Make Fertility a Priority: Resources for AYA Cancer Patients

Be your own advocate and ask the tough questions about cancer treatment and sexual health
Wednesday, June 25, 2014 - 1:20pm
Pediatrics Department

Being diagnosed with cancer is a very confusing experience. There is a lot of information to absorb in a short period of time and it’s easy to get overwhelmed. This is especially true for adolescents and young adults. Cancer affects every facet of our lives and carries some unique challenges for our age group. We have concerns that older patients don’t understand.

A very important and yet sometimes overlooked aspect of cancer treatment is the impact on fertility and sexuality. This topic is very important to the AYA population, yet the subject is often ignored due to a lack of knowledge or discomfort. While this issue is not easy to discuss, it is a necessary conversation.

Reflecting on my own experience as a patient when I was first diagnosed, the furthest thing from my mind was how chemotherapy would affect my ability to have children. After all, I was 20 years old and had no intention of having children anytime soon! In reality, this should have been one of my first questions. Six years later this is one of my biggest concerns now that I am married and want to start a family.

Radiation, chemotherapy, hormone therapy and surgery all have the capacity to affect fertility and sexual function significantly. The extent to which fertility is affected depends on factors such as cancer type, the specific course of treatment and a patient’s age.

Here are some important questions to ask your doctor before you start any treatment:

  • How will this treatment affect my ability to conceive a child in the future?
  • What steps can I take to preserve my fertility?
  • What steps should I take to protect my partner?
  • Is it necessary to use birth control during treatment and for how long after treatment ends?
  • Can I conceive during treatment?
  • Are there any intimacy issues associated with this treatment?
  • How will this affect my sexual function now and long term? 

There are several ways to preserve fertility depending on how yours will be affected. Some of these include:

  • Sperm banking prior to treatment
  • Freezing eggs or ovarian tissue
  • Insuring proper shielding of the sex organs during radiation treatments
  • Moving the ovaries slightly prior to radiation therapy out of the treatment zone

Your health care team is focused on your recent cancer diagnosis and the most effective treatment option. With so many other issues that need to be addressed, fertility might not cross their mind. It’s important for us to be our own advocates.

There are several options for fertility preservation and helpful resources to guide you through the process. Make it a priority to talk to your doctor about a referral for fertility and sexual health counseling through RPCI's AYA program. Post-treatment counseling is available as well. If you are infertile due to treatment, there are resources to help you plan for the future.

Here are a few supportive services that can help:

Jacob Madonia, a sarcoma cancer survivor and RPCI pediatric nurse, shares his insight and advice for adolescent and young adult patients each month on Cancer Talk.

Read other posts by Jacob