Fertility and cancer treatment recommendations

Waving

The American Society of Clinical Oncology 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.

A central message from this paper and other similar work, and the views of many people who have been diagnosed with cancer in the past, is this. If you are diagnosed with cancer, and you may wish to have one or more children in the future, it is most important that you discuss your fertility needs with your GP, oncologist and anyone else in your medical team who may contribute to decisions about your treatment, as soon as possible after diagnosis. Don't rely on your medical team to bring up the subject of fertility - they may not. Unfortunately it is not yet standard practice throughout the medical profession to make sure fertility needs are discussed with relevant patients before treatment commences.

Some treatments for cancer (eg chemotherapy) can reduce fertility and in some cases render a person infertile. But in many cases treatments can be tailored to improve your chances of conceiving in the future, or treatment can be deferred for sufficient time to prepare and freeze embryos and/or sperm (or possibly other reproductive tissue - still in experimental stages of development). Freezing embryos and freezing sperm give those diagnosed with cancer a good chance of having children after cancer treatment ends.

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

www.jco.org/cgi/content/full/24/18/2917

and a patient-friendly "ASCO Patient Guide: Fertility Preservation" can be found here

www.plwc.org/portal/site/PLWC/menuitem.169f5d85214941ccfd748f68ee37a01d/?vgnextoid=6a57ffdb060fa010VgnVCM100000ed730ad1RCRD

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.

This website (Breastcancer.org) has a valuable section on fertility issues relating to breast cancer and its treatment. To find it, try this direct link www.breastcancer.org/fertility_pregnancy_adoption.html . On the left side of the page that displays you can see links to the different sections on the topic (you may need to scroll down the page a bit). Alternatively click on the link 'Recovery and Renewal' near the top of this page. On the new page that displays click on the link 'Fertility, Pregnancy, Adoption'.

The organisation Fertile Hope has information about options for preserving fertility before cancer treatment, and other parenting options if your fertility has been impaired or lost during treatment, on their website www.fertilehope.org . Click on the link "Learn More" under the heading "What are my options" on their home page.