Many physicians specializing in cancer care do not tell their patients about fertility preservation options before they undergo chemotherapy, radiation, or surgery, and fewer refer their patients to fertility specialists, according to a study from the University of South Florida in Tampa.
"It's kind of medical paternalism," says Gwendolyn Quinn, senior author of the study published in the current issue of Practical Radiation Oncology, a journal of the American Society for Radiation Oncology (ASTRO), and colleagues at Moffitt Cancer Center in Tampa.
"A physician may say, well, if the patient didn't mention it, it's not an issue. And if they do mention it, perhaps saying (something like) 'I'm willing to choose a less effective treatment in order to regain my fertility,' the physician may say, 'Well no you're not. It's my job to save your life, ' " Quinn says.
She adds that preserving quality of life is increasing in importance for cancer patients because with today's more successful treatments and earlier diagnoses, more patients are surviving longer. In fact, according to A Cancer Journal for Clinicians, of 11.2 million cancer survivors in the United States in 2007, 450,000 were of reproductive age.
Even if they didn't want children when they were diagnosed, they may decide as the years pass that at age 35 or so, they do. But chemotherapy and radiation treatments as well as surgery are estimated to cause sustained infertility in 50% to 95% of cancer survivors, the paper says.