In the United States, more than 72,000 adolescents and young adults (ages 15-39 years) are diagnosed with cancer each year.1 Fortunately, advancements in early detection and treatment mean many young patients with cancer will live well beyond their cancer diagnosis. As higher rates of cancer survivorship are reached, the clinical focus has shifted from survival alone to include long-term quality-of-life issues.2 One important quality-of-life issue in young patients is the potential infertility caused by some cancer treatments.3,4 The likelihood of infertility varies according to age at diagnosis, cancer site, treatment modality, treatment agent, and other factors5; however, sustained infertility is estimated to develop in 50% to 95% of cancer survivors treated during their reproductive years.5-8
The issue of fertility subsequent to cancer treatment is a primary concern for most patients of childbearing age.9,10 Even in the face of a life-threatening illness, patients report that the loss of fertility is almost as distressing as the actual battle with cancer.11,12 Several studies have found that most cancer survivors (∼ 76%), men and women alike, are interested in having children, especially if they were childless at diagnosis.10,13-15 In fact, many patients report that their cancer experience increased the value they placed on parenthood and family ties.16,17
The long-term negative impact of infertility has also been shown among young male and female cancer survivors.18,19 More-recent studies suggest that among young women in particular, cancer-related infertility is associated with a greater risk for emotional distress and poorer quality of life.20,21 However, options are available that may preserve the ability to have biological children in the future.
The authors have disclosed that they have no financial interests, arrangements, or affiliations with the manufacturers of any products discussed in this article or their competitors. This work was supported by the American Cancer Society Funding (Grant No. RSGPB07 019-01-CPPB).
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