivors with the lack of fertility information received.…”

“…Instead they accepted cancer therapy immediately as they felt that fertility preservation was not a viable option for them. 31 The Cancer and Fertility study found that patients have a willingness to undergo fertility preservation but lack information about risks. While patients may seek out information on cancer websites about fertility risks, they do not use this information to make decisions about their future fertility.…”