NCCN Guidelines for Patients® | Caring for Adolescents and Young Adults - page 26

26
NCCN Guidelines for Patients
®
: Caring for Adolescents and Young Adults
Version 2013
Part 3: Preparing for the future
Cancer treatment and fertility
It may seem weird to be thinking about babies when
you’re about to start doing battle with cancer. But the fact
that you are at an age when you are able to have children
is one of the many things that sets you apart from the
majority of people who are diagnosed with cancer.
That’s important, because cancer and its treatment can
damage your reproductive organs and make it difficult or
impossible to have children once treatment is over.
Up until recently most young cancer patients—and their
doctors—didn’t think much about fertility (the ability to
have babies) until treatment was already completed and
the damage was done. But in 2006 the American Society
of Clinical Oncology published guidelines recommending
that oncologists talk with their AYA patients about fertility
issues, inform them about options for preserving fertility,
and provide referrals to fertility specialists when possible
before
starting treatment.
Unfortunately, not all oncologists are following these
guidelines. In fact, some surveys indicate that only
about half of oncologists talk about fertility with their
patients, and even fewer are referring at-risk patients
to reproductive specialists who can assist patients in
understanding and preserving their fertility options.
So even if you’ve never really thought much about
being a parent, it’s important to talk to your doctors
about fertility issues as soon as you’re diagnosed,
before treatment begins. (Figure 3 outlines how fertility
preservation can be worked into the process
of confirming your diagnosis and developing your
treatment plan.)
If your treatment plan includes drugs or procedures
that can have an effect on your fertility, you can work
with your oncologist and a reproductive specialist to
find ways to limit the damage or take steps so you can
still have children in the future. If treatment absolutely
can’t be delayed, a reproductive specialist can help you
to understand what your fertility options may be after
treatment is completed. Your oncologist will carefully
evaluate your case—including the risks of delaying
treatment—to arrive at a decision regarding the timing
of fertility preservation measures.
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