Abstract
Recognizing the importance of fertility and family building among adolescents and young adults with cancer, professional organizations have developed guidelines highlighting the need for oncology clinicians to inform patients about the potential risks to fertility from treatment, discuss options for fertility preservation, and refer interested patients to reproductive specialists. Nevertheless, patients continue to report unmet fertility-related informational needs. A number of organizational barriers have been identified by oncology clinicians, making it difficult for them to implement these guidelines in their professional practice. Oncology care settings must respect the challenges clinicians face in discussing fertility with their patients and develop organization-wide strategies to overcome these barriers. Specific strategies include education of oncology clinicians on fertility risks and fertility preservation options, ensuring the availability of patient education resources, establishing a network of collaborating reproductive specialists, promoting multidisciplinary responsibility for fertility discussions, and creating prompts reminding clinicians to address fertility. Success in implementing these strategies within the oncology setting, and ensuring they are institutionalized throughout the organization and sustainable over time, is optimized by using a centralized comprehensive approach.
Access this chapter
Tax calculation will be finalised at checkout
Purchases are for personal use only
References
American Cancer Society. Key statistics for cancers in young adults. 2018.
Fidler MM, Gupta S, Soerjomataram I, Ferlay J, Steliarova-Foucher E, Bray F. Cancer incidence and mortality among young adults aged 20–39 years worldwide in 2012: a population-based study. Lancet Oncol. 2017;18(12):1579–89.
Gorman JR, Su HI, Roberts SC, Dominick SA, Malcarne VL. Experiencing reproductive concerns as a female cancer survivor is associated with depression. Cancer. 2015;121(6):935–42.
Goossens J, Delbaere I, Van Lanker A, Beeckman D, Verhaeghe S, Van Heck A. Cancer patients’ and professional caregivers’ needs, preferences and factors associated with receiving and providing fertility-related information: a mixed-methods systematic review. Int J Nurs Stud. 2014;51:300–19.
Bibby H, White V, Thompson K, Anazodo A. What are the unmet needs and care experiences of adolescents and young adults with cancer? A systematic review. J Adolesc Young Adult Oncol. 2017;6(1):6–30.
Anazodo A, Laws P, Logan S, Saunders C, Travaglia J, Gerstl B, et al. How can we improve oncofertility care for patients? A systematic scoping review of current international practice and models of care. Hum Reprod Update. 2019;25(2):159–79.
Lee SJ, Schover LR, Partridge AH, Patrizio P, Wallace WH, Hagerty K, et al. American Society of Clinical Oncology recommendations on fertility preservation in cancer patients. J Clin Oncol. 2006;24(18):2917–31.
Loren AW, Mangu PB, Beck LN, Brennan L, Magdalinski AJ, Partridge AH, et al. Fertility preservation for patients with cancer: American Society of Clinical Oncology clinical practice guideline update. J Clin Oncol. 2013;31(19):2500–10.
Oktay K, Harvey BE, Partridge AH, Quinn GP, Reinecke J, Taylor HS, et al. Fertility preservation in patients with cancer: ASCO clinical practice guideline update. J Clin Oncol. 2018;36(19):1994–2001.
Coccia PF, Pappo AS, Altman J, Bhatia S, Borinstein SC, Flynn J, et al. Adolescent and young adult oncology, version 2.2014. J Natl Compr Cancer Netw. 2014;12(1):21–32.
Pentheroudakis G, Orecchia R, Hoekstra HJ, Pavlidis N, ESMO Guidelines Working Group. Cancer, fertility and pregnancy: ESMO clinical practice guidelines for diagnosis, treatment and follow-up. Ann Oncol. 2010;21(Suppl 5):v266–v73.
American Society for Reproductive Medicine. Fertility preservation in patients undergoing gonadotoxic therapy or gonadectomy: a committee opinion. Fertil Steril. 2013;100(5):1214–23.
American Society for Reproductive Medicine. Fertility preservation and reproduction in patients facing gonadotoxic therapies: an Ethics Committee opinion. Fertil Steril. 2018;110(3):380–6.
Mintziori G, Lambrinoudaki I, Ceausu I, Depypere H, Erel CT, Perez-Lopez FR, et al. EMAS position statement: fertility preservation. Maturitas. 2014;77(1):85–9.
Linkeviciute A, Boniolo G, Chiavari L, Peccatori FA. Fertility preservation in cancer patients: the global framework. Cancer Treat Rev. 2014;40(8):1019–27.
