It was great to see this psychologist sit down with a family and broach this difficult topic. Parents are always trying to get through the initial diagnosis talks, are signing multiple papers for treatment, learning about studies their child can join, and are adjusting to treatment overall. Many families, in my experience, feel blindsided when being asked to discuss topics on fertility as their children are young and sometimes have not even learned about puberty or development. I think this provider did a fantastic job of providing all the options and supporting this family. It would be interesting if these conversations could become the standard of care and discussed with every patient just as we draw labs, discuss treatment options, talk about course of treatment etc.
I think this brings up a very good point and it is on all healthcare providers to be able to converse about this topic. In my experience, some of the most honest and fruitful conversations have happened when drawing labs at 0400 in the morning and so everyone needs to be informed about these topics. No longer is the goal of chemotherapy to just treat cancer and hope that you live a couple more years. The goal of the chemotherapy would be to help you continue carrying out your natural function, to pass on your genes.
With the introduction of Car-T, CRISPR and other cell therapies that are becoming more and more prevalent (hopefully insurances jump on the same train), fertility problems, in relation to oncology treatment, may start to decline as these would be the frontline therapies that are being used. There have been way too many patients that I have conversed with wanting to have kids after treatment. When asking them if they had saved their eggs or sperm, quizzical looks were their response. It is very difficult to hide the feelings of “it may be too late then.”
The lack of the holistic treatment plan amongst the healthcare system is a bit troublesome.