Oncologists Address Fertility Issues Earlier With Patients

Oncologists are increasingly focusing on treatment-related infertility.

Originally published September 2006

Oncologists are finding they have more to discuss with patients than how best to treat their cancer. In many cases, cancer physicians are also looking to the future, offering options to preserve their patients’ fertility—and their chances of someday becoming parents. 

With improved screening techniques, earlier detection and advances in cancer treatment, more cancer survivors are living longer. Buoyed by estimates that three out of five cancer patients are disease-free five years after diagnosis, many of these cancer patients are planning for a future that includes having their own children.

Yet not so long ago, the idea of preserving patients’ fertility before cancer treatment was rarely discussed by oncologists. In the United States alone, some 800,000 men and women have been diagnosed with cancer during their prime reproductive years, and many are concerned about their fertility, according to the American Society for Reproductive Medicine.

“For a long time, oncologists focused primarily on the best treatments for cancer. But now, they are increasingly focusing on the impact of that treatment on a person’s life, such as treatment-related infertility,” says Charles Shapiro, MD, director of breast medical oncology at the Ohio State University Comprehensive Cancer Center.

Often cancer survivors are at greater risk for developing infertility because of chemotherapy or radiation treatment. In men, chemotherapy and radiation may reduce the number of sperm cells or limit their mobility, while in women, those treatments may affect menstrual cycles or cause premature menopause.

“For some patients, their hopes and dreams are to have children, even after being treated for cancer. It’s important for cancer patients to realize that there is life beyond cancer, and that children can be a part of that life,” says Dr. Shapiro, who co-chairs the task force on survivorship guidelines for the American Society of Clinical Oncology, a leading professional organization for oncologists.

Earlier this year, a separate ASCO task force released fertility preservation guidelines for cancer patients. The guidelines call for all oncologists to address potential treatment-related infertility with all fertile patients—male or female—and, in the case of children, with their parents or guardians. Oncologists should be prepared to discuss fertility preservation options or refer patients to reproductive specialists. Organizations such as Fertile Hope, a nonprofit group that offers fertility information and resources for cancer survivors, have filled the gap left open by oncologists in past decades, but now are working together to inform patients of fertility options.

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