Improving fertility care for breast cancer patients
Clinical nurse specialist Grete Brauten-Smith on a resource to help healthcare professionals discuss fertility preservation options with younger women.
Clinical nurse specialist Grete Brauten-Smith on a resource to help healthcare professionals discuss fertility preservation options with younger women
Over the years I’ve spoken to more than a thousand younger women with breast cancer at our Younger Women Together events across the UK. For breast cancer patients under 45, these events offer a unique chance to attend workshops and hear expert talks, while meeting others diagnosed at a similar age. What I hear over and over is the huge difference in fertility referrals offered.
Chemotherapy can cause infertility, so it is crucial women are offered fertility preservation options before starting cancer treatments. Yet, while some women I have met had positive experiences, most were not offered a conversation with a fertility specialist, adding extra emotional strain during an already challenging time.
It was concerning to hear these accounts, so we sent out surveys at the end of 2014 to healthcare professionals (HCPs) and younger women with breast cancer to gain further evidence. The results confirmed what we suspected - only 12% of younger women diagnosed reported being offered a fertility referral, suggesting that an estimated 5,000 younger women with breast cancer may be missing out on fertility care.
While there are times when fertility preservation is not appropriate or wanted, it is an important issue for many younger women with breast cancer.
To improve these statistics we must have discussions about how the multidisciplinary team (MDT) can work more effectively together. With the help of a group of breast care nurses from across the UK, named Younger Women Champions, and feedback from MDTs, fertility specialists and patients, we developed a Fertility toolkit.
The toolkit offers a collection of information and tips for HCPs to improve communication between breast and fertility clinics. This will help ensure women are given the choice to have this all-important discussion with a fertility specialist.
Breast care nurses are well placed to have an initial conversation with women about the possible effects of treatment on their fertility and to offer the vital referral. We understand though, that talking to a patient with cancer about fertility can be difficult. Nurses don’t have to know all the answers, so the toolkit will provide a reference and support.
The toolkit includes:
- a fertility referral pathway flowchart – to outline what should happen
- an urgent referral form template – to input information needed by the fertility clinic
- a fertility consultation information sheet – patient information
- tips for HCPs – ways to open a conversation with a patient and in your MDT
The purpose of the toolkit is to open up discussions about fertility preservation. Establishing strong links between breast and fertility teams will offer a far more joined-up service for younger women with breast cancer. Breast Cancer Care is also campaigning to ensure clinical commissioning groups will have fertility funding available for breast cancer patients.
By working together we want to enable younger women with breast cancer to make an empowered decision about their future fertility.
To speak to someone about the Fertility toolkit call 0808 800 6000.
About the author
Grete Brauten-Smith, Clinical Nurse Specialist - Younger Women at Breast Cancer Care