U. SHEFFIELD (UK) — A majority of young female cancer patients are unhappy with the way their doctors discuss available fertility options before chemotherapy or radiotherapy, new research reports.
For the study, published in Pediatric Blood and Cancer, researchers surveyed 290 young cancer patients attending support group conferences organized by the Teenager Cancer Trust in 2004 and 2011.
Their views were collected anonymously using handsets to answer questions projected onto a big screen. All questions were answered by both male and female cancer patients aged between 13 and 22 years old who had been treated for a variety of cancers in UK hospitals.
Steph Hayter, 23, from Hampshire was diagnosed with Acute Lymphoblastic Leukemia age 19. “Having a family has always been important to me so when the doctors told me the treatment would damage my fertility I was devastated,” she says. “I knew I needed to start treatment quickly but it would have been nice to be given some choice in the matter or at least the chance to talk to a fertility expert.
“Neither was offered and I felt like I had lost all control. It was as if health professionals didn’t think that it was a big deal because I was just a teenager; that made me feel silly for being so upset.”
The findings revealed that in 2004 just 38 percent of young female patients recalled their doctor talking to them about fertility preservation opinions, such as egg freezing, before starting treatment. In 2011 this number grew significantly to 69 percent; however a staggering 50 percent of patients were unhappy about the discussion—effectively the same as in 2004.
“Fertility issues are important for cancer patients because some chemotherapy and radiotherapy treatments can lead to infertility,” says Allan Pacey, a fertility expert from the University of Sheffield’s department of human metabolism.
“Whilst we have been banking sperm for cancer patients for over 30 years, we are only just able to start offering fertility preservation for females by banking eggs. However, unfortunately this is more complex to perform and is not a realistic option if cancer treatment cannot be delayed.”
Researchers also discovered that the majority of young male cancer patients (64 percent) were broadly happy with what was discussed with them with roughly the same percentage recalling their doctors talking through fertility issues with them before their cancer treatment started.
“This study highlights the need to discuss fertility issues with young patients, especially females, before treatment begins even if there are no options available for fertility preservation,” says Dan Yeomanson, consultant pediatric oncologist for Sheffield Children’s NHS Foundation Trust.
“Given the wealth of information that needs to be given before treatment begins, it is easy to see why fertility issues are sometimes not handled as well as they could be. While all oncologists aim to provide the best possible care to teenagers and young adults, this study has highlighted some important gaps which are clearly of key significance to patients.”
The researchers suggest that collecting data in this way serves a bellwether providing an overview of practice across the UK and calls for a rethink of how fertility issues are discussed with young people diagnosed with cancer, both in terms of timing of discussions and their content.
“Young people have a fundamental right to be made aware of the fertility problems cancer treatments can cause. Fertility is something many young people won’t even have considered yet and it is incredibly important that these issues are discussed and that all options are understood,” says Simon Davies, Chief Executive of Teenage Cancer Trust.
“Health professionals have a duty to give clear information about all the long term effects of treatments and hopefully this work will help keep this front of mind for those working with young people with cancer.”
The authors intend to conduct the survey again in 2018 with the same age group to see if the situation has improved.
Source: University of Sheffield