Updated clinical guidelines published this year by ASCO “give oncology care providers an opportunity to partner with their reproductive specialist colleagues to ensure that the clinical and psychosocial needs of patients with cancer are addressed as close to the time of diagnosis as possible,” according to an article in the Journal of Oncology Practice.
Previous guidelines, published in 2006, stated that oncologists should be prepared to either “discuss fertility preservation options or refer patients who are interested to reproductive specialists.” The updated guidelines “extend the responsibility for discussion and referral for fertility preservation beyond the medical oncologist to explicitly include other physician specialties (eg, surgeons, radiation oncologists) and allied health-care professionals (eg, nurses, social workers) in the oncology care setting,” Susan T. Vadaparampil, PhD, and Gwendolyn P. Quinn, PhD, of the Moffit Cancer Center and University of South Florida, Tampa, explained.
The new guidelines also stress the importance of discussing fertility-preservation options and referring to reproductive specialists early, before cancer treatment begins. “As such, the need for cancer care institutions to establish formal or informal relationships with reproductive specialists to facilitate ongoing communication serves to ensure timely access to fertility preservation consults and/or services,” the authors wrote.
The updated guidelines recognize the point of transition between pediatric and adult oncology care settings may be a unique juncture at which communication between oncology providers and reproductive specialists is needed,” the authors stated. The guidelines cite studies suggesting that adult survivors of pediatric cancer wish they had been informed of fertility options or feel regret about not having options.
Along with established methods of fertility preservation, such as sperm and oocyte cryopreservation, the guidelines suggest “that providers present other investigational methods (eg, ovarian and testicular tissue cryopreservation,” the authors noted.
“The revised guidelines also encourage clinicians to document discussions about fertility preservation in the medical record, suggesting important changes in the perception of fertility preservation discussions as a quality of care indicator,” the authors stated. ■