Diagnosed with cancer at a young
age is certainly scary, and it brings up a lot of questions. One of the questions is about fertility. Can you have children? What are your options for fertility
preservation? Coming up, an interview
with a leading expert on fertility and cancer, and you’ll also hear from a
cancer survivor who has taken steps to ensure that she’ll have the chance to
have children very soon. All next on
Hello and welcome to Patient
Power. I’m Andrew Schorr. This program, like so many, is sponsored by Northwestern Memorial Hospital where
we connect you with leading experts, inspiring patients and significant issues
for you and your family.
Well, I am a cancer survivor,
now 14 years with leukemia, but was diagnosed kind of after I’d really gotten
my family going. But what if I’d been
younger? Or what if it had been my wife
and we were about to be given treatments with powerful drugs, maybe also
radiation? How would that affect
fertility and our ability to have children?
Not at all an insignificant issue, and, let’s face it, you want to beat
the cancer but you want to preserve your options for a full life in as much as
Well, we’re going to hear about
a concept called oncofertility and meet a leading expert in a minute and also a
woman who has taken advantage of the latest approaches in oncofertility to have
the chance of starting a family even though she has dealt with cancer twice in
So let’s discuss that now. Now, first of all, there are 140 million new
cases of cancer in the United
States each year, and, yes, cancer is
primarily diseases of aging. So, yes,
most women who are diagnosed with breast cancer are postmenopausal, certainly
men with prostate cancer typically are older, and it goes on and on. But 10 percent are not. So we’re talking about 140,000 new people
each year who are in their reproductive years or younger, and so fertility
needs to be considered.
One of the leading experts in
the country, maybe the world, is Dr. Teresa Woodruff, and she is the chief
of a newly created division of fertility preservation at Northwestern, and she’s
founder and director of the Institute for Women’s Health Research. She’s done a lot of work on this and really
has helped lead the way and coined the term oncofertility. Dr. Woodruff, thank you for being with
us. How do you define
Oncofertility is really
fertility management for young cancer patients, and the term itself really
suggests that both oncologists and fertility specialists need to be together in
thinking about the concerns and issues of both the cancer treatment as well as
the potential fertility threats to those life-preserving treatments in that
immediate moment of diagnosis.
Well, let’s talk about that
immediate moment. In that moment, I
mean, somebody has been told they have cancer and if it’s a child, a young
person, young adult, everybody is saying let’s beat the cancer. And I know over the years sometimes we haven’t
even talked that much about what could be the long-term side effects of the
treatments but we want to get on with it.
So, but yet now we have I think at least 10 million cancer survivors in
the US, people
who are living, want to have a full life.
So where does this thought about oncofertility come in?
Well, I think it’s a really
important emerging topic, and there’s about 1.7 million female cancer survivors
in the US who
were younger than 40 years old at the age of diagnosis. And, you know, the really good news is that
our cancer treatments are becoming so effective that we have an increased
number of cancer survivors. And for
pediatric cancers the news is really good.
About 80 percent of children are surviving their disease and going on to
live a full life.
And so the issue of fertility as
a consequence of this same treatment is something that in the past we really
hadn’t thought about, and now because there are more people entering into their
reproductive years and wanting to have a family, a biological family of their
own, we have technologies and opportunities to both give the patients the
information they need as well as a menu of options that might fit that
particular case. And the different
options require the oncologist and the fertility specialist to really think
about a couple of things.
One is how much time does that
patient have between that initial diagnosis and the time they enter potentially
sterilizing treatment. That’s an
important part of the equation. How
young is that particular patient, and, you know, what are the expectations and
hopes of that patient for a biological family versus perhaps nonbiological
options. All of these things come into
the discussion that one would have with a young cancer patient.
And, as you said, that initial
diagnosis is very fraught. You’re really
kind of in that immediate moment, as you well know, of that kind of existential
crisis of kind of seeing the end of your life.
And by really talking about the fertility options I think you change the
dialogue to really being thoughtful about not only how we’re going to treat the
cancer but how you’re going to live in the fullness of life after you survive
So, Dr. Woodruff,
survivorship with oncofertility being part of it then is part of the discussion
on day one, it sounds like.
Right. And that actuality puts a survivorship topic
very much in that immediate first step of taking the steps to recovery. We used to really think about survivorship
issues as after you’ve gone through all of your treatment and now you might
join a survivorship group. But we really
think that survivorship really begins right as soon as that disease is
diagnosed. That first step towards treating
the disease is really part of the survivorship years.