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Sylvester Urologist Leads Collaborative Study on Fertility Counseling Prior to Chemotherapy

For younger cancer patients, fertility counseling at the time of diagnosis is important for making family planning decisions, according to Ranjith Ramasamy, M.D., a clinician and researcher at Sylvester.

“Chemotherapy and radiation treatment can affect reproductive health temporarily or permanently,” said Dr. Ramasamy, associate professor of urology and director of the Male Reproductive Medicine and Surgery Program. “Along with discussing a cancer diagnosis and treatment options, oncologists should also talk about long-term issues, including fertility counseling.”

Dr. Ramasamy was the lead author of a collaborative study, “Evaluation of Reported Fertility Preservation Counseling Before Chemotherapy Using the Quality Oncology Practice Initiative Survey,” published July 17 in the journal JAMA Network Open. The first author was Premal Patel, M.D., a former Miller School fellow now on the faculty at the University of Manitoba in Canada; other co-authors were from Johns Hopkins University School of Medicine in Baltimore.

The study, which was funded by the Miller School’s Department of Urology, used data from the American Society of Clinical Oncology (ASCO) Quality Oncology Practice Initiative, an oncologist-led quality assessment program that surveyed 400 oncology practices biannually from 2015 to 2019.

Altogether, 6,976 patients of reproductive age were included in the study, and 43.5 percent were counseled about reproductive risks before initiation of chemotherapy. Discussions about fertility preservation were more likely to occur at academic medical centers in states with mandated laws for counseling.

“Clinicians are more likely to counsel younger patients and female patients about reproductive risks before initiation of chemotherapy,” said Dr. Ramasamy. “There was an increase in the percentage of oncologists who had these patient discussions during the study period, however, more awareness is needed about the importance of this issue.”

Ramasamy Kevin and Nancy Dwyer
Dr. Ramasamy with the Dwyer family.

Sylvester patients like Kevin Dwyer, and his wife Nancy, understand the importance of fertility counseling.

“Nancy and I were married in September 2017, and a month later I started experiencing pain in the right testicle,” said Dwyer, a 30-year-old serving at the U.S. Coast Guard Air Station in Opa-locka. “I was referred to Dr. Ramasamy, who diagnosed the cancer and spoke with us about our family planning goals. I went ahead and made a sperm preservation contribution on that initial visit.”