News Release
July 14, 2005
Contact: Maureen McGuire, 860-679-4523
e-mail:
mmcguire@nso.uchc.edu
Preserving Fertility After Cancer
UConn Expert, Dr. Carolyn Runowicz, Co-Authors Study
FARMINGTON, CONN. – Doctors can offer patients with cancer a better
chance of preserving fertility without negatively affecting the outcome
of cancer treatment or survival, according to a newly released study
co-authored by Carolyn D. Runowicz, M.D., director of the Carole and Ray
Neag Comprehensive Cancer Center at the University of Connecticut Health
Center and president-elect of the American Cancer Society. The article
appears in the July/August 2005 issue of CA: A Cancer Journal for
Clinicians.
"Historically, fertility concerns of patients with cancer have not
been foremost in the mind of treating physicians. Cancer was seen as a
death sentence and saving the patient's life was the priority,” Dr.
Runowicz said.
However, in the last 20 years there have been significant increases
in the five-year survival rates for most cancers. "Today's patients with
cancer want to live as normal a life as possible," Dr. Runowicz says.
"Young women and men with cancer are demanding from physicians
treatments that are not only safe and effective, but also allow them to
maintain their fertility. In response to this demand, the medical
community has begun to offer these patients surgical and medical
therapies that are conservative, helping to preserve fertility."
The authors looked at the most common cancers that affect young
adults, for whom fertility is an issue, as well as some less common
cancers of reproductive organs. These include breast cancer, cervical
cancer, endometrial cancer, leukemia and lymphoma, ovarian cancer, and
testicular cancer.
The challenges in trying to maintain fertility are great in patients
with cancer. Many standard treatments have negative effects on
fertility. For women with ovarian cancer and men with testicular cancer,
surgery is often the treatment of choice, vastly diminishing (if not
completely eliminating) fertility. Radiation and chemotherapy destroy
cancer cells, but can also hurt the cells needed for fertility. For
example, due to the risk of ovarian damage that persists after treatment
for some malignancies, researchers have begun to evaluate new ways of
preserving ovarian tissue, including freezing ovarian strips for use
after the patient has completed her therapy. However, this procedure is
still under investigation.
For men with testicular cancer, both radiation and chemotherapy
damage healthy sperm. Semen cryopreservation is the recommended method
for men who wish to have a baby in the future. However, historically few
men being treated for cancer "bank" sperm and oncologists do not, as a
rule, speak about this option to their patients.
Historically, this has been the case for women as well. When the goal
is to prolong or save a life, fertility is often an afterthought among
treating physicians.
The authors write that "reproductive endocrinologists and urologists
continue their efforts to perfect cryopreserving technologies to retain
ovarian and testicular function." But, they say that "Patients must be
aware of standard therapies and benefits of conservative treatment, and
the need for careful follow-up."
Article: Simon B, Lee SJ, Partridge AH, Runowicz CD. Preserving
Fertility after Cancer; CA Cancer J Clin 2005;55:211-228.
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