Facilitating reproductive choices: the impact of health services on the experiences of young women with breast cancer.

Abstract:

OBJECTIVE:Chemotherapy and hormone treatments carry significant implications on the fertility of young women with breast cancer. Increasingly, nulliparous women experience fertility dilemmas due to rising survival rates and pregnancy delay. This qualitative study investigated women's responses to being told that treatments affected their fertility and how their interactions with health services impacted on their experiences. METHODS:Twenty-four women under 40 years participated in three focus groups using a flexible interview structure. Data were analysed using content analysis and participants subsequently member checked the themes generated. RESULTS:The priority for most women was survival, although women without children were more willing to take risks. Many women felt that pregnancy after breast cancer and methods of egg harvesting carried a significant risk to survival and fears appeared to be increased by conflicting advice from health professionals. Overall, the women felt the cancer, its treatment options and the health service itself had each robbed them of choice. Hence, with hindsight, many said they would have welcomed an open and honest discussion with a fertility expert to maximise their options. CONCLUSIONS:Young women with breast cancer face complex decisions regarding their fertility and treatment options. Survival remains the priority for the majority of women. Although there is a paucity of evidence concerning many fertility issues, it is essential that available options and any potential risks are discussed in a coherent, objective fashion. Early referral to specialist fertility services that provide clear, cohesive advice can aid informed decision making.

journal_name

Psychooncology

journal_title

Psycho-oncology

authors

Lee RJ,Wakefield A,Foy S,Howell SJ,Wardley AM,Armstrong AC

doi

10.1002/pon.1826

subject

Has Abstract

pub_date

2011-10-01 00:00:00

pages

1044-52

issue

10

eissn

1057-9249

issn

1099-1611

journal_volume

20

pub_type

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