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Published in: Supportive Care in Cancer 10/2020

01-10-2020 | Fertility | Original Article

Exploring patient and provider perspectives on the intersection between fertility, genetics, and family building

Authors: Paige W. Lake, Monica L. Kasting, Marleah Dean, Lindsay Fuzzell, Janella Hudson, Rodrigo Carvajal, Damon R. Reed, Gwendolyn P. Quinn, Susan T. Vadaparampil

Published in: Supportive Care in Cancer | Issue 10/2020

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Abstract

Objective

Adolescent and young adult (AYA) cancer patients have distinct medical and psychosocial needs and fertility is a key concern. Early age of onset is a risk factor for hereditary cancer and AYAs are more likely to experience reduced fertility. This has implications for future family building decisions and fertility preservation (FP) and genetic testing/counseling (GT/GC) education.

Methods

Patients diagnosed with cancer between the ages of 18 and 39 and health care providers (HCPs) who treat AYA cancer patients were recruited from a single institution. Qualitative interviews explored AYA patients’ and HCPs’ concerns regarding their experiences discussing genetics and FP.

Results

The majority of patients (n = 17) were female (59%), and the majority of HCPs (n = 18) were male (67%). Overall, participants had differing perceptions of FP and GT/GC-related information provided during the clinical visit. Patients indicated initiating the conversation about FP and did not recall HCPs discussing GT/GC with them. HCPs indicated patients were often overwhelmed with too much information and comprehension of this discussion is limited. HCPs also felt patients’ emotions/beliefs determined their information-seeking behavior specific to FP and GT/GC. Participants felt educational materials should be developed and delivered in a video format depicting a patient–provider interaction or patient testimonial.

