Many cancer treatment specialists look at the illness at hand and not the longer term effects of the cancer treatment. When facing cancer treatment, the patient needs to being up their concerns about fertility and having children later in life early in the treatment plan. The fact that the patient wants to have children later can affect the treatment choices.
While many doctors are versed in the effects of cancer treatment on the reproductive abilities of patients who may still want to have children, the patient can prepare for the conversation by making a list of the best possible questions to ask the oncologist. These questions should include:
- Does the chosen cancer treatment affect my reproductive system?
- Will any affect be long term or short term?
- If recovery is a viable option, how long will it take to regain fertility?
- Can infertility due to cancer treatments be prevented before the treatment begins?
- Do fertility options affect the cancer treatment in any way?
- How long should I wait after treatment to test for fertility?
- Can I try to have a baby while in the midst of cancer treatment?
This list of questions is far from complete, but it will be a great starting point for the conversation between the patient and the oncologist. Many oncologists understand the problems associated with reproduction and work closely with a fertility specialist if needed. If the cancer patient has chosen a fertility specialist, the oncologist will often work with that doctor to preserve fertility with the best possible outcomes.
Should I Even Think About Having Children After Cancer?
One of the first questions a cancer survivor asks themselves, if they are of reproductive age, is whether or not they should attempt to have children. The main concern is associated with the fear of the cancer recurring while they are pregnant or soon after the baby is born.
Once the oncologist is sure the cancer has been removed or affectively treated, there is no reason why a cancer survivor cannot physically have children. This is, of course, only the case when the patient has had no damage to the reproductive organs.
The general wait time between ending cancer treatment and trying to have a child is one year. This time frame is very loose and the oncologist treating the cancer will be able to talk with the patient about the effects of the cancer treatment on the male or female body and potentially on the fetus if conception were to occur too soon.
The decision to have children after cancer treatment will not only be affected by the physical ramifications of cancer, but the mental as well. Some cancer survivors are steadfast in the idea that giving birth to a child when there is even a slim chance of recurrence if not the option for them. The cancer patient may gain benefit from a cancer survivor meeting or a psychologist regarding the mental weight associated with reproduction after cancer treatment.
Is Sterilization an Option if I am in Remission?
Another topic that comes into play after cancer treatment is the accidental pregnancy or the potential for an unwanted pregnancy to occur. If the male or female cancer survivor is in remission and does not want to have children, they may seek out sterilization to prevent an unwanted pregnancy. Remission is not a 100% cure from cancer, but a lull in the growth of the cancer. At any time, the cancer could begin to grow again and some cancer patients simply do not want to take the chance of getting pregnant or impregnating their partner in case of relapse.
I Have Already Been Treated For Cancer But Did Not Preserve Fertility. What Do I Do Now?
Not all cancer treatments will affect the reproductive system over the long term post treatment. Chemotherapy, radiation, hormone therapy and surgery all affect patients differently depending on the area of the body where the cancer was growing. There have even been cases where cancer of the reproductive system has been treated successfully and the patient who was never supposed to conceive children, regained reproductive abilities.
In the case that all fertility has been lost due to the cancer treatment and no fertility preservation methods were taken into consideration before treatment, adoption, surrogacy or a sperm donor are all options. The choice would depend on the sex of the patient and the feelings regarding some of the more sensitive methods of having a child.
Can a Child's Fertility Be Preserved?
If the child is pre-puberty, there are no proven options to preserve fertility. While this can be very difficult for a parent to accept, not all cancer treatments will leave a child infertile. Many children successfully complete cancer treatment and go through a normal puberty. Girls release eggs and boys produce sperm, but this is not always the case. There are some experimental treatments out there for males who have not undergone puberty, but these are not proven to work.
The experimental treatment removes a bit of tissue from the testes and freezes that tissue in the same manner sperm would be frozen. The theory is that the tissue should have the stem cells needed to restart sperm production when injected or grafted into the tissue of the testes later in life. Unfortunately, there is a chance that same tissue could harbor cancer cells as they were taken before the cancer treatment was completed.
For both boys and girls who have passed through puberty, the same fertility options are available to the child as to the adult. The most viable is cryotherapy. This involves extracting the eggs from the ovaries or the sperm via masturbation or physical drawing from the testes. The eggs or sperm are then frozen and kept until the child's fertility can be determined after the course of the treatment. If fertility is harmed during treatment, the child has the ability to pull on the frozen eggs or sperm later in life when they are ready to have children.