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October is Breast Cancer Awareness Month. For those of us who work with infertility, it reminds us of the importance of fertility preservation for women diagnosed with cancer in their child-bearing years.
In general, a woman has a 1-in-8 chance of developing breast cancer in her lifetime. Most women are diagnosed in their 50s, 60s or 70s. The Susan G. Komen Foundation cites that while “fewer than five percent of breast cancers occur in women under age 40…breast cancer is the leading cause of cancer death (death from any type of cancer) among women ages 20 to 59.”
While breast cancer isn’t a direct cause of infertility, treatments used to eradicate the disease can wreak havoc on a woman’s reproductive system.
Breast Cancer Treatments Can Affect Fertility
The most common types of breast cancer treatment are a lumpectomy, mastectomy, radiation and/or chemotherapy. The first three treatments have no detrimental effects on infertility and, for many women, these may be the only treatments required. Chemotherapy, however, is a different story. Depending on the type of breast cancer you have – other treatments may affect your body’s ability to ovulate.
Here is a list of some of the treatments used to treat breast cancer as well as information on their potential to affect future fertility.
Hormonal therapies.
There is more than one type of breast cancer. They can be categorized as hormone-receptor-positive or hormone-receptor-negative. If you are diagnosed with a hormone-receptor-positive breast cancer, your doctor may recommend hormonal therapy. This both lowers the amounts of estrogen produced by the body as well as estrogen’s ability to “feed” cancer cells.
This treatment is similar to a hormonal form of birth control and will typically alter your normal menstrual cycle, preventing ovulation. In most cases, ovulation will resume as normal when the hormonal therapy is complete. In certain circumstances, your doctor may recommend the surgical removal of your ovaries and fallopian tubes. This permanently prevents estrogen production. Which is a procedure that will render you unable to produce and release mature eggs, resulting in an infertility diagnosis.
Chemotherapy.
Chemotherapy is usually recommended for women with more advanced breast cancer or a breast cancer that has metastasized (or spread) into the lymph nodes or other areas of the body. Whether or not chemotherapy will cause infertility depends on three factors:
- Your body. Some bodies are simply more sensitive than others and may become infertile independent of age, type of chemotherapy or dosage.
- Your age. The younger women are when they have chemotherapy, the more likely they are to remain fertile.
- Your dose. Stronger and more severe types of chemotherapy are more likely to cause infertility because their effects on the healthy tissues of the body are more dramatic. Some types of chemotherapy meds have a higher to medium risk of infertility (Cytoxan, Platinol and Adriamycin). Others are less likely to cause infertility. Your oncologist will be able to provide a comprehensive list of the risks associated with each type.
Targeted Therapy.
Medical researchers have been started creating drugs that are highly-targeted to treat the cancerous cells, rather than the whole body. Targeted breast cancer therapies consist of prescription medications designed to treat a specific form of breast cancer. Targeted therapies are relatively new and research on their effects on fertility is currently underway. However, as breastcancer.org points out, “It’s…encouraging to know that women who have been treated with Herceptin [a successful targeted therapy] have become pregnant after their treatment was completed.”
Speak With a Fertility Specialist ASAP If You’re Diagnosed With Breast Cancer
If you are interested in having children, speak with a fertility specialist as soon as you receive a diagnosis. Your health is the priority, but fertility preservation has made it possible for cancer survivors to retain their ability to bear children even if a cancer treatment renders them infertile. Freezing your eggs or embryos can make it possible to conceive a baby via IVF or via a gestational carrier once you are on the road to recovery and good health.
Contact RRC to learn more about your fertility prospects after a cancer diagnosis.