Editorial
Copyright ©The Author(s) 2015. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Med Genet. Nov 27, 2015; 5(4): 52-59
Published online Nov 27, 2015. doi: 10.5496/wjmg.v5.i4.52
Oncofertility in adolescent and young adult hereditary cancer: Considerations for genetics professionals
Gwendolyn P Quinn, Beth N Peshkin, Ivana Sehovic, Meghan Bowman, Christina Tamargo, Susan T Vadaparampil
Gwendolyn P Quinn, Susan T Vadaparampil, Health Outcomes and Behavior Program, Moffitt Cancer Center, Department of Oncologic Sciences, Morsani College of Medicine, University of South Florida, Tampa, FL 33612, United States
Beth N Peshkin, Cancer Prevention and Control Program, Georgetown Lombardi Comprehensive Cancer Center, Washington, DC 20007, United States
Ivana Sehovic, Meghan Bowman, Christina Tamargo, Health Outcomes and Behavior Program, Moffitt Cancer Center, Tampa, FL 33612, United States
Author contributions: Quinn GP, Peshkin BN, and Vadaparampil ST conceived the design and outline of the manuscript; Sehovic I, Bowman M, and Tamargo C conducted the literature review; all authors participated in the analysis and interpretation of data and in drafting the article and the revision; all authors give final approval of the version submitted.
Conflict-of-interest statement: The authors have no conflicts of interest to disclose.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Correspondence to: Gwendolyn P Quinn, PhD, Health Outcomes and Behavior Program, Moffitt Cancer Center, Department of Oncologic Sciences, Morsani College of Medicine, University of South Florida, 12902 Magnolia Drive MRC CANCONT, Tampa, FL 33612, United States. gwen.quinn@moffitt.org
Telephone: +1-813-7451359 Fax: +1-813-4498019
Received: June 29, 2015
Peer-review started: July 4, 2015
First decision: July 31, 2015
Revised: August 7, 2015
Accepted: September 25, 2015
Article in press: September 28, 2015
Published online: November 27, 2015
Abstract

Adolescents and young adults (AYA) with a cancer diagnosis or those at risk for cancer due to hereditary cancer syndromes may benefit from genetic counseling and testing not only to manage personal risk but also to address reproductive concerns, especially fertility. The opportunity for genetic counselors to provide important risk information is relevant to both the newly diagnosed as well as to unaffected carriers and survivors. However, genetic counselors may need additional training in reproductive options related to AYA cancer to provide this valuable counsel. This commentary uses hereditary breast and ovarian cancer syndrome as a model to highlight important considerations when discussing preimplanatation genetic diagnosis and prenatal diagnosis, particularly in the context of expanded testing for hereditary cancer risk including multigene panels or whole exome or whole genome sequencing. Other hereditary cancers are also addressed; however, less is known about the psychosocial and fertility concerns in these AYA populations. Additionally, we provide an overview of the concept of “oncofertility” - the linkage between cancer care and reproductive medicine that aims to expand the reproductive opportunities of cancer patients - and offer support for the expansion of guidelines to include genetic counselors in AYA cancer patients’ treatment planning related to reproductive health and fertility.

Keywords: Fertility, Oncology, Genetic counselors, Decision-making, Oncofertility, Adolescent young adults, Training, Health professionals

Core tip: Genetic counseling and testing holds great promise for adolescents and young adults (AYA) with cancer or potentially at risk for cancer. Oncofertility, the connection between reproductive medicine and oncology, provides expanded prospects for AYA to achieve childbearing and parenting goals. Genetic counselors and experts may benefit from expanded oncofertility training to provide counsel to AYA and aid in improving quality of life. Newer genomic technologies available for testing such as multi-gene testing and whole exome sequencing combined with advances in assisted reproductive technology offer novel opportunities for AYA to achieve reproductive goals.