Patient education should address fertility risks prior to chemotherapy

Honest and accurate information is of utmost importance when discussing fertility with the patient with cancer, and studies have established the need for structured patient education regarding fertility risks due to chemotherapy. However, surveys of adult oncology patients have found that fewer than 60% recall their health care provider discussing risk of infertility caused by cancer treatment or their options to preserve fertility prior to treatment initiation.

In a presentation at the Oncology Nursing Society 36th Annual Congress that described improved and structured ways for nurses to advocate for and educate patients about fertility prior to initiation of cancer treatment, Amanda Polk, BSN, RN, of the Brain and Spine Center, M.D. Anderson Cancer Center in Houston, Texas, noted that while risk of infertility is well known, there is a lack of patient education prior to the start of treatment toxic to fertility. In fact, no standard exists to educate patients about the effects of cancer treatment on fertility at her clinic.

To remedy this situation, data will be gathered to determine the satisfaction level of patients of child-bearing age regarding fertility education prior to initiation of cancer treatment, noted Polk and her colleague, Angie Ames, RN, OCN. Based on these results, patient education will be created to provide to this population within the clinic, and follow-up surveys will include a determination of the level of patient satisfaction with fertility education received before implementation of standardized patient education compared with after patient education is standardized.

The effect of cancer treatment on fertility is determined by several factors, including age, gender, diagnosis, radiation and chemotherapy agents, and treatment duration. Nurses should encourage patients to discuss infertility risks with their physician before treatment begins and provide reliable resources for fertility experts in the area as well internet resources specializing in fertility. Nurses should create an open and receptive environment to encourage patients to express their concerns, Polk concluded.
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