Preserving fertility in kids with cancer
Today, Christina Montana is just like any 16-year-old. But two years ago, she got some devastating news.
“He just straight out told me, you have something called lymphoma,” Montana said.
Montana had chemo, radiation, and a bone marrow transplant. But first she had to think about something most girls her age never even consider: her fertility.
“It’s like one of those, well, I might want babies in the future,” she said.
“Many of the cancer treatments that we give, while lifesaving, is also toxic to the finite number of eggs that each person has,” explained Irene Su, MD, Assistant Professor of Reproductive Medicine, UC San Diego Health System.
Su says there are options for preserving fertility. For girls who’ve reached puberty, it’s freezing eggs or embryos. For younger patients, it’s freezing ovarian tissue.
“We’ve had, really, as young as three or four, umm, that their parents want to talk about what is the likelihood that their kids will be able to become biologic parents later,” Su said.
About 80 percent of kids with cancer survive. But only 30 to 40 percent receive counseling on fertility options when they’re diagnosed, and fewer than 10 percent undergo a fertility preservation procedure.
Montana decided to freeze her eggs, but her doctor never mentioned the option. She’s now trying to pass a law that requires physicians to tell young patients about fertility procedures.
“Not finding out until they just can’t anymore just doesn’t seem fair at all,” Montana said.
Su says finances are a very big issue for young patients. More than half of the patients she sees can’t afford the fertility preserving procedures which can cost upwards of 10,000 dollars. Most insurance don’t cover them, and keeping the eggs frozen can run up to 50 dollars a month. Programs like Fertile Hope and Heart Beat often provide financial assistance and free fertility medications.
Getting rid of cancer can be a long, grueling, and overwhelming experience for those who have it. But it can be even more demanding when you are young. Many young cancer patients now have to make life-altering decisions about their cancer treatments, as some of the treatments could harm their fertility for life. A recent study by Northwestern University found an overwhelming majority of the nation’s complete cancer institutes, of which there are 39, lack the staff or policy guidelines to deal with fertility issues during treatment. At many of the locations, doctors are not even required to let patients know their treatment may harm or affect their fertility. For many, thinking about having children after cancer can be a positive way to look toward the future, and think about their life after treatment. (Source: http://www.northwestern.edu/newscenter/stories/2013/12/saving-fertility-not-priority-at-most-cancer-centers.html)
How Treatment Affects Fertility: You fertility can be affected by many of the most popular treatments for cancer, including surgery, radiation, or chemotherapy. For example, chemotherapy can sometimes damage sperm quality, production, or even DNA in the sperm. Premature menopause can sometimes occur as a result of treatment. The worst damage is done when radiation is applied directly to the ovaries or testicles, or when chemotherapy drugs called alkylating agents are used. Age is an important factor to consider when discussing fertility options during cancer treatment, as it can alter how the treatment will affect you. For example as women age, their risk for premature menopause increases as well. (Source: http://www.mayoclinic.com/health/fertility-preservation/MY01616)
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