Fertility Issues Must be Addressed by Oncologists

A national survey found that oncologists do not address fertility issues as adequately as they should with discussions, provision of educational materials, and referrals to reproductive specialists despite 30% to 80% of all patients with cancer being at risk for infertility. While 77% of the 613 surveyed oncologists said that they “always/often” address fertility issues, the manner in which they noted addressing them varied and sometimes the topic was just mentioned in passing. Another 24% said that they “rarely/never” refer patients to reproductive specialists and 60% said that they “rarely/never” provide educational materials. Numerous barriers to addressing fertility preservation were revealed, including lack of time to address such matters, costs of fertility preservation, and the belief that fertility is not an issue because the patient is too sick, may not live, or already has children.

According to Gwendolyn P. Quinn, PhD, MPH, of the H. Lee Moffitt Cancer Center and Research Institute, who presented the survey results noted, “Oncologists have a responsibility to discuss the risks of treatment and to refer patients to specialists who can discuss options.” She urged oncologists to follow the “American Society of Clinical Oncology Recommendations on Fertility Preservation in People Treated for Cancer,” which can be accessed at www.asco.org/ASCO/Downloads/Cancer%20Policy%20and%20Clinical%20Affairs/Clinical%20Affairs%20(derivative%20products)/Fertility%20Options%20&%20Discussion.pdf. Interestingly, the survey had also shown that 38% of oncologists were not familiar with these ASCO recommendations and that another 22% rarely referred to them. According to Kutluk Oktay, MD, of the New York Medical College-Center for Human Reproduction, said this was an “eye opening study in terms of identifying the priority and utilization of fertility preservation during cancer care” and concluded “we have to do something about this lack of knowledge. We have to be more proactive in getting the message to our colleagues.”