Leading US cancer centers neglect the future fertility of patients

Some of the most advanced and best-resourced cancer centers in the country fail to notify patients of risks to their fertility or to direct patients to speak with fertility specialists, says a new study. In 2006, the American Society of Reproductive Medicine published guidelines regarding fertility preservation advising oncologists to be prepared to discuss risks to patients' fertility and make the proper referrals. In many treatment centers, these guidelines seem to have gone unheeded. "If it turns out that there were things that could have been potentially done to help them preserve their fertility and those weren't done or those weren't talked about, then it's very upsetting, understandably," says lead study author Marla Clayman, an assistant professor of medicine at Northwestern University's Feinberg School of Medicine. Questions regarding fertility are frequently cited among adolescent and young adult cancer patients' frequent concerns in surveys, she adds.Researchers at Northwestern University phoned 39 comprehensive cancer centers to assess their fertility preservation resources. These centers are at the helm of experimental research. They are well-financed, often part of medical schools, or they are affiliated with other academic organizations. Phone survey participants were mainly staff affiliated with reproductive endocrinology, hematology or oncology divisions. Study results found that half of these centers had fertility preservation services available on site or referral systems in place. However, only about a quarter - 27 percent - of these centers employed fertility navigators or educators. Clayman says she understands an oncologist's principle goal is to save lives, but she believes cancer treatment centers ought to make an institutional commitment to providing fertility information to patients. "The vast majority of patients are not going to say, 'No, no. It's going to ruin my fertility don't give me treatment.' It's not an either or," she says. There are a number of options in fertility preservation: women can freeze embryos or cryopreserve their eggs. Other more experimental options such as freezing ovarian tissue have also surfaced in the last year. Men concerned about fertility have the option of sperm banking. Sometimes preserving a patient's fertility can delay treatment, but for certain slow-growing cancers, a few weeks difference may not be significant. These are the types of conversations patients should be having with clinicians, says Clayman. Doctors often take measures to make certain that patients are comfortable and to ensure fewer long-term side effects. "For many people the possibility of being infertile because of their cancer can result in psychological pain throughout a lifetime," says Clayman. Quality of life is important to cancer patients, particularly survivors. "You don't just want to have a life after cancer, you want to have the best life you can have after cancer, and we want that for everybody. The best that they can have - whether that means being in less pain, or whether that means having less psychological distress or whether that means being able to build a family that they want to build," says Clayman. Article: 20th December 2013 www.usnews.com

Leading US cancer centers neglect the future fertility of patients

Some of the most advanced and best-resourced cancer centers in the country fail to notify patients of risks to their fertility or to direct patients to speak with fertility specialists, says a new study. In 2006, the American Society of Reproductive Medicine published guidelines regarding fertility preservation advising oncologists to be prepared to discuss risks to patients' fertility and make the proper referrals. In many treatment centers, these guidelines seem to have gone unheeded. "If it turns out that there were things that could have been potentially done to help them preserve their fertility and those weren't done or those weren't talked about, then it's very upsetting, understandably," says lead study author Marla Clayman, an assistant professor of medicine at Northwestern University's Feinberg School of Medicine. Questions regarding fertility are frequently cited among adolescent and young adult cancer patients' frequent concerns in surveys, she adds.Researchers at Northwestern University phoned 39 comprehensive cancer centers to assess their fertility preservation resources. These centers are at the helm of experimental research. They are well-financed, often part of medical schools, or they are affiliated with other academic organizations. Phone survey participants were mainly staff affiliated with reproductive endocrinology, hematology or oncology divisions. Study results found that half of these centers had fertility preservation services available on site or referral systems in place. However, only about a quarter - 27 percent - of these centers employed fertility navigators or educators. Clayman says she understands an oncologist's principle goal is to save lives, but she believes cancer treatment centers ought to make an institutional commitment to providing fertility information to patients. "The vast majority of patients are not going to say, 'No, no. It's going to ruin my fertility don't give me treatment.' It's not an either or," she says. There are a number of options in fertility preservation: women can freeze embryos or cryopreserve their eggs. Other more experimental options such as freezing ovarian tissue have also surfaced in the last year. Men concerned about fertility have the option of sperm banking. Sometimes preserving a patient's fertility can delay treatment, but for certain slow-growing cancers, a few weeks difference may not be significant. These are the types of conversations patients should be having with clinicians, says Clayman. Doctors often take measures to make certain that patients are comfortable and to ensure fewer long-term side effects. "For many people the possibility of being infertile because of their cancer can result in psychological pain throughout a lifetime," says Clayman. Quality of life is important to cancer patients, particularly survivors. "You don't just want to have a life after cancer, you want to have the best life you can have after cancer, and we want that for everybody. The best that they can have - whether that means being in less pain, or whether that means having less psychological distress or whether that means being able to build a family that they want to build," says Clayman. Article: 20th December 2013 www.usnews.com

