As both a health lawyer and a new mom I have a message to share: oncologists and young adults diagnosed with cancer need to have the fertility talk. If the doctor doesn’t bring it up, the patient should.
It is well known that cancer treatments can lead to infertility. That is the nature of the beast. But it doesn’t mean that someone fighting cancer can’t have children in the future. However, it may be necessary to take steps to preserve fertility in advance of treatment so that children do remain an option.
One of the most commonly used chemotherapy drugs, cyclophosphamide, can lead to ovarian failure and loss of fertility, a tragic consequence of cancer treatment that has led researchers world-wide in search of a solution. The risk of chemotherapy to induce premature menopause is well-documented, and depends largely on the patient’s age, as well as the type and dose of chemotherapy. The risk of premature menopause (i.e. permanent amenorrhea) following cytotoxic chemotherapy is 50% in women aged 35-50, and as high as 85% in women over the age of 40 [Wong et al., 2012].
by Lisa Campo-Engelstein, Ph.D., Assistant Professor Alden March Bioethics Institute & Dept. of OBGYN, Albany Medical College
Approximately 10% of people diagnosed with cancer are within their reproductive years (generally defined as under 45).[i] Although life-saving, cancer treatments (e.g. radiation, chemotherapy, and surgery) can also lead to infertility in both females and males. Established reproductive technologies for women and men like gamete freezing and embryo freezing allow cancer patients to preserve their fertility in case they want to become biological parents in the future. As survival rates have increased, fertility preservation has become a more significant quality of life issue.[ii] Indeed, both young women and men state that the fertility preservation is important for them and the majority of those who are childless at the time of their cancer diagnosis express a desire to have biological children in the future.[iii],[iv]
Mission Statement: To mitigate the current disparities of care for AYA with cancer and survivors of cancer in childhood through advances in treatment and research, respecting the unique circumstances and needs of this population, enacted across all health care jurisdictions in Canada.
The Task Force was established in 2008 with the support of the Canadian Partnership Against Cancer and C17, the consortium of Canadian pediatric oncology programs. AYA with cancer have unique needs related to their maturational development and the biology of their diseases. Deficiencies in the care provided by the pediatric and adult cancer care systems result in long-term adverse health and social consequences, an increased burden on the healthcare system, an overall loss of productivity and a drain on health resources and the economy. Task Force members are from all parts of Canada, and represent all stakeholder groups including survivors, health care practitioners, administrators, and policy-makers. In 2011 the Task Force published broad principles and recommendations for the provision of health care in Canada for adolescent and young adult-aged cancer patients and survivors. The six broad recommendations highlight the need for age-appropriate psychosocial, survivorship, palliative, and medical care as well as research to redress inequities in the care provided to this group relative to both younger and older cancer patients. Task Force Working Groups are currently preparing guidance for active care, guidelines for follow-up care, recommendations on how to increase accrual to clinical trials, and an AYA-specific distress-screening tool. Improved care for this group will enable individuals to reach their full potential as productive, functioning members of society, providing economic and other societal benefits.
A note from Lorne Cooper, Founder Current Oncology; Cancer Knowledge Network, Founder/CEO Multimed Inc.
As a member of the Oncofertility Working Group, we collectively strive to improve the quality of life for AYAs living with cancer, and fertility preservation is a crucial issue for this age group. Through our Oncofertility Referral Network, CKN has proven to be the leader in the Canadian cancer community allowing instant online referrals to local fertility clinics, as well as providing a library of resources to oncologists and patients. I would like to share with you the Oncofertility Working Group’s power point presentation on fertility preservation in adults with cancer.
As a service to our viewers, CKN would like to offer this free download.
Medical Professionals: Please keep these brochures in your office to spark the discussion about fertility options with your young adult cancer patients, or email them to your young adult patients as a quick reference guide to fertility preservation options.
Patients: Be your own advocate!! Use this brochure to jump start a discussion with your oncology team about preserving your future fertility before your cancer treatment begins.
Caregivers: Pass this along to your loved one so they can be informed about their fertility options before it’s too late.
The Oncofertility Consortium is happy to announce a new collaboration with the Cancer Knowledge Network. The Consortium was established to expand the reproductive future of cancer survivors whose disease or treatment may impair future fertility. This interdisciplinary, global cooperative of researchers, health care providers, and patients investigates barriers to fertility after cancer and overcomes these hurdles. It also facilitates information flow between stakeholders within the cancer community. Our partnership with the Cancer Knowledge Network will provide our readers cutting edge information on the advanced fertility preservation techniques available to cancer patients, oncofertility resources for the health care community, and new research in the field.