Addressing Fertility Issues with Female Cancer Patients

描述(申请人提供)：虽然癌症通常被认为是一种老年人的疾病，但相当少数患有癌症的女性在绝经前被诊断出来。大约40%的这类妇女经历了过渡到更年期或其他与治疗有关的生育问题。癌症导致的生育能力丧失是罹患癌症的年轻女性所经历的最具创伤的副作用之一。尽管这一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之前与绝经前妇女讨论化疗与生育相关的副作用。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对肿瘤学家的全国性调查，以填补这一知识空白。这些数据将被用于制定干预措施，鼓励和协助肿瘤学家在开始治疗之前向妇女提供与治疗相关的生育问题的信息，并将感兴趣的妇女转介给适当的专家，以了解她们可以获得的生殖治疗选择。研究的目的是：1)了解肿瘤学家对绝经前女性癌症患者化疗可能产生的与生育相关的副作用以及这些副作用对女性癌症幸存者生活质量的影响。此外，为了确定肿瘤学家对妇女生育治疗方案的了解；2)确定医生在开始治疗之前与妇女讨论生育相关问题的感知障碍；3)确定绝经前妇女的特征，降低医生向她们提出生育问题的可能性；以及4)确定肿瘤学家的特征，他们对化疗的潜在副作用最不了解，和/或认为在治疗开始之前讨论生育相关问题存在障碍，以便为干预工作提供信息。解决与癌症妇女生育年龄段有关的生育问题的医患沟通问题对公共健康的好处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。一个间接的好处将是提高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.