Episode 319: Difficult Conversations About Pregnancy Testing in Cancer Care

"For people diagnosed with cancer that are of childbearing potential, we have to consider how [pregnancy] testing could impact them. So we never know what someone has been through, and it's important to lead with empathy while providing education of the importance of this testing. So someone may find now that pregnancy testing is a dreaded experience instead of what they thought would be a joyous one," Marissa Fors, LCSW, OSW-C, CCM, director of specialized programs at CancerCare in New York, told Jaime Weimer, MSN, RN, AGCNS-BS, AOCNS®, manager of oncology nursing practice at ONS, during a conversation about the psychosocial aspects of pregnancy testing in cancer care.

Music Credit: "Fireflies and Stardust" by Kevin MacLeod

Licensed under Creative Commons by Attribution 3.0

The planners and faculty for this episode have no relevant financial relationships with ineligible companies to disclose. ONS is accredited as a provider of NCPD by the American Nurses Credentialing Center's Commission on Accreditation.

Learning outcome: Learners will report an increase in knowledge related to the patient experience of pregnancy testing during cancer treatment.

Episode Notes

• The NCPD activity for this episode has expired, but you can still earn NCPD through many other ONS Podcast episodes. Find a full list of opportunities.
• Oncology Nursing Podcast episodes:
  • Episode 311: Standardized Pregnancy Testing Processes in Cancer Care
  • Episode 293: Access to Care: How to Manage Moral Dilemmas and Advocate for Your Patients
  • Episode 262: LGBTQ+ Inclusive Nursing Care Begins With Using Supportive Language
  • Episode 217: Support Pregnant and Postpartum Patients During Cancer Diagnosis and Treatment
  • Episode 211: Apply the LGBTQIA+ Lived Experience to Your Patient Interactions
  • Episode 208: How to Have Fertility Preservation Conversations With Your Patients
• ONS Voice articles:
  • Cultural Humility Is a Nursing Clinical Competency
  • The Case of the Pregnancy Predicament
  • Transgender Patient Populations: Inclusive Care Involves Listening and Communicating
  • Trauma-Informed Care Provides Person-Centered Support for Patients During Deep Distress
  • Use Active Listening to Engage More Deeply in Patient Discussions
• ONS book: Oncology Nurse Navigation: Delivering Patient-Centered Care Across the Continuum (second edition)
• Clinical Journal of Oncology Nursing articles:
  • Pregnancy and Cancer Treatment: Developing a Standardized Testing Policy and Procedure
  • Unintended Pregnancy: A Systematic Review of Contraception Use and Counseling in Women With Cancer
• ONS Congress® abstract: System Approach to Fertility Preservation and Pregnancy Status During Active Cancer Treatment
• ONS Huddle Cards:
  • Fertility Preservation
  • Sexuality
• ECHO Training Program (Enriching Communication Skills for Health Professionals in Oncofertility)
• Journal of the National Comprehensive Cancer Network article: Pregnancy Screening in Patients With Cancer

To discuss the information in this episode with other oncology nurses, visit the ONS Communities.

To find resources for creating an ONS Podcast Club in your chapter or nursing community, visit the ONS Podcast Library.

To provide feedback or otherwise reach ONS about the podcast, email [email protected].

Highlights From This Episode

"In everyday life, pregnancy testing is actually still really complex. It's more than just the positive pregnancy test and the happy parent we may see on commercials. For those that are hopeful for a positive test, there's still a lot of anxiety, worry, fear, maybe before, during, or after the results. And I think about how long this person has been trying to conceive and the financial impacts involved, change in family dynamics. What if that test comes back negative? Then I think about the potential disappointment or the heartbreak. I also consider the flipside—those that are scared of a positive result for fears of becoming pregnant for a range of different reasons." TS 3:40

"I think it's important to always lead with empathy and kindness and an open mind. So you don't want to assume you know or understand how a person feels or may respond. Allow your patients to share with you how they're feeling in a nonjudgmental manner. This could be an incredibly vulnerable moment, and nurses can be a valuable source of support. Take a moment to just listen, normalize their feelings or let them ask questions. And I recognize it can be difficult to know what to say or do, but sometimes just being there for someone in those ways is incredibly meaningful and opens up more effective communication and trust." TS 8:48

"For the patient that has been trying to conceive, taking another pregnancy test could be so daunting or triggering and bring back so many moments of grief. Seeing the results being negative could be heartbreaking all over again. Some people may find some relief knowing their fetus will be harmed and they won't have to make tough decisions. And then there may be guilt for feeling that way. There's no one way to feel or right or wrong way to feel. … Let them know their feelings are valid and anything they feel is okay and normal." TS 13:40

"I think that a common misconception is that if a pregnancy test comes back positive, there are no options for treatment. Education and communication with your healthcare team can help clear up those options you may have and bring back the element of shared decision-making to make these decisions together with your healthcare team." TS 31:03