The role of radiation oncologists and discussion of fertility preservation in young cancer patients

Abstract 

Purpose

The risk of infertility increases after cancer treatment with chemotherapy, with radiotherapy, and in some cases with surgery. The goal of these secondary analyses was to examine potential differences in practice behaviors, specifically referral and discussion of fertility preservation, among oncologists (ie, surgical oncologists, medical oncologists, and radiation oncologists).

Methods and Materials

Two items examining discussion and referral for fertility preservation were administered as part of a larger 53-item survey measuring oncologists’ fertility preservation knowledge, practice behaviors, and attitudes was developed and mailed to a nationally representative, stratified, random sample of US oncology care physicians.

Results

There was a significant difference by oncology subspecialty in discussion of the impact of treatment on future fertility for cancer patients of childbearing age. Follow-up χ² tests of discussion and specialty showed 82% of radiation oncologists “always/often” discussed the impact of treatment on fertility, compared with 51% for surgical oncologists. There was not a significant difference between oncology specialty and reported referrals to reproductive endocrinologist with 24% to 31% of all oncologist types reporting “rarely/never” referring patients of child-bearing age to an infertility specialist or reproductive endocrinologist.

Conclusions

These findings are important particularly for radiation oncologists, who may have a unique role in communicating fertility preservation options to their patients given their opportunity for multiple patient encounters. As such, there is a notable opportunity for further research into the reasons why and how to implement provider education about fertility preservation to improve quality of life and quality care for patients of reproductive potential.