Cancer – fertility issues often overlooked

Published: November, 2011

When dealing with cancer patients of reproductive age, doctors must ensure that they cover the many issues surrounding fertility properly, an oncologist has said.

According to Dr Adrian Murphy of St Vincent’s University Hospital in Dublin, more and more people are now surviving cancer and there is an increasing awareness of the importance of fertility among this group of patients.

However despite this, fertility issues ‘are often overlooked’ during initial consultations with patients in cancer clinics, Dr Murphy admitted.

He noted that while cancer is uncommon in teenagers and young adults, ‘many more people diagnosed with cancer are considered to be of reproductive age’. The most common type of cancers to affect such people are breast cancer, cervical cancer, melanoma, non-Hodgkin’s lymphoma and leukaemia.

Dr Murphy explained that when patients of reproductive age are diagnosed with cancer, they are usually treated with a combination of surgery, chemotherapy and/or radiotherapy. He also pointed out that when it comes to fertility, the disease itself and/or the treatment can have an effect.

He said that in general, male and female fertility can be temporarily or permanently affected by cancer treatment, however in females, it may only become apparent later on with the development of premature ovarian failure.

He also pointed out that in females, having periods is often directly linked to fertility. In other words, if a woman is having regular periods, she often assumes her fertility is fine, but ‘it is important that patients are educated that regular menstruation does not guarantee normal fertility’.

While there are a number of options open to both men and women with cancer, Dr Murphy said that most common method of fertility preservation in men involves freezing sperm for later use, while for women, it is freezing embryos.

Meanwhile, Dr Murphy pointed to a recent Irish study involving cancer specialists and their knowledge of fertility preservation. This found that almost 15% did not routinely discuss this issue with their female patients of reproductive age. Reasons given for not discussing this issue included believing that the patient had a poor prognosis and feeling that it would overwhelm the patient.

Dr Murphy insisted that the issue of fertility ‘will always be important to cancer patients of reproductive age’ and doctors should therefore strive to include information about the risks of infertility and the fertility preservation options available.

“In particular, oncologists and fertility specialists should collaborate in a timely manner to avoid missed opportunities regarding fertility preservation and delays in cancer treatment,” he added.

Dr Murphy made his comments in the Irish medical journal, Cancer Professional.