Talking with teenagers about fertility can be awkward and uncomfortable. Talking with teenagers and their families about a cancer diagnosis is devastating. How do we do both at the same time and ensure that the importance of fertility preservation is understood in light of the traumatic timing? Studies among adult cancer survivors show that fertility is their most prevalent concern, thus we need to develop a method for relaying this information to young cancer patients and their families in a timely and sensitive manner. In the article, “The Birds and the Bees and the Bank: Talking with Families Amidst a Cancer Diagnosis,” by Gwendolyn P. Quinn, Caprice A. Knapp, and Devin Murphy, in Oncofertility Medical Practice: Clinical Issues and Implementation, the authors propose using a new method for initiating these discussions.
Patients and their families often look to health care providers to guide them in their decision-making process. Receiving a cancer diagnosis is very traumatic and can leave both the patient and their parents in a highly emotional state. They may not remember all that they were told in that initial discussion, but unfortunately decisions need to be made in that moment that will have an impact on their life many years later. Depending on the cancer diagnosis and the treatment protocol, loss of fertility may be a consequence., and needs to be addressed.
Studies show that communicating with patients using interactive tools, increases a patients understanding of the information being presented. Additionally, understanding is further increased, specifically when individual decision-making is involved, using a values clarification exercise or tool. According to the authors, “A values clarification tool (VCT) is often used in environments in which a common shared vision or purpose is required, the goal of which may be to develop the common vision, define roles, or develop long-range plans.” A VCT serves as a primer for future decision-making because it does not asks participants to ponder hypothetical situations, but instead aids them in defining the values and beliefs that influence their behavior. The authors maintain, “The open-ended statements of the VCT encourage patient/parent and administrator to begin a dialogue so that the patient/parent may process the idea of having children first, and then consider their feelings about possibly not being able to have children in their future.”
Allowing young patients to take an active role in making decisions about their fertility by evaluating their own beliefs and behaviors, and processing the idea of potential infertility, can actually serve to empower their decision-making process. Studies show that adolescent and teenage cancer survivors have clear expectations about parenthood and having biological children, yet are not always able to fully express these desires. The VCT can be a helpful tool in initiating these types of discussions. Read, “The Birds and the Bees and the Bank: Talking with Families Amidst a Cancer Diagnosis.” Learn more about your fertility options by visiting our Virtual Patient Navigator.
