1 From Fred & Pamela Buffett Cancer Center at The Nebraska Medical Center; St. Jude Children’s Research Hospital/The University of Tennessee Health Science Center; Robert H. Lurie Comprehensive Cancer Center of Northwestern University; City of Hope Comprehensive Cancer Center; Vanderbilt-Ingram Cancer Center; The Ohio State University Comprehensive Cancer Center - James Cancer Hospital and Solove Research Institute; Dana-Farber/Brigham and Women’s Cancer Center; UCSF Helen Diller Family Comprehensive Cancer Center; Siteman Cancer Center at Barnes-Jewish Hospital and Washington University School of Medicine; Massachusetts General Hospital Cancer Center; Fred Hutchinson Cancer Research Center/Seattle Cancer Care Alliance; Roswell Park Cancer Institute; Stanford Cancer Institute; Memorial Sloan-Kettering Cancer Center; The Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins; Moffitt Cancer Center; Huntsman Cancer Institute at the University of Utah; The University of Texas MD Anderson Cancer Center; Fox Chase Cancer Center; Duke Cancer Institute; University of Alabama at Birmingham Comprehensive Cancer Center; University of Michigan Comprehensive Cancer Center; and National Comprehensive Cancer Network.
The NCCN Guidelines Insights on Adolescent and Young Adult (AYA) Oncology discuss the fertility and endocrine issues that are relevant to the management of AYA patients with cancer. Fertility preservation should be an essential part in the treatment of AYA patients with cancer. The NCCN Guidelines recommend discussion of fertility preservation and contraception before the start of treatment. Oophoropexy and embryo cryopreservation are the 2 established options for fertility preservation in women. Semen cryopreservation before the start of treatment is the most reliable and well-established method of preserving fertility in men. AYA women with cancer also have unique contraception needs, depending on the type of cancer, its treatment, and treatment-related complications. Management of cancer during pregnancy poses significant diagnostic and therapeutic challenges for both the patient and the physician. AYA women diagnosed with cancer during pregnancy require individualized treatment from a multidisciplinary team involving medical, surgical, radiation, and gynecologic oncologists; obstetricians; and perinatologists.