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AYA Male Melanoma and Fertility
AYA Male Melanoma and Fertility aren’t words that normally go together in a sentence. I am stringing the works together because cancer treatments such as chemotherapy and radiation can damage a person’s baby-making abilities.
They did mine. I am a long-term cancer survivor. And an AYA patient. Though the age of 34 is at the older end of the AYA age group.
While on the radiation machine, about to undergo radiation treatment to my iliac crest (abdomen), the radiation oncologist asked me if I was planning on having kids someday.
I thought about it and said that I did want to have kids someday. At which point the oncologist told me to go see the fertility nurse on the sixth floor of the building. Helga (not her real name) handed me several packets containing some sort of clear jelly and a small jar and then ushered me into a room with a bed. Helga told me that there were some magazines in the drawer next to the bed. She then left the room and closed the door behind her.
What did Helga think I was going to do with the gel, small jar and magazines anyway??? I thought for a few minutes and left the room. I explained to Helga that I lived nearby with my fiancé and could I give her a sample first thing in the morning. Helga made me promise to get the sample to her immediately. Apparently, it is essential to keep the sample warm.
Long story short, my son Alex turned 27 last month. My wife and I froze my sperm and underwent artificial insemination about a year after I underwent the experiences above.
I’m recounting this experience, thinking that guys reading this story will understand A) how difficult fertility preservation can be, but B) how cancer patients can make it work.
Male Fertility Preservation for Cancer Patients
Thinking about saving your sperm? Scroll down the page and post a question or a comment. I will reply to you ASAP.
Hang in there,
David Emerson
- Cancer Survivor
- Cancer Coach
- Director PeopleBeatingCancer
Fertility Concerns and Outcomes Among Adolescent and Young Adult Males With Melanoma Receiving Immunotherapy: A Mixed-Methods Study
Abstract
Introduction: Immune checkpoint inhibitors (ICIs) are often the initial treatment choice for melanoma, the third most common cancer in the adolescent and young adult (AYA) male population. Although ICIs have improved survival rates, their effects on male fertility and the adequacy of related counseling remain unclear. This study aimed to both characterize the current state of fertility discussions in male AYA patients with melanoma receiving first-line ICIs and to explore their experiences and concerns regarding reproductive health.
Methods: We conducted a mixed-methods study of 38 male patients aged 18-39 with metastatic or locally advanced melanoma treated with first-line PD-1/PD-L1/CTLA-4 therapies at a single academic center between 2013 and 2024. Quantitative medical record review assessed fertility counseling and preservation actions. Semi-structured interviews were conducted with ten living patients from this cohort to explore knowledge, concerns, and experiences surrounding fertility and reproductive health. Thematic analysis identified key patient perspectives.
Results: Among 38 patients (median age 32), 71% had stage IV disease and received combination immunotherapy. 74% of patients experienced at least one immune-related adverse event (irAE). Fertility counseling was documented for 27 patients, with eight referred for fertility preservation. Of the ten interviewees, nine recalled discussing fertility, while only three pursued preservation. Qualitative themes included challenges accepting uncertainty about family planning, pressure to accelerate planning, feelings of forced maturity, difficulty processing complex information, and concerns about the reliability of information from family, providers, and social media.
Conclusion: Although most young males with advanced melanoma treated with first-line ICIs had documented fertility discussions, few elected fertility preservation. Patient experiences highlight the need for collaboration among oncologists, fertility specialists, and supportive professionals to develop tailored counseling and educational materials for male AYA patients with advanced melanoma.
AYA Male Melanoma and Fertility AYA Male Melanoma and Fertility AYA Male Melanoma and Fertility