Lots of talk but little action from oncologists.
Although 70% of oncologists responding to a survey reported discussing fertility preservation with newly diagnosed patients, only 25% said they provided educational materials or referred patients to fertility specialists. Surveys were mailed to a random sample of 1,979 oncologists and 33% (613) responded. The oncologists were asked about fertility guidelines published by the American Society of Clinical Oncology (ASCO) in 2006, but 38% of the oncologists indicated that they had no knowledge of the ASCO guidelines.
It is estimated that 450,000 patients newly diagnosed with cancer may be in need of fertility counseling prior to treatment initiation. Reasons provided by oncologists for not discussing fertility preservation included the opinion that many patients need urgent treatment, the emphasis on other treatment side effects (making fertility preservation a lower priority for discussion), and the cost of fertility preservation, which usually is not covered by health insurance in the United States.
These survey findings make me wonder if oncologists will now be enlightened and begin to routinely include fertility effects and preservation while they discuss initial treatment plans with newly diagnosed patients. I suspect that some oncologists will be more attentive to this sensitive topic, especially with younger patients, but my hunch is that patients will receive information and support from nurses, or be on their own.
One helpful resource available to oncologists, nurses, and patients is Fertile Hope. Founded in October 2001, Fertile Hope is a national, nonprofit organization dedicated to providing reproductive information, support, and hope to patients whose medical treatments present the risk of infertility. Fertile Hope also provides information on financial assistance for fertility preservation, supports fertility preservation research, and provides support to help patients cope with infertility, fertility preservation, assisted reproduction, family planning, genetic counseling, pregnancy, adoption, and other related issues. For more information, visit www.fertilehope.org.
Source: Quinn G et al. National survey of physicians' practice patterns. Fertility preservation and cancer patients. J Clin Oncol 2009;27(15S): abstract CRA9508.