Impact of physicians’ personal discomfort and patient prognosis on discussion of fertility preservation with young cancer patients

Quinn, Gwendolyn P.; Vadaparampil, Susan T.; King, Lindsey; Miree, Cheryl A.; Wilson, Crystal; Raj, Opal; Watson, Jordan; Lopez, Alana D.; Albrecht, Terrance L.

doi:10.1016/j.pec.2009.09.007

Cited by 139 publications

(138 citation statements)

References 46 publications

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“…These include lack of knowledge about where to refer patients for fertility counseling, patients not bringing up the subject, medical reasons, personal reasons and lack of time (11). However, several studies have identified effective ways to overcome these communication and structural barriers (12, 13).…”

mentioning

confidence: 99%

Thinking about white bears: Fertility issues in young breast cancer survivors

Gonçalves

Tarrier

Quinn

2015

Patient Education and Counseling

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confidence: 99%

Thinking about white bears: Fertility issues in young breast cancer survivors

Gonçalves

Tarrier

Quinn

2015

Patient Education and Counseling

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“…10 Concerns about potential infertility may not be solicited by parents or healthcare providers during treatment discussions for a variety of reasons. Previous studies suggest parents and healthcare providers do not see fertility as a priority, 11,12 do not have adequate knowledge or referral sources available, [11][12][13] or feel uncomfortable discussing sexuality with adolescents. [11][12][13][14][15] Research also suggests that most adult survivors of childhood cancer are not aware of their fertility status.…”

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confidence: 99%

“…Previous studies suggest parents and healthcare providers do not see fertility as a priority, 11,12 do not have adequate knowledge or referral sources available, [11][12][13] or feel uncomfortable discussing sexuality with adolescents. [11][12][13][14][15] Research also suggests that most adult survivors of childhood cancer are not aware of their fertility status. 16 Though survivorship studies have highlighted fertility loss as a significant quality of life indicator, 17 the coping strategies adolescent cancer patients use to manage potential fertility loss are understudied.…”

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confidence: 99%

Coping Styles of Female Adolescent Cancer Patients with Potential Fertility Loss

Quinn

Murphy

Knapp

et al. 2013

Journal of Adolescent and Young Adult Oncology

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Purpose: The purpose of this qualitative study was to assess the coping styles of female adolescent cancer patients regarding potential loss of fertility. Expectations and desires for the future, coping styles in typical adolescence, and coping styles when faced with potential loss of fertility due to cancer treatment are discussed. Methods: Female adolescents diagnosed with cancer aged 12-18 years at study (N = 14) were administered a 10-item values clarification tool to pilot test the readability and relevance of the items on reproductive concerns, followed by a cognitive debriefing interview asking participants how they would respond to each item. These qualitative responses were assessed for coping style type using the constant comparative approach. Results: All adolescent participants reported having a strong desire for biological children in the future. Reactions to questions regarding the loss of fertility fell into two categories of coping styles: emotion-focused coping or problem-focused (engagement) coping. Within emotion-focused coping, there were three distinct styles: externalizing attribution style, internalizing attribution style, and repressive adaptation. Problem-focused coping adolescents displayed optimism. Conclusion: Successful interventions aimed at promoting adaptive coping styles should seek to uncover adolescents' values about future parenthood and reproduction. Development of an age-appropriate assessment to stimulate dialogue regarding fertility and initiate an adolescent's cognitive processing of potential fertility loss is warranted.

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“…Furthermore, many oncologists feel that discussions of FP are inappropriate for patients with advanced disease, poor prognoses, and functional limitations. 12,13 While our study did not assess physician attitudes about FP discussions, we suspect that physicians selectively offer …”

Section: Discussionmentioning

confidence: 98%

Fertility preservation in primary brain tumor patients

Stone

Kelvin

DeAngelis³

2016

Neuro-Oncology Practice

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Background Fertility preservation (FP) is an infrequently addressed issue for young adults with primary brain tumors. Given the improved prognosis and enhanced technology in reproductive medicine, more primary brain tumor patients see procreation as feasible, making the discussion of FP increasingly important. The goals of this study were to describe patients who received FP counseling by a fertility nurse specialist (FNS) and determine which sociodemographic and disease-related factors predict acceptance of referral to a reproductive specialist. Methods Institutional review board-approved retrospective review of primary brain tumor patients, ages 18 to 45, who were referred for FP counseling with a FNS from 2009 to 2013. Results Seventy patients were referred for FP counseling: 38 men, 32 women, with a median age of 32 years and median KPS of 90. Eighty-nine percent had gliomas; 58% grade III, 17% grade IV. Sixty-seven percent were referred for counseling at initial diagnosis. Of those referred, 73% accepted referral to a sperm bank (87% of men) or reproductive endocrinologist (56% of women). Patients were more likely to accept referral if they had no prior children (P = .048). There was no statistically significant difference in referral acceptance by age, race/ethnicity, marital status, religion, or tumor grade. After treatment, 3 men conceived naturally, 2 men conceived using banked sperm, and 2 women conceived naturally. Conclusions Despite the historically poor prognosis of patients with primary brain tumors, there is significant interest in FP among these patients, particularly if they have no prior children. Clinicians should develop strategies to incorporate FP counseling into practice.

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Impact of physicians’ personal discomfort and patient prognosis on discussion of fertility preservation with young cancer patients

Cited by 139 publications

References 46 publications

Thinking about white bears: Fertility issues in young breast cancer survivors

Thinking about white bears: Fertility issues in young breast cancer survivors

Coping Styles of Female Adolescent Cancer Patients with Potential Fertility Loss

Fertility preservation in primary brain tumor patients

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