Conclusion

AYA patients are often overwhelmed by a cancer diagnosis; the complexity/volume of information regarding FP and GT/GC may hinder understanding and decision-making about family building. Educational materials that help patients understand what questions to ask HCPs about FP and GT/GC should be developed to improve knowledge, psychosocial well-being, and future family building decisions.
Literature
1.
go back to reference Bleyer A, O’Leary M, Barr R, Ries L. Cancer epidemiology in older adolescents and young adults 15 to 29 years of age, including SEER incidence and survival: 1975–2000. 2006 Bleyer A, O’Leary M, Barr R, Ries L. Cancer epidemiology in older adolescents and young adults 15 to 29 years of age, including SEER incidence and survival: 1975–2000. 2006
2.
go back to reference Dorval M, Patenaude AF, Schneider KA, Kieffer SA, DiGianni L, Kalkbrenner KJ, Bromberg JI, Basili LA, Calzone K, Stopfer J, Weber BL, Garber JE (2000) Anticipated versus actual emotional reactions to disclosure of results of genetic tests for cancer susceptibility: findings from p53 and BRCA1 testing programs. J Clin Oncol 18(10):2135–2142CrossRef Dorval M, Patenaude AF, Schneider KA, Kieffer SA, DiGianni L, Kalkbrenner KJ, Bromberg JI, Basili LA, Calzone K, Stopfer J, Weber BL, Garber JE (2000) Anticipated versus actual emotional reactions to disclosure of results of genetic tests for cancer susceptibility: findings from p53 and BRCA1 testing programs. J Clin Oncol 18(10):2135–2142CrossRef
3.
go back to reference Murphy D, Klosky JL, Reed DR, Termuhlen AM, Shannon SV, Quinn GP (2015) The importance of assessing priorities of reproductive health concerns among adolescent and young adult patients with cancer. Cancer 121(15): 2529–36. https://doi.org/10.1002/cncer.29466 Murphy D, Klosky JL, Reed DR, Termuhlen AM, Shannon SV, Quinn GP (2015) The importance of assessing priorities of reproductive health concerns among adolescent and young adult patients with cancer. Cancer 121(15): 2529–36. https://​doi.​org/​10.​1002/​cncer.​29466
4.
go back to reference Carter J, Penson R, Barakat R, Wenzel L (2012) Contemporary quality of life issues affecting gynecologic cancer survivors. Hematol Oncol Clin North Am 26(1):169–194CrossRef Carter J, Penson R, Barakat R, Wenzel L (2012) Contemporary quality of life issues affecting gynecologic cancer survivors. Hematol Oncol Clin North Am 26(1):169–194CrossRef
5.
go back to reference Partridge AH, Gelber S, Peppercorn J, Sampson E, Knudsen K, Laufer M, Rosenberg R, Przypyszny M, Rein A, Winer EP (2004) Web-based survey of fertility issues in young women with breast cancer. J Clin Oncol 22(20):4174–4183CrossRef Partridge AH, Gelber S, Peppercorn J, Sampson E, Knudsen K, Laufer M, Rosenberg R, Przypyszny M, Rein A, Winer EP (2004) Web-based survey of fertility issues in young women with breast cancer. J Clin Oncol 22(20):4174–4183CrossRef
6.
go back to reference Schover LR (2009) Patient attitudes toward fertility preservation. Pediatr Blood Cancer 53(2):281–284CrossRef Schover LR (2009) Patient attitudes toward fertility preservation. Pediatr Blood Cancer 53(2):281–284CrossRef
7.
go back to reference Howard-Anderson J, Ganz PA, Bower JE, Stanton AL (2012) Quality of life, fertility concerns, and behavioral health outcomes in younger breast cancer survivors: a systematic review. J Natl Cancer Inst 104(5):386–405CrossRef Howard-Anderson J, Ganz PA, Bower JE, Stanton AL (2012) Quality of life, fertility concerns, and behavioral health outcomes in younger breast cancer survivors: a systematic review. J Natl Cancer Inst 104(5):386–405CrossRef
8.
go back to reference Klosky JL, Simmons JL, Russell KM, Foster RH, Sabbatini GM, Canavera KE, Hodges JR, Schover LR, McDermott M (2015) Fertility as a priority among at-risk adolescent males newly diagnosed with cancer and their parents. Support Care Cancer 23(2):333–341CrossRef Klosky JL, Simmons JL, Russell KM, Foster RH, Sabbatini GM, Canavera KE, Hodges JR, Schover LR, McDermott M (2015) Fertility as a priority among at-risk adolescent males newly diagnosed with cancer and their parents. Support Care Cancer 23(2):333–341CrossRef
