Perspectives on fertility preservation among women living with breast cancer in Ghana.

Abstract

Objective: As advanced-stage breast cancer is increasingly diagnosed among women of reproductive age, treatment involving gonadotoxic chemoradiation could compromise fertility. Fertility preservation (FP) offers breast cancer survivors the opportunity to have biological children following cancer treatment. However, in Ghana, little is known about the lived experience of women with breast cancer and their access or barriers to FP services. This study explored the knowledge, attitudes, and challenges regarding FP among Ghanaian women undergoing breast cancer treatment.

Methods: Using a qualitative design approach, we explored the FP perspectives and experiences of women undergoing breast cancer treatment at an Oncology & Radiotherapy Centre in a tertiary hospital in Ghana. Participants were purposively selected following ethical approval. The women's experiences were captured through semi-structured interviews, audio-recorded concurrently and subsequently transcribed for analysis. Using thematic analysis, key themes and patterns were identified and documented to reflect the women's perspective on FP.

Results: In all, 15 patients participated, aged 32-49 years, mostly with basic education and majority diagnosed with breast cancer within 5 years. Participants' knowledge and awareness about FP was limited. FP was considered unpopular, secondary to cancer treatment and a redundant option based on participants' fertility or parity history. While participants perceived FP as a viable way to safeguard fertility, they expressed religious beliefs, financial constraints, affordability, and insufficient success stories on FP may inhibit its uptake in Ghana. Conversely, participants argued that adequate education about FP and its benefits, and subsidized cost of care could enhance its uptake.

Conclusions: The burden of cancer care, lack of awareness and testimonials, religious beliefs, and financial constraints constitute significant barriers to FP uptake among breast cancer patients in Ghana. Emphasizing FP during pre-treatment counselling aligns with patients' rights to this knowledge and holds prospects to increase uptake.