In 2006, the American Society of Clinical Oncology (ASCO) published fertility preservation guidelines for clinicians to follow when treating young cancer patients in response to the increased likelihood of young men and women at risk of losing their fertility due to cancer and its treatment. Nonetheless, studies show that many young cancer patients still are not receiving important information related to their fertility, which would allow them to make informed decisions on their course of treatment. In a new study in Current Oncology, entitled, “Fertility Risk Discussions in Young Patients Diagnosed with Colorectal Cancer,” authors, A. Kumar, A. Merali, G.R Pond and K. Zbuk performed a retrospective chart review for patients less than 40 years of age with newly diagnosed colorectal cancer between 2000 and 2009, to identify the frequency of fertility preservation discussions.
The investigators reviewed eligible health charts for any indication that a fertility discussion had taken place after initial diagnosis. If there was a documented discussion, investigators then reviewed the charts to see if any follow-up had been done via an oncologist or a reproductive specialist. Demographic and treatment information was extracted from the charts.
The study identified 59 patients who met all the criteria for inclusion (18-40yrs old, year of diagnosis, stage of cancer, type of treatment, etc). Of those 59 patients, 35 were men and 24 were women. Their average age was 34, and 95% of the selection had received chemotherapy treatment for their cancer.
The study found that only 20 of the 59 patients received fertility counseling and 2 of those 20 did not receive a follow-up discussion with a reproductive specialist. The study also found that age was the most important factor as to whether or not an individual received a fertility discussion. Men and women under the age of 35 were more likely to receive a fertility discussion than those over 35. Finally, the investigators observed no significant difference in the frequency of discussions after 2006, when the ASCO guidelines were published.
The results of this study demonstrate that the fertility risks associated with colorectal cancer treatment and fertility perseveration options available to newly diagnosed cancer patients, were discussed infrequently. As we know, fertility preservation options are available; however, unless a patient or their clinical team are proactive about exploring those options, young cancer patients may not be getting the pertinent fertility information they need in a timely fashion. This study highlights the need for more health care professionals to discuss fertility risks with their patients prior to undergoing cancer treatment.