The Decision-making Process regarding Cancer Treatment and Fertility Preservation involving a Patient in the Late Pregnancy with Cancer and her Husband: A Case Study

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  • Hori Rie
    KANSAI University of Social Welfare, Department of Nursing
  • Tomari Yuko
    KANSAI University of Social Welfare, Graduate School of Health Sciences

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  • 妊娠後期にがんと診断された夫婦ががん治療方針と妊孕性温存について意思決定するプロセスの事例研究
  • ニンシン コウキ ニ ガン ト シンダン サレタ フウフ ガ ガン チリョウ ホウシン ト ニンヨウセイ オンゾン ニ ツイテ イシ ケッテイ スル プロセス ノ ジレイ ケンキュウ

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Abstract

<p>Objective: To clarify the decision-making process through a case study in which a patient in the late pregnancy with cancer makes decisions about cancer treatment, pregnancy continuation, and fertility preservation.</p><p>Methods: Semi-structured interviews were conducted with a patient in the late pregnancy with cancer to reflect on decision-making regarding cancer treatment and fertility preservation. An analysis was performed based on SCAT to extract texts about the decision-making process by the patient and her family, conceptualize them, and describe the storyline.</p><p>Results: The female patient, in her 30s, was diagnosed with breast cancer at 8 months of gestation. After a normal delivery, she received a mastectomy and assisted reproductive technology. Twenty-five themes were extracted regarding the decision-making process. Her and her husband’s work experience in the health care field helped them to calmly accept their situation. Because the patient had [continuation of the intention about the next child while concerns about the anti-cancer drug treatment on fertility] [concerns about the effects of the anti-cancer drug treatment on child rearing], [maternity nursing support for breastfeeding and coordinated care from her breast surgeon] as well as [guidance on newborn care for her husband] were provided. As a result, the patient [decided to take initiative to collect and integrate appropriate information]. With support from her husband and [a coordinated referral by medical staff], the patient received assisted reproductive technology for fertility preservation.</p><p>Discussion: The decision-making process was complex, involving a multidisciplinary team and family members with diverse opinions. With appropriate support from her family and care team, the patient decided to take initiative to collect and integrate information and made informed choices about treatment and fertility preservation.</p>

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