Adolescent and young adult cancer patients face unique social, physical, and emotional experiences during diagnosis and treatment that may not occur in younger or older individuals. A recent chapter in the book, Oncofertility Communication: Sharing Information and Building Relationships across Disciplines, highlights some of these complexities, which were identified from group interviews of young adult survivors of childhood cancer. The authors, Karrie Ann Snyder and Alexandra Tate, discuss that these female cancer survivors deal with some issues that have not previously been identified in adult populations.
The chapter, Cancer-Related Infertility and Young Women: Strategies for Discussing Fertility Preservation, describes the themes that emerged from group interviews of female cancer survivors who were between 14 and 20 at the time of diagnosis. At the time of the focus groups, these women ranged from 25 to 35 and were able to provide perspectives about their treatment at the time of diagnosis and as survivors. During treatment, many of the respondents were concerned with surviving their cancer, appearance, and social issues such as friendships, relationships, and school. While some of the young women do remember hearing about the potential fertility impacts of cancer treatment, others did not. In addition the women who did hear about fertility felt that the information was vague and did not include specific information about potential fertility preservation options.
Snyder and Tate also identify that there has been little research on the consultations that occur between healthcare providers and young cancer patients regarding sexual health and intimacy. Given that cancer survivors may erroneously believe they are unable to have children, these conversations, especially to teens, are integral. Most of the women interviewed did not recall any discussions with healthcare providers and the discussions that were initiated tended to focus purely on the need to prevent pregnancy and did not discuss sexual needs, building romantic relationships, feeling desirable, or other aspects of intimacy that are often important to young people.
In addition to asking survivors about their experiences, the focus groups also investigated strategies for broaching fertility preservation with newly diagnosed patients. Healthcare providers, such as Fertility Preservation Patient Navigators, can provide support for fertility preservation patients by discussing options, liaising with the oncology team, and assisting with billing and insurance issues. Snyder and Tate call for an increased dialogue between providers and adolescent patients, which will empowers young women to become an active part of their treatment plan and their sexual health as cancer survivors. To read more about the communication needs in oncofertility, read this chapter or others in Oncofertility Communication: Sharing Information and Building Relationships across Disciplines.