Addressing Fertility Issues with Female Cancer Patients

描述（由申请人提供）：虽然癌症通常被认为是老年人的疾病，但相当一部分患有癌症的妇女在绝经前被诊断出来。这些妇女中大约有40%经历了过渡到更年期或其他与生育有关的治疗问题。癌症导致的生育能力丧失是年轻女性癌症患者经历的最具创伤性的副作用之一。尽管这个问题对癌症后妇女的生活很重要，但肿瘤学家并不总是在开始治疗前与绝经前妇女讨论化疗与生育有关的副作用。目前没有国家数据表明这一问题的范围，或其背后的原因。这项发展研究的总体目标是设计和实施一项全国性的肿瘤学家调查，以填补这方面的知识空白。这些数据将用于指导干预措施的发展，以鼓励和协助肿瘤学家在开始治疗之前向妇女提供有关治疗相关生育问题的信息，并将感兴趣的妇女介绍给适当的专家，以了解她们可能可用的生殖治疗方案。研究目的是：1)了解肿瘤学家对绝经前女性癌症患者化疗可能产生的生育相关副作用的认识，以及这些副作用对女性癌症幸存者生活质量的影响。同时，确定肿瘤学家对女性生育治疗方案的了解；2)确定医生在治疗开始前与妇女讨论生育相关问题的障碍；3)确定绝经前妇女的特征，减少医生向她们提出生育问题的可能性；4)确定对化疗潜在副作用了解最少和/或在治疗开始前认为讨论生育相关问题存在障碍的肿瘤学家的特征，为干预靶向工作提供信息。解决与育龄癌症妇女有关的生育问题的医患沟通问题的公共卫生利益可能包括更多地使用不损害生育能力的化疗药物，以及更多地获得生殖健康咨询。一个间接的好处是提高了这些癌症幸存者的生活质量。

DESCRIPTION (provided by applicant): Although cancer is often thought of as a disease of the elderly, a substantial minority of women with cancer are diagnosed in their pre-menopausal years. Approximately 40% of such women experience transition to menopause or other treatment-associated problems with fertility. Loss of fertility through cancer is one of the most traumatic side effects experienced by younger women with cancer. Despite the importance of this issue to women's lives following cancer, oncologists do not always discuss the fertility-related side effects of chemotherapy with pre-menopausal women prior to initiating treatment. There is currently no national data indicating the scope of this problem, or the reasons underlying it. The overall objective of this developmental study is to design and implement a national survey of oncologists to fill this gap in knowledge. This data will be used to inform the development of an intervention to encourage and assist oncologists in providing information to women regarding treatment-associated fertility issues prior to initiating treatment, and in referring interested women to appropriate specialists to learn about the reproductive treatment options that may be available to them. Study aims are: 1)To determine oncologists' knowledge about the potential fertility-related side-effects of chemotherapy treatment for pre-menopausal women with cancer and the effect of such side effects on the quality of life of female cancer survivors. Also, to determine oncologists' knowledge of women's fertility treatment options; 2) To determine perceived physician barriers to discussing fertility-related issues with women prior to treatment initiation; 3) To identify the characteristics of pre- menopausal women that decrease the likelihood that physicians will raise fertility issues with them; and 4) To identify the characteristics of oncologists who are least knowledgeable about the potential side-effects of chemotherapy treatment and/or who perceive barriers to discussing fertility related issues prior to treatment initiation, to inform intervention targeting efforts. The public health benefits of addressing the issue of physician-patient communication about fertility issues relevant to women with cancer in their reproductive years may include greater use of chemotherapeutic drugs that are not fertility impairing and also greater access to reproductive health counseling. An indirect benefit would be enhancement of the quality of life of this population of cancer survivors.