In 2006, the American Society of Clinical Oncology (ASCO) published fertility preservation guidelines for clinicians to follow when treating young cancer patients in response to the increased likelihood of young men and women at risk of losing their fertility due to cancer and its treatment. Nonetheless, studies show that many young cancer patients still are not receiving important information related to their fertility, which would allow them to make informed decisions on their course of treatment.  In a new study in Current Oncology, entitled, “Fertility Risk Discussions in Young Patients Diagnosed with Colorectal Cancer,” authors, A. Kumar, A. Merali, G.R Pond and K. Zbuk performed a retrospective chart review for patients less than 40 years of age with newly diagnosed colorectal cancer between 2000 and 2009, to identify the frequency of fertility preservation discussions.

The investigators reviewed eligible health charts for any indication that a fertility discussion had taken place after initial diagnosis. If there was a documented discussion, investigators then reviewed the charts to see if any follow-up had been done via an oncologist or a reproductive specialist.  Demographic and treatment information was extracted from the charts.

The study identified 59 patients who met all the criteria for inclusion (18-40yrs old, year of diagnosis, stage of cancer, type of treatment, etc). Of those 59 patients, 35 were men and 24 were women. Their average age was 34, and 95% of the selection had received chemotherapy treatment for their cancer.

The study found that only 20 of the 59 patients received fertility counseling and 2 of those 20 did not receive a follow-up discussion with a reproductive specialist. The study also found that age was the most important factor as to whether or not an individual received a fertility discussion. Men and women under the age of 35 were more likely to receive a fertility discussion than those over 35.  Finally, the investigators observed no significant difference in the frequency of discussions after 2006, when the ASCO guidelines were published.

The results of this study demonstrate that the fertility risks associated with colorectal cancer treatment and fertility perseveration options available to newly diagnosed cancer patients, were discussed infrequently.  As we know, fertility preservation options are available; however, unless a patient or their clinical team are proactive about exploring those options, young cancer patients may not be getting the pertinent fertility information they need in a timely fashion. This study highlights the need for more health care professionals to discuss fertility risks with their patients prior to undergoing cancer treatment.

Read, “Fertility Risk Discussions in Young Patients Diagnosed with Colorectal Cancer.”

As you may already know, The Oncofertility Consortium partnered with the Endocrine Society to release the free, iSaveFertility iPhone App nearly a year ago this week.  iSaveFertility was developed to give oncologists and fertility specialists a quick reference guide for preserving the fertility of children, women and men diagnosed with cancer. In today’s world, more and more health care professionals are using smartphone technology as part of their daily lives, with apps being designed in lieu of cumbersome pocket-guides to meet their diagnostic and medical information needs. In oncology and fertility care, access to the most recent information and tools available at the point-of-care is critical for both providers and patients in the fight against cancer, thus iSaveFertility was born!

In July of last year, the Oncofertility Consortium partnered with the Cancer Knowledge Network (CKN), an affiliate of the Canadian journal, Current Oncology, to reach the larger  population of oncology professionals in an effort to provide insight into the complex health care and quality-of-life issues that concern cancer patients whose fertility may be threatened by disease or its treatment. As a result of this partnership, CKN is working with us to help disseminate information about fertility and cancer awareness across Canada by utilizing the iSaveFertility iPhone app in healthcare settings. It is the objective of all those involved with CKN and the Onocfertility Consortium to provide an open-access, multi-disciplinary forum for oncologists and cancer-care professionals to connect, become informed and initiate discourse.

Utilizing new technology, such as the iSaveFertility, is helping to change the face of comprehensive cancer care. Providers rely on the apps to give them the most up-to-date healthcare information, which in turn benefits the patient by ensuring they are well-informed and in control of their cancer treatment. We are excited to engage with the larger oncology community and to improve care to cancer patients with the help of CKN and iSaveFertility.

To learn more about iSaveFertility, visit SaveMyFertility.org and download the free app. To learn more about CKN, please read our past blog post or visit, Cancer Knowledge Network.

As cancer survival rates continue to increase, survivorship quality-of-life issues are also gaining more attention. One of the most debilitating conditions that breast cancer patients experience is called lymphedema. Lymphedama is an accumulation of fluid within parts of the body that is caused by reduced functioning of lymph nodes, which filter the body’s fluids to remove foreign particles such as viruses. Lymph vessels are often removed during cancer surgery and may be damaged during radiation therapy.

