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Fertility issues facing young adults with cancer appear to be an area that is overlooked, as documentation shows discussions and referrals occur in less than half of young adult patients with cancer. These results were presented in a poster at the National Comprehensive Cancer Network (NCCN) 2020 Virtual Annual conference.
For this study researchers surveyed 218 patients (median age 37 years; range, 18 to 45 years) to determine the rate at which documentation of fertility preservation discussions are completed for young adults with cancer. Cancers included a variety of solid tumors and hematologic malignancies and some patients had undergone stem cell transplantation. The researchers also surveyed health care providers on their knowledge and practice regarding fertility preservation counseling.
Survey responses revealed that discussion and documentation of fertility counseling occurred in less than 50% of cases. The primary reasons given for not conducting a discussion was the urgency of starting therapy and overall costs. Additional barriers reported were gaps in knowledge of various fertility preservation options, lack of a standard approach, unclear referral guidelines, and lack of clarity in the roles of healthcare providers.
Currently, both American Society of Clinical Oncology and NCCN guidelines recommend counseling all adolescent and young adult patients with cancer on fertility preservation options prior to initiating treatment.
The researchers suggest using a multidisciplinary team approach and seeking input from reproductive and endocrine specialists. In addition, mapping out current practices and identifying gaps in care are essential. Further steps to take to increase discussions and documentation include clinician education on available fertility preservation options, developing a clear and timely referral process, and clarifying the roles of various healthcare providers.
Reference
Pandey Y, Roy A, Konda M, Leffert J, Makhoul I, Sasapu A. Fertility preservation discussion in young adults with cancer: how often are we documenting? Poster presentation at: NCCN 2020 Virtual Annual Conference; Accessed May 6, 2020; https://www.nccn.org/professionals/meetings/annual_conference.aspx
