Understanding the Lived Fertility Preservation Experience From Diagnosis to the Start of Adjuvant Therapy: A Study of Young Breast Cancer Survivors
Abstract
Purpose
The purpose of this phenomenological study was to explore and gain an in-depth understanding of the lived fertility preservation experience of young female breast cancer survivors from diagnosis prior to the start of adjuvant therapy. The knowledge gained from the findings of this study may provide insights for nursing practice, research, and academia.
Background
Premenopausal women often present with later-stage disease and a prognosis far worse than women who develop breast cancer later in life. In addition, this disease in younger women tends to be of a more aggressive biological subtype, with outcomes that are significantly worse than for their older counterparts. The aggressiveness of the disease warrants the use of more rigorous multi-modal treatment approaches that can include surgery, chemotherapy, radiation, and hormone therapy to promote cure and prevent a recurrence. Treatment with chemotherapy can deplete the ovary of follicular stores, leading to menstrual irregularities, ovarian failure, and associated infertility. Preserving fertility is a priority for young cancer survivors, yet there is often little discussion about fertility preservation before the initiation of adjuvant therapy. Preservation of the reproductive potential of these young women is of great importance as it is timesensitive and can be significantly affected depending on the treatment.
Research Question
What is the lived experience of fertility preservation during the post-diagnosis to the pre-adjuvant therapy time period of young women with breast cancer?
Methodology
A qualitative, phenomenological method was chosen to explore the lived fertility preservation experience of young women subsequent to a breast cancer diagnosis. This study utilized the hermeneutic phenomenological perspective of Martin Heidegger (1962) along with van Manen’s (1990) methodological activities. A purposive sample of eight young women were recruited using snowballing technique, and data was collected using in-depth unstructured interviews.
Findings
Five essential themes emerged from the analysis of the data collected. The essential themes developed from the data were: (1) Grateful for Care and Support from Others; (2) Preserving Optionality During Chaos; (3) Overwhelmed with the Amount and Complexities of Medical Information; (4) Unpleasant Symptoms; and (5) Assuring Temporality and Preserving the Now for the Future. The themes illuminated the lived fertility preservation experience of young women. Participants verbalized their experiences, describing both the positive and negative experiences. The meaning of the fertility preservation experience for these women showed that despite the overwhelming, complex, unpleasant, and chaotic environment, participants were empowered by self-determination to preserve their fertility. In doing so, they found hope in protecting their future and were grateful for their network and the support they received. The findings of this study has implications for the nursing profession. Integrating this topic in curriculum for undergraduate and graduate programs will expand the knowledge base for nurses and foster a willingness to openly educte, advocate, and provide evidenced-based nursing care during this critical period.