An article recently came out in Current Oncology on efforts to promote prevention and management of lymphedema on a national scale. While lymphedema occurs in individuals with absent or malformed blood vessels, most cases in North America are caused by cancer treatment. Lymphedema has been most investigated in breast cancer survivors and incidence rates range between 3-42%. Similar rates of lymphedema occur in soft-tissue sarcoma, gynecologic cancers, and melanoma.

In the article, the authors, Hodgson, Towers, Keast, Kennedy, Pritzker, and Allen, discuss efforts in Canada to develop a clinical, research and education strategy on lymphedema. Like the field of oncofertility, the team identified that there is a lack of global awareness about lymphedema and restricted access to lymphedema treatments, such as physical compression through bandages, surgery, or laser therapy. In addition, insufficient education for health care providers, the public, and policymakers also prevent patients from taking risk-reduction measures and getting appropriate and timely treatment. Finally, members of the lymphedema community identified the need for increased research on the prevalence of lymphedema, the best treatments for the problem, and information on financial costs.

Like oncofertility, barriers to lymphedema care include a lack of clinical clarity on the medical practitioners responsible for patient education, funding, and access for treatment.  To read more details about the need and options to advance lymphedema, read the entire article.

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October was established as breast cancer awareness month in 1985 and, since that time, improved screening and treatment significantly improved survival rates. In fact, breast cancer survivors make up the largest group of cancer survivors in North America. After treatment ends, these survivors must manage their continued surveillance, long-term and late effects, and general health more proactively than people never diagnosed with cancer. Primary care physicians often provide survivorship care to cancer patients and a recent study, “Caring for survivors of breast cancer: perspective of the primary care physician,” identified the confidence of primary care physicians to provide this complex care.

The article in Current Oncology, surveyed almost 600 primary care physicians who treat at least one breast cancer survivor, though more than half treat more than 10. These physicians were most confident in managing surveillance for cancer recurrence. However, they were least confident in providing counseling for body image, sexual health, and cancer-specific side effects, such as lymphedema. In addition, few of these primary care physicians are comfortable discussing family planning with the breast cancer survivors in their practice.

The survey also found that most physicians are happy with the oncology-primary care communication when a patient leaves the care of oncologists to work with their primary care physicians after treatment ends. According to the survey, when these physicians seek out more information about breast cancer, they prefer in-person educational events and websites but are least likely to read primary academic literature and guidelines, probably due to time restrictions. Knowing that online and in person education is preferred can be used to develop continuing education programs in the future.

As breast cancer survival rates continue to rise, the medical community must adapt to treat the long-term health of these survivors. Research provides valuable information to guide education for health care providers who continue to see these survivors’ decades after diagnosis. Furthermore, it highlights the increased need to educate primary care physicians on fertility options for cancer survivors.

Are you a cancer survivor? Help oncofertility researchers study and prevent treatment-induced fertility loss by joining the FIRST online fertility registry for cancer survivors!

The journal, Current Oncology, recently published two articles on opposite ends of the cancer timeline-diagnosis and survival. The first article, “Health care strategies to promote earlier presentation of symptomatic breast cancer: perspectives of women and family physicians,” focuses on the problem that 20%–30% of women will wait at least 3 months before seeking help for breast cancer symptoms. During these extra months the tumor may grow significantly and critically decrease a woman’s chance of long-term survival.  So what are the factors that prevent women from seeing their health care provider?

In the article, many of the women who delayed seeing a health care provider had less common symptoms of breast cancer, such as nipple discharge or inversion, than the typical presentation of a painless lump in one breast. Women who previously had false alarms – earlier lumps that had been identified as benign, also took longer to go back to their physician.

In addition to breast cancer-specific issues, some women delayed seeking out their health care provider due to earlier negative experiences with health care, such as doctors dismissing previous potential cancer symptoms or other chronic health care conditions, such as chronic fatigue syndrome, which were more debilitating.  And finally, some women simply delayed going to their doctor because they were too busy.

This research highlights the need for additional work to educate both women and health care providers on both the physical symptoms of cancer and other strategies to encourage earlier presentation. In celebration of Breast Cancer Awareness month, get informed about the risks and symptoms of breast cancer. Read the entire article in Current Oncology and stay tuned for our next blog which will discuss the other end of the cancer time-line, survivorship!

Are you a cancer survivor? Help oncofertility researchers study and prevent treatment-induced fertility loss by joining the FIRST online fertility registry for cancer survivors!

