Barriers to Oncofertility Care among Female Adolescent Cancer Patients in Canada.
Tali Sara GlazerFiona S M SchultePublished in: Current oncology (Toronto, Ont.) (2022)
High survival rates in adolescent cancer patients have shifted the medical focus to the long-term outcomes of cancer treatments. Surgery, chemotherapy, and radiation increase the risk of infertility and infertility-related distress in adolescent cancer patients and survivors. The aims of this narrative review were to (1) describe the psychosocial impacts of cancer-related infertility in adolescents, (2) identify multilevel barriers to fertility preservation (FP) conversations and referrals, and (3) conclude with evidence-based clinical solutions for improving the oncofertility support available to Canadian adolescents. The results of this review revealed that FP decisions occur within the patient, parent, and health care provider (HCP) triad, and are influenced by factors such as parent attitudes, patient maturity, and HCP knowledge. Decision tools and HCP education can promote the occurrence of developmentally appropriate fertility discussions. At the systems level, cost and resource barriers prevent patients from receiving sufficient fertility information and referrals. Clinical models of care (MOCs) can define interdisciplinary roles and referral pathways to improve the integration of oncofertility services into adolescent cancer care. The continued integration of oncofertility care will ensure that all Canadian adolescents receive the exemplary medical and psychological support necessary to make empowered decisions about their own fertility.
Keyphrases
- young adults
- healthcare
- childhood cancer
- mental health
- primary care
- palliative care
- quality improvement
- end stage renal disease
- newly diagnosed
- physical activity
- case report
- minimally invasive
- affordable care act
- health information
- ejection fraction
- peritoneal dialysis
- squamous cell carcinoma
- risk assessment
- coronary artery bypass
- single cell
- locally advanced
- skeletal muscle
- radiation therapy
- decision making
- depressive symptoms
- patient reported
- metabolic syndrome
- adipose tissue
- drug induced