Breast Cancer Treatment and Fertility

Being diagnosed with breast cancer can be a devastating experience for women. Along with the fear of death, surgery and harsh cancer treatments, breast cancer also elicits fears on loss of sexuality and body image. It is of utmost importance that the patient and her physician have an in-depth discussion, so that they can make the best decisions about her care. rnMost women are ill-informed about the questions they must be asking their doctor before the treatment starts. Young women who are yet to have children and mothers who are planning for more children are advised to talk to their physician about how cancer treatment can put their fertility at risk.rnChemotherapy may affect your ability to have children. Many well-informed young women decide to freeze their eggs before the chemo starts, but not all women have sufficient knowledge about how the treatment can affect their fertility or about the options that are available to preserve their fertility.rnFertility issues during breast cancerrnMost physicians will advise you that breast cancer treatment must take priority over fertility. Fortunately, breast cancer does not mean that your dreams of becoming a parent are doomed forever. Even with cancer treatment as your first priority, you can still maximize your chances of becoming a parent.rnIt is important that the physician and the patient work together on this. If the patient is in a relationship, the partner’s concerns must be factored in as well. Some of the questions that you need to answer include: • How important is it to have a baby, for you and your partner? • Do you have an optimistic prognosis that allows you to plan for your future as a parent? • Will it be safe for you to be pregnant? • If there is a recurrence or the survival is limited, will the child have enough caretakers in your absence? • Are you comfortable with adoption or consider using donor eggs to become a parent?rnThese are definitely tough questions for anyone to answer, even more so for someone who is already bogged down by the severe emotional toll that cancer can unleash. Nonetheless, it is important that you answer these questions as you prepare for the cancer treatment.rnChemotherapy and fertilityrnWill chemotherapy make you infertile? The answer to this depends on the woman’s age and the type of chemotherapy drugs that are used. The younger you are, the better your chances that the ovaries will continue producing fertile eggs even after treatment. Certain chemotherapy drugs, especially those belonging to the group of alkylating agents, can cause relatively more damage to the ovaries than others. Talk to your physician about the type of drugs that will be used for your cancer treatment.rnPreserving fertilityrnIf you have been given a relatively good prognosis by your doctor, you may want to ask a fertility expert about the possible options to preserve your fertility. rnHere are some questions you may want to ask your fertility expert: • Should you freeze your eggs now? What does the procedure involve? • Should you also consider freezing some of your ovarian tissue? • Are there fertility treatments that will be less risky for you? • What are the financial, medical, emotional and time-wise costs that each of these options involve?rnIf your doctor says it is okay to postpone your chemo, you may want to undergo ovarian stimulation during this time to harvest enough eggs. Also consider how safe fertility drugs are. Some hormones in the drugs may encourage breast cancer cell activity and cause it to spread rapidly.rnWith some soul-searching and discussion with your oncologist and fertility expert, you can come up with a definite plan to become a parent in future.