Being diagnosed with cancer at a young age is scary and it brings up a lot of questions. Will treatment affect your fertility? What are your options for fertility preservation? In this program, Dr. Teresa Woodruff, Chief of the Division of Fertility Preservation at Northwestern Memorial Hospital discusses fertility and cancer. You will also hear from a cancer survivor who has taken steps to ensure that she will have a chance to have children.
Produced in association with Northwestern Medicine
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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 Patient Power.
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 you can.
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 her life.
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?
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 the disease.
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.
By Eliot Finkelstein