October is Breast Cancer Awareness Month. Only 25 percent of oncologists inform their patients about fertility preservation and less than 60 percent of patients received fertility information after cancer treatment, according to recent research. That makes it a patient's responsibility to seek information on her own, mostly knowing what to ask and how to be prepared. Today, a discussion and advice about talking to your doctor before cancer treatment about preserving your fertility from Mindy Berkson, infertility consultant and founder of Lotus Blossom Consulting.
Examiner: How does chemotherapy and radiation therapy can affect reproductive systems?
Mindy: Chemotherapy and radiation can cause a woman to enter early menopause. Early menopause precludes the reproductive system from being able to achieve a pregnancy. Getting pregnant can be hard for women who go through early menopause as a result of chemotherapy. If a woman is close to her natural menopause, it is more likely that chemotherapy will cause early menopause to occur.
Examiner: What questions they should be asking their doctors?
Mindy:
• Can cancer treatments be delayed in order to explore fertility preservation options?
• If so, how long can treatment be delayed?
• Would hormone treatments for IVF affect the cancer and if so, how?
• How much experience do you have in treating cancer patients such as myself?
• What are your success rates for live births with cancer patients in remission?
• Are your physician’s board certified in reproductive endocrinology and in good medical standing?
• Do you accept insurance and would my insurance cover the costs associated with fertility treatments and or preservation?
Examiner: What options are available in preserving their fertility?
Mindy:
• ovary cryopreservation
• egg freezing
• donor egg
• embryo cryopreservation
• surrogacy
• embryo donation
• adoption
Examiner: What are the risks of trying to preserve your fertility while going through treatment?
Mindy: Delaying cancer treatment may be detrimental depending on the cancer. There is no guarantee for success. Expensive medical procedures for fertility preservation may not be covered by insurance.
Examiner: How common is it for women of child-bearing age to need chemo/breast cancer treatment?
Mindy: In the United States, about 5 percent of all breast cancer cases occur in women under age 40.
Examiner: Is breast feeding an option after breast cancer treatment?
Mindy: Some treatments for breast cancer can have an impact on a woman’s ability to breastfeed. For women who have had a mastectomy or lumpectomy plus radiation, breastfeeding from the untreated breast should be fairly normal. However, feeding from the treated breast following lumpectomy plus radiation may be difficult. Both the surgery and radiation therapy can harm
tissue needed for breastfeeding. While feeding from the treated breast is possible (and the milk is safe for the baby), it is not common and the amount of milk produced is typically greatly reduced.
Examiner: Anything else you want to add?
Mindy: The diagnosis of cancer is devastating and it is very difficult to make thoughtful, decisive and emotional decisions when under undue stress. It is also difficult to know what questions to ask and what is most important to consider. Planning and expanding opportunities for the future is very hopeful and proactive.
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