9.
go back to reference Friedman LC, Kramer RM (2005) Reproductive issues for women with BRCA mutations. J Natl Cancer Inst Monogr 34:83–86CrossRef Friedman LC, Kramer RM (2005) Reproductive issues for women with BRCA mutations. J Natl Cancer Inst Monogr 34:83–86CrossRef
10.
go back to reference Smith KR, Ellington L, Chan AY, Croyle RT, Botkin JR (2004) Fertility intentions following testing for a BRCA1 gene mutation. Cancer Epidemiol Biomark Prev 13(5):733–740 Smith KR, Ellington L, Chan AY, Croyle RT, Botkin JR (2004) Fertility intentions following testing for a BRCA1 gene mutation. Cancer Epidemiol Biomark Prev 13(5):733–740
11.
go back to reference Patenaude AF, Tung N, Ryan PD, Ellisen LW, Hewitt L, Schneider KA, Tercyak KP, Aldridge J, Garber JE (2013) Young adult daughters of BRCA1/2 positive mothers: what do they know about hereditary cancer and how much do they worry? Psycho-oncology. 22(9):2024–2031CrossRef Patenaude AF, Tung N, Ryan PD, Ellisen LW, Hewitt L, Schneider KA, Tercyak KP, Aldridge J, Garber JE (2013) Young adult daughters of BRCA1/2 positive mothers: what do they know about hereditary cancer and how much do they worry? Psycho-oncology. 22(9):2024–2031CrossRef
12.
go back to reference Dommering CJ, Garvelink MM, Moll AC, van Dijk J, Imhof SM, Meijers-Heijboer H, Henneman L (2012) Reproductive behavior of individuals with increased risk of having a child with retinoblastoma. Clin Genet 81(3):216–223CrossRef Dommering CJ, Garvelink MM, Moll AC, van Dijk J, Imhof SM, Meijers-Heijboer H, Henneman L (2012) Reproductive behavior of individuals with increased risk of having a child with retinoblastoma. Clin Genet 81(3):216–223CrossRef
13.
go back to reference Dewanwala A, Chittenden A, Rosenblatt M, Mercado R, Garber JE, Syngal S, Stoffel EM (2011) Attitudes toward childbearing and prenatal testing in individuals undergoing genetic testing for Lynch syndrome. Familial Cancer 10(3):549–556CrossRef Dewanwala A, Chittenden A, Rosenblatt M, Mercado R, Garber JE, Syngal S, Stoffel EM (2011) Attitudes toward childbearing and prenatal testing in individuals undergoing genetic testing for Lynch syndrome. Familial Cancer 10(3):549–556CrossRef
14.
go back to reference Donnelly LS, Watson M, Moynihan C et al (2013) Reproductive decision-making in young female carriers of a BRCA mutation. Human Reprod (Oxford, England) 28(4):1006–1012CrossRef Donnelly LS, Watson M, Moynihan C et al (2013) Reproductive decision-making in young female carriers of a BRCA mutation. Human Reprod (Oxford, England) 28(4):1006–1012CrossRef
15.
go back to reference Quinn GP, Vadaparampil ST, Tollin S, Miree CA, Murphy D, Bower B, Silva C (2010) BRCA carriers’ thoughts on risk management in relation to preimplantation genetic diagnosis and childbearing: when too many choices are just as difficult as none. Fertil Steril 94(6):2473–2475CrossRef Quinn GP, Vadaparampil ST, Tollin S, Miree CA, Murphy D, Bower B, Silva C (2010) BRCA carriers’ thoughts on risk management in relation to preimplantation genetic diagnosis and childbearing: when too many choices are just as difficult as none. Fertil Steril 94(6):2473–2475CrossRef
16.
go back to reference National Comprehensive Cancer Network (2015) About the NCCN clinical practice guidelines in oncology (NCCN Guidelines®). Adolescent and Young Adult (AYA) Oncology. NCCN Guidelines® & Clinical Resources; http://www.nccn.org/professionals/. Accessed June 26, 2015 National Comprehensive Cancer Network (2015) About the NCCN clinical practice guidelines in oncology (NCCN Guidelines®). Adolescent and Young Adult (AYA) Oncology. NCCN Guidelines® & Clinical Resources; http://​www.​nccn.​org/​professionals/​. Accessed June 26, 2015
