John M Salsman1, Betina Yanez2,3, Mallory A Snyder4, Alexis R Avina5, Marla L Clayman6, Kristin N Smith3,7, Khouri Purnell8, David Victorson2,3. 1. Department of Social Sciences and Health Policy, Wake Forest School of Medicine & the Wake Forest Baptist Comprehensive Cancer Center, Medical Center Boulevard, Winston-Salem, NC, 27157, USA. jsalsman@wakehealth.edu. 2. Department of Medical Social Sciences, Northwestern University Feinberg School of Medicine, Chicago, IL, USA. 3. The Robert H Lurie Comprehensive Cancer Center of Northwestern University, Chicago, IL, USA. 4. Office of Research and National Laboratories, The University of Chicago, Chicago, IL, USA. 5. San Diego County Health and Human Services Agency, San Diego, CA, USA. 6. General Internal Medicine and Geriatrics, Northwestern University Feinberg School of Medicine, Chicago, IL, USA. 7. Center for Fertility and Reproductive Medicine, Northwestern Medicine, Chicago, IL, USA. 8. Georgia Psychological Associates, Canton, GA, USA.
Abstract
BACKGROUND: Young adults (YAs, ages 18-39) diagnosed with cancer face multiple challenges that affect their health-related quality of life, including the potential for cancer-related infertility. Providing information about the risk of infertility and options to maintain fertility is critical for YAs who are newly diagnosed. However, barriers to effective communication exist for oncologists and their patients. The purpose of this study was to interview medical oncologists and YAs from the same cancer center to examine attitudes and practices about fertility preservation. METHODS: Semi-structured interviews were conducted with medical oncologists (N=12) and YAs within 2 years post-treatment (N=24), representing the most common cancers affecting YAs. Interviews were audio-recorded, transcribed, and coded using qualitative methodologies with the analysis software NVivo 10. RESULTS: Twelve oncologists (50% female, 67% <50 years) and 24 YAs (67% female, M=29 years) completed interviews. Common themes across oncologist and YA interviews were the roles of cancer type or stage and patient interest or parity in influencing the decision. The most important factor for YAs was to receive accurate, in-depth information. Unique themes for oncologists focused on clinical aspects of their patient's disease. For YAs, they shared about the emotional impact of cancer-related infertility and desire for support from trusted others. CONCLUSIONS: Results provide a better understanding of the attitudes and practices about fertility preservation discussions among YAs. Given the common factors affecting fertility preservation decisions, models of shared decision-making may be ideal for YAs and oncologists. Future interventions should explore tailored applications of this approach for YAs newly diagnosed with cancer.
BACKGROUND: Young adults (YAs, ages 18-39) diagnosed with cancer face multiple challenges that affect their health-related quality of life, including the potential for cancer-related infertility. Providing information about the risk of infertility and options to maintain fertility is critical for YAs who are newly diagnosed. However, barriers to effective communication exist for oncologists and their patients. The purpose of this study was to interview medical oncologists and YAs from the same cancer center to examine attitudes and practices about fertility preservation. METHODS: Semi-structured interviews were conducted with medical oncologists (N=12) and YAs within 2 years post-treatment (N=24), representing the most common cancers affecting YAs. Interviews were audio-recorded, transcribed, and coded using qualitative methodologies with the analysis software NVivo 10. RESULTS: Twelve oncologists (50% female, 67% <50 years) and 24 YAs (67% female, M=29 years) completed interviews. Common themes across oncologist and YA interviews were the roles of cancer type or stage and patient interest or parity in influencing the decision. The most important factor for YAs was to receive accurate, in-depth information. Unique themes for oncologists focused on clinical aspects of their patient's disease. For YAs, they shared about the emotional impact of cancer-related infertility and desire for support from trusted others. CONCLUSIONS: Results provide a better understanding of the attitudes and practices about fertility preservation discussions among YAs. Given the common factors affecting fertility preservation decisions, models of shared decision-making may be ideal for YAs and oncologists. Future interventions should explore tailored applications of this approach for YAs newly diagnosed with cancer.
Authors: Giselle K Perez; John M Salsman; Kaitlyn Fladeboe; Anne C Kirchhoff; Elyse R Park; Abby R Rosenberg Journal: Am Soc Clin Oncol Educ Book Date: 2020-03
Authors: Peter F Coccia; Alberto S Pappo; Lynda Beaupin; Virginia F Borges; Scott C Borinstein; Rashmi Chugh; Shira Dinner; Jeanelle Folbrecht; A Lindsay Frazier; Robert Goldsby; Alexandra Gubin; Robert Hayashi; Mary S Huang; Michael P Link; John A Livingston; Yousif Matloub; Frederick Millard; Kevin C Oeffinger; Diane Puccetti; Damon Reed; Steven Robinson; Abby R Rosenberg; Tara Sanft; Holly L Spraker-Perlman; Margaret von Mehren; Daniel S Wechsler; Kimberly F Whelan; Nicholas Yeager; Lisa A Gurski; Dorothy A Shead Journal: J Natl Compr Canc Netw Date: 2018-01 Impact factor: 11.908
Authors: Joseph M Letourneau; James F Smith; Erin E Ebbel; Amaranta Craig; Patricia P Katz; Marcelle I Cedars; Mitchell P Rosen Journal: Cancer Date: 2012-03-26 Impact factor: 6.860
Authors: Shoshana M Rosenberg; Shari Gelber; Richard D Gelber; Ethan Krop; Larissa A Korde; Olivia Pagani; Ann H Partridge Journal: J Adolesc Young Adult Oncol Date: 2017-07-07 Impact factor: 2.223