Study Finds Young Cancer Patients Underuse Sperm Banking
Fewer than 44 percent of 146 adolescent and young adult cancer patients at risk for
infertility surveyed by researchers reported successfully banking sperm prior to starting
cancer treatment. The patients most likely to attempt sperm banking were those who
had met with a fertility specialist or whose parents recommended the procedure. The
researchers say their findings suggest more efforts are needed to increase awareness
about fertility risk among young patients and their parents.
LEARN MORE IN THE ONLINE FIRS T OC T. 4, 2017, JOURNAL OF CLINICAL ONCOLOG Y.
in Ann Arbor, skin and breast cancer
patients use apps developed by Michael
Sabel, a surgical oncologist at the center.
One of these apps, Breast Cancer Ally,
prompts patients receiving chemotherapy to answer questions about symptoms such as fever, nausea and vomiting.
If symptoms are severe, the app directs
the user to take appropriate steps, from
making an appointment with an oncologist to calling 911.
Sabel says that many patients respond
positively to the app initially, but over
time, their enthusiasm wanes. “We
have to think about how to keep people
engaged,” he says. He also notes that
the apps are not meant to replace com-
munication with care providers, but to
enhance it. “Patients sometimes don’t
call because they don’t want to bother
us, even though they should,” he says.
“If we intervene early, we can really
head off a more serious complication
down the road.”
Basch is now heading up a clini-
cal trial that will compare the app
to routine care in 1,000 patients at a
number of different cancer centers
nationwide. “Cancer doctors and nurses
really care about making people feel
better, but we don’t always know what’s
happening with our patients,” he says.
“For a whole host of reasons, people
don’t feel comfortable picking up the
phone and letting their doctor or nurse
kno w.” —CAMERON WALKER
Cancer patients often find themselves in the emergency room (ER) when symptoms
like vomiting, diarrhea and pain become severe. Yet, a recent study found that
many of these visits might have been avoided if patients had been treated sooner
for their symptoms.
Laura Panattoni, a health economist at the Hutchinson Center for Cancer Outcomes
Research in Seattle, and her colleagues looked at ER visits for more than 5,800 cancer
patients with solid tumors who lived in western Washington state and had been
treated with radiation, chemotherapy or both between 2011 and 2015. During that time,
27 percent of the patients went to the ER at least once.
The researchers compared the symptoms the patients reported to a list of
potentially preventable chemotherapy-related side effects developed by the
Centers for Medicare and Medicaid Services. They found that 53 percent of the
ER visits by patients with cancer-related symptoms could have been prevented
with earlier treatment. Avoiding the ER would have also reduced costs for
treating the symptoms.
Pain was the No. 1 symptom that sent cancer patients to the ER. “There are a lot
of ways [doctors] could manage pain outside of the ER that would be better for the
patients and also lower costs,” Panattoni says.
Cancer centers can help people going through chemotherapy address their
symptoms earlier by providing same-day appointments, extended office hours
and telephone triage nurses. Urgent care centers designed specifically for
cancer patients can also help. In 2012, Johns Hopkins Sidney Kimmel Cancer
Center in Baltimore opened a dedicated urgent care facility that now serves
patients from 8 a.m. to 8 p.m. Monday through Friday. In 2014, the center
treated about 800 people; in 2016, close to 2,000 were treated.
The nurses and physicians who work in the urgent care center have expertise in
treating cancer patients, unlike many ER doctors. This can benefit patients in
many ways. For example, cancer patients with a fever who go to the ER may not
be seen for several hours; in the cancer urgent care center, providers know the
fever may be a symptom of neutropenia (a low white blood cell count) and that
patients should immediately be treated with antibiotics, says Sharon Krumm,
director of nursing for the cancer center.
“If [cancer patients] have a broken bone or a heart attack or a stroke, we want
them to go to the emergency room,” Krumm says. But for symptoms related to
cancer and cancer treatments, “the ER is not always the best place for a patient
with a cancer diagnosis.” —C. W.
A PRESCRIPTION FOR FEWER ER VISITS
Communicating your symptoms to your care provider
can help you feel better sooner and may also help you
skip a trip to the emergency room. Here are ways you