Fast Down and Dirty on Babies after Breast Cancer

I thought this was well written and to the point.  I have my appointment with MD Anderson later this month and thought this came in a timely manner.  I'm hoping my appointment with them will be insightful rather than a short 15 minutes of, "You're healthy.  Keep up what you're doing and just go for it!  See ya!"  

Babies After Breast Cancer: What are the Options?

August 26, 2012
by Amy Jacobson, RN NP-BC UCLA LIVESTRONGTM Survivorship Center of Excellence

In an ideal world, along with chemotherapy classes, newly diagnosed breast cancer patients of reproductive age would receive counseling on how their treatment may negatively affect their ability to have children and what options are available to them to preserve it. Unfortunately, research shows this may not be the case, as a recently published study of young female cancer survivors in California indicates that only about 12% remembered receiving counseling about how to preserve their fertility¹.

What are the options available to breast cancer survivors who were unable to take steps to preserve their fertility at the time of diagnosis? The answer to this question depends on the treatment received. For example, Ductal Carcinoma in Situ (DCIS) treated with surgery and radiation will likely have no affect on a survivor’s ability to conceive and carry a pregnancy. However, if a woman is taking Tamoxifen pregnancy is contraindicated due to the risk for birth defects.  A woman who received chemotherapy that affects the ovaries (such as Cyclophosphamide or Adriamycin) and becomes prematurely menopausal may be unable to have a biological child, but could carry a pregnancy to term through fertilization and implantation of a donor egg (if she is not taking Tamoxifen or other endocrine therapy). If she doesn’t have a partner, she could utilize donor sperm. Reproductive specialists throughout the country offer women the opportunity to choose egg and sperm donors based on their physical characteristics, educational accomplishments and even what they enjoy doing in their spare time. Adoption is also a possibility, through private agencies, international channels and foster care.

But all of these options come with a cost, both financial and emotional, that a survivor may not be aware of. Most health insurance plans do not cover fertility treatments (even for cancer patients), and a donor pregnancy may cost more than $10,000. Private adoptions often include legal fees and medical coverage for the expectant mother, and the mother has the right to withdraw her consent to give up her child at any time. And, cancer survivors may carry the extra burden of fears of cancer recurrence.

So, it is important for the survivor who wants to start a family to not go it alone. Googling late at night can be overwhelming, and reading message boards filled with horror stories and secondhand information can also result in emotional overload. Establishing support with a qualified counselor or clergyperson for the journey ahead is critical. Finding a reputable reproductive specialist is also important, particularly one who has experience with women who have been through cancer treatment. Completing a realistic budget before proceeding is critical, so that emotions don’t dictate finances.

A good place to start is myoncofertility.org, which offers quality patient resources on fertility after cancer. They also have a toll free help line at (866) 708-FERT (3378) to answer questions about fertility after cancer.  Another great resource is Fertile Action (www.fertileaction.org), a non-profit organization started by breast cancer survivor Alice Crisci to assist with decreasing some of the financial burden associated with fertility preservation/treatments for both the newly diagnosed and post-treatment patient. Fertile Hope also has a searchable resource guide that includes adoption agencies, mental health professionals and surrogacy agencies on their website at www.fertilehope.org.

UCLA LIVESTRONG Survivorship Center of Excellence 

References:

1. Niemasik, EE, Letourneau, J., Dohan, D., Katz, A., Melisko, M., Rugo, H. & Rosen, M. (2012) Patient perceptions of reproductive health counseling at the time of cancer diagnosis: a qualitative study of female California cancer survivors. Journal of Cancer Survivorship. doi: 10.1007/s11764-012-0227-9