Oncofertility: Impact of Cancer on Fertility

Cancer can be a devastating diagnosis. Its face changes, as do its implications from one type to the next, and from one individual to the next. Young men and women diagnosed with various forms of this disease are often left to deal with the long-term medical and emotional consequences. In particular, malignancy and its indicated treatments have demonstrated profoundly negative impacts on fertility. Moreover, the overwhelming diagnosis and the quick decisions for treatment are often accompanied by an equally short window in which fertility preservation must be addressed and managed in an effort to mitigate the gonadal damage that may come with cancer therapy1. Improvements in cancer diagnosis and treatment and, hence, survival rates have also led to valiant efforts in fertility preservation. Oncofertility had recently emerged as a “new interdisciplinary approach to address the reproductive future of young men, women, and children facing a life-preserving but fertility-threatening cancer diagnosis”2. Despite progress, the field is still in its infancy. It has all the necessary components to achieve remarkable success and to establish hope in young cancer survivors, and yet it is still lacking in collaborative efforts. The ideal construct would involve a proactive and multidisciplinary dialogue with the patient about fertility prognosis and fertility-sparing options, provision of readily accessible information and resources, and an established, efficient system of referral to fertility specialists1. The reality of the newly diagnosed cancer patient is that fertility issues are often inadequately addressed. Despite availability, most fertility centres in Canada receive a very low yield of referrals from among newly diagnosed cancer patients of reproductive age3,4. The goal of this four-part series is to facilitate improved education and communication concerning fertility preservation in adolescent and young adult Canadians with a new diagnosis of cancer. ABSTRACT