Advances in cancer treatment methods over the past half century mean that many young men and women can now look forward to longer, healthier lives after cancer. However, many of these treatments can adversely affect survivors’ fertility, and with the emotional stress of a cancer diagnosis, conversations about fertility may take a back seat to more pressing concerns.
A recent study of young female cancer survivors showed that just 13% felt informed of their fertility preservation options, so it’s clear that many patients feel in the dark on how cancer treatment affects their fertility and what options they have available post-treatment. Here is a quick primer on oncofertility support services, including a discussion of how service line providers can meet this growing need:
Why is oncofertility important for service line leaders?
Survival rates for young people with cancer are increasing: Advances in treatment methods mean patients are living longer, healthier lives post-cancer. Currently 83% of adolescents with a malignancy achieve 5-year survival, meaning the demand for oncofertility counseling and fertility-preserving treatment will rise.
- Fertility preservation technology is evolving: Options for fertility continue to expand as technology advances. If an 18-year-old preserves her eggs in 2016, huge technological strides can be made in the intervening 20 years before she may choose to reproduce.
- Targeted and timely fertility information leads to more informed care decisions: Low levels of knowledge about fertility preservation options are associated with increased decisional conflict, which can undermine the quality of decision making.
- Cross service line collaboration is possible and preferable: Integrated care teams improve transition of care quality as well as patient flow and satisfaction.
- Reimbursement is increasingly tied to patient satisfaction: Though an oncology-specific CAHPS survey is still under development, a portion of hospital reimbursement is already tied to patient satisfaction. Lack of knowledge about fertility options may reduce a patient’s perceptions of his/her care experiences.
Where are these services housed?
Oncofertility services do not require additional staffing and there is no one type of clinician designated to offer the services. This means oncofertility discussions can occur under either the oncology or women’s service line. Non-physician members of the oncology care team, including nursing staff, clinical social workers and patient navigators, can coordinate referrals to reproductive endocrinology. The Oncofertility Consortium at Northwestern has decision making tools and resources available for all types of health care providers.
Who is included in the care team?
When in the patient care pathway should fertility preservation counseling occur?
Most fertility preservation methods require action prior to radiation or chemotherapy, meaning patients and clinicians navigate a difficult balance between weighing preservation options and treating the cancer as quickly as possible. However, it’s important that this discussion happen during or after the initial post-diagnosis consult with either a medical oncologist or surgeon.
With little to no financial investment, incorporating oncofertility counseling into your existing oncology or women’s service line can lead to huge gains in patient satisfaction making this a win for the hospital and patients.