By Alanna Kennedy
Focus on Fertility
Ongoing research aims to expand options for preserving fertility before and after cancer treatment
By Alanna Kennedy
When Renee Nicholas’ doctor told her she had stage II breast cancer at age 33, fertility was the last thing on her mind. “As someone who was just told ‘You have cancer,’ you’re obviously fearing for your life and thinking the worst,” says Nicholas. But her fears were eased when her doctor asked if she was interested in taking steps to preserve her fertility. “That vote of confidence from him made me feel like I was going to beat it,” she says, “and I was going to live.”
Like Nicholas, who is now the director of corporate relations for the LiveStrong organization, most patients are focused on survival at the time of diagnosis. But it’s also important to look ahead to life after treatment—and taking action early can help preserve fertility. Even for men and women who have already completed treatment, options still exist that can increase the odds of having biological children.
FERTILITY LOSS FROM CANCER
According to the National Cancer Institute, 72,000 men and women between the ages of 15 and 39 will be diagnosed with cancer in 2010. While it’s nearly impossible to predict how many of these patients will become infertile, it is a problem that many survivors will face.
There are several ways cancer can lead to infertility. If a patient is diagnosed with a cancer of a reproductive organ, it may be the disease itself that leads to infertility. For other cancers, it is the treatment that can cause trouble.
Sometimes infertility is temporary, especially for men, but if a woman is infertile following therapy, it is unlikely she will regain fertility. High-dose chemotherapy regimens and radiation therapy may kill some or even all of a woman’s eggs, says Jennifer Levine, a pediatric oncologist at Columbia University Medical Center in New York City. Once those eggs are gone, a woman’s body cannot create more. And egg supply isn’t the only problem, according to Levine: Pelvic radiation can damage the uterus, leaving it unable to sustain a pregnancy.
Although cancer treatment can also damage male fertility, the damage may be short-lived. “Men have stem cells that can mature to become sperm,” says Levine. If all of the stem cells are destroyed during treatment, a man will be permanently infertile. But, Levine says, in many cases the stem cells aren’t destroyed and with time, a man can become fertile again.
(illustration: © Michael Maslan Historic Photographs / Corbis)