therapy, and other treatments can be very effective at doing their job. But what
makes them good at fighting cancer or other illnesses also
can cause side
effects: As these treatments attack harmful cells, they may affect some healthy
Your doctor has probably talked about whether you'll have any side effects from
your cancer treatment. Side effects like reduced
all depend on your diagnosis, the type of treatment you're getting, and
the doses of medicines or radiation. Everyone is different, so it's best to bring
any questions or worries up with your medical team.
Which Treatments Can Affect Fertility?
Your doctor can tell you if there's a chance that cancer treatment might affect
your reproductive organs. It helps to be aware of what might happen so you can manage
the possibilities, both physically and emotionally.
Here's how some cancer treatments can affect fertility:
Some chemotherapy medicines are more likely to lead to infertility than others.
Cytoxan (also known as cyclophosphamide) is part of a group of chemo medicines called
alkylating agents. These medicines damage the DNA of cancer cells so they can't make
copies of themselves. Alkylating agents are more likely to affect the reproductive
organs when given at higher doses.
Other chemotherapy medicines and combinations of medicines also may affect your
fertility. Because there are so many different chemotherapy medicines, it's best to
ask your doctor or nurse if the ones you are taking put you at risk for fertility
Radiation treatments also can damage sperm
and eggs, whether the
treatment is focused on these areas or scattered elsewhere. Radiation that's focused
on or near the pelvic area can damage a girl's ovaries or reduce sperm count in guys.
These changes may go away after treatment ends, but can be permanent.
The radiation therapy technicians may shield the ovaries or testicles from damage
by placing a protective shield over these areas. Sometimes a surgeon moves the ovaries
out of the path of radiation by doing surgery before radiation therapy begins.
Some cancer treatments involve radiation to the head as a way to kill cancer cells
that may be in the central
nervous system. Sometimes this can injure the parts of the brain (and the pituitary
gland) that make
that control puberty
and the menstrual cycle.
If that happens, doctors can give these hormones to patients so they can have normal
pubertal development, sexual function, and fertility.
For patients who need surgery to remove tumors, doctors may sometimes need to remove
part of the reproductive organs if the cancer is nearby.
What Are My Options?
Don't hesitate to ask questions and raise any concerns. And, don't worry that fertility
isn't a topic for your doctor. It may seem like your doctor is focused only on getting
rid of the cancer. But getting better is also about your future quality of life.
You may want to ask your doctor these three questions:
Is this treatment likely to affect my fertility?
Can doctors do something to protect my fertility during treatment?
After treatment, how will I know if my fertility was affected?
Ask your doctor about all your options. Then come up with a plan together. If you
don't feel comfortable talking to your doctor about fertility, find someone on your
medical team — like a nurse or social worker — to talk to instead.
In some cases, it may be possible to preserve (or "bank") some of your
sperm or eggs. The technical term for this process is cryopreservation, and it happens
in a special facility that can freeze and save sperm, eggs, or ovarian tissue. When
you're ready to have children, your sperm or eggs can be unfrozen and used to try
to have a baby.
For males, sperm banking has been around for a long time and is
a common procedure, although not all hospitals offer it. You may have to go to a clinic
that specializes in sperm banking.
For younger teens and boys, a more experimental procedure called sperm
aspiration may be possible. This process removes immature sperm cells for
later use in in vitro fertilization. This is when:
Sperm is used to fertilize the egg outside of the woman's uterus.
The fertilized embryo is then transferred to the uterus.
Talk to your doctor about your options.
For females, it's a little trickier. Doctors can attempt to freeze eggs or ovarian
tissue, but many of the techniques are still experimental and not all hospitals or
clinics have access to the technology. Ask your doctor about the options available
In some situations, your doctor may tell you that it isn't a good idea to bank
your sperm or eggs, because using them later could put you at risk of cancer cells
getting into your body.
It's normal to worry about the side effects that go with cancer treatment. These
tips can help:
Build a positive self-image. Coping with the side effects of cancer
treatment at a time when you're developing your own identity can make everything seem
even more complicated.
an important part of a person's identity (even if you're not yet ready to have sex).
But sexuality has little to do with fertility. People who can't have kids are as feminine or masculine as people who can. And fertility
has nothing to do with a person's ability to give and receive love. In fact, some cancer
survivors develop qualities that may make them more attractive to others, like a greater
passion for life and the desire to make the most of their experiences.
Find support. You're not alone. Other teens have gone through
what you're feeling now. You can connect and share experiences through online networks
and cancer blogs. It also may help to find a support group or counselor who can help
you work through the feelings you're bound to have during your treatment. Find support
Stay positive. Many people who go through cancer treatments later
have children. Others become parents through adoption or other methods. By thinking
about the many different options for parenthood, you can be realistic and positive
at the same time. Planning for the future helps you heal. And, if you are having sex,
you'll still need to use condoms
to protect against STDs.
Right now, you're focused on recovering — and on the treatments that can save your
life. But it's also natural to think about your future. Talk to your health care team,
parents, and friends about your options, your plans, and your feelings.