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Fertility as a priority among at-risk adolescent males newly diagnosed with cancer and their parents

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Abstract

Purpose

Infertility is a frequent consequence of cancer therapy and is often associated with psychological distress. Although adult survivors prioritize fertility and parenthood, this issue remains unexplored among adolescent males. This study examined future fertility as a priority (relative to other life goals) at time of diagnosis for at-risk adolescents and their parents.

Methods

Newly diagnosed adolescent males (n = 96; age = 13.0–21.9 years) at increased risk for infertility secondary to cancer treatment prioritized eight life goals: to have school/work success, children, friends, wealth, health, a nice home, faith, and a romantic relationship. Patients’ parents (fathers, n = 30; mothers, n = 61) rank-ordered the same priorities for their children.

Results

“Having children” was ranked as a “top 3” life goal among 43.8 % of adolescents, 36.7 % of fathers, and 21.3 % of mothers. Fertility ranked third among adolescents, fourth among fathers, and fifth among mothers. Future health was ranked the top priority across groups, distinct from all other goals (ps < 0.001), and fertility ranked higher than home ownership and wealth for all groups (ps < 0.001). For adolescents, low/moderate fertility risk perception was associated with higher fertility rankings than no/high risk perceptions (p = 0.01).

Conclusions

Good health is the most important life goal among adolescents newly diagnosed with cancer and their parents. In this relatively small sample, adolescents prioritized fertility as a top goal, parents also rated fertility as being more important than home ownership and financial wealth. Health care providers should communicate fertility risk and preservation options at diagnosis and facilitate timely discussion among families, who may differ in prioritization of future fertility.

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Acknowledgments

This work was supported by the National Institute of Child Health and Human Development (HD-061296, Klosky–PI), and National Cancer Institute (CA-21765, Gilbertson-PI), with support provided to St. Jude Children’s Research Hospital by the American Lebanese Syrian Associated Charities (ALSAC). As the principal investigator on the sponsoring R21, Dr. Klosky has full control of the data reported upon in this manuscript. No conflicts of interests were reported by any of the authors.

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Authors and Affiliations

  1. Department of Psychology, St. Jude Children’s Research Hospital, 262 Danny Thomas Place, Memphis, TN, 38105-2794, USA

    James L. Klosky, Jessica L. Simmons, Kathryn M. Russell, Gina M. Sabbatini, Kristin E. Canavera, Jason R. Hodges & Michael J. McDermott

  2. Department of Psychology, The University of Memphis, Memphis, TN, USA

    Jessica L. Simmons

  3. Department of Psychology, Winona State University, Winona, MN, USA

    Rebecca H. Foster

  4. Department of Psychology, The University of Mississippi, Mississippi, MS, USA

    Leslie R. Schover

  5. Department of Behavioral Science, MD Anderson Cancer Center, Houston, TX, USA

    Michael J. McDermott

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  1. James L. Klosky
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  2. Jessica L. Simmons
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Correspondence to James L. Klosky.

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Klosky, J.L., Simmons, J.L., Russell, K.M. et al. Fertility as a priority among at-risk adolescent males newly diagnosed with cancer and their parents. Support Care Cancer 23, 333–341 (2015). https://doi.org/10.1007/s00520-014-2366-1

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  • DOI: https://doi.org/10.1007/s00520-014-2366-1

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