Approximately 100,000 people are diagnosed with cancer each year in the United States, at an age under 45 years of age; In Colombia, 196 people are diagnosed daily. Many types of cancer present excellent healing possibilities today; To the extent that the chances of survival increase, some fundamental aspects of the lives of these people come to the fore, among them, of course, their possibility of being parents.
In the case of women, some of the most used treatments for tumors with different locations can cause a decrease in the chances of fathering children. Both chemotherapy and radiation therapy have the potential to affect the function of the ovaries, preventing, in some cases temporarily and in others, the possibilities of producing eggs, and therefore, of being mothers.
In 2006, for the first time, the American Society for Reproductive Medicine, at the request of both cancer survivors, and specialists in the oncology area, included within its recommendations that every patient, as part of their informed consent, should receive from their cancer specialist information about your future fertility possibilities, and how these could be altered by the treatments; as well as information on possible fertility preservation methods.
As for chemotherapy, according to the American Cancer Society, most of the drugs used for chemotherapy have the potential to affect the eggs. The damage will depend on the type of medication, but also on the doses used, the age of the woman, making it difficult to predict the magnitude of the damage.
Medications that are most likely to affect egg production are: Busulfan, Carboplatin, Carmustinian (BCNU), Chlorambucil, Cisplatin, cyclophosphamide, dacrbazin, doxorubicin, Ifosfamide, lomustine (CCNU), mechlorethamine, melphalan, procarbazine, temozolomide.
On the other hand, the medications used for chemotherapy with the least possibility of affecting the eggs are: 5 fluouracil, bleomycin, cytarabine, dactinomycin, daunorubicin, fludarabine, gemcitabine, idarubicin, methotrexate, vinblastine, vincristine.
In the case of radiotherapy, it is the use of high-energy radiation that is used to kill malignant cells. This radiation could, however, also damage the eggs; In the case of women who must be irradiated at the level of the abdomen or pelvis, the amount of radiation absorbed will determine the magnitude of the damage, and if it will determine a subsequent infertility.
The surgery used for the treatment of cancer could also affect fertility; This is the case of oophorectomy (removal of the ovaries), trachelectomy (removal of the cervix), or abdominal surgeries that can induce the formation of adhesions in the pelvic organs, and that can be used in The treatment of various types of cancer, or even in the prevention of some, in case of mutations that predispose to the appearance of cancer.
Finally, hormone therapies, used for the treatment of breast cancer or other types of cancer, have the potential to affect fertility.
Given that it is very difficult for a patient to analyze the possible effects of such a heterogeneous group of treatments and that, unfortunately, the frequency with which oncologists touch on this issue with their patients is still very low, it is essential that a remission be requested by them, to evaluate The possibility and relevance of a procedure for preserving fertility.
As for these procedures, the most used today, and that are no longer considered experimental, but of established clinical use, are: freezing of embryos in cases of patients with a stable partner, and freezing of eggs in cases of people who do not have a partner