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Adolescent and Young Adult (AYA) cancer and fertility

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If Adolescents or Young Adults are undergoing chemotherapy and/or radiation a ounce of prevention is worth a pound of cure

I was originally diagnosed with multiple myeloma at 34 in 1994. My induction chemotherapy and autologous stem cell transplant failed so I was prescribed “palliative radiation” meaning local radiation that would eliminate the bone pain in my iliac crest.

I didn’t know it at the time but the radiation to my pelvic region would leave me sterile. I was single and had spent most of my adult life trying NOT to father a child. It never occurred to me, at 34 years of age, to even ask about my future ability to have children.

My radiation oncologist, Dr. Shina, recommended that I freeze some sperm just in case. Three years later, in early 98, my wife was inseminated and voila, Alex was born nine months later (9/25/98). Thank you Dr. Shina.

The first thing to remember is that AYA cancer survivors/caregivers need to consider fertility issues BEFORE toxic chemoradiation. The second thing to remember is that the field of reproductive science is changing fast. What I did in ’96 is now ancient science when compared to today.

The fact is that toxic therapies will cause side effects– some of these side effects will be temporary and some will be permanent. There may even be late stage side effects— health issues that you cannot identify until years later.

When it comes to AYA cancers the key is to understand your risks and options BEFORE you undergo toxic therapies of any kind.

Cryopreservation has come a long way since my experiences in ’95-’98. The articles linked below give you an idea of the brief history of fertility as it relates to cancer therapies.

As you can read for all the linked information below there is a lot for AYA patients to be concerned about. I am both a long-term cancer survivor and cancer coach. I can help.

Scroll down the page, post a question or comment and I will reply to you ASAP. 

Epigenetic Changes in Sperm Found 10 Years After Chemo

Young men who undergo chemotherapy during puberty may undergo permanent genetic changes in their sperm that could be passed on to the next generation, the results of a small-scale US study have demonstrated for the first time in humans…

Improved risk identification will aid fertility preservation in young male cancer patients

“Investigators have found the chemotherapy dose threshold below which male childhood cancer survivors are likely to have normal sperm production. By clarifying which patients are at highest risk for reduced sperm production as adults, researchers expect the findings to eventually increase use of pre-treatment fertility preservation methods such as sperm banking.”

Adolescent and Young Adult Cancer Survivors Report Cognitive, Sexual Late Effects

“Adult and young adult (AYA) cancer survivors face cognitive and sexual late effects from cancer and its treatment, according to data compiled from an online cancer survivorship care planning tool…

Researchers have found that preserving sperm prior to cancer treatment significantly boosts the odds of men being able to have children after treatment.”

Fertility preservation option for young boys with cancer

“From the stored tissue, researchers can extract spermatogonial stem cells (SSCs), which are responsible for the continuous production of sperm throughout adult life. Physicians and scientists hope that when the boys reach adulthood, the cells can be transplanted back into their testicles through a simple injection and they will be able to produce sperm…”

Preserving Fertility Before Treatment

Chemotherapy drugs and radiation to the pelvis cause genetic changes in sperm and oocytes (eggs). Embryos with genetic damage often miscarry early in pregnancy. There is also a risk of having a baby with a birth defect, but so few babies have been conceived during cancer treatment that no statistics exist on the risk of birth defects…”

Saving Fertility Not Priority at Most Cancer Centers, Study Shows

“Infertility is consistently listed as one of the most distressing long-term side effects of cancer treatment for adolescents and young adults. Yet the leading National Cancer Institute-designated comprehensive cancer centers — which should be leaders in fertility preservation — aren’t doing an adequate job of helping patients protect their fertility, reports a new Northwestern Medicine® study…

1) Please don’t rely on your oncologist to consider fertility issues for you- you are in charge.

2) Please learn about fertility issues BEFORE undergoing toxic therapies.

3) Even at 36 I was embarrassed to even talk about my fertility issues. I think an average teen would be mortified to have a fertility discussion. I would be happy to help if need be.

Thanks and hang in there

David Emerson

  • Cancer Survivor
  • Cancer Coach
  • Director PeopleBeatingCancer

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