“You have cancer.”
It’s a phrase no one wants to hear. But hearing that diagnosis can be especially devastating to men and women in their childbearing years. In addition to questions about treatment, prognosis and survival, and people of childbearing age with cancer may also be concerned about their fertility.
The good news is that many men and women are successfully treated for cancer and go on to grow their families. Navigating cancer and fertility can be challenging. Here are some principles to keep in mind:
Start with you
Your health must take priority. Talk with your oncologist about the type of cancer you have, your treatment options, and your prognosis. Every situation is unique, and your oncologist can help you understand the type of cancer you are battling and how it will impact your fertility.
Ask questions and assemble experts
Don’t be afraid to speak up. If you are of childbearing age and you are concerned about your fertility, talk about that with your oncologist upfront as you discuss treatment.
You’ll also want to have a reproductive expert on your team. As a regional referral center for oncofertility services, one of our KFI specialists will bring additional insights and tools to the conversation about your options for fertility preservation. With your oncologist and your reproductive endocrinologist working together, you’ll be able to chart the best course of action for beating cancer and preserving fertility.
Where do the threats come from?
In many cases, the threat to fertility posed by cancer is related not to the cancer itself, but due to treatment. Different treatments have different impact on fertility.
Surgery on cancers that are directly related to reproductive organs commonly have profound impacts on fertility. Emerging surgical techniques may help to reduce these impacts, preserving fertility while appropriately addressing the cancer threat.
In some cases, radiation may not pose a significant long-term risk to fertility. Because radiation is concentrated in the particular area of the body affected by cancer, impacts to reproductive organs may be minimized by shielding those areas, provided the area being treated is not near the reproductive organs. However, higher doses of radiation or full body radiation may destroy eggs in women and permanently damage sperm production in men.
Because chemotherapy drugs travel throughout your body, they may have wide-ranging impacts on tissues other than cancer cells—including reproductive organs. Chemotherapy may immediately cause infertility, or it may reduce fertility over months or years after treatment. Your age and the type, dose, and duration of chemotherapy are the leading factors in determining the impact these drugs will have on fertility.
While hormonal treatments like tamoxifen and trastuzumab, commonly used to treat breast cancer, do not directly harm the reproductive system, they are not safe for women to take while they are pregnant or trying to conceive. Hormonal therapy may be required for several years, which could delay childbearing and can negative effects on fertility due to advancing maternal age.
To sum up, treatment options that are focused on one area of the body may not affect fertility long-term, while treatment options that either focus on reproductive organs or affect the whole body are more likely to have lasting negative impacts on fertility.
Know the options
Coordination between your oncologist and reproductive endocrinologist will help you map out the best path. Many avenues are available for preserving fertility before cancer treatment and/or growing your family afterwards, including:
- Harvesting and banking eggs/embryos prior to cancer treatment
- Freezing sperm prior to cancer treatment
- Egg/sperm donation
- Embryo adoption
- Gestational surrogacy
With good information, a solid team working together, and hope, it is possible to beat cancer and still achieve your goals for growing your family. Please call our office at 502-996-4480 if you would like to learn more about the comprehensive oncofertility services offered at Kentucky Fertility Institute.
References:
https://www.livestrong.org/we-can-help/just-diagnosed/male-fertility-preservation
http://www.breastcancer.org/treatment/side_effects/fertility_issues
https://www.cancer.org/cancer/breast-cancer/treatment/chemotherapy-for-breast-cancer.html
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