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Deciding Your Future in Cancer’s Wake

Young cancer patients who choose fertility preservation in the midst of a cancer diagnosis reveal their belief in a future for themselves and in their body’s ability to create life even when faced with death. Oncofertility technologies offer possibilities to cancer patients asking them to contemplate creating life during a time when their own is in question.  This changes the road to parenthood in some ways, yet the overwhelming desire to create a future for oneself remains the same. Understanding this innate desire can help healthcare practitioners be more prepared to guide their patients in the decision-making process.

Even if a cancer patient chooses fertility preservation, there are no promises that they will later become parents so what drives the decision-making process if there are no guarantees? Some suggest that the hope for a future and new life embedded in the idea of fertility may negate many of the painful feelings associated with cancer. This idea of an “imagined” future allows the patient to confront their current diagnosis and the dire circumstances surrounding it with a renewed sense of hope and determination. Fertility preservation can become a coping mechanism for cancer patients allowing them to see a life post-cancer.

Although some may argue that it is irresponsible to pursue fertility preservation if you are not prepared to be exceptional parent in that moment, choosing fertility preservation doesn’t necessarily mean that you are choosing to be a parent. It means you are choosing to have options. It means you are protecting your right to have a biological child when and if you decide that it is right for you. For adolescents, it may mean you are placing value on your future and your imagined self as an able and fit parent. In studies, researchers have found that an individual’s capacity to aspire to a healthy and positive future is often linked to their current well-being.

In order to provide the best possible care for cancer patients seeking fertility preservation, the healthcare community needs to understand the decision-making mechanisms underlying those choices. It may be the innate desire to have a child or it may be a method for creating future goals and setting the stage to achieve those goals. Either way, they need the proper support and guidance to navigate the intersection between life and death. To learn more about this topic, please read “Choosing Life When Facing Death: Understanding Fertility Preservation Decision-Making for Cancer Patients,” by Shauna L. Gardino, PhD and Linda L. Emanuel, PhD in Oncofertility: Ethical, Legal, Social, and Medical Perspectives.

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