Fertility and cancer

[Terrafirma]

Here's a fundamentally important message relating to fertility issues and cancer, of particular relevance to those newly diagnosed with cancer, and to members of the medical profession who make cancer diagnoses and plan treatments. If you have recently been diagnosed with a cancer problem, and you may wish to have one or more children in the future, you need to inform your doctor and your medical team about your fertility needs, and if possible discuss fertility issues with your doctor and medical team before decisions are made about treatments for your cancer problem. Don't rely on them to bring the subject up - they may not do it as their first concern will be for your immediate health and safety. Supporters can help by ensuring that fertility is on the list of items to be discussed, and if you're attending medical appointments then by making sure either you or the patient initiate such discussions on fertility. There are two good reasons for discussing fertility matters before any treatment decisions are made. The first is that some treatments for cancers can lessen your fertility or even cause permanent infertility in some cases. But fortunately there are often different treatment options available so you and your medical team can choose treatments which maximise your chances of being fertile in the future. Treatments for many cancers can be delayed for a while until fertility issues have been addressed. The second reason is that if you think your fertility is going to be impaired in the future either by the cancer itself or by the recommended treatments, you may want to consider the options of preserving embryos, or eggs, or sperm, or some other procedure that preserves reproductive cells or tissue for future use. Usually these procedures either need to be done or are best done before treatment starts. The American Society of Clinical Oncology (ASCO) has recently published an important scientific paper called "American Society of Clinical Oncology Recommendations on Fertility Preservation in Cancer Patients". The paper is especially relevant to those who have been newly diagnosed with cancer who wish to retain their fertility, and for members of the medical profession who may be advising newly diagnosed patients on treatment regimes. Here are some quotes from the paper: "The purpose of this guideline is to review the literature pertaining to fertility preservation options for men, women, and children undergoing cancer treatment, and to give guidance to oncologists about these issues." "RECOMMENDATIONS: As part of education and informed consent before cancer therapy, oncologists should address the possibility of infertility with patients treated during their reproductive years and be prepared to discuss possible fertility preservation options or refer appropriate and interested patients to reproductive specialists. Clinician judgment should be employed in the timing of raising this issue, but discussion at the earliest possible opportunity is encouraged. Sperm and embryo cryopreservation are considered standard practice and are widely available; other available fertility preservation methods should be considered investigational and be performed in centers with the necessary expertise." "CONCLUSION: Fertility preservation is often possible in people undergoing treatment for cancer. To preserve the full range of options, fertility preservation approaches should be considered as early as possible during treatment planning." The full text of the scientific paper can be found here http://www.jco.org/cgi/content/full/24/18/2917 and a patient-friendly "ASCO's Guideline on Fertility Preservation" can be found here http://www.asco.org/patient/ASCO+Resources/What+to+Know%3A+ASCO%27s+Guidelines/What+to+Know%3A+ASCO%27s+Guideline+on+Fertility+Preservation I suggest browsing through the scientific paper whether or not you read the patient-friendly guide, even if you don't understand some of it - that way you get the information straight from the people who reviewed the scientific literature and prepared the guidelines. The above is mostly quoted from my webpage http://www.bestcancersites.com/fertility/ where you can find links to a variety of fertility-related websites. For anyone who has low fertility either due directly to a cancer or due to cancer treatment, there are various options you can pursue. Reproductive technology has come a long way in recent years. Eg for men with extremely low viable sperm counts, I gather that individual viable sperm can be hunted down, captured, and injected into eggs (doubtless it's not quite as simple as I've made it sound there). And for anyone who has become infertile there may be options such as adoption to consider. There will probably come a time when all doctors and other members of the medical profession who work at the front line of cancer diagnosis and treatment planning, have fertility needs on their checklist of topics to discuss at an early stage of consultations. From what I read, we are a long way from being there yet. Cheers, Ed.