17.
go back to reference Quinn GP, Vadaparampil ST, Gwede CK, Miree C, King LM, Clayton HB, Wilson C, Munster P (2007) Discussion of fertility preservation with newly diagnosed patients: oncologists’ views. J Cancer Surviv 1(2):146–155CrossRef Quinn GP, Vadaparampil ST, Gwede CK, Miree C, King LM, Clayton HB, Wilson C, Munster P (2007) Discussion of fertility preservation with newly diagnosed patients: oncologists’ views. J Cancer Surviv 1(2):146–155CrossRef
18.
go back to reference Coccia PF, Altman J, Bhatia S, Borinstein SC, Flynn J, George S, Goldsby R, Hayashi R, Huang MS, Johnson RH, Beaupin LK, Link MP, Oeffinger KC, Orr KM, Pappo AS, Reed D, Spraker HL, Thomas DA, von Mehren M, Wechsler DS, Whelan KF, Zebrack BJ, Sundar H, Shead DA (2012) Adolescent and young adult oncology. Clinical practice guidelines in oncology. J Natl Compr Cancer Netw 10(9):1112–1150CrossRef Coccia PF, Altman J, Bhatia S, Borinstein SC, Flynn J, George S, Goldsby R, Hayashi R, Huang MS, Johnson RH, Beaupin LK, Link MP, Oeffinger KC, Orr KM, Pappo AS, Reed D, Spraker HL, Thomas DA, von Mehren M, Wechsler DS, Whelan KF, Zebrack BJ, Sundar H, Shead DA (2012) Adolescent and young adult oncology. Clinical practice guidelines in oncology. J Natl Compr Cancer Netw 10(9):1112–1150CrossRef
19.
go back to reference Lindlof TR, Taylor BC (2011) Sensemaking: qualitative data analysis and interpretation. In: Qualitative Communication Research Methods, vol 3, pp 241–281 Lindlof TR, Taylor BC (2011) Sensemaking: qualitative data analysis and interpretation. In: Qualitative Communication Research Methods, vol 3, pp 241–281
20.
go back to reference Jones G, Hughes J, Mahmoodi N, Smith E, Skull J, Ledger W (2017) What factors hinder the decision-making process for women with cancer and contemplating fertility preservation treatment? Hum Reprod Update 23(4):433–457CrossRef Jones G, Hughes J, Mahmoodi N, Smith E, Skull J, Ledger W (2017) What factors hinder the decision-making process for women with cancer and contemplating fertility preservation treatment? Hum Reprod Update 23(4):433–457CrossRef
21.
go back to reference Barlevy D, Wangmo T, Elger BS, Ravitsky V (2016) Attitudes, beliefs, and trends regarding adolescent oncofertility discussions: a systematic literature review. J Adolesc Young Adult Oncol 5(2):119–134CrossRef Barlevy D, Wangmo T, Elger BS, Ravitsky V (2016) Attitudes, beliefs, and trends regarding adolescent oncofertility discussions: a systematic literature review. J Adolesc Young Adult Oncol 5(2):119–134CrossRef
22.
go back to reference Taylor JF, Ott MA (2016) Fertility preservation after a cancer diagnosis: a systematic review of adolescents’, parents’, and providers’ perspectives, experiences, and preferences. J Pediatr Adolesc Gynecol 29(6):585–598CrossRef Taylor JF, Ott MA (2016) Fertility preservation after a cancer diagnosis: a systematic review of adolescents’, parents’, and providers’ perspectives, experiences, and preferences. J Pediatr Adolesc Gynecol 29(6):585–598CrossRef
23.
go back to reference Quinn G, Vadaparampil ST, Wilson C et al (2009) Attitudes of high-risk women toward preimplantation genetic diagnosis. Fertil Steril 91(6):2361–2368CrossRef Quinn G, Vadaparampil ST, Wilson C et al (2009) Attitudes of high-risk women toward preimplantation genetic diagnosis. Fertil Steril 91(6):2361–2368CrossRef
24.
go back to reference Rich TA, Liu M, Etzel CJ et al (2014) Comparison of attitudes regarding preimplantation genetic diagnosis among patients with hereditary cancer syndromes. Familial Cancer 13(2):291–299CrossRef Rich TA, Liu M, Etzel CJ et al (2014) Comparison of attitudes regarding preimplantation genetic diagnosis among patients with hereditary cancer syndromes. Familial Cancer 13(2):291–299CrossRef
25.
