Receiving a cancer diagnosis is undoubtedly a moment of great difficulty and uncertainty. It marks the beginning of a journey to overcome the illness while also facing the future. To better understand the relationship between cancer, its diagnosis, its treatment, and fertility, we spoke with Dr Abraham Zavala, a gynaecologist and specialist in advanced reproductive medicine at Clínica Tambre. He sheds light on how cancer can impact the ability to have children and the existing solutions to preserve the possibility of parenthood in the future.
Throughout this interview, Dr Zavala provides key insights, debunking myths about the link between oncological treatments and fertility. He also shares a hopeful message for those facing this challenge.
Question: A cancer diagnosis can be devastating. Does it have a direct impact on fertility?
Answer: Cancer is undoubtedly a disease that evokes fear and, in many cases, is perceived as a shocking diagnosis. However, more and more people are surviving cancer, and at increasingly younger ages. In fact, around 5% of cancer survivors are under the age of 40. It is in this context that fertility preservation plays a crucial role, providing these individuals with the opportunity to become parents in the future. It is important to understand that cancer and its treatment can affect fertility, but there are also solutions to preserve this possibility.
Question: In what ways can cancer treatment affect fertility in both women and men?
Answer: The impact of cancer on fertility depends on the type of cancer, its location, and, of course, the treatment received. The most common treatments, such as chemotherapy, radiotherapy, and surgery, or a combination of these, can affect a woman’s ability to produce eggs or a man’s ability to produce sperm. Oncological treatments not only impact fertility due to the disease itself but also due to the side effects these treatments can have on the reproductive system.
Oncological treatments not only impact fertility due to the disease itself but also due to the side effects these treatments can have on the reproductive system.
Question: Is fertility preservation commonly discussed when a person is diagnosed with cancer?
Answer: Fortunately, fertility preservation is increasingly taken into account at the time of diagnosis. In fact, clinical guidelines in recent years have included fertility preservation as a priority for cancer patients. More and more associations and oncology specialists are insisting that when a patient receives a cancer diagnosis, they should be informed about the available options to preserve their fertility. The sooner this is considered, the better the long-term options will be.
Question: What options are available for preserving fertility in these cases?
Answer: When it comes to fertility preservation, cryopreservation – the freezing of eggs or sperm – is one of the most commonly used and successful techniques. This technique can be applied to both oncology patients and those who wish to preserve their fertility for personal reasons. However, not all patients can access this option. In some cases, such as when a cancer diagnosis is made in a young person before puberty or when chemotherapy treatment must begin urgently, options may be more limited. In these cases, ovarian tissue preservation, although still experimental, is an option that is increasingly offering hope.
Question: What type of cancer or treatment has the most significant impact on a patient’s fertility?
Answer: The type of cancer and the treatment received are crucial factors in determining the impact on fertility. For example, a neurological tumour treated with cranial radiotherapy will have a different impact compared to a pelvic cavity cancer, such as ovarian or colon cancer. Each type of treatment has specific implications for fertility, so it is essential to assess each case individually to determine the best preservation strategy.
Question: Do people undergoing treatments such as chemotherapy or radiotherapy lose their ability to produce eggs or sperm permanently?
Answer: The extent to which these treatments affect fertility varies greatly from case to case. It depends on many factors, such as the type of treatment, the administered dose, the patient’s age, and the timing of treatment. For example, women are born with a finite number of eggs that decrease over time, and treatments such as chemotherapy or radiotherapy can accelerate this process. While it is not always possible to predict precisely how treatment will impact fertility, a detailed ovarian reserve assessment can give us an idea.
Question: Is it possible to undergo fertility preservation treatment without it affecting cancer treatment?
Answer: This is a very important point. In many cases, fertility preservation treatments should not delay the start of oncological treatment. Fortunately, we can initiate ovarian stimulation at any point in the menstrual cycle, allowing us to adapt to the patient’s needs without significantly interfering with cancer treatment. Generally, stimulation is carried out over a period of 10 to 14 days, and studies show that the results are similar regardless of when we start stimulation within the cycle.
Question: How do you feel as a specialist being able to help people going through such a difficult process as cancer while also offering them a future possibility?
Answer: Helping oncology patients is an incredibly rewarding process. When someone receives a cancer diagnosis, their priorities shift drastically, but being able to offer them an option to preserve their fertility gives them a ray of hope. It is a treatment that not only gives them the chance to have children in the future but also provides a sense of control over their lives and family plans, which has a very positive psychological impact.
Question: Could you share a specific case of a patient who has undergone this process?
Answer: Of course. I recall the case of a 28-year-old woman diagnosed with a brain tumour in another country. She came to our clinic on the recommendation of other doctors, and after an evaluation, we began ovarian stimulation that very same day. Within 10-12 days, we obtained an excellent number of eggs, which were preserved. She later overcame cancer and, thanks to the preservation of her eggs, now has the option to attempt pregnancy in the future.
Question: When a person has undergone cancer treatment and preserved their fertility, is there a specific timeframe for attempting pregnancy?
Answer: There is no fixed timeframe, as it depends on various factors. In principle, patients should follow their oncologist’s advice, who will determine when it is safe to attempt pregnancy. It is important to note that the quality of preserved eggs or sperm does not deteriorate over time, providing reassurance to patients who wish to use their reproductive cells in the future.
Question: What message would you give to a young person diagnosed with cancer who wishes to become a parent in the future?
Answer: Do not lose hope. There are options, and it is essential to consult fertility specialists to explore the possibilities of preserving fertility. It is not just about overcoming cancer, but also about preserving dreams and personal aspirations, such as the possibility of becoming a parent in the future. We are here to help, and with the right treatment, they can continue with their lives and build the family they have always wanted.
If you are facing a cancer diagnosis and are concerned about the implications for your reproductive future, do not hesitate to seek support. Fertility preservation offers many patients the possibility of building a family after overcoming the illness. At Clínica Tambre, we are committed to your well-being and will support you every step of the way.
