title: Fertility as a priority among at-risk adolescent males newly diagnosed with cancer and their parents.
abstract: OBJECTIVE
  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.
authors.affiliation: Department of Psychology, St. Jude Children's Research Hospital, 262 Danny Thomas Place, Memphis, TN, 38105-2794, USA, james.klosky@stjude.org.
authors.forename: James L
authors.initials: JL
authors.lastname: Klosky
authors.forename: Jessica L
authors.initials: JL
authors.lastname: Simmons
authors.forename: Kathryn M
authors.initials: KM
authors.lastname: Russell
authors.forename: Rebecca H
authors.initials: RH
authors.lastname: Foster
authors.forename: Gina M
authors.initials: GM
authors.lastname: Sabbatini
authors.forename: Kristin E
authors.initials: KE
authors.lastname: Canavera
authors.forename: Jason R
authors.initials: JR
authors.lastname: Hodges
authors.forename: Leslie R
authors.initials: LR
authors.lastname: Schover
authors.forename: Michael J
authors.initials: MJ
authors.lastname: McDermott
mesh_terms: D000293:Adolescent; D000328:Adult; D005220:Fathers / Q000523:psychology*; D005260:Female; D005298:Fertility; D006296:Health Services; D006801:Humans; D007248:Infertility, Male / Q000139:chemically induced* / Q000523:psychology*; D008297:Male; D009035:Mothers / Q000523:psychology*; D009369:Neoplasms / Q000523:psychology*; D012106:Research; D012959:Socioeconomic Factors; D013074:Sperm Banks; D011795:Surveys and Questionnaires; D017741:Survivors / Q000523:psychology; D055815:Young Adult
references.citation: Pediatr Blood Cancer. 2008 Jan;50(1):85-9
references.pmid: 17514741
references.citation: Cancer. 2005 Aug 1;104(3):521-4
references.pmid: 15968690
references.citation: Contraception. 2013 Aug;88(2):215-20
references.pmid: 23040131
references.citation: J Clin Oncol. 2004 Oct 15;22(20):4174-83
references.pmid: 15483028
references.citation: Cancer. 1999 Aug 15;86(4):697-709
references.pmid: 10440699
references.citation: Arch Dis Child. 2006 Feb;91(2):149-52
references.pmid: 16174641
references.citation: Pediatrics. 2012 Apr;129(4):e930-6
references.pmid: 22430446
references.citation: Klin Padiatr. 2008 May-Jun;220(3):159-65
references.pmid: 18478488
references.citation: Lancet. 2002 Aug 3;360(9330):361-7
references.pmid: 12241775
references.citation: J Clin Oncol. 2013 Jul 1;31(19):2500-10
references.pmid: 23715580
references.citation: Semin Oncol Nurs. 2009 Nov;25(4):268-77
references.pmid: 19879433
references.citation: J Pediatr Hematol Oncol. 2006 Jun;28(6):350-4
references.pmid: 16794502
references.citation: Hum Reprod. 2006 Dec;21(12):3206-16
references.pmid: 16887922
references.citation: J Clin Oncol. 2007 Aug 10;25(23):3511-7
references.pmid: 17646668
references.citation: Pediatr Blood Cancer. 2008 Mar;50(3):594-8
references.pmid: 17514733
references.citation: Cancer Epidemiol Biomarkers Prev. 2009 Apr;18(4):1033-40
references.pmid: 19336557
references.citation: Can Urol Assoc J. 2012 Oct;6(5):E174-8
references.pmid: 21539768
references.citation: Psychooncology. 2003 Mar;12(2):141-52
references.pmid: 12619146
references.citation: Cancer. 2007 Sep 1;110(5):1125-9
references.pmid: 17647219
references.citation: Psychooncology. 2012 Feb;21(2):134-43
references.pmid: 22271533
references.citation: J Clin Oncol. 2002 Apr 1;20(7):1880-9
references.pmid: 11919248
references.citation: Psychooncology. 2004 Oct;13(10):689-99
references.pmid: 15386645
references.citation: Med Pediatr Oncol. 1999 Jul;33(1):53-9
references.pmid: 10401498
references.citation: Breast Cancer Res Treat. 2010 Sep;123(2):477-85
references.pmid: 20130979
references.citation: Eur J Cancer Care (Engl). 2009 Jul;18(4):381-90
references.pmid: 19594609
references.citation: Pediatr Hematol Oncol. 2009 Jun;26(4):252-60
references.pmid: 19437327
references.citation: Br J Cancer. 1999 May;80(5-6):801-7
references.pmid: 10360658
references.citation: J Cancer Surviv. 2012 Jun;6(2):200-9
references.pmid: 22179785
references.citation: Reprod Toxicol. 2001 Nov-Dec;15(6):611-7
references.pmid: 11738514