Consider future fertility before cancer chemotherapy or radiation

Cancer and cancer treatments can threaten patients’ ability to have children. Many factors affect that risk, including the patient’s age, type of cancer, chemo type and dosage, surgery to the reproductive system and radiation therapy, depending on dose and location.

Some patients may need to start chemo or radiation right away. Others can afford to wait a few weeks, long enough to harvest eggs with women – or for men, a day or so to collect sperm – to freeze and store for possible future use, known as fertility cryopreservation before the patient is exposed to radiation or chemo. ​

According to an article in U.S News surveys show a disconnect between the proportion of cancer patients interested in having kids someday and those who actually seek and pursue fertility preservation, says Dr. Jay Andersen,​ a medical oncologist and co-director of Breast Specialists-Compass Oncology​, a Portland, Oregon, practice in The US Oncology Network.

The fertility topic can get lost in the shuffle for several reasons. “Patients are already inundated with decision-making,” he says. “They’re struggling with a cancer diagnosis at a young age. Many of these women are professional women. They may already have children. They’re in the prime of their life.” Women are dealing with complex issues in an already overcrowded schedule – meeting with the plastic surgeon, medical oncologist, radiation oncologist and others. Psychologically, women may feel an urgency to get cancer treatment underway.

From a medical standpoint, Andersen says, it’s usually safe to delay the cancer treatment a bit. “If it takes an average of two weeks to navigate the fertility preservation pathway, we’re OK with that in the vast majority of breast cancer cases,” he says. “It’s not going to have a negative impact on clinical outcomes.”

The oncology team has a responsibility to bring up infertility risk and treatment options with all cancer patients (and parents of children with cancer). Andersen points to guidelines from both the National Comprehensive Cancer Network and the American Society of Clinical Oncology stating that patients should be offered a referral with a reproductive specialist as an essential part of their planning. ASCO provides a helpful cancer-fertility guide for people in this situation.

At RPMG we will make accomodations for a rapid consulation for cancer patients thinking about egg freezing and have quick protocols so as not to delay their chemotherapy or radiation more than absolutely necessary.

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