Impact of physicians’ personal discomfort and patient prognosis on discussion of fertility preservation with young cancer patients

ObjectiveThis study sought to determine if physician's personal discomfort with the topic of FP and a patient's prognosis would have an impact on the likelihood of discussing FP with cancer patients.MethodsData from larger studies of qualitative semi-structured interviews with pediatric and adult oncologists were analyzed using grounded theory and crystallizing immersion method to examine the themes of “personal comfort” and “patient prognosis” in relation to discussion.ResultsResults showed that, across both physician types, the majority of respondents’ personal comfort with the topic of FP was related to the likelihood of discussion. Personal discomfort manifested as: (a) lack of knowledge; (b) language/cultural barriers; (c) perception that subject of FP adds more stress to situation; (d) general uncertainty about success of FP methods. Data also indicate physicians do not feel discussions are appropriate for patients with poor prognosis.ConclusionDespite the ASCO guidelines suggesting physicians should discuss FP with all patients, the majority of physicians are not following these guidelines.Practice implicationsImproved training on recognition of such biases and communication strategies may improve the quality and frequency of such discussions. Involving the entire healthcare team in discussions may alleviate the need for physicians to have sole responsibility.