A third of male cancer patients not being told about fertility options

Pioneering research presented at the Fertility 2013 conference today (Thursday 3 January 2013) shows that a large proportion of male cancer patients are missing out on appropriate fertility advice. Sperm banking is routinely recommended for all men diagnosed with cancer who are at risk of long-term infertility, caused by treatment such as chemotherapy and radiotherapy. Infertility can be permanent or temporary depending on the individual's circumstances and men may need to attend follow-up appointments to assess their fertility in the years after they have been discharged from cancer treatment. These appointments are important to receive appropriate fertility advice and in light of current sperm banking regulations which state sperm samples should be disposed of after 10 years if ongoing infertility cannot be confirmed. Dr Allan Pacey, Senior Lecturer in Andrology, and Professor Christine Eiser, Professor in Psychology, at the University of Sheffield sent questionnaires to 499 male cancer survivors aged between 18 and 55 who had undergone cancer treatment more than five years ago and had taken the opportunity to bank sperm in either Sheffield or Nottingham. The research, funded by Cancer Research UK, showed that of the 193 responses over a third of men (36 per cent) had never attended a follow-up appointment to assess their fertility, with a further third (33 per cent) only attending on one occasion. Dr Allan Pacey said: "Trying to engage men with this subject is notoriously difficult. For those of us who run sperm banks, many men store their sperm and then do not contact us again, even though there are legal reasons to keep in contact. "Our research suggests that there is a need to educate men about the benefits of attending follow-up fertility clinics and the long-term consequences of non-attendance." Non-attendance was found to be more likely in men who had suffered fewer side-effects at the time of treatment, had a more negative experience of banking sperm and had a more negative attitude to the disposal of sperm. Missing follow-up appointments to monitor fertility means cancer survivors do not receive education and options available to them. In many cases, men may also be unaware their sperm may be disposed of if ongoing infertility cannot be confirmed. This could have a major impact on their future life choices and ability to father children. The study shows new education strategies are urgently needed on an ongoing basis from the time of diagnosis to inform men about the importance of fertility monitoring as well as encouraging more men to attend these follow-up appointments, with patients receiving timely letters from clinics highlighting the benefits of attendance. Professor Christine Eiser said: "Sperm banking is highly valued by men who want the option to have children once cancer treatment is completed. "Our research found that many men do not know how cancer treatment can affect their fertility or the likelihood of fertility recovery over the long-term. Having received a cancer diagnosis, patients immediately need to take in a lot of information regarding treatments and side-effects and it can be challenging to discuss potential longer-term effects on fertility at this time. We therefore need a mechanism to ensure that men are given information about fertility issues at a later date and certainly before treatment ends." Article: 4th January 2012 www.news-medical.net

Options For Preserving Fertility Help Women with Cancer

Young women undergoing cancer treatment have an increasing number of options for preserving their fertility, a leading researcher told attendees today at the 58th Annual Clinical Meeting of The American College of Obstetricians and Gynecologists.
Thanks to a new medical discipline known as oncofertility, the reproductive outlook for women cancer patients is becoming as good as for men, who long have had the option of banking their sperm, according to Teresa K. Woodruff, PhD, of Northwestern University Feinberg School of Medicine in Chicago, in her lecture "Oncofertility: The Preservation of Fertility Options for Young People with Cancer." A promising new technique for preserving ovarian tissue has the potential to safeguard the future fertility even of very young girls undergoing cancer treatment, she said.


To read more go to http://bit.ly/akmVe8