Saving Cancer Patients' Fertility
Today's cancer patient has more options than in the past and chemotherapy and radiation can effect a cure in many cases. However, while these treatments may cure cancer, they can also impair or even destroy a patient's fertility. The problem has become so widespread that researchers have developed a new field called oncofertility to help preserve the reproductive health of cancer patients. Even so, too many physicians remain unaware of the newest strategies that have been developed to counter the problem of infertility brought on by cancer treatment.
A Northwestern University Feinberg School of Medicine oncologist specializing in breast cancer surgery, in tandem with a major oncofertility researcher has created a guideline to assist doctors in finding the appropriate modern techniques to save their cancer patients' fertility and to teach them about the issues that cancer treatment poses to patient fertility. The guideline proposes fertility preservation strategies according to the type of cancer, the age of the patient, and the patient's gender. The New England Journal of Medicine published the guideline in its February 26, 2009 issue as well as in its NEJM Audio Summary.
"We hope that physicians who are not used to dealing with fertility threats associated with treatment can now talk confidently with their patients about their options," said article co-author Teresa Woodruff, chief of fertility preservation and the Thomas J. Watkins Professor of Obstetrics and Gynecology at Feinberg. "This is a new tool for them."
"Doctors are focused on saving a patient's life and are not used to thinking about preserving a patient's fertility and incorporating fertility preservation into her or his care," said lead author Jacqueline Jeruss, M.D., assistant professor of surgery at the Feinberg School. Jeruss is also on the staff at Northwestern Memorial's Prentice Women's Hospital as a surgical oncologist and does scientific research at Northwestern University's Robert H. Lurie Comprehensive Cancer Center.
At major risk for loss of future fertility are the youngest cancer patients. A recent survey of U.S. pediatric oncologists suggests that less than half of them employ available fertility preservation techniques that are found at a majority of medical institutions and which might be used for patients in their teens. The Feinberg School's Robert Brannigan, M.D., associate professor of urology and a physician at Northwestern Memorial Hospital conducted the survey. "Adolescent oncology patients are at the same risk as adults to become permanently infertile as a result of their cancer or cancer treatment, but they are not getting what they need to save their fertility," said Brannigan.
Jeruss explains that doctors haven't become used to the idea of viewing adolescent cancer patients as those who will live normal life spans, so they don't take a step back and consider the bigger picture of how cancer treatment will affect the future of their young patients.