The impact of infertility on cancer patients
New research led by Western Sydney University has revealed that infertility—one of the most distressing long-term effects of cancer treatment—is often overlooked in advising patients about treatment, and in understanding the impact of cancer on the quality of life.
In the latest ARC funded research, published by Psycho‐Oncology, a survey of 878 cancer survivors found a strong correlation between infertility caused by cancer treatments and psychological distress, relationship issues and cancer acceptance. The research also found that despite clinical guidelines recommending that fertility be discussed with all patients of reproductive age, including adolescents and young adults, only 57 percent of women and 46 percent men reported that these discussions had taken place.
According to lead researcher Professor Jane Ussher from the School of Medicine and Translational Health Research Institute, "many patients never have a discussion about fertility with a health care professional and are devastated when they find out that they are infertile. In our study, only 20.1 percent of women and 28.8 percent of men had engaged in any form of fertility investigation or preservation.
"Our research also showed that despite health care professionals acknowledging fertility is an important concern for patients and their partners; only 50 percent of doctors and nurses, and 24 percent of allied health professionals reported that they always addressed this issue."
These findings—which come on the back of findings from three papers led by Professor Ussher on the topic published in the past five years—reiterate the importance of fertility information being provided and infertility concerns acknowledged and addressed by clinicians. They also highlight the need for supportive psychological interventions for those who are unable to have children following cancer.
Professor Ussher added that while the findings suggest women and those who are childless may be in greater need of support, because of a higher risk of distress, "the psychological needs of men, and those who experience secondary infertility following cancer, should not be overlooked.
"We interviewed 78 cancer survivors, and found that infertility is a biographical disruption, associated with loss and grief, and a challenge to identity as a man or a woman. However, some people came to terms with infertility, describing other ways of nurturing, or finding meaning in life.
"Our research suggests that psychological support to address cancer‐related infertility distress should acknowledge the different meanings of infertility across gender, as well as the impact of acceptance of cancer and its impact on relationships.
"Our recommendation is that future psychological interventions should also include a focus on acceptance of cancer and infertility, identity renegotiation, relational coping, and acknowledgment of the gendered aspects of cancer related infertility distress."
The findings of the study have been translated into information booklets about infertility and cancer, published and distributed by the Cancer Council NSW and CanTeen. Professor Ussher says, "cancer patients need to know that treatment can impact on future fertility, but that fertility preservation is often possible. We found that these booklets help cancer patients to initiate the conversation with their doctor about fertility and cancer."