Panagiotopoulou N, Ghuman N, Sandher R, Herbert M, Stewart JA. Barriers and facilitators towards fertility preservation care for cancer patients: a meta-synthesis. Eur J Cancer Care (Engl). 2018;27(1) https://doi.org/10.1111/ecc.12428.
Vindrola-Padros C, Dyer KE, Cyrus J, Lubker IM. Healthcare professionals’ views on discussing fertility preservation with young cancer patients: a mixed method systematic review of the literature. Psycho-Oncology. 2017;26(1):4–14.
Reinecke JD, Kelvin JF, Arvey SR, Quinn GP, Levine J, Beck LN, et al. Implementing a systematic approach to meeting patients’ cancer and fertility needs: a review of the Fertile Hope Centers Of Excellence program. J Oncol Pract. 2012;8(5):303–8.
Carlson CA, Kolon TF, Mattei P, Hobbie W, Gracia CR, Ogle S, et al. Developing a hospital-wide fertility preservation service for pediatric and young adult patients. J Adolesc Health. 2017;61(5):571–6.
Kelvin JF, Reinecke J. Institutional approaches to implementing fertility preservation for cancer patients. Adv Exp Med Biol. 2012;732:165–73.
Smith K, Efymow B, Gracia C. Patient navigation and coordination of care for the oncofertility patient: a practical guide. In: Gracia C, Woodruss TK, editors. Oncofertility medical practice: clinical issues and implementation. New York: Springer Science+Business Media; 2012.
Kelvin JF, Thom B, Benedict C, Carter J, Corcoran S, Dickler MN, et al. Cancer and fertility program improves patient satisfaction with information received. J Clin Oncol. 2016;34(15):1780–6.
Melan K, Amant F, Veronique-Baudin J, Joachim C, Janky E. Fertility preservation healthcare circuit and networks in cancer patients worldwide: what are the issues? BMC Cancer. 2018;18(1):192.
Peavey M, Arian S, Gibbons W, Lu K, Gershenson D, Woodard T. On-site fertility preservation services for adolescents and young adults in a comprehensive cancer center. J Adolesc Young Adult Oncol. 2017;6(2):229–34.
Salsman JM, Yanez B, Smith KN, Beaumont JL, Snyder MA, Barnes K, et al. Documentation of fertility preservation discussions for young adults with cancer: examining compliance with treatment guidelines. J Natl Compr Cancer Netw. 2016;14(3):301–9.
Grover NS, Deal AM, Wood WA, Mersereau JE. Young men with cancer experience low referral rates for fertility counseling and sperm banking. J Oncol Pract. 2016;12(5):465–71.
Lewin J, Ma JMZ, Mitchell L, Tam S, Puri N, Stephens D, et al. The positive effect of a dedicated adolescent and young adult fertility program on the rates of documentation of therapy-associated infertility risk and fertility preservation options. Support Care Cancer. 2017;25(6):1915–22.
Quinn GP, Block RG, Clayman ML, Kelvin J, Arvey SR, Lee JH, et al. If you did not document it, it did not happen: rates of documentation of discussion of infertility risk in adolescent and young adult oncology patients’ medical records. J Oncol Pract. 2015;11(2):137–44.
Quinn GP, Vadaparampil ST, Gwede CK, Reinecke JD, Mason TM, Silva C. Developing a referral system for fertility preservation among patients with newly diagnosed cancer. J Natl Compr Cancer Netw. 2011;9(11):1219–25.
Sheth KR, Sharma V, Helfand BT, Cashy J, Smith K, Hedges JC, et al. Improved fertility preservation care for male patients with cancer after establishment of formalized oncofertility program. J Urol. 2012;187(3):979–86.
Acknowledgment
Funding: Funded in part through the National Institutes of Health/National Cancer Institute Cancer Center Support Grant P30CA008748.
Author information
Authors and Affiliations
Corresponding author
Editor information
Editors and Affiliations
Rights and permissions
Copyright information
© 2020 Springer Nature Switzerland AG
About this chapter
Cite this chapter
Kelvin, J.F. (2020). Organizational Strategies to Overcome Barriers to Addressing Fertility Preservation in the Oncology Setting. In: Azim Jr, H., Demeestere, I., Peccatori, F. (eds) Fertility Challenges and Solutions in Women with Cancer. Springer, Cham. https://doi.org/10.1007/978-3-030-24086-8_6
Download citation
DOI: https://doi.org/10.1007/978-3-030-24086-8_6
Published:
Publisher Name: Springer, Cham
Print ISBN: 978-3-030-24085-1
Online ISBN: 978-3-030-24086-8
eBook Packages: MedicineMedicine (R0)