Why aren't cancer docs talking to their patients about fertility?


It's been three years since the American Society of Clinical Oncology released its guidelines on fertility preservation, yet more than a third of oncologists aren't even aware ASCO has fertility preservation guidelines.On Saturday at ASCO's annual meeting, a new survey found that physicians aren't doing a good enough job of helping young patients preserve their fertility. Sure, the docs who responded to the survey had their reasons--among them the need to start cancer treatment immediately and the high cost of fertility preservation (if a patient can barely afford the cost of cancer treatment, how can they afford to preserve their fertility, some said). Presenter Gwendolyn Quinn, PhD, said she and her colleagues at Moffitt Cancer Center in Tampa are now in the process of developing training curricula for oncology nurses, hoping that nurses can be of more help to young patients.Fertility expert Kutluk Oktay, MD, of New York Medical College, said during his presentation that the ASCO guidelines are too conservative and need to be updated. They contain too many qualifiers that leave it up to the doctor to decide if they want to bring up fertility preservation, said Oktay, who heads the Institute for Fertility Preservation in New York. Oktay, who was part of the committee that developed the guidelines, said he was overruled when he wanted the guidelines to oblige doctors to discuss fertility options with young patients. He called on ASCO to update the 2006 guidelines and to lobby for legislation that would mandate insurance coverage of fertility preservation for cancer patients. (Currently, only a handful of states require coverage, but the coverage is not specific to the unique needs to cancer patients, according to another study presented during the session.)If you're a young, newly diagnosed patient and would like to know the options for preserving your fertility, I'll pass along a couple tips offered by the presenters: Check out the Institute for Fertility Preservation's website at www.fertilitypreservation.org. And use Fertile Hope's risk calculator to determine your risk of infertility based on the type of cancer treatment you'll receive.

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