Headlines
As reported by the Los Angeles Times, August 23, 2005.
Saving Eggs from Harm of Cancer Therapy
By Shari Roan, Los Angeles Times and Hilary Waldman, Courant Staff
Writer Perhaps the most compelling current use of egg-freezing is to benefit women with diseases that could interfere with fertility. An estimated 50,000 reproductive-age women are diagnosed with cancer each year in the United States. Radiation and chemotherapy can destroy fertility.
But most young cancer patients are not told about egg-freezing, says Lindsay Beck, founder and executive director of Fertile Hope, a nonprofit organization that offers support and information to cancer patients faced with infertility.
Stacie Campbell was 36 when she was diagnosed with invasive breast cancer last year. Along with a mastectomy, her surgeon recommended radiation and chemotherapy. Campbell was devastated. At the urging of her oncologist, Campbell contacted Dr. Thomas Kim of CHA Fertility Center in Los Angeles about egg-freezing. Although it slightly delayed her cancer treatment and involved taking hormones - which stimulates the development of eggs but can aggravate cancer - the San Diego woman underwent one cycle of egg retrieval and freezing.
Dr. Carolyn D. Runowicz, director of the Carole and Ray Neag Comprehensive Cancer Center at the University of Connecticut Health Center, strongly advocates taking steps to preserve fertility before cancer treatment. But she is not yet a fan of egg-freezing. While egg-freezing is still in its infancy and remains unreliable, there are other ways for cancer patients to preserve future fertility, she said.
The problem is that doctors and patients can be so focused on defeating the disease that they forget that patients often lead a long life after cancer.
Conversations with the cancer doctor about future plans for a family are important for male and female patients alike, Runowicz said.
She said options for men include sperm-freezing, which can be done even for older adolescent boys with cancer. Women who are not married might consider using a sperm bank to create embryos, which, for now, can be frozen more successfully than eggs. Women can also try using birth-control pills or other hormone therapy to suppress their ovaries during chemotherapy. Although the evidence is sketchy, it appears that suppressing egg production during chemotherapy might protect the quality of a woman's eggs for future pregnancies.
Because cancer doctors are often so busy detailing treatment plans, Runowicz urged patients to add fertility preservation to their lists of questions for the doctor.
"When [the doctor's] plate is so full talking about all the possible therapies, you can't expect to put fertility on the platter," she said. "Patients have to precipitate the conversation if the oncologist doesn't."
A specialist in gynecologic cancers, Runowicz recently counseled a young ovarian-cancer patient to think about whether she wanted to have children. The patient had recently married after having surgery to remove one cancerous ovary. She also had chemotherapy.
"Once Dr. Runowicz knew I was married, she said: `If you're thinking about having children, start trying right away,'" said Karen, the patient, who asked that only her first name be published. Karen gave birth to a daughter last July, about a year after her wedding day.
"With the fertility issue, I think if I hadn't been aware of that we would have waited awhile," Karen said. "The conversation I had with her sparked my husband and I to begin early. I'm so glad we did."
Campbell, the California woman, has since completed cancer treatment and will soon undergo breast reconstructive surgery. The man she was dating when she was diagnosed ended their relationship because of the possibility that the couple might never have children. But Campbell says that freezing her eggs has kept her hopes of having a family alive.
"I have a positive outlook that my disease will someday be solved," she says. "I didn't want to look back and say, `Why didn't I do this?' It's like having money in the bank."