The other day, I was reading a journal article, ”Pan-Canadian initiatives in colorectal cancer screening: adopting knowledge translation tools to accelerate uptake and impact,” on Canadian efforts to increase colorectal cancer (CRC) screenings, when it struck me how similar they are to our efforts in oncofertility. In 2001, the Canadian Preventative Services Task Force recommended that all people 50-74 years old receive routine CRC screenings and that local programs be developed to increase participation. Three years later, fewer than 15% of age-appropriate people were up-to-date on their CRC screening and it wasn’t until 2007 that local leaders started to work together to increase this important step in early-cancer identification.

This information reminded me of those in oncofertility, that:

• In 2006, the American Society of Clinical Oncology (ASCO) published fertility preservation guidelines for oncologists.
• Since that time, the American Academy of Pediatrics, the American Society of Reproductive Medicine, and others state that young people should be informed and educated about the reproductive risks of cancer treatment and fertility options.
• Research shows that many of today’s young cancer patients still do not receive adequate fertility information.

While this data may initially seem frustrating, the Canadian program described in Current Oncology has been hard at work since 2007 to increase CRC screening rates. They did so primarily through two methods: by identifying ways to better monitor local health centers as they implemented plans to increase screening; by identifying gaps in knowledge that prevented people from complying with screening recommendations.

We at the Oncofertility Consortium are always interested in increasing provider knowledge about fertility in cancer and helping them communicate these options to patients. While data is still being identified about the effectiveness of the Canadian initiative, I look forward to the final results, as this model may be one that we in the fertility and cancer world can use to increase oncofertility patient navigation in the future.

Read the article, ”Pan-Canadian initiatives in colorectal cancer screening: adopting knowledge translation tools to accelerate uptake and impact,” in Current Oncology.

One of the missions of the Oncofertility Consortium is to educate cancer patients, providers, and the larger oncology community. We have recently joined forces with a like-minded organization, the Cancer Knowledge Network, an affiliate of the journal, Current Oncology. Together, our organizations will promote advances in cancer research to providers and improve care to patients. The following guest blog by the Cancer Knowledge Network will be the first of many collaborations between our groups.

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By Lorne Cooper-It is with considerable pleasure that I introduce the partnership between the Oncofertility Consortium and the Cancer Knowledge Network (CKN) of the parent journal, Current Oncology. Like the Oncofertility Consortium, It is the objective of all those who have been involved in the creation of CKN to provide an open-access, multi-disciplinary online forum for oncologists and cancer-care professionals to connect, become informed and initiate discourse.

We are excited to initiate an information exchange with the Oncofertility consortium.  Our readers will benefit from the insight this esteemed organization can provide us regarding the complex health care and quality-of-life issues that concern cancer patients whose fertility may be threatened by disease or its treatment.

About the Cancer Knowledge Network

Established in 1994, Current Oncology is a Canadian-based and internationally distributed peer-reviewed medical journal. Published on a bi-monthly basis, in addition to special supplemental issues, the journal represents a multidisciplinary medium that encompasses health care workers in the field of cancer therapy. We have an international readership of over 3,000 oncologists, academics and industry professionals.  Current Oncology is proudly published by Multimed Inc. and is indexed/covered in PubMed, EMBASE (Excerpta Medica Database), Scopus, Journal Selector, CrossRef, Index Copernicus, DOAJ (Directory of Open Access Journals), Google Scholar, EMCare,EBSCOhost.com Research Databases, Science Citation Index Expanded (SciSearch), and Journal Citation Reports/Science Edition. Following publication in Current Oncology, the full text of each article is available immediately and archived in PubMed Central (PMC), the U.S. National Library of Medicine’s digital archive of biomedical and life sciences journal literature. It is also available in the databases of 100 libraries worldwide, and is a participant of the HINARI program.  Current Oncology welcomes international papers.  Contact us to learn about our submission guidelines.

In April, 2011, Multimed Inc. launched the Cancer Knowledge Network, an interactive social website that provides a peer-reviewed forum for discussing research and issues pertinent to the oncology community.  The Current Oncology senior editorial board periodically selects journal articles to be featured in forum discussions.  Users are encouraged to participate in these online debates, which are moderated by either the study’s author or a senior editor.

The Cancer Knowledge Network also provides special content for trainees via a dedicated resident’s section, as well as a special patient’s section that focuses on the theme of “life after cancer”.  Our goal is to promote reputable modes of treatment and disease management while creating a central vehicle that promotes physician and patient dialogue, improves communication and, in the process, betters long-term outcomes and quality of life of patients who have survived cancer.

Contact us:

Yours truly,

Lorne Cooper

CEO

MultiMed, Inc.