Presentation Authors: Kelly Walker*, Joris Ramstein, James Smith, San Francisco, CA
Introduction: The use of Tyrosine Kinase Inhibitors (TKI) has revolutionized the long-term survival of many patients in their battle against certain cancers. The risk of infertility caused by cancer treatments is a primary concern for many cancer patients, including male survivors. This study examines patient regret about fertility preservation (FP) decisions among male cancer patients exposed to Tyrosine Kinase Inhibitors.
Methods: A retrospective cohort study was performed to evaluate feelings of regret about fertility preservation among men undergoing or having undergone TKI treatment. Study participants were recruited from cancer patients seen at UCSF Oncology Clinics between 2012 and 2017. There were a total of 79 men enrolled and 76 men (96%) completed The Effect of TKIs on Male Reproductive Health and Sperm Function questionnaire including cancer history, counseling about impact on cancer treatment on fertility, obstacles to fertility preservation, and satisfaction with treatment decisions.
Results: While 26 patients (34%) said they would like to have children in the future and 32 (42%) had some degree of concern that their cancer treatment might affect their fertility, 36 (47%) were reported not receiving any information about the fertility risks of TKI by their medical team. Eighteen (24%) considered FP prior to their cancer therapy, and 8 (11%) attempted FP. When comparing desire to have a child to FP service seeking, 54% of those who desired children in the future considered FP compared to 8% in those who didnâ€™t wish to have children in the future (p < 0.001), and 27% of those who desired children in the future attempted FP compared to 2% in those who didnâ€™t wish to have children in the future (p=0.001). Regarding decision satisfaction regarding FP, 23% of those who desired children in the future disagreed with â€œI made the right decisionâ€ compared to 3% in those who did not wish to conceive (p=0.003); similarly, 19% of those who wished to have children in the future agreed with â€œI regret the choice I madeâ€, compared to 6% in those who did not (p=0.09).
Conclusions: An overwhelming percentage of men who desired to father children in the future were not provided with enough information about the potential fertility risks of TKI cancer treatments. Furthermore, those who desired children in the future were 3 to 6 times as likely to believe they had not made the right decision or to regret not seeking fertility preservation as those who had no interest in having future children. These findings highlight the need not only to discuss the potential risks of TKI on fertility, but also to recognize and provide supportive care to patients interested in fertility preservation.