Cancer is never good news and it comes with an extra dose of heartache when it’s a child getting the diagnosis. Improvements in cancer therapy throughout the years have made chemotherapy and radiation treatments less invasive and less destructive than they were a few decades ago; the very nature of a rapidly growing child’s body, however, means these therapies attack with a vengeance, and often leaves the child infertile. Children who survive cancer are living longer now, too, even into adulthood where concerns for infertility have a dramatic impact on quality of life.
In August 2013, the British medical journal, Lancet Oncology, published the results of a study that found as many as two-thirds of female survivors of childhood cancer sought help for infertility once they reached adulthood. This percentage parallels the rate of women in the general population who seek similar care. Dr. Lisa R. Diller urges child cancer survivors to seek help immediately when pregnancy is desired. Diller, lead author of the Lancet study, is also chief medical officer of the Dana-Farber / Boston Children’s Cancer and Blood Disorders Center.
Diller describes the ovaries as taking a hit during childhood cancer treatments but the resiliency of the young body means many women naturally regain a degree of fertility. Some of them will become pregnant without effort but others may need medical intervention to jump any medical hurdles lingering from the earlier bout with cancer.
Dr. Hal C. Danzer sees the same resiliency in male and female survivors of childhood cancer. Danzer, a reproductive endocrinologist with the Southern California Reproductive Center, finds the child’s age and reproductive maturity at the time cancer is diagnosed influence fertility in adulthood.
The long-term survival rate for a child with cancer today is about 80 percent, making the issue of fertility in adulthood a realistic concern. About two-thirds of all children diagnosed with cancer get counseling about fertility and the long-term reproductive effects of their cancer treatments before treatment even begins.
When cancer treatments are expected to affect the reproductive organs of a child of reproductive maturity, a growing number of patients choose to harvest and freeze sperm, eggs, even embryos for future use. In younger children diagnosed before puberty, ovarian and testicular tissue can be frozen for implantation when the child is grown and ready to start a family.
The process of freezing these reproductive tissues can seem daunting, starting at about $10,000, but financial assistance, including free fertility medications, is sometimes available through non-profit programs such as Heart Beat and Fertile Hope. Sometimes fertility clinics will discount their rates to cancer survivors as well.
- Barton SE, Najita JS, Ginsburg ES, Leisenring WM, Stovall M, Weathers RE, Sklar CA, Robison LL, Diller L. Infertility, infertility treatment, and achievement of pregnancy in female survivors of childhood cancer: a report from the Childhood Cancer Survivor Study cohort. Lancet Oncol. 2013 Aug;14(9):873-81
- O'Connor, Anahad. "After Cancer, Fertility Is Often Within Reach." The New York Times. 23 Sept 2013. Web. 4 Oct 2013.