go back to reference Speller B, Sissons A, Daly C, Facey M, Kennedy E, Metcalfe K, Baxter NN (2019) An evaluation of oncofertility decision support resources among breast cancer patients and health care providers. BMC Health Serv Res 19(1):101CrossRef Speller B, Sissons A, Daly C, Facey M, Kennedy E, Metcalfe K, Baxter NN (2019) An evaluation of oncofertility decision support resources among breast cancer patients and health care providers. BMC Health Serv Res 19(1):101CrossRef
28.
go back to reference Vadaparampil ST, Gwede CK, Meade C, Kelvin J, Reich RR, Reinecke J, Bowman M, Sehovic I, Quinn GP, ENRICH RESEARCH GROUP (2016) ENRICH: a promising oncology nurse training program to implement ASCO clinical practice guidelines on fertility for AYA cancer patients. Patient Educ Couns 99(11):1907–1910CrossRef Vadaparampil ST, Gwede CK, Meade C, Kelvin J, Reich RR, Reinecke J, Bowman M, Sehovic I, Quinn GP, ENRICH RESEARCH GROUP (2016) ENRICH: a promising oncology nurse training program to implement ASCO clinical practice guidelines on fertility for AYA cancer patients. Patient Educ Couns 99(11):1907–1910CrossRef
29.
go back to reference Vadaparampil ST, Hutchins NM, Quinn GP (2013) Reproductive health in the adolescent and young adult cancer patient: an innovative training program for oncology nurses. J Canc Educ 28(1):197–208CrossRef Vadaparampil ST, Hutchins NM, Quinn GP (2013) Reproductive health in the adolescent and young adult cancer patient: an innovative training program for oncology nurses. J Canc Educ 28(1):197–208CrossRef
30.
go back to reference Straughan PT, Seow A (1998) Fatalism reconceptualized: a concept to predict health screening behavior. J Gend Cult Health 3(2):85–100CrossRef Straughan PT, Seow A (1998) Fatalism reconceptualized: a concept to predict health screening behavior. J Gend Cult Health 3(2):85–100CrossRef
31.
go back to reference Kessler L, Collier A, Brewster K, Smith C, Weathers B, Wileyto EP, Halbert CH (2005) Attitudes about genetic testing and genetic testing intentions in African American women at increased risk for hereditary breast cancer. Genet Med 7(4):230–238CrossRef Kessler L, Collier A, Brewster K, Smith C, Weathers B, Wileyto EP, Halbert CH (2005) Attitudes about genetic testing and genetic testing intentions in African American women at increased risk for hereditary breast cancer. Genet Med 7(4):230–238CrossRef
32.
go back to reference Ardern-Jones A, Kenen R, Eeles R (2005) Too much, too soon? Patients and health professionals’ views concerning the impact of genetic testing at the time of breast cancer diagnosis in women under the age of 40. Eur J Canc Care 14(3):272–281CrossRef Ardern-Jones A, Kenen R, Eeles R (2005) Too much, too soon? Patients and health professionals’ views concerning the impact of genetic testing at the time of breast cancer diagnosis in women under the age of 40. Eur J Canc Care 14(3):272–281CrossRef
33.
go back to reference Shin DW, Cho J, Roter DL, Kim SY, Yang HK, Park K, Kim HJ, Shin HY, Kwon TG, Park JH (2017) Attitudes toward family involvement in cancer treatment decision making: the perspectives of patients, family caregivers, and their oncologists. Psycho-oncology. 26(6):770–778CrossRef Shin DW, Cho J, Roter DL, Kim SY, Yang HK, Park K, Kim HJ, Shin HY, Kwon TG, Park JH (2017) Attitudes toward family involvement in cancer treatment decision making: the perspectives of patients, family caregivers, and their oncologists. Psycho-oncology. 26(6):770–778CrossRef
Metadata
Title
Exploring patient and provider perspectives on the intersection between fertility, genetics, and family building
Authors
Paige W. Lake
Monica L. Kasting
Marleah Dean
Lindsay Fuzzell
Janella Hudson
Rodrigo Carvajal
Damon R. Reed
Gwendolyn P. Quinn
Susan T. Vadaparampil
Publication date
01-10-2020
Publisher
Springer Berlin Heidelberg
Keyword
Fertility
Published in
Supportive Care in Cancer / Issue 10/2020
Print ISSN: 0941-4355
Electronic ISSN: 1433-7339
DOI
https://doi.org/10.1007/s00520-020-05315-1

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