More discussion needed regarding infertility risk from CRC treatment
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Though clinical guidelines specify that oncologists should talk with patients about the risks for treatment-induced infertility, many colon and rectal cancer patients report they did not receive or do not remember receiving information from their health care providers, according to a presentation at ASCO21 Annual Meeting.
"Providers must fully disclose and explain available options to the patient including the impact of their treatment on their fertility to allow the patient to make an informed decision. Shared decision making is imperative to ensure quality of life is not impacted after treatment," Julia Stal, a PhD student in preventative medicine and one of the study’s investigators said.
Half of both the women and men surveyed reported that their doctor did not discuss the potential of infertility due to treatment side effects.
"Without an adequate understanding of the varying lead effects posed by cancer treatment, providers are unable to prevent and address subsequent patient outcomes," Stal said.
The survey included questions meant to evaluate whether doctors discussed potential infertility problems related to cancer treatment, and if patients were informed about their options to bank sperm or eggs prior to treatment,
Of the 234 patients surveyed, 61.9% were men and 77.9% were white. The patient population included colon or rectal cancer survivors, with the majority having had a diagnosis of stage 2 cancer.
Seventy-five percent of patients did not choose the option to bank eggs, embryos or sperm prior to treatment with 20% specifying that they did not know it was an option and 20% indicating that they could not afford it.
"Cost is a prominent barrier for preservation [of sperm or eggs] with one-fifth of survivors endorsing a desire to, but being unable to afford preservation. High cancer treatment costs may create an initial burden on the patient, and fertility preservation may become an added financial burden," Stal, said.
There is often very little time to make important fertility preservation decisions prior to cancer treatment, according to Stal. This can further complicate financial decision making for patients, she said.
A mutual understanding between patient and provider of the patient's treatment options and their subsequent effects is a key factor for cancer survivorship, she said.
"Cancer treatment is equally as important as ensuring that patients experience a positive quality of life and minimal late effects after treatment. Equitable guideline concordant care is crucial to improving survivor quality of life," Stal said.
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Stal J, et al. Abstract 3518. Presented at: ASCO Annual Meeting; June 4-8, 2021 (virtual meeting).
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