Surgical oncologists less likely than medical, radiation oncologists to discuss fertility risks with patients

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Medical and radiation oncologists are more likely than surgical oncologists to discuss with patients of childbearing age how treatment might affect the patient's future fertility, a survey has revealed.

The risk of infertility for people with cancer increases after chemotherapy, radiotherapy, and, in some cases, surgery, noted a research group led by Gwendolyn P. Quinn, PhD, director of the Survey Methods Core Facility at Moffitt Cancer Center in Tampa, Florida. The investigators surveyed a random sample of US oncology care physicians to examine potential differences in practice behaviors among different types of oncologists in terms of referral for and discussion of fertility preservation.

The analysis of survey responses demonstrated a significant difference by oncology subspecialty in discussion of how treatment would affect fertility. Of 165 medical oncologists or hematologists who responded, 84.0% “always/often” discussed the impact of treatment on fertility with cancer patients of childbearing age. The same was true of 82.6% of 110 radiation oncologists, but of only 51.4% of 105 surgical oncologists. Surgical oncologists “never” discussed fertility with their patients 20% of the time, compared with 4% of medical oncologists and 0% of radiation oncologists.

Despite this wide range, all three groups referred patients for fertility preservation at approximately the same low rate, with radiation oncologists at the lowest end of the spectrum: These specialists reported “always/often” making such referrals 40% of the time, compared with medical oncologists at 45% and surgical oncologists at 46%.

There is a notable opportunity to implement provider education about fertility preservation to improve quality of life and quality care for patients of reproductive potential, concluded Quinn and colleagues in Practical Radiation Oncology.

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