Cancer Research Now: Fertility Issues for Adolescents and Young Adults with Cancer

Uploaded by NCIcancerbulletin on 04.08.2011

Johnson: There are issues
that are common
to all young adults
with a cancer,
such as the potential
for infertility
because of their
cancer treatment.
Brian: I didn't think
about being a father at 17.
I didn't think
about being a cancer
patient either.
If I had thought about it,
if I had researched it then,
I don't know what my view
would've been.
But that was the last thing
on my mind.
Jessica: As someone
who is approaching the age
where I need to start thinking
about having children
or where that's going to happen
in my life,
there's always a concern
about that.
Especially as a woman,
what's going to happen
to my baby making abilities?
Are my eggs going
to be any good later?
What is this going to do
to the rest of my body?
I was fortunate enough
that the kinds of procedures
that I had are supposed
to have minimal effects
on my ability to have children,
but it's still something
that could happen.
And the truth is, I won't know
until I try.
Trevor: I do kind
of wish there was more
on the fertility aspect
and that kind of thing.
Because I sort
of got differing stories
from different people.
And at the end of the day,
I just decided to be safe
about it, and go ahead
and you know bank some sperm
just in case, because I do want
to have kids.
Johnson: In our own institution
at Seattle Children's we've been
trying to create best practices
for ways that we can encourage
people to preserve their
fertility prior to the start
of their cancer therapy.
So, get teenage
and young adult males
to go sperm bank,
on a routine basis,
if they're interested in that,
and getting selected populations
of teen and young adult female
cancer patients
to bank usually oocytes,
in our pediatric population,
this is now an option for,
again, for some cancers.
And in older populations
of young adults embryo
freezing down embryos
for later use is also
a possibility.
Johnson: When people will become
infertile from cancer
how do you predict the ovarian
reserve that's present
in a woman after her cancer
therapy is done
and thus define how early she
might have menopause,
if she does have
menopause early.
Miller: So one of the policies
that we're working on is one
around insurance reform
to address the needs of those
who could potentially have their
fertility impaired as a result
of their cancer treatment.
We know that most insurance
plans right now do not cover
fertility preservation services
and iatrogenic infertility is
something that should be covered
just as breast reconstruction is
covered for women who have
to have a mastectomy.
If we know that the treatment is
going to potentially cause
people to lose their fertility,
I think we have an obligation
to ensure that their fertility
is preserved
through evidence-based
technologies that we know work
and it should be reimbursed.
Because the risk is,
if someone takes the decision
as to whether
or not their fertility is going
to be impaired
and makes a less effectacious
treatment decision based
on that reality they're putting
themselves at risk.
And so we want people to be able
to make the best decisions
for themselves and not have
to make the choice,
should I take the treatment
that's recommended,
and risk my fertility being
preserved, or preserve my
fertility and don't take the
recommended treatment.
That's a terrible choice to have
to make and it's unnecessary
when it's based on economic
or insurance issues.