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Protecting Fertility During Breast Cancer Treatment
In many cases, breast cancer treatment involves chemotherapy, radiation therapy, or a combination of the two. These treatments can affect your reproductive system and, as a result, your fertility.
Chemotherapy is the use of drugs to kill cancer cells which divide rapidly. However, these drugs also kill some healthy cells, including those involved in the production of eggs, which also divide rapidly. The type of chemotherapy drug or drugs used, the length of treatment, and the person's age at the time of treatment are all factors that can affect fertility. In some cases, the effect of chemotherapy on fertility is temporary, but it can be permanent.
Radiation therapy is a way of treating disease using radiation (high-energy rays) or radioactive substances. Radiation kills cancer cells by interfering with their growth and division. The potential for fertility problems due to radiation therapy are not as great as for chemotherapy because the area affected by cancer is away from the reproductive organs. However, because radiation beams often pass through healthy tissues, the organs near the cancer site may be affected by the radiation, which can lead to either temporary or permanent infertility.
Factors that affect sexual desire can also be a problem for someone who may want to become pregnant. For example, a decreased sex drive is a possible complication of breast cancer treatment. This may result from hormonal changes caused by the treatment or from fatigue that often accompanies cancer therapy.
In addition, breast cancer pain or treatment -- especially chemotherapy -- can cause nausea. Self-image may also be a problem. Breast cancer and its treatment may leave physical and emotional scars. Time and counseling may help overcome the mental and emotional side effects of breast cancer.
Be sure to discuss your concerns about fertility with your doctor before you begin breast cancer treatment.
Can Fertility Be Preserved After Breast Cancer Treatment?
There are ways for breast cancer patients to increase their chances of having children following treatment.
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Cryopreservation. Cryopreservation is the process of freezing and
storing embryos (fertilized eggs) for later use. The embryos can be implanted
in the woman after she recovers from breast cancer treatment or in a surrogate
(a woman who carries the baby when the natural mother is unable). Unfertilized
eggs are more delicate and can be easily damaged during the freezing process.
For this reason, cryopreservation of unfertilized eggs is less effective.
Improvements in the techniques of assisted reproduction -- such as in vitro fertilization (a procedure in which thousands of sperm are placed in a laboratory dish with an egg) and intracytoplasmic sperm injection (a procedure in which a sperm is injected directly into an egg) -- have increased the production of usable embryos for cryopreservation. -
Use of less toxic chemotherapy drugs. While some chemotherapy drugs
may cause less damage to the reproductive organs, these drugs may also be less
effective at treating breast cancer. Your oncologist can determine if a less
toxic chemotherapy drug is appropriate for your cancer treatment.
Researchers also are looking at new methods of treatment that spare the reproductive system. These include the following:
- Hormonal suppression of the reproductive organs. This approach involves using hormones to place the reproductive organs in a dormant (inactive) state, shutting down your body's production of eggs. This process seems to protect the cells that develop into eggs (germ cells) from damage by chemotherapy and radiation
WebMD Medical Reference
Breast Cancer Guide
VIVELLE-DOT (estradiol transdermal system) IS AVAILABLE BY PRESCRPTION ONLY.
INDICATION
Vivelle-Dot is used after menopause to: reduce moderate to severe hot flashes; treat moderate to severe dryness, itching and burning in or around the vagina; help reduce your chances of getting osteoporosis (thin weak bones); and treat certain conditions in which a young woman's ovaries do not produce enough estrogens naturally. Vivelle-Dot 0.025 mg/day is only used to prevent osteoporosis from menopause. If you use Vivelle-Dot only to treat your dryness, itching, and burning in and around your vagina or if you use Vivelle-Dot only to prevent osteoporosis from menopause, talk with your healthcare professional about whether a different treatment or medicine without estrogens might be better for you.
IMPORTANT SAFETY INFORMATION
Estrogens increase the chances of getting cancer of the uterus (womb). Report any unusual vaginal bleeding right away while you are taking estrogens. Vaginal bleeding after menopause may be a warning sign of cancer of the uterus (womb).
Do not use estrogens with or without progestins to prevent heart disease, heart attacks, or strokes. Using estrogens with or without progestins may increase your chances of getting heart attacks, strokes, breast cancer, and blood clots. Using estrogens with progestins may increase your risk of dementia (decline in memory and thinking skills).
Vivelle-Dot should not be used if you have unusual vaginal bleeding; currently have or have had certain cancers, including cancer of the breast or uterus; had a stroke or heart attack in the recent past (for example, in the past year); currently have or have had blood clots; currently have or have had liver problems; or think you may be, or know that you are, pregnant.
The most common side effects that may occur with Vivelle-Dot are headache, breast tenderness, and back pain.
You and your healthcare professional should talk regularly about whether you still need treatment with Vivelle-Dot.
You are encouraged to report negative side effects of prescription drugs to the FDA. Visit www.fda.gov/medwatch or call 1-800-FDA-1088.
Please see Full Prescribing Information for Vivelle-Dot.
October is National Breast Cancer Awareness Month, and a new study reveals why a high number of women with the disease still prefer to have the entire breast surgically removed instead of just the tumor. It's not always because doctors recommend it.
