Childhood Cancer and Fertility: Oct. 14 Informational Session
MADISON – When a child has cancer, the adult years may seem remote as parents focus on the present – getting their sick child through treatment and surviving a life-threatening disease.The panel will include Sana Salih, MD and Daniel Williams IV, MD, UW Health physicians who specialize in reproductive endocrinology and fertility issues. Other panel members include health psychologist Joel Wish, PhD; Lisa Keller, a nurse practitioner at American Family Children's Hospital; and Charles Bormann, UW Health's Reproductive Endocrinology and Infertility lab director.
According to the American Cancer Society, about three out of four children treated for cancer will live for many years post-treatment. Though high cure rates mean that most childhood cancer patients are living into adulthood, the very treatments that saved them may cause infertility issues for survivors in the post-treatment years.
Nurse practitioner Lisa Keller says approaching a teenage boy and his family about sperm banking can be an embarrassing conversation, but it's one that may spare him problems down the road.
"It's kind of awkward, but it's sort of like it's now or never," says Keller. "We don't always know which treatments will leave kids with the ability to reproduce, so we kind of have to guess that any chemo or radiation could have an impact on fertility."
Keller says the timing of such discussions can be "very inopportune."
"It's something like this: 'I'm sorry to tell you, your child has cancer… and do you want a sperm sample?'" Keller says. "As they're going through treatment, these boys might be thinking, 'Just go ahead and cure me and talk to me about it later.' But 10 or 15 years from now, they might say, 'Hey, how come no one ever offered this to me?'"
- For boys, testicular tissue freezing: This option would be available to boys before puberty. In this procedure, small pieces of testicular tissue would be surgically removed before the boy undergoes cancer treatment. The tissue would then be frozen for future use. Currently, there are no proven fertility-preserving methods for boys who have not gone through puberty.
- For girls, ovarian tissue freezing: In ovarian tissue freezing, all or part of one ovary is removed before cancer treatment. The tissue would then be frozen and transplanted back into the body in adulthood. This method is currently experimental and has produced very few live births so far, according to the American Cancer Society.
"This technology's not developed right now, but they're working on it," says Keller. "This field is constantly moving forward and we'd like to be a part of that and offer these new options to our patients as early as they're available."
Other measures that may be taken to preserve fertility include shielding the pelvic area if the child is going to undergo radiation to the pelvis during treatment. In some cases, a girl's ovaries can even be surgically moved to another area of the body, and then moved back after the potentially harmful radiation process is complete.
What Do Families Want to Hear?
In addition to educating parents about the fertility-sparing technology advances on the horizon for childhood cancer patients, the October 14 informational session will also include a discussion to help American Family Children's Hospital staff determine the best ways to broach the topic with families.
"I think we would be remiss if we overlooked the fact that a lot of adults will want to become parents," Keller said. "If we don't address this prior to treatment, we kind of lose our opportunity after we start the therapy."
"We want parents to be involved in our decision-making and the processes we put in place to talk to families about their child's fertility," Keller added. "Parents have insights that we don't have. We go along and we think we're doing the right thing, but we're never doing the right thing if we don't get the input from the population that we're meant to serve."
Oct. 14 Informational Session Details
Date: Tuesday, Oct. 14, 2008
Time: 6-8pm
Location: University of Wisconsin Hospital and Clinics, 600 Highland Avenue (view Map and Driving Directions), in the auditorium near the cafeteria on the first floor (room G5/119)
Cost: Free
RSVP: Complete RSVP form, or call Sandy Bakk, parent liaison, (608) 890-8312
Parking: Parking is available in the UW Hospital and Clinics patient and visitor ramp
Date published: 9/18/2008
Date Published: 07/08/2009
